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Barrett EM, Pettigrew S, Neal B, Rayner M, Coyle DH, Jones A, Maganja D, Gaines A, Mozaffarian D, Taylor F, Ghammachi N, Wu JHY. Modifying the Health Star Rating nutrient profiling algorithm to account for ultra-processing. Nutr Diet 2024. [PMID: 38984976 DOI: 10.1111/1747-0080.12892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 05/08/2024] [Accepted: 05/19/2024] [Indexed: 07/11/2024]
Abstract
AIM To modify the Australian and New Zealand Health Star Rating to account for ultra-processing and compare the alignment of the modified ratings with NOVA classifications and the current Australian Dietary Guidelines classifications of core (recommended foods) and discretionary (foods to limit). METHODS Data was cross-sectionally analysed for 25 486 products. Four approaches were compared to the original Health Star Rating: (1) five 'negative' points added to ultra-processed products (modification 1; inclusion approach); (2) ultra-processed products restricted to a maximum of 3.0 Health Stars (modification 2; capping approach); (3 and 4) same approach used for modifications 1 and 2 but only applied to products that already exceeded 10 'negative' points from existing Health Star Rating attributes (modifications 3 and 4, respectively; hybrid approaches). Alignment occurred when products (i) received <3.5 Health Stars and were NOVA group 4 (for NOVA comparison) or discretionary (for Dietary Guidelines comparison), or (ii) received ≥3.5 Health Stars and were NOVA groups 1-3 or core. RESULTS All Health Star Rating modifications resulted in greater alignment with NOVA (ranging from 69% to 88%) compared to the original Health Star Rating (66%). None of the modifications resulted in greater alignment to the Dietary Guidelines classifications overall (69% to 76%, compared with 77% for the original Health Star Rating), but alignment varied considerably by food category. CONCLUSIONS If ultra-processing were incorporated into the Australian and New Zealand Health Star Rating, consideration of ultra-processing within the broader dietary guidance framework would be essential to ensure coherent dietary messaging to Australians.
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Affiliation(s)
- Eden M Barrett
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
- Friedman School of Nutrition Science & Policy, Food is Medicine Institute, Tufts University, Boston, Massachusetts, USA
| | - Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Bruce Neal
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Mike Rayner
- Oxford Martin Programme on the Future of Food and Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Daisy H Coyle
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Alexandra Jones
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Damian Maganja
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Allison Gaines
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science & Policy, Food is Medicine Institute, Tufts University, Boston, Massachusetts, USA
- Tufts School of Medicine and Division of Cardiology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Fraser Taylor
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Nadine Ghammachi
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Jason H Y Wu
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
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2
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Ma P, Wu Y, Yu N, Jia X, He Y, Zhang Y, Backes M, Wang Q, Wei CI. Integrating Vision-Language Models for Accelerated High-Throughput Nutrition Screening. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024:e2403578. [PMID: 38973336 DOI: 10.1002/advs.202403578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 06/10/2024] [Indexed: 07/09/2024]
Abstract
Addressing the critical need for swift and precise nutritional profiling in healthcare and in food industry, this study pioneers the integration of vision-language models (VLMs) with chemical analysis techniques. A cutting-edge VLM is unveiled, utilizing the expansive UMDFood-90k database, to significantly improve the speed and accuracy of nutrient estimation processes. Demonstrating a macro-AUCROC of 0.921 for lipid quantification, the model exhibits less than 10% variance compared to traditional chemical analyses for over 82% of the analyzed food items. This innovative approach not only accelerates nutritional screening by 36.9% when tested amongst students but also sets a new benchmark in the precision of nutritional data compilation. This research marks a substantial leap forward in food science, employing a blend of advanced computational models and chemical validation to offer a rapid, high-throughput solution for nutritional analysis.
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Affiliation(s)
- Peihua Ma
- Department of Nutrition and Food Science, College of Agriculture and Natural Resources, University of Maryland, College Park, MD, 20742, USA
| | - Yixin Wu
- CISPA Helmholtz Center for Information Security, 66123, Saarbrucken, Germany
| | - Ning Yu
- Netflix Eyeline Studios, Los Angeles, CA, 90028, USA
| | - Xiaoxue Jia
- Department of Nutrition and Food Science, College of Agriculture and Natural Resources, University of Maryland, College Park, MD, 20742, USA
| | - Yiyang He
- Department of Nutrition and Food Science, College of Agriculture and Natural Resources, University of Maryland, College Park, MD, 20742, USA
| | - Yang Zhang
- CISPA Helmholtz Center for Information Security, 66123, Saarbrucken, Germany
| | - Michael Backes
- CISPA Helmholtz Center for Information Security, 66123, Saarbrucken, Germany
| | - Qin Wang
- Department of Nutrition and Food Science, College of Agriculture and Natural Resources, University of Maryland, College Park, MD, 20742, USA
| | - Cheng-I Wei
- Department of Nutrition and Food Science, College of Agriculture and Natural Resources, University of Maryland, College Park, MD, 20742, USA
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3
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Trumbo PR, Bleiweiss-Sande R, Campbell JK, Decker E, Drewnowski A, Erdman JW, Ferruzzi MG, Forde CG, Gibney MJ, Hess JM, Klurfeld DM, Latulippe ME, O’Connor LE, Reimers KJ, Rolls BJ, Schulz J, Weaver C, Yu L. Toward a science-based classification of processed foods to support meaningful research and effective health policies. Front Nutr 2024; 11:1389601. [PMID: 39055388 PMCID: PMC11271201 DOI: 10.3389/fnut.2024.1389601] [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: 02/22/2024] [Accepted: 06/12/2024] [Indexed: 07/27/2024] Open
Abstract
Processed foods have been part of the American diet for decades, with key roles in providing a safe, available, affordable, and nutritious food supply. The USDA Food Guides beginning in 1916 and the US Dietary Guidelines for Americans (DGA) since 1980 have included various types of commonly consumed processed foods (e.g., heated, fermented, dried) as part of their recommendations. However, there are multiple classification systems based on "level" of food processing, and additional evidence is needed to establish the specific properties of foods classified as "highly" or "ultra"-processed (HPF/UPFs). Importantly, many foods are captured under HPF/UPF definitions, ranging from ready-to-eat fortified whole grain breakfast cereals to sugar-sweetened beverages and baked goods. The consequences of implementing dietary guidance to limit all intake of foods currently classified as HPF/UPF may require additional scrutiny to evaluate the impact on consumers' ability to meet daily nutrient recommendations and to access affordable food, and ultimately, on health outcomes. Based on a meeting held by the Institute for the Advancement of Food and Nutrition Sciences in May 2023, this paper provides perspectives on the broad array of foods classified as HPF/UPFs based on processing and formulation, including contributions to nutrient intake and dietary patterns, food acceptability, and cost. Characteristics of foods classified as UPF/HPFs are considered, including the roles and safety approval of food additives and the effect of food processing on the food matrix. Finally, this paper identifies information gaps and research needs to better understand how the processing of food affects nutrition and health outcomes.
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Affiliation(s)
- Paula R. Trumbo
- Paula R. Trumbo Consulting, Mount Pleasant, SC, United States
- School of Health Sciences, Liberty University, Lynchburg, VA, United States
| | | | - Jessica K. Campbell
- Bell Institute of Health and Nutrition, General Mills, Golden Valley, MN, United States
| | - Eric Decker
- Department of Food Science, University of Massachusetts, Amherst, MA, United States
| | - Adam Drewnowski
- Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - John W. Erdman
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL, United States
| | - Mario G. Ferruzzi
- Arkansas Children’s Nutrition Center, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Ciaran G. Forde
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Michael J. Gibney
- Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Julie M. Hess
- USDA-ARS Grand Forks Human Nutrition Research Center, Grand Forks, ND, United States
| | - David M. Klurfeld
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, United States
| | - Marie E. Latulippe
- Institute for the Advancement of Food and Nutrition Sciences, Washington, DC, United States
| | - Lauren E. O’Connor
- Beltsville Human Nutrition Research Center, Agricultural Research Service, United States Department of Agriculture, Beltsville, MD, United States
| | | | - Barbara J. Rolls
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, United States
| | | | - Connie Weaver
- College of Health and Human Services, School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, United States
| | - Lynn Yu
- The Kraft Heinz Company, Chicago, IL, United States
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4
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Yu T, Zhang S, Wakayama R, Horimoto T, Tange C, Nishita Y, Otsuka R. The relationship between the dietary index based Meiji nutritional profiling system for adults and lifestyle-related diseases: a predictive validity study from the National Institute for Longevity Sciences-Longitudinal Study of Aging. Front Nutr 2024; 11:1413980. [PMID: 39021596 PMCID: PMC11252029 DOI: 10.3389/fnut.2024.1413980] [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: 04/08/2024] [Accepted: 06/19/2024] [Indexed: 07/20/2024] Open
Abstract
Background Nutritional profiling system (NPS) holds promise as a public health tool for companies to measure product healthiness and for individuals in making healthier food choices. The Meiji NPS for adults specifically targets lifestyle-related diseases prevalent among Japan's adult population, including overweight/obesity, hypertension, diabetes, and dyslipidemia. This study examined the cross-sectional association between the Meiji NPS for adults Dietary Index (MNfA-DI) and indicators of lifestyle-related diseases in a population. Methods The study comprised 1,272 middle-aged individuals (40-64 years, 50.1% male) who participated in the seventh wave (2010-2012) of the National Institute for Longevity Sciences-Longitudinal Study of Aging project, with no missing data on three-day dietary records. The MNfA-DI was computed at the individual diet level (accounting for the whole diet) using arithmetic energy-weighted means. A higher MNfA-DI indicated a greater nutritional quality of an individual's overall diet. Lifestyle-related disease indicators included body mass index (BMI, kg/m2), body fat (%), systolic and diastolic blood pressure (mmHg), fasting plasma glucose (mg/dL), HbA1c (%), triglyceride levels (mg/dL), LDL, and HDL cholesterol levels (mg/dL). A multiple regression model was used to assess the association between the MNfA-DI and lifestyle-related disease indicators, adjusting for demographics, socioeconomic status, lifestyle factors, disease history, and energy intake as covariates, depending on the outcome. Results The median (interquartile range) age and MNfA-DI were 53.0 (46.0, 59.0) years and 10.1 (6.0, 14.0) points, respectively. MNfA-DI was negatively associated with body fat [partial regression coefficient (95% confidence interval) -0.04 (-0.07, -0.01)], diastolic blood pressure [-0.08 (-0.17, -0.002)], fasting plasma glucose [-0.18 (-0.33, -0.01)], and triglyceride [-1.36 (-2.16, -0.55)]. Additionally, MNfA-DI was also associated with almost indicators (except for LDL and HDL cholesterol) among participants with a BMI between 18.5 and 24.9 kg/m2. Conclusion These findings suggest that the Meiji NPS for adults could be associated with a lower risk of lifestyle-related diseases. In addition, from a public health nutrition perspective, the Meiji NPS for adults may be useful to assess the food healthiness of the adult population.
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Affiliation(s)
- Tao Yu
- R&D Division Meiji Co., Ltd., Tokyo, Japan
- National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Shu Zhang
- National Center for Geriatrics and Gerontology, Aichi, Japan
| | | | | | - Chikako Tange
- National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Yukiko Nishita
- National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Rei Otsuka
- National Center for Geriatrics and Gerontology, Aichi, Japan
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5
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Gaines A, Shahid M, Coyle D, Barrett E, Hadjikakou M, Wu JHY, Taylor F, Pettigrew S, Neal B, Seferidi P. Switches in food and beverage product purchases can reduce greenhouse gas emissions in Australia. NATURE FOOD 2024; 5:524-532. [PMID: 38806695 PMCID: PMC11199139 DOI: 10.1038/s43016-024-00971-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/05/2024] [Indexed: 05/30/2024]
Abstract
Switching between similar food and beverage products may reduce greenhouse gas emissions (GHGe). Here, using consumer data linked to 23,550 product-specific GHGe values, we estimated annual GHGe attributable to product purchases consumed at home in Australia and calculated reductions from specific switches. Potential changes to mean Health Star Rating, mean energy density and the proportion of ultraprocessed foods purchased were assessed. Approximately 31 million tonnes of GHGe were attributable to products consumed at home in 2019, the three highest contributors of GHGe being 'meat and meat products' (49%), 'dairy' (17%) and 'non-alcoholic beverages' (16%). Switching higher-emission products for 'very similar' lower-emission products could reduce total emissions by 26%. Switches to 'less similar' lower-emission products could lead to a 71% reduction. Switches had little impact on the average Health Star Rating, energy density of purchases and proportion of ultraprocessed foods purchased. Directing manufacturing and marketing towards lower-environmental-impact products and signposting such options to consumers are key.
