Redécouverte des propriétés fonctionnelles de l’aliment : fondements scientifiques généraux

Historically the links between food and health have been reported a long time ago. Food scarcity triggered first progress in food technology to secure production and storage of enough food. After satisfying basics nutritional needs with a balanced and diversified diet, the potential role of food on physiological functions, well-being and reduction of risk diseases factor are (re)discovered. This is the concept of Functional Food. It has been explored and formalised by a large panel of multidisciplinary experts within a EU programme (FUFOSE) that we summarized.     

Quels types de produits céréaliers pour le petit déjeuner ?

Breakfast is an essential meal since it provides 25% of the energetic needs and participates to a better food balance over the day; furthermore breakfast consumption is correlated with a better mental and physical health. An increased consumption of high-quality cereals, such as bread and ready-to-eat cereals, at breakfast should allow reaching the objective of 55% energy supplied by carbohydrates, notably complex carbohydrates (starch and fibre). However, both products exhibit inconstant nutritional qualities according to the raw materials and technological processes used. Brown bread should be favoured instead of white bread which has a low nutritional density and a high glycaemic index; baking processes will have to be improved, and a better communication will be necessary to favour the consumption of breads of high nutritional quality. Ready-to-eat cereals intended for adults are of better nutritional quality than those intended for children, containing less simple sugars and lipids, and more fibre.     

Position of the American Dietetic Association: food and nutrition misinformation

It is the position of the American Dietetic Association (ADA) that food and nutrition misinformation can have harmful effects on the health, well-being, and economic status of consumers. Nationally credentialed dietetics professionals working in health care, academia, public health, the media, government, and the food industry are uniquely qualified to advocate for and promote science-based nutrition information to the public, function as primary nutrition educators to health professionals, and actively correct food and nutrition misinformation. Enormous scientific advances have been made in the area of food and nutrition, leading to a fine-tuning of recommendations about healthful eating. Consumers have become increasingly aware of the nutrition-health link and reliant on nutrition information to base their decisions, and have assumed partial responsibility for changing their eating behaviors. Unfortunately, these same trends also create opportunities for food and nutrition misinformation to flourish. News reports rarely provide enough context for consumers to interpret or apply the advice given, and preliminary findings often attract unmerited and misleading attention. Effective nutrition communication must be consumer-friendly and contain sufficient context to allow consumers to consider the information and determine whether it applies to their unique health and nutritional needs. Consistent with ADA's organizational vision that members "are the leading source of nutrition expertise," ADA recognizes its responsibility to help consumers identify food and nutrition misinformation in the following ways: (a) ADA members should provide consumers with sound, science-based nutrition information and help them to recognize misinformation; (b) ADA members need to be the primary source of sound, science-based nutrition information for the media and to inform them when misinformation is presented; and (c) ADA members should continue to diligently work with other health care practitioners, educators, policy makers, and food and dietary supplement industry representatives to responsibly address the health and psychological, physiological, and economic effects of nutrition-related misinformation.     

Place du diététicien dans l’équipe de soutien nutritionnel : évolution d’une profession

Recognised 30 years ago, hospital nutritional depletion remains a major problem of public health which concerns from 30% to 50% of all patients at admission. The circular DHOS/E 1 n? 2002-186 of the 29 March 2002, recommending the implementation of both the committee for food-nutrition (CLAN: Comité de Liaison Alimentation Nutrition) and the nutrition support team within the hospital, is the result of 10 years effort in regard to food-nutrition and the accreditation process in health care. The dietician, previously accountable for the quality of food and dietary services, has now the opportunity to play a leading role within the nutritional care team for the screening and treatment of nutritional depletion. However, the initial training and the present status of the dietician don’t allow him to follow this evolution effectively. Updating of his training and the redefinition of his missions seem indispensable to respond to today's health care needs. This will help to ensure that above legal recommendation can be applied.     

Organic foods: do they have a role?

