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Westenbrink S, Tenhagen CJ, Toxopeus I, Verkaik-Kloosterman J, Feskens EJM, Ocké M. Procedure to identify fortified foods in the Dutch branded food database. Front Nutr 2024; 11:1366083. [PMID: 38660063 PMCID: PMC11040091 DOI: 10.3389/fnut.2024.1366083] [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: 01/05/2024] [Accepted: 03/18/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction Information on fortified foods is needed for multiple purposes, including food consumption research and dietary advice. Branded food databases are a valuable source of food label data. European labeling legislation prescribes that food fortification should be indicated in the ingredient list, and nutrient values should be declared under certain conditions. This creates the potential to identify fortified foods in branded food databases, though it is not straightforward and labor-intensive. The aim of our study was to develop an automated approach to identify fortified foods in the Dutch branded food database called LEDA. Methods An automated procedure, based on a stepwise approach conforming with European labeling legislation, using a list of rules and search terms, was developed to identify fortified foods. Fortification with calcium, folic acid, vitamin B12, and zinc was studied as an example. The results of a random stratified sample with fortified and not-fortified foods were validated by two experts. Results The automated approach resulted in identifying 1,817 foods fortified with one or more of the selected nutrients in the LEDA dataset (0.94%). The proportions of fortified foods per nutrient were below 0.7%. The classification of fortified/non-fortified foods matched manual validation by experts for the majority of the foods in the sample, i.e., sensitivity and specificity indicating the probability of correctly identifying fortified and non-fortified foods was high (>94.0%). Conclusion The automated approach is capable of easily and quickly identifying fortified foods in the Dutch branded food database with high accuracy, although some improvements to the automated procedure could be made. In addition, the completeness, correctness, and consistency of the LEDA database can be improved. To fully benefit from this automated approach, it needs to be expanded to cover all micronutrients that may be added to foods.
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Affiliation(s)
- Susanne Westenbrink
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Cyrelle J. Tenhagen
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Ido Toxopeus
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | | | - Edith J. M. Feskens
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Marga Ocké
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
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Yusta-Boyo MJ, González EG, García-Solano M, Rollán Gordo A, Peña-Rey I, Rodríguez-Artalejo F. Reduction of sugar, salt and fat content in foods over the period 2016-2021 in Spain: the National Food Reformulation Plan. Eur J Clin Nutr 2024; 78:149-154. [PMID: 37875613 DOI: 10.1038/s41430-023-01357-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/02/2023] [Accepted: 10/05/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND/OBJECTIVES Population´s dietary intake of saturated fat, sodium, and sugars is higher than the current recommendations in Spain and most European countries. Nationwide food reformulation strategies have the potential to improve nutritional quality; however, evaluations are only available in a few countries and are difficult to compare. This study shows the degree of compliance with the nutrient reduction objectives included in a 4-year (2016-2020) Spanish food reformulation initiative. METHODS In 2016, baseline median nutrient content was established for 57 food subcategories. Agreed reduction (%) expressed as the median content to be reached by 2020 was set as the objective. In 2021, Spanish Food Safety and Nutrition Agency (AESAN) collected mandatory nutritional information from 3118 products belonging to the food subcategories included in the PLAN. Median nutrient content was calculated and compared with baseline data established in 2016 and PLAN objectives. RESULTS Median nutrient content reduction was observed in all food subcategories. Relative reductions (%) ranged from 0.6 to 60% for added sugars, 4.8 to 33.3% for salt, 4.5 to 78.3% for saturated fat, and 24.9 to 36% for total fat. PLAN objectives were achieved in all subcategories except for one. The number of products involved, belonging to the highly consumed food categories, shows the potential of national reformulation strategies to improve the nutritional quality of the diet. CONCLUSION Compliance with nutrient reduction agreements was 99%; however, the variability of nutrient content within subcategories shows that there is room for further reduction in selected nutrients and food subcategories.
