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Maimaitiyiming M, Yang R, Da H, Wang J, Qi X, Wang Y, Dunk MM, Xu W. The association of a low-inflammatory diet with the trajectory of multimorbidity: a large community-based longitudinal study. Am J Clin Nutr 2024:S0002-9165(24)00726-3. [PMID: 39218306 DOI: 10.1016/j.ajcnut.2024.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 08/02/2024] [Accepted: 08/26/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND A proinflammatory diet has been associated with a risk of individual chronic diseases, however, evidence on the association between inflammatory dietary patterns and the trajectory of chronic disease multimorbidity is sparse. OBJECTIVES We aimed to investigate the associations of a low-inflammatory diet with the multimorbidity trajectory. METHODS Within the UK Biobank, 102,424 chronic disease-free participants (mean age 54.7 ± 7.9 y, 54.8% female) were followed up to detect multimorbidity trajectory (annual change in the number of 59 chronic diseases). Baseline inflammatory diet index (IDI) and empirical dietary inflammatory pattern (EDIP) were separately calculated from the weighted sum of 32 posteriori-derived (15 anti-inflammatory) and 18 prior-defined (9 anti-inflammatory) food groups, and tertiled as low-, moderate-, and high-inflammatory diet. Data were analyzed using linear mixed effects model, Cox model, and Laplace regression with adjustment for potential confounders. RESULTS During the follow-up (median 10.23 y), 15,672 and 35,801 participants developed 1 and 2+ chronic conditions, respectively. Adherence to a low-inflammatory diet was associated with decreased multimorbidity risk (hazard ratio [HRIDI] = 0.84, 95% confidence interval [CI]: 0.81, 0.86; HREDIP = 0.91, 95% CI: 0.89, 0.94) and a slower multimorbidity accumulation (βIDI = -0.033, 95% CI: -0.036, -0.029; βEDIP = -0.006, 95% CI: -0.010, -0.003) compared with a high-inflammatory diet, especially in participants aged > 60 y (βIDI = -0.051, 95% CI: -0.059, -0.042; βEDIP = -0.020, 95% CI: -0.029, -0.012; both P-interactions < 0.05). The 50th percentile difference (95% CI) of chronic disease-free survival time was prolonged by 0.81 (0.64, 0.97) and 0.49 (0.34, 0.64) y for participants with a low IDI and EDIP, respectively. Higher IDI and EDIP were associated with the development of 4 and 3 multimorbidity clusters (especially for cardiometabolic diseases), respectively. CONCLUSIONS A low-inflammatory diet is associated with a lower risk and slower accumulation of multimorbidity (especially in participants aged > 60 y). A low-inflammatory diet may prolong chronic disease-free survival time.
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Affiliation(s)
- Maiwulamujiang Maimaitiyiming
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Rongrong Yang
- Public Health Science and Engineering College, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Huiying Da
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Jiao Wang
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Xiuying Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.
| | - Yaogang Wang
- School of Public Health, Medical University, Tianjin, China.
| | - Michelle M Dunk
- Aging Research Center, Department of Neurobiology, Health Care Sciences and Society Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Weili Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Aging Research Center, Department of Neurobiology, Health Care Sciences and Society Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Robert M, Martin F, Xhonneux A, Mosser F, Favre E, Richonnet C. Nutritional Quality of Breakfast Cereals on the French, Belgian and Luxembourg Markets: Which Cereals for Children? Nutrients 2024; 16:2701. [PMID: 39203837 PMCID: PMC11357527 DOI: 10.3390/nu16162701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 07/28/2024] [Indexed: 09/03/2024] Open
Abstract
Objective: Analyse the breakfast cereal market to help to help healthcare professionals to guide parents in choosing healthy products for their children. Study design: Observational study of the breakfast cereals available in the biggest supermarkets, discount stores and organic chains in France, Belgium and Luxembourg. Methods: An analysis of nutritional qualities using three indicators: Nutri-Score (initial and modified version), WHO Europe nutrient profile model, and Nova. Results: 645 products were listed; 559 excluding duplicates. A total of 28.8% are marketed to children and make up the group of "children's" cereals, 62.1% of cereals are Muesli, Oats and other cereal flakes (MOCF), and 54.9% are "organic". The study shows that "children's" cereals have a poorer nutritional profile: a higher proportion of Nutri-Score D, higher sugar content, lower fibre content, less conformity with the WHO Europe nutrient profile model and a higher proportion ofultra-processed. On the other hand, MOCF and "organic" products generally have a better nutritional profile: less sugar, more fibre, more Nutri-Score A, less Nutri-Score D and fewer ultra-processed products. Conclusions: Parents should therefore opt for cereals that do not bear any reference to children on the packaging.
