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Packer J, Michalopoulou S, Cruz J, Dhar D, Stansfield C, Kaczmarska H, Viner RM, Mytton O, Russell SJ. The Impact of Non-Fiscal Mandatory and Voluntary Policies and Interventions on the Reformulation of Food and Beverage Products: A Systematic Review. Nutrients 2024; 16:3484. [PMID: 39458480 PMCID: PMC11509918 DOI: 10.3390/nu16203484] [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: 08/14/2024] [Revised: 09/26/2024] [Accepted: 10/04/2024] [Indexed: 10/28/2024] Open
Abstract
Background/Objectives: Low quality diets are a risk factor for non-communicable diseases; therefore, improving diet quality is a public health and policy priority in the UK and elsewhere. Reformulating food/beverage products to make them healthier may be an effective approach. Evidence suggests that fiscal interventions, notably taxes/levies on soft drinks, can lead to reformulation but the evidence for voluntary or mandated non-fiscal interventions is less clear. We aimed to review and synthesise contemporary evidence to determine whether non-fiscal policies/interventions result in the reformulation of food/beverage products Methods: In April 2023, we systematically searched ten international academic and nine grey literature databases. We included real-world study designs, all nutrients, in- and out-of-home sectors, and studies published from 2013, to ensure policy relevancy. We excluded modelling studies. Using the Synthesis Without Meta-Analysis method we conducted vote counting of studies based on the direction of effect and narrative synthesis by intervention type. Risk of bias was assessed using a tool developed by the EPPI-Centre and quality was assessed using GRADE. Results: We included 77 real-world studies from 19 countries, reporting 100 non-fiscal policies/interventions. Most commonly, these were reduction targets (n = 44), front-of-pack labels (n = 23), and advertising standards (n = 9). Most interventions were voluntary (n = 67), compared to mandatory (n = 33), and focused on the in-home sector (n = 63). The vote counting results showed non-fiscal policies/interventions overall led to improvements in reformulation in 60/63 studies with a valid direction of effect (95%, 95% CI 0.869, 0.984, p < 0.001). Mandatory implementations were more successful than voluntary implementations with 15/15 showing an improvement (100%, 95% CI 0.796, 1], p < 0.001), compared 40/43 showing an improvement (93%, 95% CI 0.814, 0.976, p < 0.001). Most of the studies were of low quality, due to the observational nature of the studies. Sodium was the most commonly targeted nutrient (n = 56) and was found to be reformulated in most studies. Causation is difficult to establish from real-world studies, but evidence suggests that regulatory and multi-component strategies may be effective at driving reformulation. Conclusions: Non-fiscal policies/interventions can play an important role in driving reformulation, alongside fiscal measures. This work was funded by the National Institute for Health and Care Research PRP-PRU-02-15-Healthy Weight and registered on Open Science Framework.
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Affiliation(s)
- Jessica Packer
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (S.M.); (J.C.); (D.D.); (H.K.); (R.M.V.); (O.M.); (S.J.R.)
| | - Semina Michalopoulou
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (S.M.); (J.C.); (D.D.); (H.K.); (R.M.V.); (O.M.); (S.J.R.)
| | - Joana Cruz
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (S.M.); (J.C.); (D.D.); (H.K.); (R.M.V.); (O.M.); (S.J.R.)
| | - Disha Dhar
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (S.M.); (J.C.); (D.D.); (H.K.); (R.M.V.); (O.M.); (S.J.R.)
| | - Claire Stansfield
- EPPI-Centre, UCL Social Research Institute, University College London, London WC1H 0NR, UK;
| | - Helena Kaczmarska
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (S.M.); (J.C.); (D.D.); (H.K.); (R.M.V.); (O.M.); (S.J.R.)
| | - Russell M. Viner
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (S.M.); (J.C.); (D.D.); (H.K.); (R.M.V.); (O.M.); (S.J.R.)
| | - Oliver Mytton
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (S.M.); (J.C.); (D.D.); (H.K.); (R.M.V.); (O.M.); (S.J.R.)
| | - Simon J. Russell
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (S.M.); (J.C.); (D.D.); (H.K.); (R.M.V.); (O.M.); (S.J.R.)
