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Flexner N, Ahmed M, Mulligan C, Bernstein JT, Christoforou AK, Lee JJ, Khandpur N, L’Abbe MR. The estimated dietary and health impact of implementing the recently approved 'high in' front-of-package nutrition symbol in Canada: a food substitution scenario modeling study. Front Nutr 2023; 10:1158498. [PMID: 37614744 PMCID: PMC10443708 DOI: 10.3389/fnut.2023.1158498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 07/17/2023] [Indexed: 08/25/2023] Open
Abstract
Background Front-of-pack labeling (FOPL) has been identified as a cost-effective policy to promote healthy food environments and to help consumers make healthier food choices. Consumer surveys report that after implementation of mandatory 'high in' FOPL symbols between 30 and 70% of consumers choose or were willing to choose products with fewer 'high in' symbols. Health Canada has recently published FOPL regulations that will require prepackaged food and beverages that meet or exceed thresholds for sodium, total sugars, or saturated fat to display a 'high in' FOPL nutrition symbol. Objectives The aims were to estimate the potential (1) dietary impact of substituting foods with similar foods that would display at least one less 'high in' symbol, and (2) the number of diet-related noncommunicable disease (NCD) deaths that could be averted or delayed due to estimated dietary changes. Methods Baseline and counterfactual intakes of sodium, total sugars, saturated fats, and energy were estimated among Canadian adults (n = 11,992) using both available days of 24 h-recall data from the 2015 Canadian Community Health Survey-Nutrition (CCHS). Similar foods to those reported in CCHS that would display at least one less 'high in' symbol (n = 239) were identified using a Canadian branded food composition database. Based on current FOPL consumer research, identified foods were substituted for 30, 50, and 70% of randomly selected CCHS-Nutrition adult participants and for all adult participants. Potential health impacts were estimated using the Preventable Risk Integrated ModEl. Results Mean dietary reductions of between 73 and 259 mg/day of sodium, 2.0 and 6.9 g/day of total sugars, 0.2 and 0.5 g/day of saturated fats, and 14 and 46 kcal/day of energy were estimated. Between 2,148 (95% UI 1,913-2,386) and 7,047 (95% UI 6,249-7,886) of deaths due to diet-related NCDs, primarily from cardiovascular diseases (70%), could potentially be averted or delayed if Canadians choose products with fewer 'high in' symbols. Conclusion Results suggest that FOPL could significantly reduce sodium and total sugar intakes among Canadian adults, the consequences of which could avert or delay an important number of diet-related NCD deaths. These findings provide relevant data to support the importance of the impending FOPL regulations.
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Affiliation(s)
- Nadia Flexner
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Mavra Ahmed
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Joannah and Brian Lawson Centre for Child Nutrition, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Christine Mulligan
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jodi T. Bernstein
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Anthea K. Christoforou
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jennifer J. Lee
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Neha Khandpur
- Department of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
- Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of São Paulo, São Paulo, Brazil
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
| | - Mary R. L’Abbe
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Momtaz M, Bubli SY, Khan MS. Mechanisms and Health Aspects of Food Adulteration: A Comprehensive Review. Foods 2023; 12. [PMID: 36613416 DOI: 10.3390/foods12010199] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 12/26/2022] [Accepted: 12/28/2022] [Indexed: 01/04/2023] Open
Abstract
Food adulteration refers to the alteration of food quality that takes place deliberately. It includes the addition of ingredients to modify different properties of food products for economic advantage. Color, appearance, taste, weight, volume, and shelf life are such food properties. Substitution of food or its nutritional content is also accomplished to spark the apparent quality. Substitution with species, protein content, fat content, or plant ingredients are major forms of food substitution. Origin misrepresentation of food is often practiced to increase the market demand of food. Organic and synthetic compounds are added to ensure a rapid effect on the human body. Adulterated food products are responsible for mild to severe health impacts as well as financial damage. Diarrhea, nausea, allergic reaction, diabetes, cardiovascular disease, etc., are frequently observed illnesses upon consumption of adulterated food. Some adulterants have shown carcinogenic, clastogenic, and genotoxic properties. This review article discusses different forms of food adulteration. The health impacts also have been documented in brief.