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Affiliation(s)
| | | | | | | | | | - Celine Richonnet
- Club Européen des Diététiciens de l’Enfance (CEDE), Esplanade, 17-7800 Ath, Belgium
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Vaillancourt C, Ahmed M, Kirk S, Labonté MÈ, Laar A, Mah CL, Minaker L, Olstad DL, Potvin Kent M, Provencher V, Prowse R, Raine KD, Schram A, Zavala-Mora D, Rancourt-Bouchard M, Vanderlee L. Food environment research in Canada: a rapid review of methodologies and measures deployed between 2010 and 2021. Int J Behav Nutr Phys Act 2024; 21:18. [PMID: 38373957 PMCID: PMC10875887 DOI: 10.1186/s12966-024-01558-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 01/03/2024] [Indexed: 02/21/2024] Open
Abstract
Numerous research methodologies have been used to examine food environments. Existing reviews synthesizing food environment measures have examined a limited number of domains or settings and none have specifically targeted Canada. This rapid review aimed to 1) map research methodologies and measures that have been used to assess food environments; 2) examine what food environment dimensions and equity related-factors have been assessed; and 3) identify research gaps and priorities to guide future research. A systematic search of primary articles evaluating the Canadian food environment in a real-world setting was conducted. Publications in English or French published in peer-reviewed journals between January 1 2010 and June 17 2021 and indexed in Web of Science, CAB Abstracts and Ovid MEDLINE were considered. The search strategy adapted an internationally-adopted food environment monitoring framework covering 7 domains (Food Marketing; Labelling; Prices; Provision; Composition; Retail; and Trade and Investment). The final sample included 220 articles. Overall, Trade and Investment (1%, n = 2), Labelling (7%, n = 15) and, to a lesser extent, Prices (14%, n = 30) were the least studied domains in Canada. Among Provision articles, healthcare (2%, n = 1) settings were underrepresented compared to school (67%, n = 28) and recreation and sport (24%, n = 10) settings, as was the food service industry (14%, n = 6) compared to grocery stores (86%, n = 36) in the Composition domain. The study identified a vast selection of measures employed in Canada overall and within single domains. Equity-related factors were only examined in half of articles (n = 108), mostly related to Retail (n = 81). A number of gaps remain that prevent a holistic and systems-level analysis of food environments in Canada. As Canada continues to implement policies to improve the quality of food environments in order to improve dietary patterns, targeted research to address identified gaps and harmonize methods across studies will help evaluate policy impact over time.
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Affiliation(s)
- Caroline Vaillancourt
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Mavra Ahmed
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
| | - Sara Kirk
- School of Health and Human Performance, Dalhousie University, 6230 South Street, Kjipuktuk (Halifax), NS, B3H 4R2, Canada
| | - Marie-Ève Labonté
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Amos Laar
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, P. O. Box LG 13, Legon, Accra, Ghana
| | - Catherine L Mah
- School of Health Administration, Dalhousie University, 5850 College Street, Halifax, NS, B3H 4R2, Canada
| | - Leia Minaker
- School of Planning, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3T1, Canada
| | - Dana Lee Olstad
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Monique Potvin Kent
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
| | - Véronique Provencher
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Rachel Prowse
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada
| | - Kim D Raine
- School of Public Health, University of Alberta, 11405 87 Ave Northwest, Edmonton, AB, T6G 1C9, Canada
| | - Ashley Schram
- School of Regulation and Global Governance (RegNet), ANU College of Asia & the Pacific, The Australian National University, 8 Fellows Road, Canberra, Australian Capital Territory, 2600, Australia
| | - Daniela Zavala-Mora
- Science Library, Université Laval, 1045 Avenue de La Médecine, Québec, QC, G1V 0A6, Canada
| | - Maryka Rancourt-Bouchard
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Lana Vanderlee
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada.