Nutritional quality is defined as the value of the product for the consumer's physical health, growth, development, reproduction and psychological or emotional well-being. This extended definition of nutritional quality can be divided into two terms. One term is for the effects of food determined by its substance, i.e., the sum of all ingredients, beneficial and harmful compounds and their nutritional (or biological) aspects. As a function of inherent inconsistencies ranging from soil and climate differences to effects of cultivars, seasons and agricultural practices, differences in desirable ingredients are less pronounced compared with undesirable ingredients. Where differences are detected, the higher product quality is mostly found in organic produce. A potential advantage of organic agriculture in producing healthy foods is based on higher concentrations of beneficial secondary plant substances in organically grown crops compared to nonorganically grown crops. The second term of nutritional quality covers the feelings of well-being (or indisposition) that certain foods can induce in consumers. Organic agriculture has been confirmed as environmentally sound and more sustainable than mainstream agriculture. Related to this knowledge, the consumer's well-being is based on indulgence and the certainty that by purchasing, eating and enjoying organic food, one has contributed to a better future and an improved environment. These effects with their social implications along with improved animal welfare may, in the end, be more important than any measurable contribution of balanced Western diets to individual nutritional health.     

Food advertising: advice or merely stimulation of consumption?

Current advertising messages for food products deserve special attention, since they indicate that the media has played a central role in shaping new eating habits. The food industry, seeking to serve a new customer segment (increasingly preoccupied with health and physical well-being), and with a specific interest in this promising market, has intensified its marketing strategies for stimulating consumption of diet and light food products. This study analyzed 20 food advertisements published from June to October 2006 in Brazilian magazines and newspapers with nationwide circulation. The following elements were analyzed in the advertisements: the advertiser; the audience; the language; and the message. It was seen that the advertising message mainly targeted women, proposing guilt-free consumption, promising a combination of esthetics and health. In order to enhance their product, several advertisements omitted relevant nutritional information while others promoted hazardous combinations with pharmaceutical products, and still others induced the target public to replace regular meals with their product. The results signal the need to broaden the discussion on the strategies for food advertising, as the citizen's right to information and health cannot be subjugated to market values.     

Le coût et la qualité nutritionnelle des groupes d’aliments: quelle hiérarchie?

Based on the mean retail price of 691 foods grouped in 7 food-groups and 26 sub-groups, and on the consumption of these foods by 4 834 participants to the SUVIMAX study, we estimated the cost, the nutrient density and the excess in undesirable components in 10 MJ provided by each food group and sub-group. Meat/fish/eggs and fruits and vegetables, which are the most expensive sources of energy, have the highest nutritional quality. High sugar, fat and salt containing products and added fats, which are the cheapest sources of energy, have the lowest nutritional quality. Unrefined staples are interesting because they are cheap sources of energy that have a low content in undesirable components. In each group, some food-groups have a higher nutritional quality/price ratio than others, suggesting that, by selecting them preferentially, a healthy diet could be obtained at a moderate cost.     

Un outil à découvrir en nutrition humaine : la programmation linéaire

Linear programming (LP) makes it possible to devise, from a list of foods of known nutritional composition, food rations which conform to a set of nutritional recommendations whilst satisfying various requirements as regards cost, preferences and eating habits. Using the “solver” function in the “Tools” drop-down menu, the Excel program can solve LP problems. The principle of LP and its practical implementation are explained here in detail using a simple example based on just two foods. The listing of numerous possible uses of LP in human nutrition illustrates the value of this tool to take account of the fundamentally multifactorial aspect of the problems posed in this domain, in particular the existence of numerous foods made up of numerous nutrients and the wide diversity of human dietary behaviours and food availability contexts.     

Global Obesity: Nestle Initiatives in Nutrition, Health, and Wellness

This paper addresses some of the ways that Nestle is making a long-term commitment to the health and well-being of consumers. In particular, Nestle, like other food companies, has a role to play in improving people's health and wellness by improving the nutritional profile of foods, by ensuring sound communication on nutrition and consumer education, and by collaborating with other stakeholders in order to improve consumer health.     