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Affiliation(s)
- María José Yusta-Boyo
- Spanish Food Safety and Nutrition Agency, Ministry of Consumer's Affairs, Madrid, Spain.
| | | | - Marta García-Solano
- Spanish Food Safety and Nutrition Agency, Ministry of Consumer's Affairs, Madrid, Spain
| | - Almudena Rollán Gordo
- Spanish Food Safety and Nutrition Agency, Ministry of Consumer's Affairs, Madrid, Spain
| | - Isabel Peña-Rey
- Spanish Food Safety and Nutrition Agency, Ministry of Consumer's Affairs, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain
- CIBERESP, Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
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Radoš Krnel S, Pravst I, Hribar M, Blažica B, Kušar A. How effective are health messages/warnings in improving knowledge and awareness of alcohol-related harm? The Slovenian case on using a mobile app. BMC Public Health 2023; 23:2467. [PMID: 38082375 PMCID: PMC10712114 DOI: 10.1186/s12889-023-17353-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Consumers generally lack access to information on alcoholic beverages, in spite of it being readily available for food and non-alcoholic beverages. Given the rights of consumers, and as with other products harmful to the population, there have been increasing calls for health warnings to be placed on alcoholic beverages, similar to those implemented on tobacco products. The aim of our research was to assess whether knowledge and awareness of the risks and harms associated with alcohol can be improved with a mobile app. METHODS Intervention was conducted using VKJ mobile app, which enables users to scan the barcode of an alcoholic beverage and receive feedback on its labelled alcohol content and estimated energy value. At each search, eleven different health messages/warnings about the risks and harms of alcohol are also displayed randomly, rotating on the screen. A survey was conducted before and after the intervention, to assess the knowledge and awareness of the risks and harms associated with drinking alcohol. RESULTS Significant differences were found for eight of the twelve tested statements. The improvement was seen to a greater extent in the group of high-risk drinkers. The results also showed that the vast majority of participants (78%) who were exposed to the health messages supported mandatory labelling of alcoholic beverages with information on ingredient listing and energy value, and 72% would like to have health warnings on alcohol products. CONCLUSIONS The use of a mobile app can be an option to improve knowledge and raise awareness of the risks and harms related to alcohol.
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Affiliation(s)
- Sandra Radoš Krnel
- Analysis and Development Centre, National Institute of Public Health, Trubarjeva Cesta 2, Ljubljana, Slovenia.
| | - Igor Pravst
- Nutrition and Public Health Research Group, Nutrition Institute, Koprska Ulica 98, Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, Ljubljana, Slovenia
- VIST - Faculty of Applied Sciences, Gerbičeva Ulica 53, Ljubljana, Slovenia
| | - Maša Hribar
- Nutrition and Public Health Research Group, Nutrition Institute, Koprska Ulica 98, Ljubljana, Slovenia
| | - Bojan Blažica
- Computer Systems Department, Jožef Stefan Institute, Jamova Cesta 39, Ljubljana, Slovenia
| | - Anita Kušar
- Nutrition and Public Health Research Group, Nutrition Institute, Koprska Ulica 98, Ljubljana, Slovenia
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Krušič S, Hristov H, Hribar M, Lavriša Ž, Žmitek K, Pravst I. Changes in the Sodium Content in Branded Foods in the Slovenian Food Supply (2011-2020). Nutrients 2023; 15:4304. [PMID: 37836588 PMCID: PMC10574098 DOI: 10.3390/nu15194304] [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: 08/04/2023] [Revised: 09/27/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023] Open
Abstract
High sodium intake is the leading diet-related risk factor for mortality globally. Many countries have introduced policies to support the reformulation of foods and to reduce sodium intake, mainly on a voluntary basis, but there are limited data available about the long-term efficiency of such measures. Slovenia implemented salt reduction policies for the period of 2010-2020; these policies also included the voluntary reformulation of foods with the lowering of sodium content. This study's aim was to explore the nationally representative branded food datasets collected in the years 2011, 2015, 2017, and 2020 to investigate the changes in the sodium content in prepacked branded foods. The study was conducted with datasets collected from food labels using standard food monitoring studies and included all the major retailers. Differences in market shares were adjusted by sales weighting, which was conducted using the yearly sales data provided by the major retailers. The food categories with a major contribution to the overall sales of sodium in prepacked branded foods were processed meat and derivatives (19.0%), canned vegetables (7.1%), water (6.7%), bread (7.2%), and cheese (6.3%). Considering the available food products, a notable decreasing sodium content trend was observed in biscuits, breakfast cereals, pizza, and spreads. Year-to-year differences were much less expressed after the correction for market share differences, and neutral trends were most frequently highlighted. This indicates that sodium was less frequently reduced in market-leading products. The study results revealed that very limited progress in sodium food reformulation was achieved in the 10-year period, indicating the need for more efficient policy approaches. The study demonstrated the importance of the systematic monitoring of the food supply for the evaluation of food policies.