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Rosin M, Young L, Jiang Y, Vandevijvere S, Waterlander W, Mackay S, Ni Mhurchu C. Product promotional strategies in supermarkets and their effects on sales: A case study of breakfast cereals and drinks in New Zealand. Nutr Diet 2023; 80:463-471. [PMID: 36843241 DOI: 10.1111/1747-0080.12800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/15/2023] [Accepted: 01/18/2023] [Indexed: 02/28/2023]
Abstract
AIMS To examine the frequency of promotions on breakfast cereals and drinks in a major New Zealand supermarket chain, determine the healthiness of promoted versus non-promoted products, and quantify the effects of promotions on sales. METHODS Weekly data on product promotions and sales were collected in six Auckland supermarkets for 198 breakfast products over 12 weeks. The healthiness of products was determined using the Health Star Rating system, and the effect of promotions on sales was estimated using linear mixed models. RESULTS On average, 47% of breakfast products in a given week were promoted using on-shelf tickets, 12% in weekly mailers, and 9% via promotional displays. The healthiness of promoted and non-promoted breakfast products was comparable. In relation to weekly sales of non-promoted products, all three promotional strategies had substantial (2 to 2.5 times higher sales) and statistically significant (P < 0.001) effects on product sales. CONCLUSION Promotions are frequently used and effective at increasing sales. Marketing strategies focusing solely on promoting healthier products could be an important nudging strategy to improve the healthiness of supermarket food purchases.
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Affiliation(s)
- Magda Rosin
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Leanne Young
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Yannan Jiang
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Stefanie Vandevijvere
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
- Department of Public Health and Epidemiology, Scientific Institute of Public Health (Sciensano), Brussels, Belgium
| | - Wilma Waterlander
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Sally Mackay
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Cliona Ni Mhurchu
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
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O’Mahony S, O’Donovan CB, Collins N, Burke K, Doyle G, Gibney ER. Reformulation of Processed Yogurt and Breakfast Cereals over Time: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3322. [PMID: 36834017 PMCID: PMC9964677 DOI: 10.3390/ijerph20043322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Poor diet is responsible for a quarter of European non-communicable disease (NCD)-related deaths. The reformulation of sugar, salt, and saturated fat in processed packaged foods offers an opportunity to reduce consumption of nutrients of concern and also support a reduction in energy intake. To date, there have been no publications measuring progress in food reformulation by compiling published evidence for a food category. The aim of this scoping review was to identify, characterize and summarise the findings of studies analysing the reformulation of processed yogurt and breakfast cereals. The review answered the research question: "What is the impact of food reformulation on the nutrient quality of yogurt and breakfast cereals available in the retail environment?" The research protocol was defined based on PRISMA-ScR guidelines. Five databases were searched in May 2022. Thirteen studies, published between 2010 and 2021 and completed across seven countries were eligible for inclusion. There were sufficient eligible studies to identify trends in sodium, salt, and sugar reduction in breakfast cereals. However, there was minimal or no reduction in energy, which may bring into question the use of food reformulation as part of an overall health strategy for obesity reduction.
