Development of food literacy in children and adolescents: implications for the design of strategies to promote healthier and more sustainable diets

Food literacy has emerged as a key individual trait to promote the transformation of food systems toward healthy and sustainable diets. Childhood and adolescence are key periods for establishing the foundations of eating habits. Different food literacy competencies are acquired as children develop different cognitive abilities, skills, and experiences, contributing to the development of critical tools that allow them to navigate a complex food system. Thus, the design and implementation of programs to support the development of food literacy from early childhood can contribute to healthier and more sustainable eating habits. In this context, the aim of the present narrative review is to provide an in-depth description of how different food literacy competencies are developed in childhood and adolescence, integrating the extensive body of evidence on cognitive, social, and food-related development. Implications for the development of multisectoral strategies to target the multidimensional nature of food literacy and promote the development of the 3 types of competencies (relational, functional, and critical) are discussed.

Methodological approaches to assess tactile sensitivity in the food context-A scoping review

In contrast to taste sensitivity, the assessment of texture or tactile sensitivity has received relatively little attention in the food context. Texture plays an important role in food preferences and food intake, and individual differences make it important to understand physiological drivers of perception as tactile sensitivity. The multi-dimensional and dynamic aspects of texture perception suggest there is not one single method that can explain individual differences. This scoping review aims to systematically map methods assessing tactile sensitivity, in the context of food, highlighting differences in approach and implementation. Eligibility criteria included papers describing methods to assess individual differences in tactile sensitivity, that involved human participants and the context was relevant to food behavior. Sources are peer-reviewed publications of original research in English. In mapping the methods, we assessed how they relate to food texture parameters (mechanical, geometrical, and surface) and the dynamics of breaking down (touch with hand, first bite/sip, oral processing, residual or after-swallowing sensations). We also review other parameters associated (oral processing, preference, diet and food intake behavior). The literature in this relatively young area is still very fragmented and it is difficult to have a clear picture regarding best practices or recommendations for the measurement of tactile sensitivity in the food context. Future studies should aim to methodological harmonization for application in the food behavior area, with a design of experiment combining different aspects of tactile sensitivity to food, focusing on the thresholds and perceived intensity of textural parameters as well as affective and behavioral responses, and covering the whole spectrum of tactile texture perception (mechanical, geometrics, and surface), including the dynamics of perception.

Bringing down barriers to children's healthy eating: a critical review of opportunities, within a complex food system

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.

Children's reaction to sugar reduced dairy desserts in the context of the implementation of nutritional warning labels: An exploratory study

The aim of the present work was to explore children's reaction to sugar reduction in the context of the implementation of nutritional warnings in Uruguay. The study was composed of two sessions involving three evaluation conditions: tasting without package information, package evaluation without tasting, and tasting with package information. A total of 122 children, ages ranging between 6 and 13 years old (47% girls) were involved in the study. In the first session, children's hedonic and emotional response to a regular and a sugar-reduced chocolate dairy dessert (without other sweeteners) was evaluated. In the second session, children first evaluated their expected liking, emotional associations and choice of packages differing in the presence of warning labels for excessive sugar content and cartoon character (2x2 design). Finally, they tasted the selected sample in the presence of the package and evaluated their liking, emotional associations, and intention to re-taste it. Although sugar reduction led to a significant reduction in overall liking, the dessert with 40% sugar reduction showed a mean overall score of 6.5 in a 9-point hedonic scale and was described using positive emoji (, , ). When the desserts were tasted with package information, no significant differences in the expected overall liking of the regular and sugar-reduced dessert were found. Regarding the effect of packaging elements, the presence of a warning label highlighting excessive content of sugar did not have a significant effect on children's choice. Instead, children's choices were defined by the presence of a cartoon character. Results from the present work provide additional evidence about the feasibility of reducing the sugar content and sweetness of dairy products targeted at children and stress the need to regulate the use of cartoon characters on products with an unfavorable nutritional profile. Methodological recommendations for sensory and consumer research with children are also discussed.