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Affiliation(s)
- Sanja Krušič
- Nutrition Institute, Koprska Ulica 98, SI-1000 Ljubljana, Slovenia; (S.K.); (H.H.); (M.H.); (Ž.L.); (K.Ž.)
| | - Hristo Hristov
- Nutrition Institute, Koprska Ulica 98, SI-1000 Ljubljana, Slovenia; (S.K.); (H.H.); (M.H.); (Ž.L.); (K.Ž.)
| | - Maša Hribar
- Nutrition Institute, Koprska Ulica 98, SI-1000 Ljubljana, Slovenia; (S.K.); (H.H.); (M.H.); (Ž.L.); (K.Ž.)
| | - Živa Lavriša
- Nutrition Institute, Koprska Ulica 98, SI-1000 Ljubljana, Slovenia; (S.K.); (H.H.); (M.H.); (Ž.L.); (K.Ž.)
| | - Katja Žmitek
- Nutrition Institute, Koprska Ulica 98, SI-1000 Ljubljana, Slovenia; (S.K.); (H.H.); (M.H.); (Ž.L.); (K.Ž.)
- VIST–Faculty of Applied Sciences, Gerbičeva Cesta 51A, SI-1000 Ljubljana, Slovenia
| | - Igor Pravst
- Nutrition Institute, Koprska Ulica 98, SI-1000 Ljubljana, Slovenia; (S.K.); (H.H.); (M.H.); (Ž.L.); (K.Ž.)
- VIST–Faculty of Applied Sciences, Gerbičeva Cesta 51A, SI-1000 Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, SI-1000 Ljubljana, Slovenia
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Aldhirgham T, Alammari N, Aljameel GM, Alzuwaydi A, Almasoud SA, Alawwad SA, Alabbas NH, Alqahtani AS. The Saudi branded food database: First-phase development (Branded Beverage Database). J Food Compost Anal 2023. [DOI: 10.1016/j.jfca.2023.105299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
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Pravst I, Lavriša Ž, Hristov H, Hribar M, Krušič S, Žmitek K, Kušar A, Zdešar Kotnik K, Golja P, Čibej Andlovec A, Pograjc L. Assessment of the Use of Food Supplements by Military Personnel: Study Protocol and Results. Nutrients 2023; 15:nu15081902. [PMID: 37111120 PMCID: PMC10145590 DOI: 10.3390/nu15081902] [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: 03/20/2023] [Revised: 04/04/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
Due to their specific mode of operation, military personnel are challenged physically as well as mentally. In most countries, the use of food supplements by military personnel is not regulated, and a high prevalence of supplementation is expected. However, data on this are scarce or very limited, without insights into the importance of supplementation for the intake of bioactive substances. Our goal was, therefore, to develop a study protocol to enable an assessment of the prevalence of using food supplements and an estimate of the contribution of supplementation practices to the dietary intake of specific nutrients and other compounds. The protocol was tested in a study of Slovene Armed Forces (SAF) personnel. Data were collected using an anonymous questionnaire in a sample of 470 participants from different military units-about half from the barracks located across the country, and the other half returning from military operations abroad. To provide meaningful results, we recorded the use of food supplements and functional foods available in single-sized portions (i.e., energy drinks, protein bars, etc.). Altogether, 68% of the participants reported supplementation, most commonly with vitamin, mineral, and protein supplements. Military rank, participation status in military operations, and physical activity were the main determinants of the specific supplements used. Surprisingly, a lower prevalence of overall and protein supplementation was observed in subjects returning from military operations abroad (62 vs. 74%) than in personnel stationed in barracks across Slovenia; however, the frequency of the use of energy drinks and caffeine supplements was higher in this population (25 vs. 11%). The study design allowed for estimations of the daily intake of supplemented bioactive compounds. We describe the challenges and approaches used in the study to support similar studies in the future and within other populations.