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Affiliation(s)
- Sinead O’Mahony
- Food Safety Authority of Ireland, The Exchange, Georges Dock, D01 P2V6 Dublin, Ireland
- Institute of Food and Health, School of Agriculture and Food Science, University College Dublin (UCD), Belfield, D04 V1W8 Dublin, Ireland
- School of Agriculture and Food Science, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
| | - Clare B. O’Donovan
- Food Safety Authority of Ireland, The Exchange, Georges Dock, D01 P2V6 Dublin, Ireland
| | - Nuala Collins
- Food Safety Authority of Ireland, The Exchange, Georges Dock, D01 P2V6 Dublin, Ireland
| | - Kevin Burke
- Department of Mathematics and Statistics, University of Limerick, V94 T9PX Limerick, Ireland
| | - Gerardine Doyle
- College of Business, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
- UCD Geary Institute of Public Policy, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
| | - Eileen R. Gibney
- Institute of Food and Health, School of Agriculture and Food Science, University College Dublin (UCD), Belfield, D04 V1W8 Dublin, Ireland
- School of Agriculture and Food Science, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
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Potvin Kent M, Hatoum F, Wu D, Remedios L, Bagnato M. Benchmarking unhealthy food marketing to children and adolescents in Canada: a scoping review. Health Promot Chronic Dis Prev Can 2022; 42:307-318. [PMID: 35993602 PMCID: PMC9514213 DOI: 10.24095/hpcdp.42.8.01] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Unhealthy food and beverage marketing in various media and settings contributes to children's poor dietary intake. In 2019, the Canadian federal government recommended the introduction of new restrictions on food marketing to children. This scoping review aimed to provide an up-to-date assessment of the frequency of food marketing to children and youth in Canada as well as children's exposure to this marketing in various media and settings in order to determine where gaps exist in the research. METHODS For this scoping review, detailed search strategies were used to identify relevant peer-reviewed and grey literature published between October 2016 and November 2021. Two reviewers screened all results. RESULTS A total of 32 relevant and unique articles were identified; 28 were peer reviewed and 4 were from the grey literature. The majority of the studies (n = 26) examined the frequency of food marketing while 6 examined actual exposure to food marketing. Most research focussed on children from Ontario and Quebec and television and digital media. There was little research exploring food marketing to children by age, geographical location, sex/gender, race/ethnicity and/or socioeconomic status. CONCLUSION Our synthesis suggests that unhealthy food marketing to children and adolescents is extensive and that current self-regulatory policies are insufficient at reducing the presence of such marketing. Research assessing the frequency of food marketing and preschooler, child and adolescent exposure to this marketing is needed across a variety of media and settings to inform future government policies.
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Affiliation(s)
- Monique Potvin Kent
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Farah Hatoum
- School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - David Wu
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Lauren Remedios
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Mariangela Bagnato
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
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Santos D, Pintado M, Lopes da Silva JA. Potential nutritional and functional improvement of extruded breakfast cereals based on incorporation of fruit and vegetable by-products - A review. Trends Food Sci Technol 2022. [DOI: 10.1016/j.tifs.2022.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Santos M, Matias F, Rito AI, Castanheira I, Torres D, Loureiro I, Assunção R. Breakfast Cereals Intended for Children: Opportunities for Reformulation and Potential Impact on Nutrient Intake. Foods 2021; 10:1772. [PMID: 34441549 PMCID: PMC8394760 DOI: 10.3390/foods10081772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/15/2021] [Accepted: 07/28/2021] [Indexed: 11/17/2022] Open
Abstract
Ready-to-eat cereals (RTECs) have become a popular breakfast option claiming to provide important nutrients to children's diets, despite being a source of excess sugar and, therefore, a health concern. Thus, food reformulation constitutes an important public health strategy that could benefit from inputs provided by nutrient profiling. This study aimed to assess the adequacy of the RTECs for children available in Portuguese supermarkets, applying three nutrient profile models (NPMs)-the nutrient profile model of the World Health Organization's Regional Office for Europe (WHO-EURO), the profile of the private-sector EU Pledge (EU-Pledge), and the national model developed by the Directorate-General of Health (NPM-PT)-in order to explore the potential for reformulation of the RTECs identified as not adequate and evaluate the impact of RTECs' reformulation on the nutritional quality of Portuguese children's diets. In total, 78 RTECs intended for children were assessed and two scenarios-current (not considering reformulation) and alternative (considering reformulation to accomplish the nutrient profile requirements)-were considered to assess the impact of reformulation on nutritional quality. Across all RTECs, only 5.1% could be promoted to children according to the considered NPMs. The most common nutrients requiring reformulation were sugar, saturated fatty acids (SFA), salt, and dietary fiber. The scenarios of reformulation considered could reduce the RTECs average content of total sugars, SFA, and salt by 43%, 8.7%, and 1.1%, respectively, and dietary fiber intake could be increased by 34%. Thus, these results support policies to implement reformulation strategies for developing healthier food products to be promoted to children.
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Affiliation(s)
- Mariana Santos
- Food and Nutrition Department, National Health Institute Dr Ricardo Jorge, Av Padre Cruz, 1649-016 Lisboa, Portugal; (M.S.); (F.M.); (A.I.R.); (I.C.)