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Wu H, Li S, Chen L, Xia Y, Tan X. Intake of the different types of dairy products, genetic predisposition, and the risks of nonalcoholic fatty liver disease and cirrhosis: a prospective cohort study. Food Funct 2024; 15:5050-5062. [PMID: 38656457 DOI: 10.1039/d3fo04602h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Background: The association of dairy product consumption with nonalcoholic fatty liver disease (NAFLD) and cirrhosis remains controversial. This study aimed to prospectively investigate the associations between the consumption of the different types of dairy products, genetic predisposition, and the risks of NAFLD and cirrhosis. Methods: This cohort study included 190 145 participants from the UK Biobank Study. The consumption of the different types of dairy products was assessed based on the Oxford WebQ at baseline and defined as the sum of milk, yogurt, and cheese. NAFLD and cirrhosis were evaluated using hospital inpatient records and death data in the UK Biobank. The weighted genetic risk score (GRS) for NAFLD and cirrhosis was constructed using 5 and 6 single-nucleotide variants (SNVs), respectively. Cox proportional hazards regression models were utilized to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between genetic factors and different types of dairy products with the incidence of NAFLD and cirrhosis. Results: During a median follow-up of 11.6 years, 1512 NAFLD and 556 cirrhosis cases were ascertained. After adjusting for several potential confounders, the HRs (95% CIs) (Q4 vs. Q1) of NAFLD were 0.86 (0.74, 0.995) for total dairy products, 0.96 (0.84, 1.09) for high-fat dairy products, 0.78 (0.67, 0.92) for low-fat dairy products, 0.86 (0.74, 0.99) for unfermented dairy products, and 0.79 (0.68, 0.91) for fermented dairy products. The multivariable-adjusted HRs (95% CIs) (Q4 vs. Q1) of cirrhosis were 0.75 (0.59, 0.96) for total dairy products, 0.97 (0.78, 1.19) for high-fat dairy products, 0.67 (0.51, 0.89) for low-fat dairy products, 0.75 (0.59, 0.96) for unfermented dairy products, and 0.71 (0.56, 0.90) for fermented dairy products. The associations of high-fat dairy products and fermented dairy products with NAFLD and cirrhosis were found to be nonlinear (P for nonlinear <0.05). No interaction was observed between dairy product consumption and NAFLD or cirrhosis genetic susceptibility. Conclusions: Higher consumption of dairy products, except for high-fat dairy, was correlated with lower risks of NAFLD and cirrhosis, regardless of their differences in genetic susceptibility.
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Affiliation(s)
- Hanzhang Wu
- Department of Big Data in Health Science, Zhejiang University School of Public Health and Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
- The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, China
| | - Shiwen Li
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Liangkai Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Xia
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, China.
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiao Tan
- Department of Big Data in Health Science, Zhejiang University School of Public Health and Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
- The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, China
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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Souza LMS, Chaves SCL, Santana JM, Pereira M. Public policy interventions for preventing and treating obesity: scoping review. Nutr Rev 2023; 81:1653-1664. [PMID: 37080562 DOI: 10.1093/nutrit/nuad028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
CONTEXT Obesity is a multicausal social problem and a pandemic, and it presents a public health challenge in many countries. Hence, public health interventions have been used in an endeavour to prevent and/or control increased obesity among populations. OBJECTIVE This review study aimed to provide an overview of the academic literature and to analyze the strategies involved in the main public policies focused on preventing and controlling obesity in a number of countries. DATA SOURCES MEDLINE/PubMed, Web of Science, and LILACS databases were searched. DATA EXTRACTION Original studies were included for which the core objective was related to real-life public policy interventions for obesity. DATA ANALYSIS The studies were organized according to their characteristics, and the qualitative analysis was based on the categorization proposed by the author Poulain. The review included 41 studies and identified 15 types of interventions focused on obesity; the largest proportion of actions were developed in school and city environments and were geared toward behavioral change, supported by direct or indirect government action. It was observed that many strategies focused on environmental line through regulatory and legislative measures, and health promotion geared toward the individual was based on the dissemination of information as a means for behavioral change. A smaller focus was given to individual care and treatment, and participative actions in the community. CONCLUSION The design of public health strategies applicable to obesity as proposed by Poulain provides a valid model for evaluating interventions. The behavioral approach involving guidance through health education toward a healthy lifestyle prevails in public policies, indicating a movement toward accountability of individuals. However, it is necessary to deepen the debate on the social structures that determine obesity (and which limit possibilities of choice), aligned with cultural change regarding its occurrence, and to employ care strategies based on scientific evidence and which focus on the needs of the subjects.