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Affiliation(s)
- Allison Gaines
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
- The George Institute for Global Health, Sydney, New South Wales, Australia.
| | - Maria Shahid
- The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Daisy Coyle
- The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Eden Barrett
- The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Michalis Hadjikakou
- School of Life and Environmental Sciences, Centre for Integrative Ecology, Deakin University, Melbourne, Victoria, Australia
| | - Jason H Y Wu
- The George Institute for Global Health, Sydney, New South Wales, Australia
- School of Public Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Fraser Taylor
- The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Simone Pettigrew
- The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Bruce Neal
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Paraskevi Seferidi
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
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6
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Wakayama R, Drewnowski A, Horimoto T, Saito Y, Yu T, Suzuki T, Takasugi S. Development and Validation of the Meiji Nutritional Profiling System (Meiji NPS) to Address Dietary Needs of Adults and Older Adults in Japan. Nutrients 2024; 16:936. [PMID: 38612970 PMCID: PMC11013258 DOI: 10.3390/nu16070936] [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: 02/08/2024] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024] Open
Abstract
This study introduces the Meiji Nutritional Profiling System (Meiji NPS), which was specifically designed to respond to age-related shifts in nutrient requirements among Japanese adults (<65 years old) and older adults (≥65 years old). Japan has one of the most aged societies in the world. The health issues of interest are malnutrition and lifestyle-related diseases among adults and frailty among older adults. Two versions of the NPS were developed based on nutrients to encourage (protein, dietary fibers, calcium, iron, and vitamin D), food groups to encourage (fruits, vegetables, nuts, legumes, and dairy), and nutrients to limit (energy, saturated fatty acids, sugars, and salt equivalents). The Meiji NPS for older adults did not include iron or saturated fatty acids. The algorithms were based on the Nutrient-Rich Foods Index (NRF). The convergent validity between the Meiji NPS and the existing NPSs for the same foods was confirmed using Spearman's correlation coefficients (NRF: r = 0.67 for adults and r = 0.60 for older adults; Health Star Rating: r = 0.64 for adults and r = 0.61 for older adults). The Meiji NPS may be useful for nutritional evaluation and reformulation of food products, tailored to adults and older adults to ameliorate health issues in Japan.
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Affiliation(s)
- Ryota Wakayama
- Meiji Co., Ltd., 2-2-1 Kyobashi, Chuo-ku, Tokyo 104-9306, Japan; (T.H.); (T.Y.); (S.T.)
| | - Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, WA 98195, USA;
| | - Tomohito Horimoto
- Meiji Co., Ltd., 2-2-1 Kyobashi, Chuo-ku, Tokyo 104-9306, Japan; (T.H.); (T.Y.); (S.T.)
| | - Yoshie Saito
- Meiji Co., Ltd., 2-2-1 Kyobashi, Chuo-ku, Tokyo 104-9306, Japan; (T.H.); (T.Y.); (S.T.)
| | - Tao Yu
- Meiji Co., Ltd., 2-2-1 Kyobashi, Chuo-ku, Tokyo 104-9306, Japan; (T.H.); (T.Y.); (S.T.)
| | - Takao Suzuki
- Institute for Gerontology, J. F. Oberlin University, 3758 Tokiwa, Machida, Tokyo 194-0294, Japan
| | - Satoshi Takasugi
- Meiji Co., Ltd., 2-2-1 Kyobashi, Chuo-ku, Tokyo 104-9306, Japan; (T.H.); (T.Y.); (S.T.)
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7
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Muzzioli L, Frigerio F, Mazziotta M, Donini LM, Pinto A, Poggiogalle E. Food Compass and the challenge of sustainability on the route towards healthful diets. Sci Rep 2024; 14:6919. [PMID: 38519527 PMCID: PMC10960031 DOI: 10.1038/s41598-024-57615-9] [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: 07/20/2023] [Accepted: 03/20/2024] [Indexed: 03/25/2024] Open
Abstract
In order to tackle the global increase in overweight and obesity prevalence, several nutrient profiling systems have been developed; among others, Food Compass Score (FCS) has been designed to encompass multiple domains of food healthfulness. However, environmental sustainability of healthy diets is another crucial dimension which should not be overlooked in the context of human health. The aim of the present study is to assess the association between healthiness and environmental sustainability of food items, using the FCS and Agribalyse databases, respectively. A total of 806 matching food items were identified, grouped in 12 food categories; within each category, differences in median Z-scores between FCS and Single Environmental Footprint (EF) Score were assessed. While Fruits, Legumes and Nuts, Mixed foods, Meat Poultry and Eggs (MPE), Savory and Sweets, and Vegetables showed statistically significant differences (all p < 0.001), Beverages (p = 0.361), Dairy (p = 0.092), Fats and Oils (p = 0.594), Grains (p = 0.436), Sauce and Condiments (p = 0.093), and Seafood (p = 0.241) had similar Food Compass and Single EF Z-scores distributions. These findings underscore a relevant lack of difference between healthfulness and environmental impact of some prominent food categories, such as Grains and Seafood. Therefore, we suggest matching nutrient profiling systems with adequate environmental sustainability indices.
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Affiliation(s)
- Luca Muzzioli
- Department of Experimental Medicine, Sapienza University, 00185, Rome, Italy.
| | - Francesco Frigerio
- Department of Experimental Medicine, Sapienza University, 00185, Rome, Italy
| | | | | | - Alessandro Pinto
- Department of Experimental Medicine, Sapienza University, 00185, Rome, Italy
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8
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Montericcio A, Bonaccio M, Ghulam A, Di Castelnuovo A, Gianfagna F, de Gaetano G, Iacoviello L. Dietary indices underpinning front-of-pack nutrition labels and health outcomes: a systematic review and meta-analysis of prospective cohort studies. Am J Clin Nutr 2024; 119:756-768. [PMID: 38145705 DOI: 10.1016/j.ajcnut.2023.12.017] [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: 06/14/2023] [Revised: 12/13/2023] [Accepted: 12/22/2023] [Indexed: 12/27/2023] Open
Abstract
BACKGROUND Nutrient profiling systems are increasingly used to characterize the healthfulness of foods for front-of-package (FOP) labeling, which have been proposed as an effective public health strategy to help people make healthier food choices. OBJECTIVE This study aimed to review available evidence from cohort studies that evaluated the association of dietary indices underpinning FOP nutrition labels with all-cause mortality and incidence of cardiovascular diseases (CVDs) or cancer. METHODS PubMed, Web of Science, and Scopus were systematically searched up to October 2023. We included articles if they were prospective cohort studies, if the exposure was any dietary index underpinning FOP nutrition labels [e.g., the modified Food Standard Agency-Nutrient Profiling System (FSAm-NPS) and the Health Star Rating System], and if outcomes were all-cause mortality or incidence of or mortality due to CVD and cancer. Random-effects models were used to calculate the pooled hazard ratios (HRs) and 95% CIs. RESULTS We identified 11 records (7 unique prospective studies), which were included in the systematic review. The meta-analysis comprised 8 studies analyzing the FSAm-NPS dietary index (DI) as exposure. The pooled HRs associated with a 2-unit increase in the FSAm-NPS DI of all-cause mortality, CVD, and cancer risk were 1.06 (95% confidence interval [CI]: 0.99, 1.13; I2: 80%), 1.08 (95% CI: 1.00, 1.18; I2: 70%), and 1.09 (95% CI: 1.00, 1.19; I2: 77%), respectively. The Chilean Warning Label score and the Health Star Rating systems were examined by 1 study each and were significantly associated with the outcomes. CONCLUSIONS DIs underpinning most common FOP nutrition labels and reflecting nutrient-poor diets show a tendency toward an increased incidence of CVD and cancer, but the observed effects are quite modest in magnitude. Further studies at the population level are needed to support the widely shared hypothesis that FOP labels, possibly in conjunction with other interventions, may contribute to reduce noncommunicable disease risk. This meta-analysis was registered at PROSPERO as CRD42021292625.
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Affiliation(s)
- Alberto Montericcio
- Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese-Como, Italy
| | - Marialaura Bonaccio
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy.
| | - Anwal Ghulam
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy
| | | | - Francesco Gianfagna
- Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese-Como, Italy; Mediterranea Cardiocentro, Napoli, Italy
| | - Giovanni de Gaetano
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy; Department of Medicine and Surgery LUM University "Giuseppe Degennaro," Casamassima (BA), Italy
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9
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Frederic MK, Guo X, Zhao X, Nzudie HLF, Tillotson MR, Zhou Y, Li Y. Evaluating the water footprint and nutritional quality of takeaway dishes for selected large cities in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 911:168632. [PMID: 37984654 DOI: 10.1016/j.scitotenv.2023.168632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/04/2023] [Accepted: 11/14/2023] [Indexed: 11/22/2023]
Abstract
The takeaway food and delivery market is developing rapidly in China, raising concerns about the impacts of takeaway dishes on both health and the environment. Here, we compare the environmental impact and nutritional performance of 32 popular takeaway dishes, which stem from the top 10 best-selling takeaway dishes in 10 large cities in China. We select water footprint and water scarcity footprint indicators to represent the environmental impact, and the Food Compass Score to measure nutritional quality. Our results show that 24 out of 32 takeaway dishes contains meat, which has a higher water footprint. The inhabitants of water stressed Chinese cities, mainly located in northern China, tend to favor meat dishes, resulting in a larger water scarcity footprint. The results also highlight the lower nutrition quality of the majority of takeaway dishes, with only three takeaway dishes meeting acceptable environmental and nutritional standards. Our study highlights the importance of analyzing dishes rather than individual foods, which can facilitate sustainable dietary choices for consumers.
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Affiliation(s)
- Mpiya Kapalata Frederic
- Key Laboratory of Integrated Regulation and Resource Development on Shallow Lakes, Ministry of Education, College of Environment, Hohai University, Nanjing 210098, People's Republic of China
| | - Xinyu Guo
- Business School, Shandong University, Weihai 264209, People's Republic of China; Institute of Blue and Green Development, Shandong University, Weihai 264209, People's Republic of China
| | - Xu Zhao
- Institute of Blue and Green Development, Shandong University, Weihai 264209, People's Republic of China.
| | | | - Martin R Tillotson
- water@leeds, School of Civil Engineering, University of Leeds, Leeds LS2 9JT, United Kingdom
| | - Ya Zhou
- Key Laboratory for City Cluster Environmental Safety and Green Development of the Ministry of Education, School of Ecology, Environment and Resources, Guangdong University of Technology, Guangzhou 510006, China
| | - Yiping Li
- Key Laboratory of Integrated Regulation and Resource Development on Shallow Lakes, Ministry of Education, College of Environment, Hohai University, Nanjing 210098, People's Republic of China
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10
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Merz B, Temme E, Alexiou H, Beulens JWJ, Buyken AE, Bohn T, Ducrot P, Falquet MN, Solano MG, Haidar H, Infanger E, Kühnelt C, Rodríguez-Artalejo F, Sarda B, Steenbergen E, Vandevijvere S, Julia C. Nutri-Score 2023 update. NATURE FOOD 2024; 5:102-110. [PMID: 38356074 DOI: 10.1038/s43016-024-00920-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 12/20/2023] [Indexed: 02/16/2024]
Abstract
In 2023, the algorithm underlying the Nutri-Score front-of-pack label was updated to better align with food-based dietary guidelines (FBDGs) across countries engaged in the system. On the basis of a comparison of FBDGs and literature reviews with the current Nutri-Score classification, modification scenarios were developed and tested in nutritional composition databases of branded products in four countries. The updated Nutri-Score nutrient profile model allows a better discrimination between products, in closer alignment with FBDGs, while the updated algorithm adopts a stricter approach for products that are high in components of concern (including non-nutritive sweeteners) and low in favourable dietary components. The updated Nutri-Score algorithm increases the alignment between the front-of-pack label system and FBDGs, strengthening its potential as a complementary public health tool in an international perspective.