Identifying temporal sensory drivers of liking of biscuit supplemented with brewer's spent grain for young consumers

Brewer's spent grain (BSG), a by-product of the brewing industry, has great potential as food additive. BSG is particularly rich in protein and fibre content which makes it an ideal nutritional fortifier for biscuits. However, adding BSG to biscuits can lead to changes in sensory perception and consumer acceptance. This study explored the temporal sensory profiles and drivers/inhibitors of liking in BSG-fortified biscuits. Six biscuit formulations were obtained from a design with factors oat flake particle size (three levels: 0.5 mm, small commercial flakes, large commercial flakes) and baking powder (two levels: with, without). Consumers (n = 104) tasted the samples, described their dynamic sensory perception using the Temporal Check-All-That-Apply (TCATA) method, and rated their liking on a 7-point categorical scale. The Clustering around Latent Variables (CLV) approach was used to group consumers into two clusters based on their preferences. The temporal sensory profiles and drivers/inhibitors of liking were investigated within each cluster. Foamy and Easy-to-swallow were sensory drivers of liking for both groups of consumers. However, inhibitors of liking were different in the two clusters: Dense and Hard-to-swallow for one cluster and Chewy, Hard-to-swallow and Hard for the other cluster. These findings give evidence that manipulating oat particle size and presence/absence of baking powder changes BSG-fortified biscuits' sensory profiles and consumer preferences. A complementary analysis of the area-under-curve of the TCATA data and inspection of individual temporal curves showed the dynamics of perception and showed how oat particle size and presence/absence of baking powder affected consumer perception and acceptance of BSG-fortified biscuits. The methods proposed in this paper can be further applied to understand how enriching products with ingredients that would otherwise go to waste affects acceptance in different consumer segments.

Opportunities and barriers for food intake in older age - a Norwegian perspective

Background

The ageing processes occur slowly over time and are often not detectable by the individual. Thus, preparing for dietary needs in later years should start at an earlier age than most people realise.

Objective

This study aims at better understanding what characterises food-related practices in active, home-living older adults, in order to identify food-related factors that act as barriers and those that promote healthy ageing.

Design

Three experiments were conducted: First, a web-based quantitative survey to collect information about home-living older adults' food-related behaviours (67+ years, N = 1,005). Second, two focus groups with respondents 67-74 years (N = 7) and 75-84 years (N = 6) to elicit aspects not adequately covered in the survey. Third, 10 individual interviews to provide in-depth insights.

Results

Two distinct groups were identified in the survey; 67-79 years and 80+ years. The older age group experienced more barriers and restrictions in food intake and food-related behaviours compared to the younger group. Good taste, routines and social settings were important for appetite and food intake.

Discussion

Using a mixed-methods approach proved valuable for extracting information and a better understanding of what impacts on food-related aspects amongst older adults. Strategies for upholding a healthy food intake involve establishing daily routines and meeting arenas where older adults can socialise and eat food together.

Conclusion

This study confirmed that knowledge of older adults' physical needs, barriers and abilities must be a part in preparation for a healthy diet.

ITER collective Thomson scattering-Preparing to diagnose fusion-born alpha particles (invited)

The ITER Collective Thomson scattering (CTS) diagnostic will measure the dynamics of fusion-born alpha particles in the burning ITER plasma by scattering a 1 MW 60 GHz gyrotron beam off fast-ion induced fluctuations in the plasma. The diagnostic will have seven measurement volumes across the ITER cross section and will resolve the alpha particle energies in the range from 300 keV to 3.5 MeV; importantly, the CTS diagnostic is the only diagnostic capable of measuring confined alpha particles for energies below ∼1.7 MeV and will also be sensitive to the other fast-ion populations. The temporal resolution is 100 ms, allowing the capture of dynamics on that timescale, and the typical spatial resolution is 10-50 cm. The development and design of the in-vessel and primary parts of the CTS diagnostic has been completed. This marks the beginning of a new phase of preparation to maximize the scientific benefit of the diagnostic, e.g., by investigating the capability to contribute to the determination of the fuel-ion ratio and the bulk ion temperature as well as integrating data analysis with other fast-ion and bulk-ion diagnostics.

Sixteen-week multicentre randomised controlled trial to study the effect of the consumption of an oat beta-glucan-enriched bread versus a whole-grain wheat bread on glycaemic control among persons with pre-diabetes: a study protocol of the CarbHealth study

INTRODUCTION

In 2012, the estimated global prevalence of pre-diabetes was 280 million, and the prevalence is expected to rise to 400 million by 2030. Oat-based foods are a good source of beta-glucans, which have been shown to lower postprandial blood glucose. Studies to evaluate the effectiveness of the long-term intake of beta-glucan-enriched bread as part of a habitual diet among individuals with pre-diabetes are needed. Therefore, we designed a multicentre intervention study in adults with pre-diabetes to investigate the effects of consumption of an oat-derived beta-glucan-enriched bread as part of a normal diet on glycated haemoglobin (HbA1c) in comparison to consumption of whole-grain wheat bread.