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Affiliation(s)
- Igor Pravst
- Nutrition Institute, Koprska ulica 98, SI-1000 Ljubljana, Slovenia
- VIST-Faculty of Applied Sciences, Gerbičeva Cesta 51A, SI-1000 Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, SI-1000 Ljubljana, Slovenia
| | - Živa Lavriša
- Nutrition Institute, Koprska ulica 98, SI-1000 Ljubljana, Slovenia
| | - Hristo Hristov
- Nutrition Institute, Koprska ulica 98, SI-1000 Ljubljana, Slovenia
| | - Maša Hribar
- Nutrition Institute, Koprska ulica 98, SI-1000 Ljubljana, Slovenia
| | - Sanja Krušič
- Nutrition Institute, Koprska ulica 98, SI-1000 Ljubljana, Slovenia
| | - Katja Žmitek
- Nutrition Institute, Koprska ulica 98, SI-1000 Ljubljana, Slovenia
- VIST-Faculty of Applied Sciences, Gerbičeva Cesta 51A, SI-1000 Ljubljana, Slovenia
| | - Anita Kušar
- Nutrition Institute, Koprska ulica 98, SI-1000 Ljubljana, Slovenia
| | - Katja Zdešar Kotnik
- Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, SI-1000 Ljubljana, Slovenia
| | - Petra Golja
- Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, SI-1000 Ljubljana, Slovenia
| | - Anja Čibej Andlovec
- Ministry of Defence of the Republic of Slovenia, Vojkova Cesta 55, SI-1000 Ljubljana, Slovenia
| | - Larisa Pograjc
- Ministry of Defence of the Republic of Slovenia, Vojkova Cesta 55, SI-1000 Ljubljana, Slovenia
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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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Nutritional Quality of Plant-Based Meat and Dairy Imitation Products and Comparison with Animal-Based Counterparts. Nutrients 2023; 15:nu15020401. [PMID: 36678272 PMCID: PMC9862700 DOI: 10.3390/nu15020401] [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: 12/27/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
While consumers are increasingly adopting plant-based meat and dairy imitation products, the nutritional quality and adequacy of those foods to act as a substitute is still under discussion. The Greek Branded Food Composition Database (HelTH) was expanded to map currently available meat and dairy imitations in Greece. Their main ingredient used, nutritional composition, and promotion as a healthy, nutritious food were described, and their overall nutritional quality using the Nutri-Score algorithm was evaluated. A total of n = 421 plant-based imitations were analyzed, made primarily of wheat or wheat mixes (83.5%) for meat imitations and grain (19.8%) or vegetable oil (17.1%) for dairy imitations. All meat imitations were high in protein and fiber, while, for dairy, only yogurts carried a protein content claim (80.9%). Imitation sausages, milk, and yogurt products had lower total fat and saturated fat content compared to their animal-based counterparts. All dairy imitations had lower protein content than animal-based dairy. The nutritional quality of imitation cheeses was graded as D-E, under the Nutri-Score system, compared to A-C for the animal-based cheese. Plant-based imitations have variable composition based on their main ingredient, and the substitution of specific food groups with plant-based alternatives may not support an equivalent or improved diet.
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Alignment of Nutri-Score with Mediterranean Diet Pyramid: A Food Level Analysis. Nutrients 2022; 14:nu14235097. [PMID: 36501126 PMCID: PMC9741127 DOI: 10.3390/nu14235097] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/23/2022] [Accepted: 11/28/2022] [Indexed: 12/04/2022] Open
Abstract
The Mediterranean diet (MD) has been incorporated as a healthy diet pattern in food-based dietary guidelines of countries all over Europe and the world. Testing the alignment of Nutri-Score with the MD Pyramid is a key step in ensuring that future food-level policies will not be conflicting with existing dietary guidelines. All foods available (n = 4002) in the HelTH database, were classified as eligible or not for inclusion in the MD and they were ranked in their respective tier in the food pyramid following two pyramid schemes, the 1995 traditional and 2020 sustainable MD pyramids. For all foods, Nutri-Score was calculated both as the continuous FSAm-NPS score and its categorical outcome-Nutri-Score grades-and their distribution across the MD pyramid tiers was used as a measure of alignment between the MD and the Nutri-Score algorithm. Only 25% of all foods were eligible under the traditional MD, while the sustainable MD covered ~58% of all foods. For both pyramids, Nutri-Score was successful in clearly separating the foods at the top and the bottom of the pyramids (Nutri-Score Mode "D" or "E" for the top tiers and "A" for the bottom tiers), thus suggesting a good alignment between the two. Good discriminatory capacity was also seen within each tier.