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Affiliation(s)
- Benedikt Merz
- Department of Physiology and Biochemistry of Nutrition, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
| | - Elisabeth Temme
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Hélène Alexiou
- Haute Ecole Leonard de Vinci, Health Sector, Dietetics Department, Brussels, Belgium
| | - Joline Wilhelma Johanna Beulens
- Department of Epidemiology and Data Science, Amsterdam UMC, location Vrije Universiteit, Amsterdam, the Netherlands
- Amsterdam Public Health, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Anette Elisabeth Buyken
- Paderborn University, Institute of Nutrition, Consumption and Health, Faculty of Natural Science, Paderborn, Germany
| | - Torsten Bohn
- Nutrition and Health Research Group, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Pauline Ducrot
- Santé publique France, French National Public Health Agency, Saint-Maurice, France
| | - Marie-Noëlle Falquet
- Department of Agricultural, Forest and Food Sciences, Bern University of Applied Sciences, Zollikofen, Switzerland
| | - Marta García Solano
- Observatory of Nutrition and Study of Obesity in Spanish Agency for Food Safety and Nutrition, Madrid, Spain
| | - Hanna Haidar
- Department of Physiology and Biochemistry of Nutrition, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
| | | | - Charlotte Kühnelt
- Department of Physiology and Biochemistry of Nutrition, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
- Department of Epidemiology and Health Monitoring, Robert Koch-Institut, Berlin, Germany
| | - Fernando Rodríguez-Artalejo
- Universidad Autónoma de Madrid, CIBER of Epidemiology and Public Health, and IMDEA-Food (CEI UAM+CSIC), Madrid, Spain
| | - Barthélémy Sarda
- Nutritional Epidemiology Research Team - Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Elly Steenbergen
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Chantal Julia
- Nutritional Epidemiology Research Team - Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France.
- Public Health Department, Paris-Seine-Saint-Denis University Hospitals (AP-HP), Bobigny, France.
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11
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Damigou E, Detopoulou P, Antonopoulou S, Chrysohoou C, Barkas F, Vlachopoulou E, Vafia C, Tsioufis C, Liberopoulos E, Sfikakis PP, Pitsavos C, Panagiotakos D. Food Compass Score predicts incident cardiovascular disease: The ATTICA cohort study (2002-2022). J Hum Nutr Diet 2024; 37:203-216. [PMID: 37908110 DOI: 10.1111/jhn.13247] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/19/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND The Food Compass Score (FCS) is a novel nutrient profiling system, which evaluates food and diet quality. The present study aimed to prospectively assess the relationship of FCS with short-term (10 years) and long-term (20 years) cardiovascular disease (CVD) incidence and to explore whether this relationship is modified by long-term adherence to a Mediterranean type diet (MTD). METHODS Volunteers of the ATTICA cohort study, with complete data for the calculation of FCS and incident CVD were included (n = 759). Development of CVD was determined at 10 and 20 years after baseline. Dietary intake was assessed through a validated food frequency questionnaire. The FCS was calculated for each participant based on the published algorithm. Long-term adherence to a MTD was evaluated through MedDietScore. RESULTS FCS was inversely associated with CVD incidence (hazard ratio [HR] for 20-year follow-up = 0.97, 95% confidence interval [CI] = 0.95-0.99; HR for 10-year follow-up = 0.98, 95% CI = 0.96-1.01) in the total sample, as well as in those with a high baseline adherence to a MTD (HR for 20-year follow-up = 0.96, 95% CI = 0.93-0.99; HR for 10-year follow-up = 0.98, 95% CI = 0.95-1.02). FCS was also inversely associated with CVD risk in those who went away from the MTD (HR = 0.97, 95% CI = 0.96-0.99). CONCLUSIONS FCS, a novel tool for assessing overall diet quality, was also found to be useful in identifying potential CVD candidates in a long-term period, even in populations with good background dietary habits, such as those following a MTD.
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Affiliation(s)
- Evangelia Damigou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, Athens, Greece
| | - Paraskevi Detopoulou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, Athens, Greece
| | - Smaragdi Antonopoulou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, Athens, Greece
| | - Christina Chrysohoou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Fotios Barkas
- Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece
| | - Elpiniki Vlachopoulou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, Athens, Greece
| | - Christina Vafia
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, Athens, Greece
| | - Costas Tsioufis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Evangelos Liberopoulos
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Petros P Sfikakis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Christos Pitsavos
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, Athens, Greece
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12
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Barrett EM, Afrin H, Rayner M, Pettigrew S, Gaines A, Maganja D, Jones A, Mozaffarian D, Beck EJ, Neal B, Taylor F, Munn E, Wu JH. Criterion validation of nutrient profiling systems: a systematic review and meta-analysis. Am J Clin Nutr 2024; 119:145-163. [PMID: 37863430 DOI: 10.1016/j.ajcnut.2023.10.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/21/2023] [Accepted: 10/16/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Nutrient profiling systems (NPSs) use algorithms to evaluate the nutritional quality of foods and beverages. Criterion validation, which assesses the relationship between consuming foods rated as healthier by the NPS and objective measures of health, is essential to ensure the accuracy of NPSs. OBJECTIVE We examined and compared NPSs that have undergone criterion validity testing in relation to diet-related disease risk and risk markers. METHODS Academic databases were searched for prospective cohort and cross-sectional studies published before November, 2022. NPSs were eligible if they incorporated multiple nutrients or food components using an algorithm to determine an overall summary indicator (e.g., a score or rank) for individual foods. Studies were included if they assessed the criterion validity of an eligible NPS. Validation evidence was first summarized in narrative form by NPS, with random effects meta-analysis where ≥2 prospective cohort studies assessed the same NPS and outcomes. RESULTS Of 4519 publications identified, 29 describing 9 NPSs were included in the review. The Nutri-Score NPS was assessed as having substantial criterion validation evidence. Highest compared with lowest diet quality as defined by the Nutri-Score was associated with significantly lower risk of cardiovascular disease (hazard ratio [HR]: 0.74; 95% confidence interval [CI]: 0.59, 0.93; n = 6), cancer (HR: 0.75; 95% CI: 0.59, 0.94; n = 5), all-cause mortality (HR: 0.74; 95% CI; 0.59, 0.91; n = 4) and change in body mass index (HR: 0.68; 95% CI: 0.50, 0.92; n = 3). The Food Standards Agency NPS, Health Star Rating, Nutrient Profiling Scoring Criterion, Food Compass, Overall Nutrition Quality Index, and the Nutrient-Rich Food Index were determined as having intermediate criterion validation evidence. Two other NPSs were determined as having limited criterion validation evidence. CONCLUSIONS We found limited criterion validation studies compared with the number of NPSs estimated to exist. Greater emphasis on conducting and reporting on criterion validation studies across varied contexts may improve the confidence in existing NPSs.
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Affiliation(s)
- Eden M Barrett
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
| | - Habiba Afrin
- School of Public Health, University of California, Berkeley, CA, United States
| | - Mike Rayner
- Oxford Martin Programme on the Future of Food and Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Simone Pettigrew
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Allison Gaines
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Damian Maganja
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Alexandra Jones
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Dariush Mozaffarian
- Food is Medicine Institute, Friedman School of Nutrition Science & Policy, Tufts University, Boston, MA, United States; Tufts School of Medicine and Division of Cardiology, Tufts Medical Center, Boston, MA, United States
| | - Eleanor J Beck
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Bruce Neal
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Fraser Taylor
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Elizabeth Munn
- Population and Public Health, New South Wales Ministry of Health, Sydney, NSW, Australia
| | - Jason Hy Wu
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
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13
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O'Hearn M, Reedy J, Robinson E, Economos C, Wong JB, Sacks G, Mozaffarian D. Landscape analysis of environmental, social and governance (ESG) investing metrics for consumer nutrition and health in the food and beverage sector. BMJ Nutr Prev Health 2023; 6:139-152. [PMID: 38264364 PMCID: PMC10800242 DOI: 10.1136/bmjnph-2022-000600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 06/30/2023] [Indexed: 01/25/2024] Open
Abstract
Introduction The private sector plays a critical role in influencing food choices and health outcomes of consumers. Among private sector actors, investors are a powerful yet underutilised stakeholder for driving scalable public health impact. There are systems to facilitate investors' involvement, notably environmental, social and governance (ESG) investing, which is well placed to include an assessment of business risks to social well-being. However, nutrition efforts within the ESG agenda (ESG-Nutrition) are nascent. We aimed to critically assess the strength of existing ESG-Nutrition metrics to advance the science of measuring business impacts on consumer nutrition and health. Methods ESG-Nutrition metrics were extracted from eight ESG frameworks and categorised across four domains: product portfolio healthfulness; product distribution and equity; product marketing and labelling; and nutrition-related governance. The strength of each metric was evaluated and scored 1-3 (best), independently by two researchers, based on six attributes: materiality, objectivity, alignment, activity, resolution and verifiability. The total score (range 6-18) and intercorrelation for each attribute was calculated. Results Across 529 metrics, most related to product marketing and labelling (n=230, 43.5%), followed by product healthfulness (n=126, 23.8%), nutrition-related governance (n=108, 20.4%) and product distribution and equity (n=65, 12.3%). Across all metrics, average total score was 10.94 (1.58), with average attribute scoring highest for verifiability (mean: 2.36 (SD: 0.57)), objectivity (2.11 (0.61)) and materiality (2.01 (0.68)) and lowest for activity (1.83 (0.74)), alignment (1.37 (0.67)) and resolution (1.26 (0.65)). Most intercorrelations were null, suggesting attributes were measuring distinct characteristics of each metric. Significant heterogeneity across domains and frameworks was also observed. Conclusions This research identifies a range of nutrition-related metrics used in ESG frameworks with respect to food companies, but with substantial heterogeneity in relevant nutrition domains covered and strength of each metric. Efforts are required to improve the quality of metrics across frameworks, establish standardised reporting and align these with investor priorities.
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Affiliation(s)
- Meghan O'Hearn
- Food Systems for the Future Institute, Chicago, Illinois, USA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Julia Reedy
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Ella Robinson
- Global Centre for Preventive Health and Nutrition, Deakin University, Burwood, Victoria, Australia
| | - Christina Economos
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - John B Wong
- Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts, USA
- Tufts Medical Center, Institute for Clinical Research and Health Policy Studies, Boston, Massachusetts, USA
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition, Deakin University, Burwood, Victoria, Australia
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
- Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts, USA
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14
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Barrett EM, Gaines A, Coyle DH, Pettigrew S, Shahid M, Maganja D, Jones A, Rayner M, Mozaffarian D, Taylor F, Ghammachi N, Wu JHY. Comparing product healthiness according to the Health Star Rating and the NOVA classification system and implications for food labelling systems: An analysis of 25 486 products in Australia. NUTR BULL 2023; 48:523-534. [PMID: 37897130 DOI: 10.1111/nbu.12640] [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: 06/29/2023] [Revised: 09/06/2023] [Accepted: 09/06/2023] [Indexed: 10/29/2023]
Abstract
We investigated the extent of alignment between 'healthiness' defined by a food classification system that classifies foods and beverages primarily by their nutrient composition, the Health Star Rating (HSR) and a system that considers only the degree of processing of the product, the NOVA classification system. We used data for 25 486 products contained within the George Institute for Global Health's Australian 2022 FoodSwitch Dataset. Agreement between the two systems in the proportion of products classified as 'healthier' (HSR ≥3.5 or NOVA group 1-3) or 'less healthy' (HSR <3.5 or NOVA group 4) was assessed using the κ statistic. There was 'fair' agreement (κ = 0.30, 95%CI: 0.29-0.31) between both systems in the proportion of all products classified as healthier or less healthy. Approximately one-third (n = 8729) of all products were defined as 'discordant', including 34.3% (n = 5620) of NOVA group 4 products with HSR ≥3.5 (commonly convenience foods, sports/diet foods, meat alternatives, as well as products containing non-sugar sweeteners) and 34.1% (n = 3109) of NOVA group 1-3 products with HSR <3.5 (commonly single-ingredient foods such as sugars/syrups, full-fat dairy and products specially produced to contain no ultra-processed ingredients). Our analysis strengthens the evidence for the similarities and differences in product healthiness according to a nutrient-based classification system and a processing-based classification system. Although the systems' classifications align for the majority of food and beverage products, the discordance found for some product categories indicates potential for confusion if systems are deployed alongside each other within food policies.