Athletes’ and Coaches’ Perceptions of Nutritional Advice: Eating More Food for Health and Performance

Background: Low energy availability results in physiological adaptations which contribute to unfavourable health outcomes. Little information exists on perceptions of nutritional advice to eat more food to maintain health and enhance performance. The aim of this study was to explore athletes’ and coaches’ perceptions towards advice to athletes to eat larger than their current quantities of food and to explore how nutritionists could deliver this advice. Methods: Semi-structured interviews (~20 min in length) were conducted using online communication technology, audio-recorded, and transcribed verbatim. The interview explored perceptions of the nutritional advice provided, its role in health and performance, and the challenges to eating larger amounts of food. Data were analysed using NVIVO 1.2 using an inductive thematic approach. Results: Nine elite athletes (female = 6; males = 3) and nine high-performance coaches (female = 3; male = 6) completed the semi-structured interviews. Athletes reported improved training consistency, fewer injuries and illnesses, and improved resilience when consuming adequate energy and nutrients to meet their needs. Lack of time and meal preparation difficulties were the main challenges faced to fuelling. Conclusions: Although education about under-fuelling is important, motivating, enabling, and supporting athletes to change behaviour is pivotal to increasing athlete self-awareness and to make long-term nutritional changes.     

Nutrimap: un outil opérationnel pour le profilage nutritionnel des produits alimentaires et des repas

Based on current nutritional guidelines and on observed levels of dietary intakes, Nutrimap^® is a nutritional profiling system designed to help choices orientated towards an improvement of the global nutritional quality of the diet. Nutrimap^® enables the positioning of food items on a two-dimension graph where both coordinates correspond to their nutritional assets or weaknesses. These coordinates are generated through an analysis of the nutritional composition of the food, which takes into account the considered food group and its contribution to nutrient supply to weight differently the nutritional criteria. The discriminative power of Nutrimap^® is exemplified with two food categories (meat, egg and fish and composite dishes). Simulation on children’s afternoon collation gathering different food items shows that Nutrimap^® can be a valuable help in designing meals of controlled nutritional value. Other uses, namely food labelling or support for nutritional policies, are mentioned.     

Impact des allégations nutritionnelles et de santé sur le consommateur

Several consumer studies have shown that consumers are quite sceptical towards the concept of functional foods in general. Consumer acceptance is mainly shaped by subjective determinants, more specifically personal confidence in the alleged nutrition and health claims. Additionally, consumers are hardly willing to compromise on taste for the promise of better health. Strongest hesitation is seen towards disease reduction claims, which are also the most explicit and most difficult to prove claim type, as well as for non-natural and unfamiliar combinations of carrier products and functional ingredients. Higher levels of perceived control over personal health, and stronger perceptions of functional foods as a marketing scam have a strong negative impact on consumer reactions towards foods with nutrition and health claims. Reactions of consumers from specific risk groups, e.g. because of their health status or nutritional needs, have hardly been investigated thus far. The identification of needs and interests of these market segments, as well as the evaluation of consumer understanding of claims constitute a major challenge for future consumer research in this domain.     

Sexual satisfaction and sexual health among university students in the United States

Despite the World Health Organization's definition of sexual health as a state of well-being, virtually no public health research has examined sexual well-being outcomes, including sexual satisfaction. Emerging evidence suggests that sexual well-being indicators are associated with more classic measures of healthy sexual behaviors. We surveyed 2168 university students in the United States and asked them to rate their physiological and psychological satisfaction with their current sexual lives. Many respondents reported that they were either satisfied (approximately half) or very satisfied (approximately one third). In multivariate analyses, significant (P < .05) correlates of both physiological and psychological satisfaction included sexual guilt, sexual self-comfort, self-esteem (especially among men), relationship status, and sexual frequency. To enhance sexual well-being, public health practitioners should work to improve sexual self-comfort, alleviate sexual guilt, and promote longer term relationships.     

School-based "Shokuiku" program in Japan: application to nutrition education in Asian countries

This paper provides the overview of "Shokuiku" in Japan, and discusses the future perspective on application of its concepts to nutrition education in other Asian countries. In Japan, there has been a growing concern on increase of obesity and the metabolic syndrome among middle-aged men. Additionally, child obesity has also become one of the important health problems. The increased obesity among them is possibly associated with inappropriate dietary habits (eg skipping breakfast, excessive fat intake and insufficient vegetable). Under this circumstance, the "Basic Law on Shokuiku" was enacted in 2005, which was the first law that regulates one's diets and eating habits. For effective implementation of Shokuiku program, dietitians and registered dietitians would play important roles in various settings. Japan has a long history of dietitian system as well as school-lunch programs. Later, in order to further enhance the school-based Shokuiku programs, the Diet and Nutrition Teacher System was established in April 2007. From an international point of view, "nutrition education" programs aim to improve dietary practices so as to ensure adequate energy or nutrient intake and also to reduce obesity and lifestyle-related diseases, whereas the concepts of Shokuiku have very wide approaches. Shokuiku's efforts expand to support food culture, especially through school-based programs, as well as to improve food environment by providing information on appropriate diets. These approaches can be introduced in nutrition education in other Asian countries, not only to improve one's health and nutritional status but also to secure food culture and food safety in each country.     