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Würtz AML, Jakobsen MU, Bertoia ML, Hou T, Schmidt EB, Willett WC, Overvad K, Sun Q, Manson JE, Hu FB, Rimm EB. Replacing the consumption of red meat with other major dietary protein sources and risk of type 2 diabetes mellitus: a prospective cohort study. Am J Clin Nutr 2021; 113:612-621. [PMID: 33094800 PMCID: PMC7948828 DOI: 10.1093/ajcn/nqaa284] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/15/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Greater consumption of red meat has been associated with a higher risk of type 2 diabetes mellitus (T2DM). A decreased intake of red meat and simultaneous increased intake of other high-protein foods may be associated with a lower risk of T2DM. These analyses of specific food replacements for red meat may provide more accurate dietary advice. OBJECTIVE We examined the association between a decrease in intake of red meat accompanied by an increase in other major dietary protein sources and risk of T2DM. METHODS We prospectively followed 27,634 males in the Health Professionals Follow-up Study, 46,023 females in the Nurses' Health Study, and 75,196 females in the Nurses' Health Study II. Diet was assessed by a validated FFQ and updated every 4 y. Cox proportional hazards models adjusted for T2DM risk factors were used to model the food replacements. We calculated HRs and 95% CIs for the T2DM risk associated with replacements of 1 daily serving of red meat with another protein source. RESULTS During 2,113,245 person-years of follow-up, we identified 8763 incident T2DM cases from 1990 to 2013. In the pooled analyses, a decrease in total red meat intake during a 4-y period replaced with another common protein food was associated with a lower risk of T2DM in the subsequent 4-y period. The HR (95% CI) per 1 serving/d was 0.82 (0.75, 0.90) for poultry, 0.87 (0.77, 0.98) for seafood, 0.82 (0.78, 0.86) for low-fat dairy, 0.82 (0.77, 0.86) for high-fat dairy, 0.90 (0.81, 0.99) for eggs, 0.89 (0.82, 0.98) for legumes, and 0.83 (0.78, 0.89) for nuts. The associations were present for both unprocessed and processed red meat, although stronger for the replacement of processed red meat. CONCLUSIONS Replacing red meat consumption with other protein sources was associated with a lower risk of T2DM.
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Affiliation(s)
- Anne Mette L Würtz
- Department of Public Health, Research Unit for Epidemiology, Aarhus University, Aarhus, Denmark.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Marianne U Jakobsen
- Department of Public Health, Research Unit for Epidemiology, Aarhus University, Aarhus, Denmark.,Division for Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Monica L Bertoia
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Tao Hou
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Erik B Schmidt
- Department of Cardiology, Aalborg University Hospital, Aalborg University, Aalborg, Denmark
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kim Overvad
- Department of Public Health, Research Unit for Epidemiology, Aarhus University, Aarhus, Denmark.,Department of Cardiology, Aalborg University Hospital, Aalborg University, Aalborg, Denmark
| | - Qi Sun
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - JoAnn E Manson
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Eric B Rimm
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Salomé M, de Gavelle E, Dufour A, Dubuisson C, Volatier JL, Fouillet H, Huneau JF, Mariotti F. Plant-Protein Diversity Is Critical to Ensuring the Nutritional Adequacy of Diets When Replacing Animal With Plant Protein: Observed and Modeled Diets of French Adults (INCA3). J Nutr 2020; 150:536-545. [PMID: 31618433 DOI: 10.1093/jn/nxz252] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/08/2019] [Accepted: 09/18/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND There is a current trend in Western countries toward increasing the intake of plant protein. A higher plant-protein intake has been associated with nutritional and health benefits, but these may depend on the pattern of plant-protein sources. OBJECTIVE We hypothesized that the diversity of plant foods could be important to nutrient adequacy when increasing plant-protein intake in the diet. METHODS Using data on 1341 adults (aged 18-64 y) from a representative French national dietary survey conducted in 2014-2015 (the third Individual and National Study on Food Consumption Survey-INCA3), we studied the links between plant-protein intake, dietary diversity (using various dimensions), and nutrient adequacy [assessed using the PANDiet (Probability of Adequate Nutrient Intake) scoring system, comprising adequacy (AS) and moderation (MS) subscores]. We simulated substituting plant-protein foods for animal-protein foods using different models of plant-protein diversity. RESULTS We found that overall diet quality was weakly associated with total and protein diversity and more strongly with plant-protein diversity. Plant-protein intake was inversely associated with animal-protein intake, and positively with the PANDiet and MS, but not with the AS. Plant-protein intake displayed little diversity, mostly taking the form of grains (61% of plant-protein intake), and this diversity was even less marked under a higher plant-protein intake. Finally, modeled substitutions showed that reducing animal-protein intake increased the MS (by 32%) in a similar manner whichever plant protein was used for substitution, whereas it decreased the AS (by 20%) unless using a highly diversified plant-protein mix. These simulated improvements in overall adequacy included marked decreases in adequacy regarding certain nutrients that are typically of animal origin. CONCLUSIONS We conclude that in French adults the current pattern of plant-protein intake is hindering the nutritional benefits of a transition toward more plant protein, indicating that the consumption of plant-protein-based foods other than refined grains should be encouraged.
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Affiliation(s)
- Marion Salomé
- UMR PNCA, AgroParisTech, INRA, Université Paris-Saclay, Paris, France
| | - Erwan de Gavelle
- UMR PNCA, AgroParisTech, INRA, Université Paris-Saclay, Paris, France
| | - Ariane Dufour
- Risk Assessment Department, French Agency for Food, Environmental, and Occupational Health & Safety (ANSES), Maisons-Alfort, France
| | - Carine Dubuisson
- Risk Assessment Department, French Agency for Food, Environmental, and Occupational Health & Safety (ANSES), Maisons-Alfort, France
| | - Jean-Luc Volatier
- Risk Assessment Department, French Agency for Food, Environmental, and Occupational Health & Safety (ANSES), Maisons-Alfort, France
| | - Hélène Fouillet
- UMR PNCA, AgroParisTech, INRA, Université Paris-Saclay, Paris, France
| | | | - François Mariotti
- UMR PNCA, AgroParisTech, INRA, Université Paris-Saclay, Paris, France
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