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Affiliation(s)
- Eden M Barrett
- Faculty of Medicine and Health, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
- Food is Medicine Institute, Friedman School of Nutrition Science & Policy, Tufts University, Boston, Massachusetts, USA
| | - Allison Gaines
- Faculty of Medicine and Health, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Daisy H Coyle
- Faculty of Medicine and Health, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Simone Pettigrew
- Faculty of Medicine and Health, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Maria Shahid
- Faculty of Medicine and Health, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Damian Maganja
- Faculty of Medicine and Health, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Alexandra Jones
- Faculty of Medicine and Health, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Mike Rayner
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Dariush Mozaffarian
- Food is Medicine Institute, Friedman School of Nutrition Science & Policy, Tufts University, Boston, Massachusetts, USA
- Division of Cardiology, Tufts School of Medicine, Tufts Medical Center, Boston, Massachusetts, USA
| | - Fraser Taylor
- Faculty of Medicine and Health, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Nadine Ghammachi
- Faculty of Medicine and Health, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Jason H Y Wu
- Faculty of Medicine and Health, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
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15
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Aidoo R, Abe-Inge V, Kwofie EM, Baum JI, Kubow S. Sustainable healthy diet modeling for a plant-based dietary transitioning in the United States. NPJ Sci Food 2023; 7:61. [PMID: 38016966 PMCID: PMC10684880 DOI: 10.1038/s41538-023-00239-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 11/15/2023] [Indexed: 11/30/2023] Open
Abstract
The potential environmental and nutritional benefits of plant-based dietary shifts require thorough investigation to outline suitable routes to achieve these benefits. Whereas dietary consumption is usually in composite forms, sustainable healthy diet assessments have not adequately addressed composite diets. In this study, we build on available data in the Food4HealthyLife calculator to develop 3 dietary concepts (M) containing 24 model composite diet scenarios (S) assessed for their environmental and nutritional performances. The Health Nutritional Index (HENI) and Food Compass scoring systems were used for nutritional quality profiling and estimates of environmental impact were derived from previously reported midpoint impact values for foods listed in the What We Eat in America database. The diets were ranked using the Kruskal‒Wallis nonparametric test, and a dual-scale data chart was employed for a trade-off analysis to identify the optimal composite diet scenario. The results showcased a distinct variation in ranks for each scenario on the environment and nutrition scales, describing an inherent nonlinear relationship between environmental and nutritional performances. However, trade-off analysis revealed a diet with 10% legumes, 0.11% red meat, 0.28% processed meat and 2.81% white meat could reduce global warming by 54.72% while yielding a diet quality of 74.13 on the Food Compass Scoring system. These observations provide an interesting forecast of the benefits of transitioning to an optimal plant- and animal-based dieting pattern, which advances global nutritional needs and environmental stewardship among consumers.
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Affiliation(s)
- Raphael Aidoo
- Department of Bioresource Engineering, McGill University (Macdonald Campus), 21111 Lakeshore, Ste-Anne-de-Bellevue, Québec, H9X 3V9, Canada
| | - Vincent Abe-Inge
- Department of Bioresource Engineering, McGill University (Macdonald Campus), 21111 Lakeshore, Ste-Anne-de-Bellevue, Québec, H9X 3V9, Canada
| | - Ebenezer M Kwofie
- Department of Bioresource Engineering, McGill University (Macdonald Campus), 21111 Lakeshore, Ste-Anne-de-Bellevue, Québec, H9X 3V9, Canada.
| | - Jamie I Baum
- Center for Human Nutrition, University of Arkansas System Division of Agriculture, Fayetteville, AR, 72704, USA
- Department of Food Science, University of Arkansas, Fayetteville, AR, 72704, USA
| | - Stan Kubow
- School of Human Nutrition, McGill University, 21111 Lakeshore, Ste-Anne-de-Bellevue, Québec, H9X 3V9, Canada
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16
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Touvier M, da Costa Louzada ML, Mozaffarian D, Baker P, Juul F, Srour B. Ultra-processed foods and cardiometabolic health: public health policies to reduce consumption cannot wait. BMJ 2023; 383:e075294. [PMID: 37813465 PMCID: PMC10561017 DOI: 10.1136/bmj-2023-075294] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Affiliation(s)
- Mathilde Touvier
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), Bobigny, France
| | | | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Phillip Baker
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Filippa Juul
- Department of Public Health Policy and Management, School of Global Public Health, New York University, New York, NY, USA
| | - Bernard Srour
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), Bobigny, France
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17
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Detopoulou P, Damigou E, Antonopoulou S, Fragopoulou E, Chysohoou C, Pitsavos C, Panagiotakos D. Food Compass Score and its association with inflammatory markers and homocysteine in cardiovascular disease-free adults: a cross-sectional analysis of the ATTICA epidemiological study. Eur J Clin Nutr 2023; 77:998-1004. [PMID: 37400562 DOI: 10.1038/s41430-023-01300-z] [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: 12/17/2022] [Revised: 06/07/2023] [Accepted: 06/12/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND/OBJECTIVES Several nutrient profiling systems have been developed to assist in food choices and policy. Food Compass Score (FCS) is a novel holistic food score assessing 54 parameters. The aim was to assess the relation of FCS with inflammatory and lipid markers in cardiovascular disease-free volunteers. SUBJECTS/METHODS Information from the ATTICA epidemiological study participants, with complete data on lipid, inflammatory markers and dietary intake were studied (n = 1018). C-reactive protein (CRP) and amyloid A were determined by immunonephelometry, fibrinogen by nephelometry, homocysteine by fluorometry, while tumor necrosis factor-a (TNF-a), interleukin-6 (IL-6), adiponectin and leptin were determined by ELISA in fasting blood samples. Dietary intake was assessed through a semi-quantitative validated food frequency questionnaire. Each food was assigned a FCS value from the published values and then individual's FCS values were calculated. RESULTS Mean FCS was 56 (standard deviation: 5.7) and it was similar in men and women. FCS was inversely correlated with age (r = -0.06, p = 0.03). In multiple linear regression models, FCS was inversely associated with CRP (-0.03, 0.01), TNF-a (-0.04, 0.01), amyloid A (-0.10, 0.04) and homocysteine (-0.09, 0.04) (b coefficients, standard errors, all p < 0.05) and was not associated with IL-6, fibrinogen, adiponectin, leptin, or lipids levels (all p > 0.05). CONCLUSIONS The inverse correlations of the FCS with inflammatory markers suggest that a diet containing foods with high FCS might be protective against inflammation process. Our results support the usefulness of the FCS, but future studies should evaluate its relation to cardiovascular and other inflammation-related chronic diseases.
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Affiliation(s)
- Paraskevi Detopoulou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Evangelia Damigou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Smaragdi Antonopoulou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Elizabeth Fragopoulou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Christina Chysohoou
- First Cardiology Clinic, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Christos Pitsavos
- First Cardiology Clinic, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece.
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18
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Tan LJ, Hwang SB, Shin S. The Longitudinal Effect of Ultra-Processed Food on the Development of Dyslipidemia/Obesity as Assessed by the NOVA System and Food Compass Score. Mol Nutr Food Res 2023; 67:e2300003. [PMID: 37650269 DOI: 10.1002/mnfr.202300003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 07/10/2023] [Indexed: 09/01/2023]
Abstract
SCOPE Ultra-processing food (UPF) has been a nutrition and health interest. This study is aimed to investigate the association between UPF consumption and the risk of obesity or dyslipidemia. METHODS AND RESULTS This study is performed using an ongoing cohort study including 17 310 individuals aged ≥40 years in South Korea. UPF is categorized by the NOVA system and FCS, respectively. After an average 5-year follow-up, there is a positive association between NOVA-defined UPF and dyslipidemia. The risk of the Q4 group is almost 20% higher than that of the Q1 group (men, adjusted HR = 1.209 [95% CI 1.039-1.407], women, adjusted HR = 1.195 [95% CI 1.096-1.303]). Consuming high-FCS foods (less processed and healthier foods) show a lower risk for dyslipidemia in both sexes and lower obesity risk in women compared to low-FCS consumption (men, dyslipidemia, adjusted HR = 0.857 [95% CI 0.744-0.988]; women, dyslipidemia, adjusted HR = 0.919 [95% CI 0.850-0.993], obesity, adjusted HR = 0.759 [95% CI 0.628-0.916]). CONCLUSION Higher UPF intakes assessed by the NOVA system and FCS are associated with increased incidences of dyslipidemia and obesity. Furthermore, NOVA-defined UPF shows a statistically significant negative association with AMED score, indicating poor diet quality.
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Affiliation(s)
- Li-Juan Tan
- Department of Food and Nutrition, Chung-Ang University, Anseong, Gyeonggi-do, 17546, South Korea
| | - Su Bin Hwang
- Department of Food and Nutrition, Chung-Ang University, Anseong, Gyeonggi-do, 17546, South Korea
| | - Sangah Shin
- Department of Food and Nutrition, Chung-Ang University, Anseong, Gyeonggi-do, 17546, South Korea
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19
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Abstract
Food-based dietary guidelines have been the basis of public health recommendations for over half a century, but more recently, there has been a trend to classify the health properties of food not by its nutrient composition, but by the degree to which it has been processed. This concept has been supported by many association studies, narrative reviews and the findings from one randomised controlled feeding trial, which demonstrated the sustained effect of ultra-processed diets on increasing both energy intake and body weight. This has led to widespread speculation as to specific features of ultra-processed foods that promote increased energy intakes. Rising interest in the ultra-processed topic has led to proposals to include guidance and restrictions on the consumption of processed foods in national dietary guidelines, with some countries encouraging consumers to avoid highly processed foods completely, and only choose minimally processed foods. However, there remains a lack of consensus on the role of processed foods in human health when faced with the challenges of securing the food supply for a growing global population, that is, healthy, affordable and sustainable. There has also been criticism of the subjective nature of definitions used to differentiate foods by their degree of processing, and there is currently a lack of empirical data to support a clear mechanism by which highly processed foods promote greater energy intakes. Recommendations to avoid all highly processed foods are potentially harmful if they remove affordable sources of nutrients and will be impractical for most when an estimated two-thirds of current energy purchased are from processed or ultra-processed foods. The current review highlights some considerations when interpreting the dietary association studies that link processed food intake to health and offers a critique on some of the mechanisms proposed to explain the link between ultra-processed food and poor health. Recent research suggests a combination of higher energy density and faster meal eating rates are likely to influence meal size and energy intakes from processed foods and offers new perspectives on how to manage this in the future. In going beyond the ultra-processed debate, the aim is to summarise some important considerations when interpreting existing data and identify the important gaps for future research on the role of processed food in health.
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Affiliation(s)
- Ciarán G Forde
- Sensory Science and Eating Behaviour, Division of Human Nutrition and Health, Wageningen University and Research, P.O. Box 17, 6700 AA Wageningen, The Netherlands
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20
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Erndt-Marino J, O'Hearn M, Menichetti G. An integrative analytical framework to identify healthy, impactful, and equitable foods: a case study on 100% orange juice. Int J Food Sci Nutr 2023; 74:668-684. [PMID: 37545294 DOI: 10.1080/09637486.2023.2241672] [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: 03/07/2023] [Revised: 07/19/2023] [Accepted: 07/23/2023] [Indexed: 08/08/2023]
Abstract
To identify healthy, impactful, and equitable foods, we combined health scores from six diverse nutrient profiling systems (NPS) into a meta-framework (meta-NPS) and paired this with dietary guideline adherence assessment via multilevel regression and poststratification. In a case-study format, a commonly debated beverage formulation - 100% orange juice (OJ) - was chosen to showcase the utility and depth of our framework, systematically scoring high across multiple food systems (i.e. a Meta-Score percentile = 93rd and Stability percentile = 75th) and leading to an expected increase of US dietary fruit guideline adherence by ∼10%. Moreover, the increased adherence varies across the 300 sociodemographic strata, with the benefit patterns being sensitive to absolute or relative quantification of the difference of adherence affected by OJ. In sum, the adaptable, integrative framework we established deepens the science of nutrient profiling and dietary guideline adherence assessment while shedding light on the nuances of defining equitable health effects.