Consommation alimentaire et durée d’hémodialyse chez l’insuffisant rénal chronique : corrélation aux paramètres nutritionnels

The aim of this study was to describe food consumption of CRF patients after different hemodialysis duration and to correlate them with some nutritional parameters. Fifty-eight patients divided into three groups: GI: <1 year, GII: 1 to 5 years, GIII: 5 to 13 years of hemodialysis were compared with 22 controls. Reduction of total energy intake by 47% and 30% and protein intake by 49% and 38% was noted in GIII vs GI and GII, respectively. Patients had a dialysis dose (Kt/V) of 0.83±0.35 and a low body mass index. Seventy-seven per cent of patients had hypoalbuminemia (<37g/L). Decreased food consumption involves protein-energy malnutrition and represents a mortality risk.     

Nutrition assessment of athletes: a model for integrating nutrition and physical performance indicators.

Athletes, like all people, have special nutritional needs based on their age, lifestyle, health status, level of physical activity, physical conditioning, and type of sport. The diets of many athletes are inadequate due to overly restrictive eating habits, nutrition misinformation, dietary fads, and/or obsession with weight and food. There is a growing need for sports nutrition counseling and education to help athletes improve their eating habits. However, before attempting to develop intervention strategies, sports nutritionists should assess the metabolic changes that take place during exercise and how these changes affect nutrition status. In addition, it is important to consider how psychosocial factors may influence an athlete's eating habits and his/her ability to make positive changes. A two-pronged model is introduced that can be used as a guide for the practitioner in interpreting relevant data and integrating physiological and psychological considerations for the design of individualized nutrition care plans for athletes.     

Pleasure, pursuit of health or negotiation of identity? Personality correlates of food choice motives among young and middle-aged women.

The clustering of four food choice motives (health, weight concern, pleasure and ideological reasons) and the relationship between personality and the food choice motives were analysed among young and middle-aged women in two studies. The personality variables included personal strivings, magical beliefs about food, awareness and internalization of thinness pressures, appearance and weight dissatisfaction, depression, self-esteem and symptoms of eating disorders. Study 1 was done with 171 young and middle-aged women. In Study 2, with data provided by 118 senior high-school girls, one cluster of girls who did not regard any of the food choice motives as important was found, otherwise the food choice clusters were fairly similar in both studies. They were labelled as health fosterers, gourmets, ideological eaters, health dieters and distressed dieters. Only the second dieter group, distressed dieters, showed low psychological well-being and symptoms of disordered eating. The results also indicated that ideological food choice motives (i.e. expression of one's identity via food) were best predicted by vegetarianism, magical beliefs about food and health, and personal strivings for ecological welfare and for understanding self and the world.     

Facteurs associés aux consommations alimentaires des bénéficiaires de l’aide alimentaire : étude abena

The majority of data available on the nutritional situation of low socioeconomic populations in industrialized countries describe a diet that is less favorable for health. The objective of this article is to describe the demographic and economic factors associated with low food intakes as defined by the National Nutrition and Health Program (Programme National Nutrition Santé, PNNS) dietary guidelines in a food aid dependent population.Subjects from the Abena (Food and nutritional status of food aid recipients) study were recruited in four urban zones (Marseille, Dijon, Paris, Seine-Saint-Denis). Questionnaires were principally about food intake frequencies, food supplies and food insecurity.Among the 1,164 included subjects, low consumption frequencies of fruits and vegetables (94.5% consuming <3.5/day), meat, fish and eggs group (42.6% <1/day), and dairy products (81.9% <3/day) were found. Men, young and aged people, and individuals with dependent children seem to be more often at risk for inadequate intakes with regard to the PNNS dietary guidelines. The food insecurity (49.2% declared not having enough to eat “sometimes” or “often”) was associated with an insufficient intake of fruits and vegetables, and meat, fish, and eggs.The described factors associated with lower food intakes observed in this precarious population confirms the notion that fruit and vegetable, and meat, fish and egg consumptions are markers of the socioeconomic status. This has been already observed in studies on more various socioeconomic statuses. The nutritional situation of food aid recipients described here underlines the need for food aid improvement, eventually focused on specific groups which have been identified.     