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Vlassopoulos A, Katidi A, Kapsokefalou M. Performance and discriminatory capacity of Nutri-Score in branded foods in Greece. Front Nutr 2022; 9:993238. [PMID: 36245544 PMCID: PMC9554652 DOI: 10.3389/fnut.2022.993238] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/14/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe harmonization of front-of-pack nutritional declaration is in the heart of food and nutrition policy discussions in Europe. The Nutri-Score system has been proposed by many countries as a potential candidate but its suitability for use across Europe is still under consideration. The current study aimed to evaluate the performance and discriminatory capacity of Nutri-Score in Greece and to test its alignment with the national food-based dietary guidelines.Materials and methodsData on the energy, saturated fat, total sugars, sodium, protein, and fiber content per 100°g or ml were extracted for all foods available (n = 4,002) in the Greek branded food composition database HelTH. Each food content in fruits, vegetables, pulses, nuts and oils was manually estimated from the ingredients list. The Nutri-Score algorithm was used both as a continuous (FSAm-NPS Score) and a categorical variable [Grades (A)–(E)].ResultsThe average FSAm-NPS Score in Greece was 8.52 ± 9.4. More than half of the solid foods (53.8%) were graded from (A) to (C), while most beverages (59.2%) were graded (E). More than 50% of food categories were populated with foods in all Nutri-Score grades, indicative of a good discriminatory capacity. The system scores favorably vegetables, pulses, and low-fat dairy products and unfavourablly sweets and processed meats showing in this way good alignment with the national guidelines. Eggs and seafood scored preferably compared to meat products. Animal fats received less favorable scores and so did cereal products that were highly processed.DiscussionNutri-Score showed good capacity to inform consumers toward better food choices in line with the national guidelines. It showed a potential to guide consumers and manufacturers toward less energy dense and more nutrient dense options and highlighted areas of improvement in the food supply.
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Li KJ, Burton-Pimentel KJ, Vergères G, Feskens EJM, Brouwer-Brolsma EM. Fermented foods and cardiometabolic health: Definitions, current evidence, and future perspectives. Front Nutr 2022; 9:976020. [PMID: 36204374 PMCID: PMC9530890 DOI: 10.3389/fnut.2022.976020] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/30/2022] [Indexed: 11/30/2022] Open
Abstract
Unhealthy diets contribute to the increasing burden of non-communicable diseases. Annually, over 11 million deaths worldwide are attributed to dietary risk factors, with the vast majority of deaths resulting from cardiometabolic diseases (CMDs) including cardiovascular disease (∼10 million) and type II diabetes (∼339,000). As such, defining diets and dietary patterns that mitigate CMD risk is of great public health importance. Recently, the consumption of fermented foods has emerged as an important dietary strategy for improving cardiometabolic health. Fermented foods have been present in the human diet for over 10,000 years, but knowledge on whether their consumption benefits human health, and the molecular and microbiological mechanisms underpinning their purported health benefits, is relatively nascent. This review provides an overview of the definitions of fermented foods, types and qualities of fermented foods consumed in Europe and globally, possible mechanisms between the consumption of fermented foods and cardiometabolic health, as well as the current state of the epidemiological evidence on fermented food intake and cardiometabolic health. Finally, we outline future perspectives and opportunities for improving the role of fermented foods in human diets.