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Affiliation(s)
| | - Meghan O'Hearn
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Food Systems for the Future, Chicago, IL, USA
| | - Giulia Menichetti
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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21
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Rosenfeld RM, Juszczak HM, Wong MA. Scoping review of the association of plant-based diet quality with health outcomes. Front Nutr 2023; 10:1211535. [PMID: 37637943 PMCID: PMC10447911 DOI: 10.3389/fnut.2023.1211535] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/28/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction The association of plant-based dietary patterns with health outcomes has traditionally been assessed without considering nutritional value. The plant-based dietary index (PDI), first published in 2016, overcomes this limitation with both a healthful PDI (hPDI) and an unhealthful PDI (uPDI), based on the quality of plant foods consumed plus the frequency of animal foods. We sought to summarize the breadth of research using the hPDI and uPDI to gain insight into how the quality of plant-based dietary patterns might be associated with health outcomes. Methods Scoping review of studies that used the PDI, hPDI, or uPDI to report associations with health outcomes. Multiple databases were searched from 2010 through April 2023 with 2 authors independently assessing eligibility and extracting data. In addition to assessing the association of the indices to health outcomes, we determined the frequency of concordant or discordant findings for hPDI versus PDI and for hPDI versus uPDI. Results We included 95 articles (54% longitudinal, 37% cross-sectional, and 9% case-control) with a median sample size of 3,646. Higher hPDI levels were associated with favorable health outcomes in 36% of comparisons (most often for obesity, mortality, diabetes, cardiovascular disease, and psychiatric disorders), compared to 25% for the PDI and only 2% for the uPDI. Conversely, higher levels of the uPDI were associated with unfavorable health outcomes in 33% of comparisons, in contrast to under 1% for the hPDI and 2% for the PDI. When the hPDI association to an outcome was discordant with the uPDI or PDI, the significance and directionality always favored the hPDI over the uPDI, and nearly always favored the hPDI over the PDI. Discussion Dietary indices that account for the quality of plant foods can show health benefits that might be missed by a generic plant-based index. A greater focus on the quality of plant foods could improve nutrition guidelines, raise awareness about the benefits of adding unrefined plant foods to the diet, and empower consumers to make incremental additions of such foods to displace unhealthy foods. We anticipate increasing use of indices that address food quality in future research.
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Affiliation(s)
- Richard M. Rosenfeld
- Department of Otolaryngology, SUNY Downstate Health Sciences University, Brooklyn, NY, United States
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22
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McAuliffe GA, Lynch J, Cain M, Buckingham S, Rees RM, Collins AL, Allen M, Pierrehumbert R, Lee MRF, Takahashi T. Are single global warming potential impact assessments adequate for carbon footprints of agri-food systems? ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2023; 18:084014. [PMID: 37469672 PMCID: PMC10353732 DOI: 10.1088/1748-9326/ace204] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 05/09/2023] [Accepted: 06/27/2023] [Indexed: 07/21/2023]
Abstract
The vast majority of agri-food climate-based sustainability analyses use global warming potential (GWP100) as an impact assessment, usually in isolation; however, in recent years, discussions have criticised the 'across-the-board' application of GWP100 in Life Cycle Assessments (LCAs), particularly of food systems which generate large amounts of methane (CH4) and considered whether reporting additional and/or alternative metrics may be more applicable to certain circumstances or research questions (e.g. Global Temperature Change Potential (GTP)). This paper reports a largescale sensitivity analysis using a pasture-based beef production system (a high producer of CH4 emissions) as an exemplar to compare various climatatic impact assessments: CO2-equivalents using GWP100 and GTP100, and 'CO2-warming-equivalents' using 'GWP Star', or GWP*. The inventory for this system was compiled using data from the UK Research and Innovation National Capability, the North Wyke Farm Platform, in Devon, SW England. LCAs can have an important bearing on: (i) policymakers' decisions; (ii) farmer management decisions; (iii) consumers' purchasing habits; and (iv) wider perceptions of whether certain activities can be considered 'sustainable' or not; it is, therefore, the responsibility of LCA practitioners and scientists to ensure that subjective decisions are tested as robustly as possible through appropriate sensitivity and uncertainty analyses. We demonstrate herein that the choice of climate impact assessment has dramatic effects on interpretation, with GWP100 and GTP100 producing substantially different results due to their different treatments of CH4 in the context of carbon dioxide (CO2) equivalents. Given its dynamic nature and previously proven strong correspondence with climate models, out of the three assessments covered, GWP* provides the most complete coverage of the temporal evolution of temperature change for different greenhouse gas emissions. We extend previous discussions on the limitations of static emission metrics and encourage LCA practitioners to consider due care and attention where additional information or dynamic approaches may prove superior, scientifically speaking, particularly in cases of decision support.
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Affiliation(s)
- Graham A McAuliffe
- Net Zero and Resilient Farming, Rothamsted Research, North Wyke, Okehampton, Devon EX20 2SB, United Kingdom
| | - John Lynch
- Nature-based Solutions Initiative, Department of Biology, University of Oxford, Oxford OX1 3SZ, United Kingdom
| | - Michelle Cain
- Cranfield University, Cranfield Environment Centre, Bedfordshire MK43 0AL, United Kingdom
| | - Sarah Buckingham
- Scotland’s Rural College, West Mains Road, Edinburgh EH9 3JG, United Kingdom
| | - Robert M Rees
- Scotland’s Rural College, West Mains Road, Edinburgh EH9 3JG, United Kingdom
| | - Adrian L Collins
- Net Zero and Resilient Farming, Rothamsted Research, North Wyke, Okehampton, Devon EX20 2SB, United Kingdom
| | - Myles Allen
- Department of Physics, University of Oxford, Oxford OX1 3PJ, United Kingdom
| | | | - Michael R F Lee
- Harper Adams University, Newport, Shropshire TF10 8NB, United Kingdom
| | - Taro Takahashi
- Net Zero and Resilient Farming, Rothamsted Research, North Wyke, Okehampton, Devon EX20 2SB, United Kingdom
- University of Bristol, Bristol Veterinary School, Langford, Somerset BS40 5DU, United Kingdom
- Agri-Food and Biosciences Institute, AFBI, Large Park, Hillsborough, Belfast, Northern Ireland BT26 6DR, United Kingdom
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23
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Stiletto A, Cei L, Trestini S. A Little Bird Told Me… Nutri-Score Panoramas from a Flight over Europe, Connecting Science and Society. Nutrients 2023; 15:3367. [PMID: 37571304 PMCID: PMC10421117 DOI: 10.3390/nu15153367] [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: 06/19/2023] [Revised: 07/21/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
Within the Farm to Fork Strategy, the European Commission ask for a unified Front Of Pack nutritional label for food to be used at the European level. The scientific debate identified the Nutri-Score (NS) as the most promising candidate, but within the political discussion, some Member States brought to attention several issues related to its introduction. This misalignment led to a postponement of the final decision. With the aim to shed some light on the current stances and contribute to the forthcoming debate, the objective of the present work is to understand to what extent scientific research addresses the issues raised by the general public. We applied a structural topic model to tweets from four European countries (France, Germany, Italy, Spain) and to abstracts of scientific papers, all dealing with the NS topic. Different aspects of the NS debate are discussed in different countries, but scientific research, while addressing some of them (e.g., the comparison between NS and other labels), disregards others (e.g., relations between NS and traditional products). It is advisable, therefore, to widen the scope of NS research to properly address the concerns of European society and to provide policymakers with robust evidence to support their decisions.
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Affiliation(s)
| | | | - Samuele Trestini
- Department of Land, Environment, Agriculture and Forestry, University of Padova, 35020 Legnaro, Italy; (A.S.); (L.C.)
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24
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POMERANZ JENNIFERL, CASH SEANB, MOZAFFARIAN DARIUSH. US Policies That Define Foods for Junk Food Taxes, 1991-2021. Milbank Q 2023; 101:560-600. [PMID: 37101340 PMCID: PMC10262384 DOI: 10.1111/1468-0009.12652] [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: 09/10/2022] [Revised: 01/28/2023] [Accepted: 03/02/2023] [Indexed: 04/28/2023] Open
Abstract
Policy Points Suboptimal diet is a leading cause of mortality and morbidity in the United States. Excise taxes on junk food are not widely utilized in the United States. The development of a workable definition of the food to be taxed is a substantial barrier to implementation. Three decades of legislative and regulatory definitions of food for taxes and related purposes provide insight into methods to characterize food to advance new policies. Defining policies through Product Categories combined with Nutrients or Processing may be a method to identify foods for health-related goals. CONTEXT Suboptimal diet is a substantial contributor to weight gain, cardiometabolic diseases, and certain cancers. Junk food taxes can raise the price of the taxed product to reduce consumption and the revenue can be used to invest in low-resource communities. Taxes on junk food are administratively and legally feasible but no definition of "junk food" has been established. METHODS To identify legislative and regulatory definitions characterizing food for tax and other related purposes, this research used Lexis+ and the NOURISHING policy database to identify federal, state, territorial, and Washington DC statutes, regulations, and bills (collectively denoted as "policies") defining and characterizing food for tax and related policies, 1991-2021. FINDINGS This research identified and evaluated 47 unique laws and bills that defined food through one or more of the following criteria: Product Category (20 definitions), Processing (4 definitions), Product intertwined with Processing (19 definitions), Place (12 definitions), Nutrients (9 definitions), and Serving Size (7 definitions). Of the 47 policies, 26 used more than one criterion to define food categories, especially those with nutrition-related goals. Policy goals included taxing foods (snack, healthy, unhealthy, or processed foods), exempting foods from taxation (snack, healthy, unhealthy, or unprocessed foods), exempting homemade or farm-made foods from state and local retail regulations, and supporting federal nutrition assistance objectives. Policies based on Product Categories alone differentiated between necessity/staple foods on the one hand and nonnecessity/nonstaple foods on the other. CONCLUSIONS In order to specifically identify unhealthy food, policies commonly included a combination of Product Category, Processing, and/or Nutrient criteria. Explanations for repealed state sales tax laws on snack foods identified retailers' difficulty pinpointing which specific foods were subject to the tax as a barrier to implementation. An excise tax assessed on manufacturers or distributors of junk food is a method to overcome this barrier and may be warranted.
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Affiliation(s)
| | - SEAN B CASH
- Tufts University Friedman School of Nutrition Science and Policy
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25
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Shekar M, O'Hearn M, Knudsen E, Shibuya K, Bishop S, van Berchem H, Egerton-Warburton C, Shibata Okamura K, Mozaffarian D. Innovative financing for nutrition. NATURE FOOD 2023; 4:464-471. [PMID: 37353573 DOI: 10.1038/s43016-023-00778-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 05/12/2023] [Indexed: 06/25/2023]
Abstract
Given the constraints of both overseas development aid and domestic financing for nutrition, innovative financing is critical-yet nutrition lags behind other sectors in catalysing it. Here, we argue that the framing for nutrition must evolve and critical actions must be taken to generate more money for nutrition and more nutrition for money. Food systems hold some of the most powerful opportunities to improve human and planetary health while increasing productivity-and the private sector has a key role to play in this.
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Affiliation(s)
| | - Meghan O'Hearn
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Food Systems for the Future, Chicago, IL, USA
| | | | | | | | | | | | | | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Department of Medicine, Tufts Medical Center, Boston, MA, USA
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26
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Damman CJ. Perspective: Nutrition’s Next Chapter – Bioactive Gaps & the Microbiome-Mitochondria Axis. Adv Nutr 2023; 14:420-425. [PMID: 37011764 DOI: 10.1016/j.advnut.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/03/2023] [Accepted: 03/30/2023] [Indexed: 04/03/2023] Open
Abstract
Food has the power to heal. Our bodies transform and are transformed by the elements in food and the adage that we are what we eat is figuratively and literally true. Twentieth century nutrition science focused on decoding the processes and building blocks of this transformation -- the proteins, fats, carbohydrates, vitamins, and minerals. Twenty-first century nutrition science is aimed at better understanding the increasingly appreciated bioactives within the food matrix that help regulate this transformation - fibers, phytonutrients, bioactive fats, and ferments. Our microbiome and the mitochondria play a key function in orchestrating the role of bioactives in health and are inspiring next-generation nutritional approaches for addressing over- and undernutrition.