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Affiliation(s)
- Lana M S Souza
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Canela, Salvador, Brazil
| | - Sônia C L Chaves
- Faculdade de Odontologia, Universidade Federal da Bahia, Salvador, Brazil
| | - Jerusa M Santana
- Centro de Ciências da Saúde, Universidade Federal do Recôncavo da Bahia, Santo Antônio de Jesus, Brazil
| | - Marcos Pereira
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
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Varela P, De Rosso S, Ferreira Moura A, Galler M, Philippe K, Pickard A, Rageliene T, Sick J, van Nee R, Almli VL, Ares G, Grønhøj A, Spinelli S, van Kleef E. Bringing down barriers to children's healthy eating: a critical review of opportunities, within a complex food system. Nutr Res Rev 2023:1-21. [PMID: 37746804 DOI: 10.1017/s0954422423000203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
This narrative review revises the scientific evidence of recent years on healthy eating in children and adolescents, making sense of promising avenues of action, from a food system perspective. A conceptual framework is provided to better understand how eating habits of children and adolescents are shaped to identify key multisectoral approaches that should be implemented to promote healthier diets. The following influencing factors are discussed: individual factors (physiological and psychological factors, food preferences and food literacy competencies), factors within the personal and socio-cultural food environments, external food environments, and the supply chain. In each section, the main barriers to healthy eating are briefly discussed focussing on how to overcome them. Finally, a discussion with recommendations of actions is provided, anchored in scientific knowledge, and transferable to the general public, industry, and policymakers. We highlight that multidisciplinary approaches are not enough, a systems approach, with a truly holistic view, is needed. Apart from introducing systemic changes, a variety of interventions can be implemented at different levels to foster healthier diets in children through fostering healthier and more sustainable food environments, facilitating pleasurable sensory experiences, increasing their food literacy, and enhancing their agency by empowering them to make better food related decisions. Acknowledging children as unique individuals is required, through interpersonal interactions, as well as their role in their environments. Actions should aim to enable children and adolescents as active participants within sustainable food systems, to support healthier dietary behaviours that can be sustained throughout life, impacting health at a societal level.
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Affiliation(s)
| | - Sofia De Rosso
- Centre des Sciences du Goût et de l'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne Franche-Comté, F-21000 Dijon, France
| | | | | | - Kaat Philippe
- Centre des Sciences du Goût et de l'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne Franche-Comté, F-21000 Dijon, France
| | | | | | - Julia Sick
- Department of Agriculture, Food, Environment and Forestry (DAGRI), University of Florence, Florence, Italy
| | - Roselinde van Nee
- Wageningen University, Marketing & Consumer Behaviour Group, Wageningen, The Netherlands
| | | | - Gastón Ares
- Sensometrics and Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, Montevideo, Uruguay
| | | | - Sara Spinelli
- Department of Agriculture, Food, Environment and Forestry (DAGRI), University of Florence, Florence, Italy
| | - Ellen van Kleef
- Wageningen University, Marketing & Consumer Behaviour Group, Wageningen, The Netherlands
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O’Mahony S, O’Donovan CB, Collins N, Burke K, Doyle G, Gibney ER. Reformulation of Processed Yogurt and Breakfast Cereals over Time: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3322. [PMID: 36834017 PMCID: PMC9964677 DOI: 10.3390/ijerph20043322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Poor diet is responsible for a quarter of European non-communicable disease (NCD)-related deaths. The reformulation of sugar, salt, and saturated fat in processed packaged foods offers an opportunity to reduce consumption of nutrients of concern and also support a reduction in energy intake. To date, there have been no publications measuring progress in food reformulation by compiling published evidence for a food category. The aim of this scoping review was to identify, characterize and summarise the findings of studies analysing the reformulation of processed yogurt and breakfast cereals. The review answered the research question: "What is the impact of food reformulation on the nutrient quality of yogurt and breakfast cereals available in the retail environment?" The research protocol was defined based on PRISMA-ScR guidelines. Five databases were searched in May 2022. Thirteen studies, published between 2010 and 2021 and completed across seven countries were eligible for inclusion. There were sufficient eligible studies to identify trends in sodium, salt, and sugar reduction in breakfast cereals. However, there was minimal or no reduction in energy, which may bring into question the use of food reformulation as part of an overall health strategy for obesity reduction.