- NOVA National School of Public Health, NOVA University of Lisbon, Av Padre Cruz, 1600-560 Lisboa, Portugal
| | - Filipa Matias
- Food and Nutrition Department, National Health Institute Dr Ricardo Jorge, Av Padre Cruz, 1649-016 Lisboa, Portugal; (M.S.); (F.M.); (A.I.R.); (I.C.)
| | - Ana Isabel Rito
- Food and Nutrition Department, National Health Institute Dr Ricardo Jorge, Av Padre Cruz, 1649-016 Lisboa, Portugal; (M.S.); (F.M.); (A.I.R.); (I.C.)
- Center for Studies and Research in Social Dynamics and Health (CEIDSS), Av Padre Cruz, 1649-016 Lisboa, Portugal
| | - Isabel Castanheira
- Food and Nutrition Department, National Health Institute Dr Ricardo Jorge, Av Padre Cruz, 1649-016 Lisboa, Portugal; (M.S.); (F.M.); (A.I.R.); (I.C.)
| | - Duarte Torres
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Rua Das Taipas 135, 4050-091 Porto, Portugal;
- Faculty of Nutrition and Food Sciences, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - Isabel Loureiro
- NOVA National School of Public Health, Public Health Research Center (CISP), Comprehensive Health Research Center, NOVA University of Lisbon, Avenida Padre Cruz, 1600-560 Lisboa, Portugal;
| | - Ricardo Assunção
- Food and Nutrition Department, National Health Institute Dr Ricardo Jorge, Av Padre Cruz, 1649-016 Lisboa, Portugal; (M.S.); (F.M.); (A.I.R.); (I.C.)
- NOVA National School of Public Health, Public Health Research Center (CISP), Comprehensive Health Research Center, NOVA University of Lisbon, Avenida Padre Cruz, 1600-560 Lisboa, Portugal;
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
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Croisier E, Hughes J, Duncombe S, Grafenauer S. Back in Time for Breakfast: An Analysis of the Changing Breakfast Cereal Aisle. Nutrients 2021; 13:nu13020489. [PMID: 33540761 PMCID: PMC7912995 DOI: 10.3390/nu13020489] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 01/28/2021] [Accepted: 01/28/2021] [Indexed: 12/21/2022] Open
Abstract
Breakfast cereal improves overall diet quality yet is under constant scrutiny with assertions that the category has not improved over time. This study aimed to comprehensively analyse the category of breakfast cereals, the nutritional values, and health claims across eight distinct sub-categories at four time points (2013, 2015, 2018, and 2020). An audit of products from four major supermarkets in metropolitan Sydney (Aldi, Coles, IGA, and Woolworths) collected ingredient lists, nutrition information, claims and Health Star Rating (HSR) for biscuits and bites; brans; bubbles, puffs, and flakes; granola and clusters; hot cereal flavoured; hot cereal plain; muesli; breakfast biscuits. The median (IQR) were calculated for energy, protein, fat, saturated fat, carbohydrate, sugars, dietary fibre, and sodium for comparisons over time points by nutrient. Data from 2013 was compared with 2020 (by sub-category and then for a sub-section of common products available at each time point). Product numbers between 2013 (n = 283) and 2020 (n = 543) almost doubled, led by granola and clusters. Whole grain cereals ≥ 8 g/serve made up 67% of products (↑114%). While there were positive changes in nutrient composition over time within the full data set, the most notable changes were in the nutrition composition of cereals marketed as the same product in both years (n = 134); with decreases in mean carbohydrate (2%), sugar (10%) and sodium (16%) (p < 0.000), while protein and total fat increased significantly (p = 0.036; p = 0.021). Claims regarding Dietary Fibre and Whole Grain doubled since 2013. Analysis of sub-categories of breakfast cereal assisted in identifying some changes over time, but products common to both timeframes provided a clearer analysis of change within the breakfast category, following introduction of HSR. Whole grain products were lower in the two target nutrients, sodium and sugars, and well-chosen products represent a better choice within this category.
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Affiliation(s)
- Emilie Croisier
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD 4072, Australia; (E.C.); (S.D.)
| | - Jaimee Hughes
- Grains & Legumes Nutrition Council, 1 Rivett Road, North Ryde, NSW 2113, Australia;
| | - Stephanie Duncombe
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD 4072, Australia; (E.C.); (S.D.)
- Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter EX1 2LU, UK
| | - Sara Grafenauer
- Grains & Legumes Nutrition Council, 1 Rivett Road, North Ryde, NSW 2113, Australia;
- School of Medicine, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
- Correspondence: ; Tel.: +61-401-265-142
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Cuadrado-Soto E, López-Sobaler AM, Jiménez-Ortega AI, Bermejo LM, Aparicio A, Ortega RM. Breakfast Habits of a Representative Sample of the Spanish Child and Adolescent Population (The ENALIA Study): Association with Diet Quality. Nutrients 2020; 12:E3772. [PMID: 33302560 PMCID: PMC7763817 DOI: 10.3390/nu12123772] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/25/2020] [Accepted: 12/04/2020] [Indexed: 12/12/2022] Open
Abstract
The association between breakfast quality and total diet quality of children and adolescents ((1-17.9 years (n = 1570)) from the National Dietary Survey on the Child and Adolescent Population in Spain (ENALIA) was analyzed. Dietary information was collected using two non-consecutive one-day food diaries (1-10 years old) or two 24 h dietary recalls (>10 years). Breakfast quality index (BQI) and a variant of Nutrient Rich Foods index (NRF9.3) were calculated to assess the total diet quality. Children and adolescents who had breakfast on at least one day (n = 1561) were divided into two groups according to BQI: Worse Quality Breakfast (WQB) (BQI < 4 points (P66), n = 781) and Good Quality Breakfast (GQB) (BQI ≥ 4, n = 780). Younger children and those whose parents have university education presented higher BQI. GQB group had significantly higher intakes of micronutrients (vitamins A, D, C, B1, B2, B6, niacin, folate, calcium, potassium, magnesium). Fewer GQB children exceeded the Acceptable Macronutrient Distribution Range for fat and had folate and calcium intakes below their estimated average requirement. Daily NRF9.3 was 496.2 ± 54.0, being higher in GQB (503.8 ± 50.6 vs. 488.6 ± 56.2, p < 0.001). Increasing the quality of breakfast increased the possibility of having a NRF9.3 higher than P50 (OR: 1.893, CI: 1.549-2.315, p < 0.0001). Breakfasts have room for quality improvement in a high percentage of children. A higher quality breakfast is associated with a benefit in the quality of the total diet.
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Affiliation(s)
- Esther Cuadrado-Soto
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (E.C.-S.); (L.M.B.); (A.A.); (R.M.O.)
- Nutritional Genomics and Epigenomics Group, Madrid Institute for Advanced Studies (IMDEA) Food Institute, Campus of International Excellence UAM+CSIC, 28049 Madrid, Spain
| | - Ana M. López-Sobaler
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (E.C.-S.); (L.M.B.); (A.A.); (R.M.O.)
- UCM Research Group VALORNUT-920030, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain;
| | - Ana Isabel Jiménez-Ortega
- UCM Research Group VALORNUT-920030, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain;
- Pediatric Gastroenterology Unit, San Rafael Hospital, 28016 Madrid, Spain
| | - Laura M. Bermejo
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (E.C.-S.); (L.M.B.); (A.A.); (R.M.O.)
- UCM Research Group VALORNUT-920030, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain;
| | - Aránzazu Aparicio
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (E.C.-S.); (L.M.B.); (A.A.); (R.M.O.)
- UCM Research Group VALORNUT-920030, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain;
| | - Rosa M. Ortega
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (E.C.-S.); (L.M.B.); (A.A.); (R.M.O.)
- UCM Research Group VALORNUT-920030, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain;
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Comparison of food and beverage products' availability, variety, price and quality in German and US supermarkets. Public Health Nutr 2020; 23:3387-3393. [PMID: 32912374 PMCID: PMC7737043 DOI: 10.1017/s1368980020002645] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective: To assess availability, variety, price and quality of different food products in a convenience sample of supermarkets in Germany and the USA. Design: Cross-sectional study using an adapted version of the Bridging the Gap Food Store Observation Form. Setting: Information on availability, quality, price and variety of selected food products in eight German and seven US supermarkets (discount and full service) was obtained and compared by country. Results: A general tendency for lower prices of fruits and vegetables in Germany was observed, while produce quality and variety did not seem to differ between countries, with the exception of the variety of some vegetables such as tomatoes. Chips and cereals did not differ significantly in variety nor price. In both countries, high energy-dense foods were lower in energy costs than lower energy-dense foods. Conclusions: The influence of food prices and availability on consumption should be further explored, including the impact of country differences.