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27
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Harlan TS, Gow RV, Kornstädt A, Alderson PW, Lustig RH. The Metabolic Matrix: Re-engineering ultraprocessed foods to feed the gut, protect the liver, and support the brain. Front Nutr 2023; 10:1098453. [PMID: 37063330 PMCID: PMC10097968 DOI: 10.3389/fnut.2023.1098453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/03/2023] [Indexed: 04/03/2023] Open
Abstract
Ultraprocessed food is established as a metabolic disruptor acting to increase adiposity, reduce mitochondrial efficiency, drive insulin resistance, alter growth, and contribute to human morbidity and mortality. Consumer packaged goods (CPG) companies are beginning to understand the detrimental impact of the food they market, and have employed substitution strategies to reduce salt, sugar, and fat. However, the harms of ultraprocessed foods are far more complex than any single component, and are not ameliorated by such simple substitutions. Over the past 2 years, the authors have worked with the Kuwaiti Danish Dairy Company (KDD) to conduct a comprehensive scientific evaluation of their entire commercial food and beverage portfolio. Assay of the macronutrients, micronutrients, additives, and toxins contained in each of their products was undertaken to determine the precise nature of each product’s ingredients as well as the health impacts of processing. The authors formed a Scientific Advisory Team (SAT) and developed a tiered “Metabolic Matrix” founded in three science-based principles: (1) protect the liver, (2) feed the gut, and (3) support the brain. The Metabolic Matrix categorizes each product and provides the criteria, metrics, and recommendations for improvement or reformulation. Real-time consultation with the KDD Executive and Operations teams was vital to see these procedures through to fruition. This scientific exercise has enabled KDD to lay the groundwork for improving the health, well-being, and sustainability of their entire product line, while maintaining flavor, economic, and fiscal viability. This process is easily transferrable, and we are sharing this effort and its approaches as a proof-of-concept. The key aim of our work is to not only make ultraprocessed food healthier but to urge other food companies to implement similar analysis and reformulation of their product lines to improve the metabolic health and well-being of consumers worldwide.
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Affiliation(s)
- Timothy S. Harlan
- Division of General Internal Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
- *Correspondence: Timothy S. Harlan,
| | - Rachel V. Gow
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
| | | | - P. Wolfram Alderson
- Human & Environmental Health Department, Kuwaiti Danish Dairy Company, Kuwait City, Kuwait
| | - Robert H. Lustig
- Department of Pediatrics and Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, United States
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28
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Messina M, Duncan AM, Glenn AJ, Mariotti F. Plant-Based Meat Alternatives Can Help Facilitate and Maintain a Lower Animal to Plant Protein Intake Ratio. Adv Nutr 2023; 14:392-405. [PMID: 36906147 DOI: 10.1016/j.advnut.2023.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/28/2023] [Accepted: 03/07/2023] [Indexed: 03/12/2023] Open
Abstract
The health and environmental advantages of plant-predominant diets will likely lead to increasing numbers of consumers reducing their reliance on animal products. Consequently, health organizations and professionals will need to provide guidance on how best to make this change. In many developed countries, nearly twice as much protein is derived from animal versus plant sources. Potential benefits could result from consuming a higher share of plant protein. Advice to consume equal amounts from each source is more likely to be embraced than advice to eschew all or most animal products. However, much of the plant protein currently consumed comes from refined grains, which is unlikely to provide the benefits associated with plant-predominant diets. In contrast, legumes provide ample amounts of protein as well other components such as fiber, resistant starch, and polyphenolics, which are collectively thougt to exert health benefits. But despite their many accolades and endorsement by the nutrition community, legumes make a negligible contribution to global protein intake, especially in developed countries. Furthermore, evidence suggests the consumption of cooked legumes will not substantially increase over the next several decades. We argue here that plant-based meat alternatives (PBMAs) made from legumes are a viable alternative, or a complement, to consuming legumes in the traditional manner. These products may be accepted by meat eaters because they can emulate the orosensory properties and functionality of the foods they are intended to replace. PBMAs can be both transition foods and maintenance foods in that they can facilitate the transition to a plant-predominant diet and make it easier to maintain. PBMAs also have a distinct advantage of being able to be fortified with shortfall nutrients in plant-predominant diets. Whether existing PBMAs provide similar health benefits as whole legumes, or can be formulated to do so, remains to be established. Adv Nutr 2023;xx:xx-xx.
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Affiliation(s)
- Mark Messina
- Soy Nutrition Institute Global, Washington, DC, USA.
| | - Alison M Duncan
- Department of Human Health and Nutritional Sciences, University of Guelp, Guelph, Ontario, Canada
| | - Andrea J Glenn
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Francois Mariotti
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, Palaiseau, France
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29
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Fitzgerald M. It is time to appreciate the value of processed foods. Trends Food Sci Technol 2023. [DOI: 10.1016/j.tifs.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
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30
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Ortenzi F, Kolby M, Lawrence M, Leroy F, Nordhagen S, Phillips SM, van Vliet S, Beal T. Limitations of the Food Compass Nutrient Profiling System. J Nutr 2023; 153:610-614. [PMID: 36787879 DOI: 10.1016/j.tjnut.2023.01.027] [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: 09/14/2022] [Revised: 12/31/2022] [Accepted: 01/10/2023] [Indexed: 02/04/2023] Open
Abstract
Nutrient Profiling Systems provide frameworks to assess the healthfulness of foods based on food composition and are intended as inputs into strategies to improve diets. Many Nutrient Profiling Systems are founded on a reductionist assumption that the healthfulness of foods is determined by the sum of their individual nutrients, with no consideration for the extent and purpose of processing and its health implications. A novel Nutrient Profiling System called Food Compass attempted to address existing gaps and provide a more holistic assessment of the healthfulness of foods. We propose that the chosen algorithm is not well justified and produces results that fail to discriminate for common shortfall nutrients, exaggerate the risks associated with animal-source foods, and underestimate the risks associated with ultraprocessed foods. We caution against the use of Food Compass in its current form to inform consumer choices, policies, programs, industry reformulations, and investment decisions.
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Affiliation(s)
| | - Marit Kolby
- Bjørknes University College, Department of Health Sciences, Oslo, Norway
| | - Mark Lawrence
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia
| | - Frédéric Leroy
- Industrial Microbiology and Food Biotechnology (IMDO), Faculty of Sciences and Bioengineering Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Stephan van Vliet
- Center for Human Nutrition Studies, Utah State University, Logan, UT, United States
| | - Ty Beal
- Global Alliance for Improved Nutrition, Washington, DC, United States; Institute for Social, Behavioral and Economic Research, University of California, Santa Barbara, CA, United States.
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31
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Hafner E, Pravst I. Comparison of Nutri-Score and Health Star Rating Nutrient Profiling Models Using Large Branded Foods Composition Database and Sales Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3980. [PMID: 36900987 PMCID: PMC10002453 DOI: 10.3390/ijerph20053980] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
Front-of-package nutrition labelling (FOPNL) is known as an effective tool that can encourage healthier food choices and food reformulation. A very interesting type of FOPNL is grading schemes. Our objective was to compare two market-implemented grading schemes-European Nutri-Score (NS) and Australian Health Star Rating (HSR), using large Slovenian branded foods database. NS and HSR were used for profiling 17,226 pre-packed foods and drinks, available in Slovenian food supply dataset (2020). Alignment between models was evaluated with agreement (% of agreement and Cohen's Kappa) and correlation (Spearman rho). The 12-month nationwide sales-data were used for sale-weighing, to address market-share differences. Study results indicated that both models have good discriminatory ability between products based on their nutritional composition. NS and HSR ranked 22% and 33% of Slovenian food supply as healthy, respectively. Agreement between NS and HSR was strong (70%, κ = 0.62) with a very strong correlation (rho = 0.87). Observed profiling models were most aligned within food categories Beverages and Bread and bakery products, while less aligned for Dairy and imitates and Edible oils and emulsions. Notable disagreements were particularly observed in subcategories of Cheese and processed cheeses (8%, κ = 0.01, rho = 0.38) and Cooking oils (27%, κ = 0.11, rho = 0.40). Further analysis showed that the main differences in Cooking oils were due to olive oil and walnut oil, which are favoured by NS and grapeseed, flaxseed and sunflower oil that are favoured by HSR. For Cheeses and cheese products, we observed that HSR graded products across the whole scale, with majority (63%) being classified as healthy (≥3.5 *), while NS mostly graded lower scores. Sale-weighting analyses showed that offer in the food supply does not always reflect the sales. Sale-weighting increased overall agreement between profiles from 70% to 81%, with notable differences between food categories. In conclusion, NS and HSR were shown as highly compliant FOPNLs with few divergences in some subcategories. Even these models do not always grade products equally high, very similar ranking trends were observed. However, the observed differences highlight the challenges of FOPNL ranking schemes, which are tailored to address somewhat different public health priorities in different countries. International harmonization can support further development of grading type nutrient profiling models for the use in FOPNL, and make those acceptable for more stake-holders, which will be crucial for their successful regulatory implementation.
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Affiliation(s)
- Edvina Hafner
- Nutrition Institute, Tržaška Cesta 40, SI-1000 Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, SI-1000 Ljubljana, Slovenia
| | - Igor Pravst
- Nutrition Institute, Tržaška Cesta 40, SI-1000 Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, SI-1000 Ljubljana, Slovenia
- VIST—Faculty of Applied Sciences, Gerbičeva Cesta 51A, SI-1000 Ljubljana, Slovenia
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Dickie S, Woods J, Machado P, Lawrence M. A novel food processing-based nutrition classification scheme for guiding policy actions applied to the Australian food supply. Front Nutr 2023; 10:1071356. [PMID: 36742430 PMCID: PMC9895835 DOI: 10.3389/fnut.2023.1071356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/05/2023] [Indexed: 01/22/2023] Open
Abstract
Unhealthy diets are a leading risk factor for non-communicable diseases and negatively impact environmental sustainability. Policy actions recommended to address dietary risk factors, such as restrictions on marketing and front-of-pack labelling, are informed by nutrition classification schemes (NCSs). Ultra-processed foods are associated with adverse population and planetary health outcomes, yet the concept is rarely incorporated in nutrition classification schemes for policy actions. This study aims to develop a novel food processing-based nutrition classification scheme for guiding policy actions. A secondary aim is to validate the scheme by classifying food and beverage items in the Australian food supply (face validity) and comparing them to the classifications of existing NCSs (convergent validity). Two versions of a model were developed, classifying foods and beverages in two steps, first using the NOVA classification system and secondly by applying upper thresholds for added free sugars and sodium, producing a binary output of either healthy or unhealthy. All food and beverage items (n = 7,322) in a dataset combining the Australian Food Composition Database (AUSNUT 2011-2013) and Mintel's Global New Product Database (2014-2019) were classified using the two models. The same dataset was also classified by the Health Star Rating system (HSR), The Australian Dietary Guidelines (ADGs), The Pan American Health Organization's Nutrient Profile Model (PAHO NPM), and the NOVA classification scheme, and pairwise agreement between all NCSs and the two models was determined (using Cohen's Kappa coefficient). A higher proportion of food categories consistent with dietary patterns that are associated with positive health outcomes, such and fruits, vegetables, and eggs were classified as healthy. And the clear majority of food categories consistent with dietary patterns associated with adverse health outcomes, such as confectionery, snack foods, and convenience foods were classified as unhealthy. The two versions of the model showed substantial agreement with NOVA and the PAHO NPM, fair agreement with the ADGs and slight to moderate agreement with the HSR system. A model NCS combining level of processing and nutrient criteria presents a valid alternative to existing methods to classify the health potential of individual foods for policy purposes.
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O'Hearn M, Erndt-Marino J, Gerber S, Lauren BN, Economos C, Wong JB, Blumberg JB, Mozaffarian D. Validation of Food Compass with a healthy diet, cardiometabolic health, and mortality among U.S. adults, 1999-2018. Nat Commun 2022; 13:7066. [PMID: 36414619 PMCID: PMC9681774 DOI: 10.1038/s41467-022-34195-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 10/14/2022] [Indexed: 11/23/2022] Open
Abstract
The Food Compass is a nutrient profiling system (NPS) to characterize the healthfulness of diverse foods, beverages and meals. In a nationally representative cohort of 47,999 U.S. adults, we validated a person's individual Food Compass Score (i.FCS), ranging from 1 (least healthful) to 100 (most healthful) based on cumulative scores of items consumed, against: (a) the Healthy Eating Index (HEI) 2015; (b) clinical risk factors and health conditions; and (c) all-cause mortality. Nationally, the mean (SD) of i.FCS was 35.5 (10.9). i.FCS correlated highly with HEI-2015 (R = 0.81). After multivariable-adjustment, each one SD (10.9 point) higher i.FCS associated with more favorable BMI (-0.60 kg/m2 [-0.70,-0.51]), systolic blood pressure (-0.69 mmHg [-0.91,-0.48]), diastolic blood pressure (-0.49 mmHg [-0.66,-0.32]), LDL-C (-2.01 mg/dl [-2.63,-1.40]), HDL-C (1.65 mg/d [1.44,1.85]), HbA1c (-0.02% [-0.03,-0.01]), and fasting plasma glucose (-0.44 mg/dL [-0.74,-0.15]); lower prevalence of metabolic syndrome (OR = 0.85 [0.82,0.88]), CVD (0.92 [0.88,0.96]), cancer (0.95 [0.91,0.99]), and lung disease (0.92 [0.88,0.96]); and higher prevalence of optimal cardiometabolic health (1.24 [1.16,1.32]). i.FCS also associated with lower all-cause mortality (HR = 0.93 [0.89,0.96]). Findings were similar by age, sex, race/ethnicity, education, income, and BMI. These findings support validity of Food Compass as a tool to guide public health and private sector strategies to identify and encourage healthier eating.
