4.1. Main Findings

The present study aimed to investigate the nutritional status of Slovene adults in the post-COVID-19 epidemic period, with the primary outcomes related to their BC status. Analysis of a large sample of adults showed that a high proportion of adults and older adults were in the overweight and obese BMI categories, with more females than males. However, females had significantly higher FAT% and lower FFM% values. In addition, the proportion of obese subjects based on BMI and FAT% obesity classifications showed a lower proportion of obese females in the BMI obesity category, with the theoretical possibility of underestimation or overestimation using only the BMI obesity classification tool. Furthermore, the estimated dietary intake of Slovene adults compared with the dietary reference values showed an unbalanced dietary pattern, namely, a lower (complex) carbohydrate intake (i.e., whole grains and legumes) and a higher intake of highly processed and/or nutrient-depleted foods (i.e., white bread and pasta, vegetable oils and butter). Specifically, we estimated a lower intake of macronutrients than the recommended intake for carbohydrates and fiber and within the recommendation of free sugar intake, while simultaneously estimating a higher intake of total fat, SFAs (for males) and cholesterol. In terms of micronutrient adequacy, we found a lower intake of vitamins C, D and E (for males) and calcium but a higher intake of sodium and chloride (for males) than the recommended intake.

4.2. Body Composition Status

In our study, we found that 42% of adults and 64% of older adults were either in the overweight or obese BMI category. In addition, the average FAT% for adult females and males were 26.9% and 19.5%, respectively, while for older adult females and males, they were 32.7% and 23%, respectively. Our results are consistent with those from before the COVID-19 pandemic period in Slovenia in terms of the pattern of results obtained, although the proportion of subjects in the overweight and obese categories and the FAT% value in our study were lower for both sexes and age groups. Finally, the BMI and FAT% obesity classification comparison suggests that the female obesity rate with a cut-off of >35% for FAT% may be underestimated, at least in our study, when the average BMI and FAT% values for females in the overweight category were 29.3 kg/m2 and 32.7%, respectively.

According to a recent Slovenian nationally representative dietary survey (SI.Menu 2017/2018) of 780 adults and older adults, as many as 59% and 74% of adults and older adults were in the overweight or obese BMI category [12]. Unfortunately, there are no other recent past or current (post-COVID-19 epidemic period) data on obesity status in Slovenian adults. Nevertheless, we have data from one large Slovenian study (n = 8036) of adolescents from 2014 that showed a similar trend, namely, 29% of females and 38% of males in this study were overweight or obese [35]. In addition, some data from the SiMenu 2017/2018 study were published only in a scientific monograph [36] and may be used for comparison with our results, which is perhaps relevant. The researchers used electrical bioimpedance (Tanita BC 730) for BC analysis and found that the average FAT% for adult females and males was 33% and 24.9%, respectively, while that for older adult females and males was 37.5% and 29%, respectively [36]. Of note, we were not able to find data on the sample size on which the BC measurements were performed. However, in our previous study of 151 people with plant-based diets, we found that their baseline BC status (before they went on a plant-based diet) was in line with both mentioned results [14]. Specifically, 50% of the subjects were overweight or obese, while their baseline FAT% was 28.7%. The data are of importance since the study sample also covers all Slovenian regions and had significantly more females than males, similar to our study.It Is well established that obesity is defined as the accumulation of excess body fat and not simply an excess of BM. This fact is very important, for a significant proportion of individuals in the overweight BMI category have an increased FFM% and low FAT% or are within the normal BMI category with low FFM% and increased FAT% (i.e., sarcopenic obesity) [15,37]. It is becoming clear that BMI is a rather poor indicator of FAT% (and it does not capture fat segmentation) [11,38]; in addition, we are seeing an increased rate of sarcopenic obesity that is currently also becoming a major public health challenge, with an estimated worldwide prevalence of up to 42% of adults [39,40]. That being said, BC provides important prognostic information on an individual’s BM management and mortality risk that is not provided by traditional proxies of adiposity, such as BMI [37,41,42]. 4.3. Dietary Intake Status

The estimated average dietary intake indicates the presence of an unbalanced diet. The most obvious deviations from the dietary reference values were seen for carbohydrate, fiber, total fat and SFAs, cholesterol, vitamins C, D and E (for males) and calcium intake. Interestingly, males consumed significantly more total protein and animal protein than females (41 ± 19 (9% of E) vs. 74 ± 35 g/d (14% E), p = 0.004 (p = 0.003)).