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Affiliation(s)
- Sinead O’Mahony
- Food Safety Authority of Ireland, The Exchange, Georges Dock, D01 P2V6 Dublin, Ireland
- Institute of Food and Health, School of Agriculture and Food Science, University College Dublin (UCD), Belfield, D04 V1W8 Dublin, Ireland
- School of Agriculture and Food Science, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
| | - Clare B. O’Donovan
- Food Safety Authority of Ireland, The Exchange, Georges Dock, D01 P2V6 Dublin, Ireland
| | - Nuala Collins
- Food Safety Authority of Ireland, The Exchange, Georges Dock, D01 P2V6 Dublin, Ireland
| | - Kevin Burke
- Department of Mathematics and Statistics, University of Limerick, V94 T9PX Limerick, Ireland
| | - Gerardine Doyle
- College of Business, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
- UCD Geary Institute of Public Policy, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
| | - Eileen R. Gibney
- Institute of Food and Health, School of Agriculture and Food Science, University College Dublin (UCD), Belfield, D04 V1W8 Dublin, Ireland
- School of Agriculture and Food Science, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
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Légeret C, Lohmann C, Pedrini L, Sarbach L, Furlano R, Köhler H. Use of Health-Promoting Food and Supplements in Swiss Children. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121842. [PMID: 36553285 PMCID: PMC9776924 DOI: 10.3390/children9121842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/21/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Our diet is the sum of many different influences and has visibly changed over the past decades. Since children also imitate their parents when it comes to eating habits, the aim of the study was to assess the current dietary habits in Swiss children. METHOD Cross-sectional study of children between 0 and 18 years of age in Switzerland. RESULTS A total of 1964 children participated, with an average age of 7.4 years. A total of 57.9% of participants stated to buy supplements to promote health, while fruit juices/smoothies were the most popular product (42.5%), followed by protein-enriched products (40%) and vitamins/minerals (29%). A statistically significant correlation between longer screen time, a higher socioeconomic background, and the intake of supplements was found. Over 20% of all families regularly consume plant-based drinks. DISCUSSION This Swiss cross-sectional study of over 1900 participants reveals that 58% of all participants buy supplements or special kid's food to promote the child's health. There is a correlation between higher screen time, higher parental income, and the usage of supplements. A total of 23% of participating families consume at least one plant-based drink on a regular basis. As more and more families use supplements, the pediatrician should not only focus on weight, which reflects the intake of macronutrients but should also take a history of whether children omit certain foods or take supplements to ensure the child does not have a deficiency of micronutrients.
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Affiliation(s)
- Corinne Légeret
- University Children’s Hospital Basel, Spitalstrasse 33, 4056 Basel, Switzerland
- Correspondence:
| | - Clarissa Lohmann
- Children’s Hospital of Aarau, Tellstrasse 25, 5001 Aarau, Switzerland
| | - Laura Pedrini
- Medical Faculty, University of Basel, 4001 Basel, Switzerland
| | - Laurin Sarbach
- Medical Faculty, University of Basel, 4001 Basel, Switzerland
| | - Raoul Furlano
- University Children’s Hospital Basel, Spitalstrasse 33, 4056 Basel, Switzerland
| | - Henrik Köhler
- Children’s Hospital of Aarau, Tellstrasse 25, 5001 Aarau, Switzerland
- Medical Faculty, University of Basel, 4001 Basel, Switzerland
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Consumers Respond Positively to the Sensory, Health, and Sustainability Benefits of the Rare Sugar Allulose in Yogurt Formulations. Foods 2022; 11:foods11223718. [PMID: 36429310 PMCID: PMC9689152 DOI: 10.3390/foods11223718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/07/2022] [Accepted: 11/14/2022] [Indexed: 11/22/2022] Open
Abstract
Increased added sugar consumption is associated with type II diabetes, metabolic syndrome, and cardiovascular disease. Low and no-calorie alternative sweeteners have long been used as an aid in the reduction of added sugar. Unfortunately, these alternative sweeteners often have notable sensory deficits when compared to sucrose. Furthermore, many alternative sweeteners have synthetic origins, while consumers are increasingly turning to foods from natural origins, and from more sustainable sources. Such sweeteners include the rare sugar allulose, which can be manufactured from common agricultural waste and dairy co-product streams, and is reported to have a sensory profile similar to sucrose. This study aimed to determine the influence of the rare sugar allulose on consumer perception of sweetened vanilla yogurt. Participants were recruited to evaluate 4 vanilla yogurts sweetened with either sucrose, allulose, stevia or sucralose, and to rate their liking of the samples overall, and for flavor, texture, and their purchase intent. Statistical analysis of hedonic data from 100 consumers suggested that allulose performed similarly to sucrose in liking and purchase intent, and superior to other sweeteners tested in this study, with fewer off-flavors. Moreover, when consumers were queried on their purchase intent after learning details on the sweetener for each formulation, allulose scored significantly higher than all other formulations in purchase intent. This study highlights the potential of the rare sugar allulose as a low calorie, zero glycemic index, natural and better tasting sugar replacement in sweetened yogurt.