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Affiliation(s)
- Meghan O'Hearn
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
| | | | - Suzannah Gerber
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Brianna N Lauren
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Christina Economos
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - John B Wong
- Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
- Tufts Medical Center, Institute for Clinical Research and Health Policy Studies, Boston, MA, USA
| | - Jeffrey B Blumberg
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
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Detopoulou P, Panoutsopoulos GI, Kalonarchi G, Papamikos V. Is food compass score useful for menu planning in the hospital setting? Nutr Health 2022:2601060221138369. [PMID: 36352736 DOI: 10.1177/02601060221138369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Background: The novel food compass score (FCS) may ease food choices and policy actions. Aim: To assess the correlations of FCS with key nutrients in hospital meals. Methods: A 14-day hospital menu was recorded and analyzed with the USDA database and published FCS values. Results: The menu FCS was 40.6 ± 3.7 (mean ± standard deviation). Fish, vegetable, chicken, and egg-based meals had the highest FCS, while pork/beef meals had the lowest FCS. The FCS was positively related to vitamins (vitamin C, thiamine, B6, folate, pantothenic acid, vitamin E, vitamin D, vitamin A, carotenoids), choline and minerals (calcium, magnesium, phosphorus, potassium, sodium, copper, and manganese) and negatively associated with zinc, niacin, and animal protein. Moreover, the FCS was positively related to portions of cheese, fish, vegetables, and eggs and negatively to portions of poultry, refined grains, and margarine. Conclusion: The FCS may help in designing healthier nutrient-dense hospital menus.
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Affiliation(s)
- Paraskevi Detopoulou
- Department of Nutrition, 168201General Hospital Korgialenio-Benakio (Red Cross Hospital), Athens, Greece
- Department of Nutrition and Dietetics, 69211University of Peloponnese, Kalamata, Greece
| | | | - Garifallia Kalonarchi
- Department of Nutrition, 168201General Hospital Korgialenio-Benakio (Red Cross Hospital), Athens, Greece
| | - Vassilios Papamikos
- Department of Nutrition, 168201General Hospital Korgialenio-Benakio (Red Cross Hospital), Athens, Greece
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Lappi J, Silventoinen-Veijalainen P, Vanhatalo S, Rosa-Sibakov N, Sozer N. The nutritional quality of animal-alternative processed foods based on plant or microbial proteins and the role of the food matrix. Trends Food Sci Technol 2022. [DOI: 10.1016/j.tifs.2022.09.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Lisa Clodoveo M, Tarsitano E, Crupi P, Pasculli L, Piscitelli P, Miani A, Corbo F. Towards a new food labelling system for sustainable food production and healthy responsible consumption: The Med Index Checklist. J Funct Foods 2022. [DOI: 10.1016/j.jff.2022.105277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Nature of the evidence base and strengths, challenges and recommendations in the area of nutrition and health claims: a position paper from the Academy of Nutrition Sciences. Br J Nutr 2022:1-18. [DOI: 10.1017/s0007114522003300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
The regulation of health claims for foods by the Nutrition and Health Claims Regulation is intended, primarily, to protect consumers from unscrupulous claims by ensuring claims are accurate and substantiated with high quality scientific evidence. In this position paper, the Academy of Nutrition Sciences uniquely recognises the strengths of the transparent, rigorous scientific assessment by independent scientists of the evidence underpinning claims in Europe, an approach now independently adopted in UK. Further strengths are the separation of risk assessment from risk management, and the extensive guidance for those submitting claims. Nevertheless, four main challenges in assessing the scientific evidence and context remain: (i) defining a healthy population, (ii) undertaking efficacy trials for foods, (iii) developing clearly defined biomarkers for some trial outcomes and (iv) ensuring the composition of a food bearing a health claim is consistent with generally accepted nutrition principles. Although the Regulation aims to protect the consumer from harm, we identify some challenges from consumer research: (i) making the wording of some health claims more easily understood and (ii) understanding the implications of the misperceptions around products bearing nutrition or health claims. Recommendations are made to overcome these challenges. Further, the Academy recommends that a dialogue is developed with the relevant national bodies about Article 12(c) in the Regulation. This should further clarify the GB Guidance to avoid the current non-level playing field between health professionals and untrained ‘influencers’ who are not covered by this Article about the communication of authorised claims within commercial communications.
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Ultra-processed Foods and Cardiometabolic Health Outcomes: from Evidence to Practice. Curr Atheroscler Rep 2022; 24:849-860. [PMID: 36070170 DOI: 10.1007/s11883-022-01061-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW Poor diet quality is the leading risk factor related to the overall cardiometabolic disease burden in the USA and globally. We review the current evidence linking ultra-processed foods and cardiometabolic health risk and provide recommendations for action at the clinical and public health levels. RECENT FINDINGS A growing body of evidence conducted in a variety of study populations supports an association between ultra-processed food intake and increased risk of metabolic syndrome, hypertension, type 2 diabetes, overweight and obesity trajectories, and cardiovascular disease. The strongest evidence is observed in relation to weight gain and obesity among adults, as this association is supported by high-quality epidemiological and experimental evidence. Accumulating epidemiologic evidence and putative biological mechanisms link ultra-processed foods to cardiometabolic health outcomes. The high intake of ultra-processed foods in all population groups and its associated risks make ultra-processed foods an ideal target for intensive health promotion messaging and interventions.
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Clark M, Springmann M, Rayner M, Scarborough P, Hill J, Tilman D, Macdiarmid JI, Fanzo J, Bandy L, Harrington RA. Estimating the environmental impacts of 57,000 food products. Proc Natl Acad Sci U S A 2022; 119:e2120584119. [PMID: 35939701 PMCID: PMC9388151 DOI: 10.1073/pnas.2120584119] [Citation(s) in RCA: 62] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 06/21/2022] [Indexed: 11/18/2022] Open
Abstract
Understanding and communicating the environmental impacts of food products is key to enabling transitions to environmentally sustainable food systems [El Bilali and Allahyari, Inf. Process. Agric. 5, 456-464 (2018)]. While previous analyses compared the impacts of food commodities such as fruits, wheat, and beef [Poore and Nemecek, Science 360, 987-992 (2018)], most food products contain numerous ingredients. However, because the amount of each ingredient in a product is often known only by the manufacturer, it has been difficult to assess their environmental impacts. Here, we develop an approach to overcome this limitation. It uses prior knowledge from ingredient lists to infer the composition of each ingredient, and then pairs this with environmental databases [Poore and Nemecek Science 360, 987-992 (2018); Gephart et al., Nature 597, 360-365 (2021)] to derive estimates of a food product's environmental impact across four indicators: greenhouse gas emissions, land use, water stress, and eutrophication potential. Using the approach on 57,000 products in the United Kingdom and Ireland shows food types have low (e.g., sugary beverages, fruits, breads), to intermediate (e.g., many desserts, pastries), to high environmental impacts (e.g., meat, fish, cheese). Incorporating NutriScore reveals more nutritious products are often more environmentally sustainable but there are exceptions to this trend, and foods consumers may view as substitutable can have markedly different impacts. Sensitivity analyses indicate the approach is robust to uncertainty in ingredient composition and in most cases sourcing. This approach provides a step toward enabling consumers, retailers, and policy makers to make informed decisions on the environmental impacts of food products.
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Affiliation(s)
- Michael Clark
- Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LFUK
- Oxford Martin School, University of Oxford, Oxford, OX1 3BDUK
- Interdisciplinary Centre of Conservation Science, Department of Zoology, University of Oxford, Oxford, OX1 3SZUK
- Smith School of Enterprise and Environment, University of Oxford, Oxford, OX1 3QYUK
| | - Marco Springmann
- Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LFUK
- Oxford Martin School, University of Oxford, Oxford, OX1 3BDUK
| | - Mike Rayner
- Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LFUK
| | - Peter Scarborough
- Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LFUK
- NIHR Biomedical Research Centre at Oxford, University of Oxford, Oxford, OX3 7LFUK
| | - Jason Hill
- Department of Bioproducts and Bioengineering, University of Minnesota, St Paul, MN 55108
| | - David Tilman
- Department of Ecology, Evolution, and Behavior, University of Minnesota, St Paul, MN 55108
- Bren School of Environmental Science & Management, University of California, Santa Barbara, Santa Barbara, CA 93117
| | | | - Jessica Fanzo
- Nitze School of Advanced International Studies, Johns Hopkins University, Washington, D.C. 20036
- Global Food Ethics and Policy Program, Johns Hopkins University, Baltimore, MD 21205
| | - Lauren Bandy
- Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LFUK
- Nuffield Department of Primary Care, University of Oxford, Oxford, OX2 6GGUK
| | - Richard A. Harrington
- Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LFUK
- NIHR Biomedical Research Centre at Oxford, University of Oxford, Oxford, OX3 7LFUK
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Drewnowski A. Matters Arising: Food Compass novelty and NOVA category assignments. NATURE FOOD 2022; 3:581-583. [PMID: 37118608 DOI: 10.1038/s43016-022-00556-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 06/20/2022] [Indexed: 04/30/2023]
Affiliation(s)
- Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, WA, USA.
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Dickie S, Woods J, Machado P, Lawrence M. Nutrition Classification Schemes for Informing Nutrition Policy in Australia: Nutrient-Based, Food-Based, or Dietary-Based? Curr Dev Nutr 2022; 6:nzac112. [PMID: 36060220 PMCID: PMC9429971 DOI: 10.1093/cdn/nzac112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 05/27/2022] [Accepted: 06/22/2022] [Indexed: 11/23/2022] Open
Abstract
Background Policy makers are increasingly using nutrition classification schemes (NCSs) to assess a food's health potential for informing nutrition policy actions. However, there is wide variability among the NCSs implemented and no standard benchmark against which their contrasting assessments can be validated. Objectives This study aimed to compare the agreement of nutrient-, food-, and dietary-based NCSs in their assessment of a food's health potential within the Australian food supply, and examine the conceptual underpinnings and technical characteristics that explain differences in performance. Methods A dataset combining food compositional data from the Mintel Global New Products Database and the Australian Food Composition Database (AUSNUT 2011-2012) (n = 7322) was assembled. Products were classified by 7 prominent NCSs that were selected as representative of one or other of 1) nutrient-based NCSs [the Chilean nutrient profile model (NPM), Health Star Rating (HSR), Nutri-Score, the WHO European Region's NPM (WHO-Euro NPM), and the Pan American Health Organization's (PAHO) NPM]; 2) food-based NCS (NOVA), and 3) dietary-based NCS [Australian Dietary Guidelines (ADGs)]. Results The PAHO NPM classified the lowest proportion (22%) of products as "healthy", and the HSR the highest (63%). The PAHO NPM, NOVA, WHO-Euro NPM, and the Chilean NPM classified >50% of products as "unhealthy," and the ADGs, HSR, and Nutri-Score classified <50% of products as "unhealthy." The HSR and Nutri-Score had the highest pairwise agreement (κ = 0.7809, 89.70%), and the PAHO NPM and HSR the lowest (κ = 0.1793, 53.22%). Characteristics of NCSs that more effectively identified ultraprocessed and discretionary foods were: category-specific assessment, the classification of categories as always "healthy" or "unhealthy," consideration of level of food processing, thresholds for "risk" nutrients that do not penalize whole foods; and no allowance for the substitution of ingredients. Conclusions Wide variation was observed in agreement of the assessment of a food's health potential among the NCSs analyzed due to differing conceptual underpinnings and technical characteristics.