Nutritional intervention and quality of life in adult oncology patients

The evaluation of quality of life (QoL) assesses patients' well-being by taking into account physical, psychological and social conditions. Cancer and its treatment result in severe biochemical and physiological alterations associated with a deterioration of QoL. These metabolic changes lead to decreased food intake and promote wasting. Cancer-related malnutrition can evolve to cancer cachexia due to complex interactions between pro-inflammatory cytokines and host metabolism. Beside and beyond the physical and the metabolic effects of cancer, patients often suffer as well from psychological distress, including depression. Depending on the type of cancer treatment (either curative or palliative) and on patients' clinical conditions and nutritional status, adequate and patient-tailored nutritional intervention should be prescribed (diet counselling, oral supplementation, enteral or total parenteral nutrition). Such an approach, which should be started as early as possible, can reduce or even reverse their poor nutritional status, improve their performance status and consequently their QoL. Nutritional intervention accompanying curative treatment has an additional and specific role, which is to increase the tolerance and response to the oncology treatment, decrease the rate of complications and possibly reduce morbidity by optimizing the balance between energy expenditure and food intake. In palliative care, nutritional support aims at improving patient's QoL by controlling symptoms such as nausea, vomiting and pain related to food intake and postponing loss of autonomy. The literature review supports that nutritional care should be integrated into the global oncology care because of its significant contribution to QoL. Furthermore, the assessment of QoL should be part of the evaluation of any nutritional support to optimize its adequacy to the patient's needs and expectations.     

Bases nutritionnelles pour un vieillissement réussi

Aging is an inevitable biological feature of living organisms. Moreover, human lifespan is increasing. In last years, many studies featured a molecular basis and biological events that contribute to the progressive decline in cellular functioning at the time of senescence.The aging itself may be at the origin of various states that render this population very heterogeneous because subjects, at equivalent age, can be: in a state of good health at home, active - “fragile”, less active and at risk of diseases - ill, acute or chronic, dependent or independent. But they can also benefit from “successful aging” described for the first time by Rowe and Kahn in 1987 as an aging without disease or handicap, allowing a high level of physical activity and cognitive function and accompanied by an engagement and activities in the social life. The optimal nutrition is one of the most accessible modifiable factors to module the aging by means of targeted strategies in order to favor a successful aging. One of the first is the identification of persons at risk of nutritional diseases, either being by overcharge or by defects, and even by deficiencies such as denutrition. Because of physiological changes linked to aging itself can reach the capacities of eating and cause consequences on the nutritional state: loss of appetite, precocious satiety, and decreased taste perception. The nutrition plays a role on practically all factors of senescence. We will limit the subject to some fundamental mechanisms on which the nutritional impact is recognized: insulin resistance, oxidative stress, stabilization of the weight and the loss of the muscular mass called sarcopenia whose consequences are deleterious. Two levers for action are synergetic: the alimentation and the moderate physical exercise which improves its efficiency. Some practical means will then be proposed to equilibrate food, on the sight of the study results, that follows Euronut-Seneca, Healthy Aging: Longitudinal Study in Europe (HALE) which proposes a multi disciplinary approach to the successful aging and to its determinants in 11 European countries, by featuring the positive factors of successful aging in volunteers having reached a long longevity, in a good state of physical and psychological health… These advises are also those allowing to preserve a good cardiovascular, metabolic, and even vascular cerebral state, so a good cognitive status.Finally, to preserve the status in micronutrients, without hoping that global alimentary supplements allow compensating all deficiencies due to the aberrant alimentations, in particular restrictive. The epidemiological studies show that subjects taking the most of supplements are those having no deficits… in particular in antioxidatives, which increases the risk of limiting the necessary apoptosis of damaged cells.In conclusion: to conserve the desire to eat, a varied diet in moderation, in convivial manner each time is possible and without monotony which is deleterious for alimentation like sedentarity for physical well-being.