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Saavedra-Garcia L, Taboada-Ramirez X, Hernández-Vásquez A, Diez-Canseco F. Marketing techniques, health, and nutritional claims on processed foods and beverages before and after the implementation of mandatory front-of-package warning labels in Peru. Front Nutr 2022; 9:1004106. [PMID: 36407533 PMCID: PMC9666783 DOI: 10.3389/fnut.2022.1004106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/06/2022] [Indexed: 08/06/2023] Open
Abstract
In June 2019, mandatory front-of-package warning labels (FOPL) were implemented in Peru. The aim of the study was to describe changes in marketing strategies on packaging: marketing techniques (MT), health claims (HC), and nutritional claims (NC) on the packaging of products frequently consumed by children before and after the FOPL implementation. Product photos were taken pre- (March 2019) and post-implementation (March-October 2020) in three supermarkets in Lima, Peru. Following INFORMAS protocols and Peruvian Technical Norms, the presence of MT, HC, and NC was assessed on all package sides. Products were classified as "high-in" and "not high-in" based on the regulation threshold for critical nutrients. Differences in the proportion of products with each strategy in both periods were evaluated. Also, a subsample of products was matched according to the barcode and exact McNemar test was used to compare proportions of strategies pre/post-implementation. We included 883 and 1,035 products in pre- and post-implementation, respectively. In both periods, MT appeared on almost 70% of all products. The presence of HC increased significantly only for beverages (24.5-38.1%, p < 0.001). In both phases, NC were commonly used on beverages (>80%). Overall, the prevalence of "high-in" products using MT increased (73.6-82.1%, p = 0.007), while use of HC increased among "not high-in" products (32.9-41.6%, p < 0.001). There is a high frequency of MT on all products and NC on beverages. The increase in MT in "high-in" products may be an industry response to minimize the impact of the FOPL on food choices and sales. New regulatory aspects regarding labeling should be implemented to strengthen the current policy.
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Chang MY, Huang CC, Du YC, Chen HS. Choice Experiment Assessment of Consumer Preferences for Yogurt Products Attributes: Evidence from Taiwan. Nutrients 2022; 14:nu14173523. [PMID: 36079781 PMCID: PMC9460311 DOI: 10.3390/nu14173523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/23/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Previous studies on consumer yogurt preferences have mainly focused on added sugar, nutrient content, and health claims, leaving several knowledge gaps that should be filled through in-depth research. In this study, a more complete multi-attribute preference model was developed using the number of probiotic types, type of milk source, presence of edible gels (GEL), and usage of health food labels as the main yogurt attributes. A choice experiment (CE) was then conducted to investigate the relationship between multiple attribute preferences and willingness-to-pay (WTP). A total of 435 valid questionnaires were collected by the convenience sampling method. The results show that (1) respondents highly value the health food label (HEA), followed by the number of probiotic types (PRO); (2) the highest WTP in the conditional logit (CL) model was New Taiwan Dollar (NTD) (USD 10.5 for HEA, and the lowest was NTD 1.0 for 100% milk powder (MLK2); (3) in the random-parameter logit (RPL) model, the highest WTP was NTD 14.6 for HEA, and the lowest was NTD 2.8 for GEL; (4) the most preferred attribute combination of yogurt was “8 or more probiotic types”, “a blend of raw milk and milk powder”, “the absence of edible gels”, “the presence of a health food label”, and “a price premium of NTD 6–10”; (5) married respondents with children were more willing to pay extra for yogurt products with a higher number of probiotic types and a health food label. The results may help the food industry understand and pay attention to consumer needs, which will, in turn, provide a reference for future product development and marketing strategies.