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Affiliation(s)
- Sarah Dickie
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Julie Woods
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Priscila Machado
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Mark Lawrence
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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O'Hearn M, Gerber S, Cruz SM, Mozaffarian D. The time is ripe for ESG + Nutrition: evidence-based nutrition metrics for Environmental, Social, and Governance (ESG) investing. Eur J Clin Nutr 2022; 76:1047-1052. [PMID: 35075230 PMCID: PMC9352572 DOI: 10.1038/s41430-022-01075-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 01/04/2022] [Accepted: 01/10/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Meghan O'Hearn
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
| | - Suzannah Gerber
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Sylara Marie Cruz
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
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Detopoulou P, Syka D, Koumi K, Dedes V, Tzirogiannis K, Panoutsopoulos GI. Clinical Application of the Food Compass Score: Positive Association to Mediterranean Diet Score, Health Star Rating System and an Early Eating Pattern in University Students. Diseases 2022; 10:43. [PMID: 35892737 PMCID: PMC9326537 DOI: 10.3390/diseases10030043] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/27/2022] [Accepted: 07/05/2022] [Indexed: 12/27/2022] Open
Abstract
Nutrient profiling systems (NPS) assist consumers in food choices. Several scores based on NPS have been proposed, but data on their clinical application are lacking. The food compass score (FCS) is a newly developed NPS per 100 kcal (from 1 “least healthy” to 100 “most healthy”). We examined the correlations of FCS with other indices, food groups, and meal patterns. A total of 346 students of the University of the Peloponnese (269 women and 77 men) participated. Dietary habits were evaluated with a food frequency questionnaire, and FCS, health star rating score (HSR), and MedDietScore were computed. Meal and snack frequency consumption was reported. Principal component analysis revealed three meal patterns: “early eater” (breakfast, morning snack and afternoon snack), “medium eater” (lunch and dinner), and “late eater” (bedtime snack). Pearson partial correlations between ranked variables were used to test the correlation coefficients between FCS, other scores, and meal patterns, after adjustment for age, sex, BMI, and underreporting. FCS was positively correlated to HSR (rho = 0.761, p ≤ 0.001) in a multi-adjusted analysis. In the highest tertile of MedDietScore FCS was also positively correlated to MedDietScore (rho = 0.379, p < 0.001). The FCS was positively correlated with juices, high-fat dairy, vegetables, legumes, fruits, and olive oil and negatively correlated with sodas, alcoholic drinks, red meat, refined grains, sweets, fats other than olive oil, fast foods, and coffee. In addition, it related positively to the “early eater” pattern (rho = 0.207, p < 0.001). The FCS was associated with other quality indices and better nutritional habits, such as being an early eater.
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Affiliation(s)
- Paraskevi Detopoulou
- Department of Nutritional Science and Dietetics, Faculty of Health Sciences, University of Peloponnese, New Building, Antikalamos, 24100 Kalamata, Greece; (P.D.); (D.S.); (V.D.)
- Department of Clinical Nutrition, General Hospital Korgialenio Benakio, Athanassaki 2, 11526 Athens, Greece;
| | - Dimitra Syka
- Department of Nutritional Science and Dietetics, Faculty of Health Sciences, University of Peloponnese, New Building, Antikalamos, 24100 Kalamata, Greece; (P.D.); (D.S.); (V.D.)
| | - Konstantina Koumi
- Department of Clinical Nutrition, General Hospital Korgialenio Benakio, Athanassaki 2, 11526 Athens, Greece;
| | - Vasileios Dedes
- Department of Nutritional Science and Dietetics, Faculty of Health Sciences, University of Peloponnese, New Building, Antikalamos, 24100 Kalamata, Greece; (P.D.); (D.S.); (V.D.)
| | | | - Georgios I. Panoutsopoulos
- Department of Nutritional Science and Dietetics, Faculty of Health Sciences, University of Peloponnese, New Building, Antikalamos, 24100 Kalamata, Greece; (P.D.); (D.S.); (V.D.)
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Forde CG, Bolhuis D. Interrelations Between Food Form, Texture, and Matrix Influence Energy Intake and Metabolic Responses. Curr Nutr Rep 2022; 11:124-132. [PMID: 35325399 PMCID: PMC9174310 DOI: 10.1007/s13668-022-00413-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2022] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW Nutrition often focuses on food composition, yet differences in food form, texture, and matrix influence energy intake and metabolism. This review outlines how these attributes of food impact oral processing, energy intake, and metabolism. RECENT FINDINGS Food form has a well-established impact on intake, where liquids are consumed more than solids and semi-solids. For solids, texture properties like thickness, hardness, and lubrication, and geometrical properties like size and shape influence oral processing, eating rate, and intake. Food matrix integrity can influence nutrient and energy absorption and is strongly influenced by food processing. Food texture and matrix play important roles in modulating energy intake and absorption. Future research needs to consider the often overlooked role of texture and matrix effects on energy and metabolic responses to composite foods and meals. Research is needed to understand how processing impacts macro- and micro-structure of food and its long-term impact on energy balance and health.
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Affiliation(s)
- Ciarán G Forde
- Sensory Science and Eating Behaviour, Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands.
| | - Dieuwerke Bolhuis
- Food Quality and Design, Division of Food Technology, Wageningen University and Research, Wageningen, the Netherlands
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Drewnowski A, Gonzalez TD, Rehm CD. Balanced Hybrid Nutrient Density Score Compared to Nutri-Score and Health Star Rating Using Receiver Operating Characteristic Curve Analyses. Front Nutr 2022; 9:867096. [PMID: 35586737 PMCID: PMC9108770 DOI: 10.3389/fnut.2022.867096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background Nutrient profiling (NP) models that are used to assess the nutrient density of foods can be based on a combination of key nutrients and desirable food groups. Objective To compare the diagnostic accuracy of a new balanced hybrid nutrient density score (bHNDS) to Nutri-Score and Health Star Rating (HSR) front-of-pack systems using receiver operating characteristic (ROC) curve analyses. The diet-level bHNDS was first validated against Healthy Eating Index (HEI-2015) using data from the 2017-18 National Health and Nutrition Examination Survey (2017-18 NHANES). Food-level bHNDS values were then compared to both the Nutri-Score and HSR using ROC curve analyses. Results The bHNDS was based on 6 nutrients to encourage (protein, fiber, calcium, iron, potassium, and vitamin D); 5 food groups to encourage (whole grains, nuts and seeds, dairy, vegetables, and fruit), and 3 nutrients (saturated fat, added sugar, and sodium) to limit. The algorithm balanced components to encourage against those to limit. Diet-level bHNDS values correlated well with HEI-2015 (r = 0.67; p < 0.001). Food-level correlations with both Nutri-Score (r = 0.60) and with HSR (r = 0.58) were significant (both p < 0.001). ROC estimates of the Area Under the Curve (AUC) showed high agreement between bHNDS values and optimal Nutri-Score and HSR ratings (>0.90 in most cases). ROC analysis identified those bHNDS cut-off points that were predictive of A-grade Nutri-Score or 5-star HSR. Those cut-off points were highly category-specific. Conclusion The new bHNDS model showed high agreement with two front-of-pack labeling systems. Cross-model comparisons based on ROC curve analyses are the first step toward harmonization of proliferating NP methods that aim to "diagnose" high nutrient-density foods.
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Affiliation(s)
- Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, WA, United States
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Drewnowski A, Maillot M, Papanikolaou Y, Jones JM, Rodriguez J, Slavin J, Angadi SS, Comerford KB. A New Carbohydrate Food Quality Scoring System to Reflect Dietary Guidelines: An Expert Panel Report. Nutrients 2022; 14:1485. [PMID: 35406096 PMCID: PMC9003092 DOI: 10.3390/nu14071485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 12/11/2022] Open
Abstract
Existing metrics of carbohydrate food quality have been based, for the most part, on favorable fiber- and free sugar-to-carbohydrate ratios. In these metrics, higher nutritional quality carbohydrate foods are defined as those with >10% fiber and <10% free sugar per 100 g carbohydrate. Although fiber- and sugar-based metrics may help to differentiate the nutritional quality of various types of grain products, they may not aptly capture the nutritional quality of other healthy carbohydrate foods, including beans, legumes, vegetables, and fruits. Carbohydrate food quality metrics need to be applicable across these diverse food groups. This report introduces a new carbohydrate food scoring system known as a Carbohydrate Food Quality Score (CFQS), which supplements the fiber and free sugar components of previous metrics with additional dietary components of public health concern (e.g., sodium, potassium, and whole grains) as identified by the Dietary Guidelines for Americans. Two CFQS models are developed and tested in this study: one that includes four dietary components (CFQS-4: fiber, free sugars, sodium, potassium) and one that considers five dietary components (CFQS-5: fiber, free sugars, sodium, potassium, and whole grains). These models are applied to 2596 carbohydrate foods in the Food and Nutrient Database for Dietary Studies (FNDDS) 2017−2018. Consistent with past studies, the new carbohydrate food scoring system places large percentages of beans, vegetables, and fruits among the top scoring carbohydrate foods. The whole grain component, which only applies to grain foods (N = 1561), identifies ready-to-eat cereals, oatmeal, other cooked cereals, and selected whole grain breads and crackers as higher-quality carbohydrate foods. The new carbohydrate food scoring system shows a high correlation with the Nutrient Rich Food (NRF9.3) index and the Nutri-Score. Metrics of carbohydrate food quality that incorporate whole grains, potassium, and sodium, in addition to sugar and fiber, are strategically aligned with multiple 2020−2025 dietary recommendations and may therefore help with the implementation of present and future dietary guidelines.
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Affiliation(s)
- Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, WA 98195, USA;
| | - Matthieu Maillot
- MS-Nutrition, Faculté de Médecine La Timone, CEDEX 5, 13385 Marseille, France;
| | - Yanni Papanikolaou
- Nutritional Strategies Inc., Nutrition Research & Regulatory Affairs, Paris, ON N3L 0A3, Canada;
| | - Julie Miller Jones
- Emerita, Department of Nutrition and Exercise Science, St. Catherine University, St. Paul, MN 55105, USA;
| | - Judith Rodriguez
- Department of Nutrition & Dietetics, Brooks College of Health, University of North Florida, Jacksonville, FL 32224, USA;
| | - Joanne Slavin
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, MN 55108, USA;
| | - Siddhartha S. Angadi
- School of Education and Human Development, University of Virginia, Charlottesville, VA 22904, USA;
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Moran AJ, Headrick G, Perez C, Greatsinger A, Taillie LS, Zatz L, Bleich SN, Rimm EB, Khandpur N. Food marketing practices of major online grocery retailers in the United States, 2019-2020. J Acad Nutr Diet 2022; 122:2295-2310.e2. [DOI: 10.1016/j.jand.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 03/02/2022] [Accepted: 04/07/2022] [Indexed: 11/30/2022]
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Gibney MJ, Forde CG. Nutrition research challenges for processed food and health. NATURE FOOD 2022; 3:104-109. [PMID: 37117956 DOI: 10.1038/s43016-021-00457-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 12/22/2021] [Indexed: 04/30/2023]
Abstract
Existing highly processed food (HPF) classification systems show large differences in the impact of these foods on biochemical risk factors for disease. If public health nutrition is to consider the degree of food processing as an important element of the link between food and health, certain gaps in research must be acknowledged. Quantifying the food additive exposure derived from HPFs is a task made challenging by the lack of data available on the occurrence and concentration of additives in food and the degree to which the natural occurrence of additives in unprocessed foods confounds exposure estimates. The proposed role of HPFs in health outcomes could also be associated with altered nutrient profiles. Differences exist within and between HPF classification systems in this regard and there are conflicting data on the impact of controlling for nutrient intake. Furthermore, research is needed on how the sensory aspects of HPFs contribute to energy intake. Current data suggest that high energy intake rate may be the mechanism linking HPFs and increased energy intake. A high priority now is to clarify the basis of definitions used to categorize foods as highly processed and, in a constructive sense, to distinguish between the contributions of nutrients, additives and sensory properties to health.
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Affiliation(s)
- Michael J Gibney
- Institute of Food and Health, University College Dublin, Dublin, Ireland.
| | - Ciarán G Forde
- Sensory Science and Eating Behaviour, Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
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Bioactive compounds from plants. Development of new or novel food. NUTR HOSP 2022; 39:8-11. [DOI: 10.20960/nh.04302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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