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Nutritional Content, Labelling and Marketing of Breakfast Cereals on the Belgian Market and Their Reformulation in Anticipation of the Implementation of the Nutri-Score Front-Of-Pack Labelling System. Nutrients 2020; 12:nu12040884. [PMID: 32218115 PMCID: PMC7230794 DOI: 10.3390/nu12040884] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 03/20/2020] [Accepted: 03/23/2020] [Indexed: 12/27/2022] Open
Abstract
Objective: Breakfast cereals are frequently consumed in Belgium, especially among children. We investigated the nutritional content, labelling and marketing of breakfast cereals and the changes in nutrient content and reformulation in anticipation of the implementation of the Nutri-Score front-of-pack label. Design: Pictures were taken of cereal packages. The WHO-Europe nutrient profiling tool was used to classify cereals into ‘permitted’/‘not-permitted’ to be marketed to children, while the nutritional quality was assessed using Nutri-Score. The proportion of cereals with nutrition and health claims and/or promotional characters on the front-of-pack was compared between permitted and not-permitted cereals and between different Nutriscore categories using Chi-squared tests. The average nutrient contents per 100g were compared between 2017 and 2018 using paired t-tests. Setting: Belgium. Participants: All breakfast cereals in the major supermarkets (n = 7) in 2017 and 2018. Results: Overall, 330 cereals were included. About 77.2% of cereals were not permitted to be marketed to children but, of those, 22.0% displayed promotional characters. More claims (68.9% of all claims) were found on ‘not-permitted’ compared with ‘permitted’ cereals, particularly nutrition claims. Most claims were displayed on cereals with the allocated Nutri-Score A (42.0%) and C (37.0%). A significant reformulation of cereals was found between 2017 and 2018, with reductions in total sugar (−5%) (p < 0.001) and sodium (−20%) (p = 0.002) and increases in fibre (+3%) (p = 0.012) and proteins (+2%) (p = 0.002). Conclusion: Breakfast cereals on the Belgian market are predominantly unhealthy and frequently carry claims and promotional characters. Minimal reformulation occurred over one year. Policy recommendations include restrictions on claims and marketing for not-permitted cereals.
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Sugar Content and Nutritional Quality of Child Orientated Ready to Eat Cereals and Yoghurts in the UK and Latin America; Does Food Policy Matter? Nutrients 2020; 12:nu12030856. [PMID: 32210128 PMCID: PMC7146401 DOI: 10.3390/nu12030856] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/06/2020] [Accepted: 03/18/2020] [Indexed: 12/12/2022] Open
Abstract
Ready to eat breakfast cereals (REBCs) and yoghurts provide important nutrients to children's diets, but concerns about their high sugar content exist. Food reformulation could contribute to sugar reduction, but policies across countries are not uniform. We aimed to compare the sugar content and nutritional quality of child-orientated REBCs and yoghurts in Latin American countries with the UK. In a cross-sectional study, nutritional information, marketing strategies, and claims were collected from the food labels and packaging of products available in Guatemala, Mexico, Ecuador and the UK. Nutritional quality was assessed using the UK Ofcom Nutrient Profiling System. In total, 262 products were analysed (59% REBCs/41% yoghurts). REBCs in the UK had a lower sugar content (mean ± SD) (24.6 ± 6.4) than products in Ecuador (34.6 ± 10.8; p < 0.001), Mexico (32.6 ± 7.6; p = 0.001) and Guatemala (31.5 ± 8.3; p = 0.001). Across countries, there were no differences in the sugar content of yoghurts. A large proportion (83%) of REBCs and 33% of yoghurts were classified as "less healthy". In conclusion, the sugar content of REBCs in Latin America is higher than those of the UK, which could be attributed to the UK voluntary sugar reduction programme. Sugar reformulation policies are required in Guatemala, Mexico and Ecuador.
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