METHODS AND ANALYSIS

The CarbHealth trial is a multicentre double-blind randomised controlled 16-week dietary intervention trial in participants 40-70 years of age with a body mass index of ≥27 kg/m² and HbA1c of 35-50 mmol/mol. The study is conducted at four universities located in Norway, Sweden and Germany and uses intervention breads specifically designed for the trial by Nofima AS. The aim is to recruit 250 participants. The primary outcome is the difference in HbA1c between the intervention and the control groups. The main analysis will include intervention group, study centre and baseline HbA1c as independent variables in an analysis of covariance model.

ETHICS AND DISSEMINATION

The study protocol was approved by respective ethical authorities in participating countries. The results of the study will be communicated through publication in international scientific journals and presentations at (inter)national conferences.

TRIAL REGISTRATION NUMBER

NCT04994327.

The fourth industrial revolution in the food industry-part II: Emerging food trends

The food industry has recently been under unprecedented pressure due to major global challenges, such as climate change, exponential increase in world population and urbanization, and the worldwide spread of new diseases and pandemics, such as the COVID-19. The fourth industrial revolution (Industry 4.0) has been gaining momentum since 2015 and has revolutionized the way in which food is produced, transported, stored, perceived, and consumed worldwide, leading to the emergence of new food trends. After reviewing Industry 4.0 technologies (e.g. artificial intelligence, smart sensors, robotics, blockchain, and the Internet of Things) in Part I of this work (Hassoun, Aït-Kaddour, et al. 2022. The fourth industrial revolution in the food industry-Part I: Industry 4.0 technologies. Critical Reviews in Food Science and Nutrition, 1-17.), this complimentary review will focus on emerging food trends (such as fortified and functional foods, additive manufacturing technologies, cultured meat, precision fermentation, and personalized food) and their connection with Industry 4.0 innovations. Implementation of new food trends has been associated with recent advances in Industry 4.0 technologies, enabling a range of new possibilities. The results show several positive food trends that reflect increased awareness of food chain actors of the food-related health and environmental impacts of food systems. Emergence of other food trends and higher consumer interest and engagement in the transition toward sustainable food development and innovative green strategies are expected in the future.

Meat consumption and consumer attitudes - A Norwegian perspective

Norway has lower meat consumption than other North European countries. Meat is acknowledged as important for food security in Norway, as Norway's agricultural possibilities are best suited for free-ranging and self-foraging animals. Meat has a strong position in the Norwegian diet, particularly as a centrepiece for special occasions. Good taste, product variety, and affordable price make meat a convenient choice. Norwegian consumers are not worried about animal welfare in local production, nor highly driven by environmental motives for reducing their consumption. Meat analogues have a very small market share, and taste and processing level do not make it a primary replacement for meat reducers. Still, Norwegian consumers' attitudes towards meat have become more diverse in later years. More consumer segments display meat-reducing behaviours citing both health and sustainability reasons. Females are particularly interested in reducing meat consumption, young age and urban lifestyle are other characteristics of meat reducing segments.

Meat replacer? No thanks! The clash between naturalness and processing: An explorative study of the perception of plant-based foods

A shift towards a plant-based diet is desired to promote sustainability, improve health, and minimize animal suffering. However, many consumers are not willing to make such a transition, because of attachment to meat and unwillingness to change habits. The present work explored the perception of Norwegian and French consumers' attitudes, barriers and opportunities to increase the likelihood of a shift in diet. Three creative focus groups (CFGs), using interactive tasks such as photo-collage, projective mapping, story completion and third person technique, were run with omnivorous adult consumers in each country. CFGs gathers undirected feedback, providing less biased responses than other exploration methods, related to e.g. social norms. In both countries, results were in general lines comparable. Nutritional knowledge was low regarding vegetable proteins; familiar sources of protein were mostly animal. There is a strong gap between respondents' desired behaviour (balancing nutrition, eating less meat) and their actual behaviour: meat is very important, and the menu is often organized around it. Consumers are curious about vegetable sources of protein, but major constraints were hedonics in France, and convenience in Norway. The main barrier to a shift in diet is the lack of knowledge on how to prepare plant-based meals. Many participants find a conflict between health & sustainability in industrial products, perceiving them as highly processed and suggesting that meat replacers might not be a straightforward way to drive omnivorous consumers to shift to a more plant-based diet.