A higher intake of animal protein, especially for males, is logical in the annual meat consumption statistics for Slovene adults (calculated from the age of zero and including discarded meat). The average Slovene adult eats as much as six times more than the sustainable average annual amount of meat, set in the framework of the Planetary diet (calculated from the age of two onwards) [43]. Furthermore, the average weekly intake of meat and meat products of Slovenian adults were estimated to be four times higher than the reference values of the Planetary diet [36,44].Compared with our results, the abovementioned Slovenian nationally representative dietary survey (SI. Menu 2017/2018) revealed greater nutritional insufficiency for the nutrients for which the researchers have already published data, for example, for fiber (20.9–22.4 g/d vs. 26 g/d), vitamin D (2.45–2.8 µg/d vs. 4.5 µg/d) and folate intake (294.6–295.5 µg/d vs. 396 µg/d) but not for vitamin B12 (5–6.2 µg/d vs. 4.9 µg/d) [12,45,46,47] and free sugar intake (6.4–6.5% E vs. 3% E) [48]. Although it is clear from the available data that the adequate nutrient intake of a Slovenian adult is problematic, we emphasize that the method of assessing the energy and nutrient intake of the Si.Menu 2017/2018 study was more rigorous (i.e., the dietary intake data were collected with two nonconsecutive 24 h dietary recalls complemented with a food propensity questionnaire) [12,45,46,47,48]. Although there are few current data on the nutritional intake of the Slovenian adult population, these trends are consistent in several ways with an older, first national study on the dietary intake of Slovenian adolescents (n = 1813) aged 14–17 years, for example, in excess SFA and sodium intake and insufficient vitamin D and calcium intake [49]. In addition, the results for the adolescents differed from the results of both studies for adults in terms of excess free sugar intake, adequate fiber intake and insufficient folate and PUFA intake. All these available data indicate the less-than-optimal dietary habits of Slovenians. Importantly, the results of both studies of adults estimated that the unbalanced diet is tied to the dietary reference values for a mixed (omnivorous) diet, with most adults eating this way. However, in the future, there will likely be an actual need to differentiate dietary reference values for other increasingly recognized dietary patterns (e.g., Mediterranean, low-fat vegan or low-carbohydrate, high-fat (ketogenic) diets) that show various more or less (un)favorable health outcomes.Finally, the researchers evaluated various health benefits (e.g., BM loss, effect on cardiovascular/type 2 diabetes risk factors and disease outcomes) and potential risks or limitations of recently trendy dietary patterns (i.e., low-carbohydrate, high-fat (ketogenic) diet [50,51,52,53,54,55,56], Mediterranean diet [57,58], vegetarian diet [56,59,60,61,62,63,64,65] and omnivorous diet [21,66]). The weight of evidence strongly supports a balanced (well-designed) diet and simultaneously allows for various variations and interpretations of research results. Although further research is always needed, a comparison of different dietary patterns has shown that a well-designed dietary pattern should primarily be based on unprocessed or minimally processed plant-based food [44,67]. The mechanisms of action are known and described in great detail elsewhere [60,68,69,70,71,72,73,74,75]. Regardless, it is necessary to be aware that a sustainable diet can only be built on a multidisciplinary approach, as due to various objective challenges/limitations in society (e.g., sociological, physiological, ethnic-traditional, geographical and economic), an easy shift to a stricter plant-based dietary pattern, therefore, cannot be a “one-way street” [76]. Nevertheless, the beginning of changes for the better in terms of improving global human health and environmental issues can be the implementation of many sustainable dietary patterns [77], which would lead to a reduction in the currently excessive production and intake of meat [78] and a greater intake of healthy plant-based foods [79], with which we can have a beneficial effect on the health of the environment and reduce the risk of common chronic non-communicable diseases [67,77].