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Affiliation(s)
- Katherine J. Li
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
- Agroscope, Bern, Switzerland
- *Correspondence: Katherine J. Li,
| | | | | | - Edith J. M. Feskens
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Elske M. Brouwer-Brolsma
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
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Hafner E, Lavriša Ž, Hribar M, Krušič S, Kušar A, Žmitek K, Skrt M, Poklar Ulrih N, Pravst I. Verifying the Use of Food Labeling Data for Compiling Branded Food Databases: A Case Study of Sugars in Beverages. Front Nutr 2022; 9:794468. [PMID: 35187031 PMCID: PMC8850951 DOI: 10.3389/fnut.2022.794468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/10/2022] [Indexed: 11/18/2022] Open
Abstract
Branded food composition databases are an important tool for research, education, healthcare, and policy making, amongst others. Such databases are typically compiled using food labeling data without chemical analyses of specific products. This study aimed to verify whether the labeled sugar content in sugar-sweetened beverages (SSBs) corresponds to the actual sugar content in these products, thus enabling food monitoring studies to be conducted. A secondary objective was to determine the specific types of sugars in these SSBs. A case study was conducted using market share-driven sampling of these beverages from the Slovenian food supply. On the basis of nationwide yearly sales data, 51 best-selling products were sampled in 2020 and analyzed using high-performance liquid chromatography. This sales-driven approach to sampling has been shown to be very useful for conducting food monitoring studies. With the careful selection of a small proportion of available products, we finished with a manageable sample size, reflecting the composition of a majority (69%) of the national market share volume. The analyzed total sugar content was compared with labeled data, within the context of the European Union's regulatory labeling tolerances. In all samples, the sugar content was within the tolerance levels. The most common (N = 41) deviation was within ±10% of the labeled sugar content. In the subcategories, the differences between the analyzed and labeled median sugar contents were not statistically significant. Sucrose was most commonly (N = 36; 71%) used for sweetening, suggesting that the proportion of fructose in most SSBs was around 50%. A higher fructose content was only observed in beverages with fructose–glucose syrup or a higher content of fruit juice. The study results show that the labeled sugar content information in SSBs is reliable and can be used to compile branded food databases and monitor the nutritional quality of foods in the food supply.
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Affiliation(s)
- Edvina Hafner
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Živa Lavriša
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
| | - Maša Hribar
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
| | - Sanja Krušič
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
| | - Anita Kušar
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
| | - Katja Žmitek
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
- VIST–Faculty of Applied Sciences, Ljubljana, Slovenia
| | - Mihaela Skrt
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | | | - Igor Pravst
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
- VIST–Faculty of Applied Sciences, Ljubljana, Slovenia
- *Correspondence: Igor Pravst
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Krušič S, Hribar M, Hafner E, Žmitek K, Pravst I. Use of Branded Food Composition Databases for the Exploitation of Food Fortification Practices: A Case Study on Vitamin D in the Slovenian Food Supply. Front Nutr 2022; 8:775163. [PMID: 35059424 PMCID: PMC8763681 DOI: 10.3389/fnut.2021.775163] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/12/2021] [Indexed: 12/11/2022] Open
Abstract
Vitamin D deficiency is a worldwide public health concern, which can be addressed with voluntary or mandatory food fortification. The aim of this study was to determine if branded food composition databases can be used to investigate voluntary fortification practices. A case study was conducted using two nationally representative cross-sectional datasets of branded foods in Slovenia, collected in 2017 and 2020, and yearly sales data. Using food labeling data we investigated prevalence of fortification and average vitamin D content, while nutrient profiling was used to investigate overall nutritional quality of the foods. In both datasets, the highest prevalence of vitamin D fortification was observed in meal replacements (78% in 2017; 100% in 2020) and in margarine, corresponding to high market share. Other food categories commonly fortified with vitamin D are breakfast cereals (5% in 2017; 6% in 2020), yogurts and their imitates (5% in 2017; 4% in 2020), and baby foods (18% in both years). The highest declared average content of vitamin D was observed in margarine and foods for specific dietary use (7-8 μg/100g), followed by breakfast cereals (4 μg/100g), while the average content in other foods was below 2 μg/100g. Only minor differences were observed between 2017 and 2020. Major food-category differences were also observed in comparison of the overall nutritional quality of the fortified foods; higher overall nutritional quality was only observed in fortified margarine. Our study showed that branded food composition databases are extremely useful resources for the investigation and monitoring of fortification practices, particularly if sales data can also be used. In the absence of mandatory or recommended fortification in Slovenia, very few manufacturers decide to add vitamin D, and even when this is the case, such products are commonly niche foods with lower market shares. We observed exceptions in imported foods, which can be subject to fortification policies introduced in other countries.
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Affiliation(s)
- Sanja Krušič
- Nutrition Institute, Nutrition and Public Health Research Group, Ljubljana, Slovenia
| | - Maša Hribar
- Nutrition Institute, Nutrition and Public Health Research Group, Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Edvina Hafner
- Nutrition Institute, Nutrition and Public Health Research Group, Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Katja Žmitek
- Nutrition Institute, Nutrition and Public Health Research Group, Ljubljana, Slovenia
- VIST—Faculty of Applied Sciences, Ljubljana, Slovenia
| | - Igor Pravst
- Nutrition Institute, Nutrition and Public Health Research Group, Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
- VIST—Faculty of Applied Sciences, Ljubljana, Slovenia
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