[Management of elective surgical activity in a tertiary hospital during the SARS-CoV-2 pandemic]

Introducción

Durante la pandemia por SARS-CoV-2 la actividad quirúrgica electiva se redujo a su mínima expresión. A medida que disminuyeron tanto el número de casos, como las necesidades de hospitalización para esta patología creímos oportuno proceder a recuperar progresivamente la actividad quirúrgica programada. El presente trabajo describe como, aún con el estado de alarma vigente, pudimos prácticamente normalizar dicha actividad en pocas semanas.

Metodología

Dos semanas antes de la intervención quirúrgica, se contactó telefónicamente con los pacientes incluidos en las listas de espera. Tras comprobar su estado de salud y manifestar su deseo de ser intervenidos quirúrgicamente se les proporcionaron recomendaciones para disminuir el riesgo de infección por coronavirus. Asimismo, se estableció un circuito exclusivo para llevar a cabo, 48 horas antes de la intervención, la detección de SARS-CoV-2 mediante reacción en cadena de la polimerasa (PCR) de exudado nasofaríngeo. Los resultados fueron valorados por cada servicio quirúrgico y el de anestesiología. Además, los profesionales del Área Quirúrgica asintomáticos podían someterse a un cribado semanal para la detección de coronavirus, según las recomendaciones de Salud Laboral.

Resultados

En plena pandemia, la actividad quirúrgica electiva se redujo un 85%. A partir de la semana del 13 de abril, se fueron recuperando los quirófanos disponibles, lo que permitió recobrar la práctica total de la actividad quirúrgica la semana del 25 de mayo.

Conclusiones

La creación de circuitos y procedimientos para agilizar la actividad quirúrgica, aún en plena vigencia del estado de alarma, nos ha permitido, en pocas semanas, recuperar la práctica total de la misma.

Children as food designers: The potential of co-creation to make the healthy choice the preferred one

According to the WHO, childhood obesity is one of the most serious public health challenges of the twenty-first century. In this context, finding ways to make the healthier food choices the preferred ones can be a valuable contribution to solving this multifaceted problem. Sensory and consumer science offers a wide range of tools that can support the development of healthy and well-accepted food alternatives. In traditional sensory and consumer science, children would be involved in the product development process either as testers or informants. However, in our opinion, it would be valuable to extend their role to co-creators or co-designers, an approach already more established in the field of innovation and design, where children actively participate in the idea generation and development of healthy food that they will like and choose. Our own experience has shown that involving children in the idea-generation step for healthy food can be highly motivating and stimulating for them. In this opinion article, we discuss why it is important to include children actively as a relevant consumer segment in product development and suggest a process and methods that could be valuable for brainstorming about food ideas with children.

Validation of BGaze method supporting ADHD diagnosis

Introduction

Eye movement recordings can provide information about higher-level processing of visual information. Recent evidence shows a novel role for eye vergence in orienting attention (Solé Puig et al., 2013). Based on such eye tracking data, the BGaze method (Braingaze; Spain) detects visual attention. The outcomes of the BGaze method have been applied to classify ADHD patients from healthy controls.

Aim

In this study, we validated the BGaze method.

Objective

We therefore recorded eye movements in children while performing a visual detection task.

Methods

We evaluated the BGaze method using 4 types of supervised machine learning algorithms. In total, 138 different trained models were tested. Nineteen ADHD diagnosed patients (children 7–14 years of age) and 19 healthy age matched controls were used to build the 138 models. We performed 30 times repeated random sub-sampling validation. In each repeated random split, training set consisted of 80% of the data and test set of the remaining 20%. Finally, all the 138 models were tested with a validation set consisting of 232 children, including 22 ADHD patients.

Results

Across all the 138 models, BGaze method showed an average accuracy of 90.84% (minimum 86.21%; maximum, 95.26%) and an average AUC of 0.95 (minimum 0.90; maximum, 0.97). Best models gave accuracies of 92%, AUCs of 0.96 and FN and FP rates of 4.3% and 7.5%, respectively. Mean scores during the training-testing phase averaged 99.63%.