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Affiliation(s)
- Min-Yen Chang
- Department of Accounting, Jiaxing University, Jiaxing 314001, China
| | - Chien-Cheng Huang
- Department of Health Industry Technology Management, Chung Shan Medical University, Taichung City 40201, Taiwan
| | - Ying-Chi Du
- Division of Forest Protection, Taiwan Forestry Research Institute, 53 Nan-Hai Road, Taipei 10066, Taiwan
| | - Han-Shen Chen
- Department of Health Industry Technology Management, Chung Shan Medical University, Taichung City 40201, Taiwan
- Department of Medical Management, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Rd., Taichung City 40201, Taiwan
- Correspondence: ; Tel.: +886-4-2473-0022 (ext. 12225)
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Feldens CA, Pinheiro LL, Cury JA, Mendonça F, Groisman M, Costa RAH, Pereira HC, Vieira AR. Added Sugar and Oral Health: A Position Paper of the Brazilian Academy of Dentistry. FRONTIERS IN ORAL HEALTH 2022; 3:869112. [PMID: 35464781 PMCID: PMC9020561 DOI: 10.3389/froh.2022.869112] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/07/2022] [Indexed: 11/13/2022] Open
Abstract
Excessive sugar consumption is the main cause of dental caries. Dental caries is highly prevalent and negatively impacts the quality of life at all stages. Furthermore, sugar consumption is associated with other noncommunicable conditions and diseases, such as obesity, diabetes, and cardiovascular diseases. The aim of this paper is to propose recommendations at the individual and population levels for health professionals, families, educators, stakeholders, and public officials to reduce the burden of dental caries and other noncommunicable diseases that are caused by the excessive sugar intake. A systematic search was performed in PubMed and Cochrane databases to investigate the effectiveness of strategies and policies aiming to reduce sugar consumption as well as the impact of different patterns of sugar consumption on the occurrence of dental caries. Reference list of the identified papers and practice guidelines were manually reviewed as well. Based on the best evidence available, the Brazilian Academy of Dentistry recommends not to offer sugars to children younger than 2 years of age, and to limit total sugar consumption to <25 g per day after 2 years of age. Furthermore, families should be informed to limit sugar exposure, sugar-free areas should be available, content of food labels and advertisement should be regulated, taxation of products with sugar should be introduced, and reformulation of foods and drinks to reduce concentrations of sugars should be considered.
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Affiliation(s)
| | | | - Jaime A. Cury
- Piracicaba Dental School, Universidade de Campinas, Piracicaba, Brazil
| | | | | | - Rafael A. H. Costa
- National School of Public Health, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Alexandre R. Vieira
- School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, United States
- *Correspondence: Alexandre R. Vieira
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Ares G, Velázquez AL, Vidal L, Curutchet MR, Varela P. The role of food packaging on children's diet: Insights for the design of comprehensive regulations to encourage healthier eating habits in childhood and beyond. Food Qual Prefer 2022. [DOI: 10.1016/j.foodqual.2021.104366] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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12
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Influence of sucrose reduction on fouling during the production of dulce de leche. J DAIRY RES 2021; 88:457-460. [PMID: 34886919 DOI: 10.1017/s0022029921000777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In this Research Communication we focus the food industry´s broad tendency to decrease sugar content in food products onto dulce de leche (DL) and examine the influence of sucrose reduction on the detrimental deposits formed during the production process. The method used to identify the impact produced directly on the heat exchanger during the production of this product with low sucrose content required varying the quantity of sucrose in the milk. Different percentages of sucrose (20, 15, 10, 5 and 0% w/w) were submitted to the DL concentration process in a process simulator. After concentration, the quantification of the deposits formed in each was carried out and these deposits were characterized according to their composition. Methods such as Kjeldahl, Pregl-Dumas and sem-EDS were used. Thus, the work highlights the need to change the product manufacturing process due to changes in the formulation that directly impact the formation of deposits in the equipment used (fouling). This deposit changes significantly in relation to its quantity as well as in relation to the composition and chemical characteristics as the gradual reduction of the sucrose content in the production takes place. Therefore, these impacts must be considered in order to maintain better manufacturing and ensure efficient cleaning of equipment.