Conclusion

The BGaze method is robust, accurate, and can provide an objective tool supporting the clinical diagnosis of ADHD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Cross-modal interactions as a strategy for sugar reduction in products targeted at children: Case study with vanilla milk desserts

The high availability of products with high sugar content, particularly among those targeted as children, has been identified as one of the factors that contribute to the childhood obesity epidemic. For this reason, product reformulation has been recommended as one of the strategies that can be implemented to achieve short-term reductions in children's sugar intake. In this context, the objective of this study was to evaluate the feasibility of using cross-modal (taste-odor-texture) interactions as a strategy for reducing the sugar content of products targeted at children, using milk desserts as case study. A series of 5 vanilla milk desserts were formulated: a control sample with 12% added sugar and 4 sugar-reduced samples (7% added sugar) prepared following a 2 × 2 experimental design by varying vanilla (0.4% and 0.6% w/w) and starch (4.3% and 4.7% w/w) concentrations. A total of 112 children (8-12 years old) tasted the desserts and performed a dynamic sensory characterization task using either temporal check-all-that-apply or temporal dominance of sensations. In addition, they assessed the overall liking of all samples. Results showed that sugar-reduced samples did not significantly differ from the control sample in terms of their average overall liking scores. However, individual differences in children's hedonic reaction were found; three clusters of children with distinctive liking patterns were identified. The increase in vanilla and starch concentration led to an increase in overall liking for over 80% of the children. Sensory dynamic profiles revealed significant but subtle differences among samples. Results from the present work suggest that cross-modal interactions could contribute to minimizing the sensory changes caused by sugar reduction, which could enable to achieve larger reductions if implemented in the context of gradual sugar reduction programs.

Potential Impact of Oat Ingredient Type on Oral Fragmentation of Biscuits and Oro-Digestibility of Starch-An In Vitro Approach

The aim of the present study was to determine how variation in the biscuit matrix affects both the degree of in vitro fragmentation and the starch hydrolysis that occurs during the oral phase of digestion. Using three different oat ingredient types (oat flour, small flakes, and big flakes) and baking powder (or none), six biscuits with different matrices were obtained. The instrumental texture (force and sound measurements) of the biscuits was analyzed. The samples were then subjected to in vitro fragmentation. The particle size distribution and in vitro oral starch hydrolysis over time of the fragmented samples were evaluated. The results showed that the samples presented different fragmentation patterns, mainly depending on the oat ingredient type, which could be related to their differences in texture. The biscuits made with oat flour were harder, had a more compact matrix and showed more irregular fragmentation and a higher percentage area of small particles than those made with big oat flakes, which were more fragile and crumbly. The highest degree of starch hydrolysis corresponded to the biscuits made with flour. Conclusions: Differences in the mechanical properties of the biscuit matrix, in this case due to differences in the oat ingredient, play a role in the in vitro fragmentation pattern of biscuits and in the oral phase of starch hydrolysis.

Connecting flavors in social media: A cross cultural study with beer pairing

Culture is an important driver of food preferences and largely determines exposure to ingredients combinations. The cultural variety in culinary practices across countries raises the question of how flavor combinations are built and how they transcend individual differences in consumers' preferences. For example, in Latin America, despite having similar cultures and language, the diversity in culinary practices leads to different flavor combinations across nations. Therefore, we hypothesize that each country will show different preferences in flavor combinations that could be understood by social media exploration as an innovative approach. One study was conducted exploring social media in four countries (Argentina, Colombia, Peru, and Mexico) on a one-year basis, using a list of fifty-seven keywords associated with beer flavors. In a first analysis, the list of mentions from consumers was categorized in frequencies of flavors per country and analyzed using correspondence analysis (CA) and agglomerative hierarchical clustering (AHC). Results showed that the countries could be clustered in three groups. Cluster 1 with Mexico and Peru, and the rest of the countries in different clusters. The co-occurrence of paired flavors in social media was used to build a similarity matrix that was analyzed using multidimensional scaling (MDS) in order to find a pattern of pairing per country. The obtained map was useful to understand the cultural differences in flavor paring per country. Overall, the analysis of flavor pairing through social media was an effective technique to access the structure of flavor pairing for beer in different countries.