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Zhu Y, Jain N, Holschuh N, Smith J. Associations between frequency of yogurt consumption and nutrient intake and diet quality in the United Kingdom. J Nutr Sci 2021; 10:e85. [PMID: 34733497 PMCID: PMC8532067 DOI: 10.1017/jns.2021.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 07/30/2021] [Indexed: 11/06/2022] Open
Abstract
Little is known on the association between frequency of yogurt consumption and dietary intake in the United Kingdom (UK). The aim of the present study was to examine associations between frequency of yogurt consumption and dietary outcomes in children (n 1912, age 9⋅6 ± 0⋅1 years, 51 % boys) and adults (n 2064, age 48⋅7 ± 0⋅5 years, 49 % men) using cross-sectional data from the National Diet and Nutrition Survey rolling programme year 7 to year 9 (2014/15-2016/17). The frequency of yogurt consumption was determined by the number of days with yogurt reported in 4-d food diaries and participants were classified as non-eaters, occasional eaters (1-2 d of consumption) or regular eaters (3-4 d of consumption). Dietary outcomes were estimated from food diaries. The frequency of yogurt consumption was positively associated with intake of key vitamins and minerals such as thiamin, riboflavin, vitamin C, potassium, calcium, magnesium, phosphorus and iodine in both children and adults (all P < 0⋅0018), as well as higher intake of total dairy (P < 0⋅0001 for both children and adults). Regular yogurt eaters were more likely to meet or exceed nutrient recommendations for vitamins and minerals such as vitamin A, riboflavin, folate, potassium, calcium, magnesium, zinc and iodine (all P < 0⋅001). Diet quality was positively associated with frequency of yogurt consumption in children (P = 0⋅045) and adults (P < 0⋅001). No association between yogurt consumption and free sugar intake was found (P = 0⋅49 for children and P = 0⋅29 for adults). The study suggests that frequency of yogurt consumption is associated with better dietary intake and diet quality in children and adults in the UK.
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Affiliation(s)
- Yong Zhu
- Bell Institute of Health and Nutrition, General Mills, Inc., Minneapolis, MN55427, USA
| | - Neha Jain
- Global Knowledge Solutions, General Mills Canada Corporation, Mississauga, ONL4W 5N9, Canada
| | - Norton Holschuh
- Global Knowledge Solutions, General Mills, Inc., Minneapolis, MN55427, USA
| | - Jessica Smith
- Bell Institute of Health and Nutrition, General Mills, Inc., Minneapolis, MN55427, USA
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Moz-Christofoletti MA, Wollgast J. Sugars, Salt, Saturated Fat and Fibre Purchased through Packaged Food and Soft Drinks in Europe 2015-2018: Are We Making Progress? Nutrients 2021; 13:nu13072416. [PMID: 34371927 PMCID: PMC8308506 DOI: 10.3390/nu13072416] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 11/16/2022] Open
Abstract
The availability, purchase and consumption of foods high in fat, sugars and salt and low in fibre are linked to the high health and economic burden of noncommunicable diseases, including cancer, in Europe. Therefore, assessing the quality of the food offer is key as feedback to decision makers, as well as to identify good practices and areas of the food supply still requiring urgent action. We combined detailed market share and sales data with nutrition composition data to evaluate the nutritional quality of 14 packaged food and soft drinks categories sold across 22 European countries over the 2015–2018 period. Our analysis shows great variability of the nutritional composition within and among packaged food and soft drinks categories across European countries. Our estimates of the market-share weighted mean, a measure that integrates possible changes in nutrient content with the amount of a product sold to consumers, as well as daily per capita nutrient sale estimates, suggest a small but statistically significant progress in certain food categories only. Overall, the amounts of sugars, saturated fat, salt and fibre being sold to European citizens through these products is not improving to an extent to meet public health objectives.
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Velázquez AL, Vidal L, Varela P, Ares G. Sugar reduction in products targeted at children: Why are we not there yet? J SENS STUD 2021. [DOI: 10.1111/joss.12666] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Ana Laura Velázquez
- Sensometrics & Consumer Science Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República Pando Uruguay
- Graduate Program in Chemistry Facultad de Química, Universidad de la República Pando Uruguay
| | - Leticia Vidal
- Sensometrics & Consumer Science Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República Pando Uruguay
| | | | - Gastón Ares
- Sensometrics & Consumer Science Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República Pando Uruguay
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Temperature of sugar solutions during tasting affects sweetness difference thresholds. Lebensm Wiss Technol 2021. [DOI: 10.1016/j.lwt.2020.110676] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Significant sugar-reduction in dairy products targeted at children is possible without affecting hedonic perception. Int Dairy J 2021. [DOI: 10.1016/j.idairyj.2020.104937] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Dimitrellou D, Solomakou N, Kokkinomagoulos E, Kandylis P. Yogurts Supplemented with Juices from Grapes and Berries. Foods 2020; 9:foods9091158. [PMID: 32825783 PMCID: PMC7555734 DOI: 10.3390/foods9091158] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/17/2020] [Accepted: 08/19/2020] [Indexed: 02/06/2023] Open
Abstract
Nowadays, there is growing interest for the development of enriched dairy products with phenolic compounds derived from edible sources, mainly due to their safety and potential health benefits. Following that trend, in the present study, fruit juices (blueberry, aronia, and grape) were supplemented into yogurt as functional ingredients. The main physicochemical characteristics (pH, reducing sugars, acidity, color, and syneresis), total phenolic content, antioxidant activity, and viability of yogurt starters were monitored during production and storage. The use of juices had no significant effect on milk acidification rate and on the main physicochemical characteristics of yogurts, while resulted in increased red color. Total phenolic content increased from 30 to 33% (grape and aronia) and up to 49% (blueberry), while similar results were observed in antioxidant activity. Similar values of syneresis were presented in all yogurts, probably due to exopolysaccharide producing starter culture. Streptococcus thermophilus retained high viable counts during storage especially in yogurts with fruit juices (>108 cells g−1) revealing a possible prebiotic effect of juices. The results obtained from this study show that fruit juices (aronia, blueberry, and grape) have potential to be used in yogurt production in order to optimize the benefits of probiotic products with high phenolic compound intake.
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Sugar Content and Nutritional Quality of Child Orientated Ready to Eat Cereals and Yoghurts in the UK and Latin America; Does Food Policy Matter? Nutrients 2020; 12:nu12030856. [PMID: 32210128 PMCID: PMC7146401 DOI: 10.3390/nu12030856] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/06/2020] [Accepted: 03/18/2020] [Indexed: 12/12/2022] Open
Abstract
Ready to eat breakfast cereals (REBCs) and yoghurts provide important nutrients to children's diets, but concerns about their high sugar content exist. Food reformulation could contribute to sugar reduction, but policies across countries are not uniform. We aimed to compare the sugar content and nutritional quality of child-orientated REBCs and yoghurts in Latin American countries with the UK. In a cross-sectional study, nutritional information, marketing strategies, and claims were collected from the food labels and packaging of products available in Guatemala, Mexico, Ecuador and the UK. Nutritional quality was assessed using the UK Ofcom Nutrient Profiling System. In total, 262 products were analysed (59% REBCs/41% yoghurts). REBCs in the UK had a lower sugar content (mean ± SD) (24.6 ± 6.4) than products in Ecuador (34.6 ± 10.8; p < 0.001), Mexico (32.6 ± 7.6; p = 0.001) and Guatemala (31.5 ± 8.3; p = 0.001). Across countries, there were no differences in the sugar content of yoghurts. A large proportion (83%) of REBCs and 33% of yoghurts were classified as "less healthy". In conclusion, the sugar content of REBCs in Latin America is higher than those of the UK, which could be attributed to the UK voluntary sugar reduction programme. Sugar reformulation policies are required in Guatemala, Mexico and Ecuador.
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Sugar levels drop in yoghurts. Br Dent J 2020. [DOI: 10.1038/s41415-020-1217-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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