Nutritional characterisation of foods: Science-based approach to nutrient profiling

Background

The background of the workshop was the proposed EU legislation to regulate nutrition and health claims for foods in Europe. This regulation will require the development of a science-based nutrient profiling system in order to determine which foods or categories of foods will be permitted to make nutrition or health claims. Nutrient profiling can also be used to categorize foods, based on an assessment of their nutrient composition according to scientific principles. Today, various nutrient profiling schemes are available to classify foods based on their nutritional characteristics.

Aim

The aim of the workshop was to discuss the work developed by ILSI Europe’s expert group and to explore wider scientific aspects of nutrient profiling, including their relative effectiveness, strengths and weaknesses. In particular, the focus of the workshop was on scientific approaches to the development of nutrient profiles for the purpose of regulating nutrition and health claims. The 76 workshop participants were scientists from European academic institutions, research institutes, food standards agencies, food industry and other interested parties, all of whom contributed their thinking on this topic.

Results

The workshop reached a degree of agreement on several central points. Most participants favored a food category approach rather than an ‘across the board’ system for nutrient profiling. Most also felt that nutrient profiling schemes should focus on disqualifying nutrients, while taking into due account relevant qualifying nutrients. Levels of each nutrient should be clearly defined for all food categories to be profiled. Reference amounts selected for further considerations were: (1) per 100 g/100 ml, (2) legislated reference amounts, and (3) per 100 kcal. The majority of workshop participants agreed that nutrient profiling schemes should allow for a two-step decision process; step (1) identify which nutrients to take into account, and step (2) define the thresholds for these nutrients. All participants agreed that an objective validation should be conducted before implementation of nutrient profiling. This would include determination of sensitivity and specificity using “indicator foods” selected on their potential to affect major health issues. The management of any adopted system needs to allow it to be dynamic over time and revise the system when new scientific knowledge emerges.

Conclusions

The majority of participants favored a food category approach rather than an ‘across the board’ system. Further work is required to identify the final list of qualifying and disqualifying nutrients for any food category that may be identified and for the selection of optimal reference amounts. It is essential that key stakeholders continue to communicate and work together on the complex issues of nutrient profiling.

     

Colonic Microflora: Nutrition and Health0. Summary and Conclusions of an International Life Sciences Institute (ILSI) [Europe] Workshop held in Barcelona, Spain

The colonic microflora is an organism that performs a variety of unique activities. It is more important to evaluate these activities than to analyze bacterial composition in terms of genera, species, or strains. Unless the bacteria translocate, it is the activities of the colonic microflora that affect colonic and systemic physiology and not the bacteria themselves.     

Nutrient-dense food groups have high energy costs: an econometric approach to nutrient profiling

Consumers wishing to replace some of the foods in their diets with more nutrient-dense options need to be able to identify such foods on the basis of nutrient profiling. The present study used nutrient profiling to rank 7 major food groups and 25 subgroups in terms of their contribution to dietary energy, diet quality, and diet cost for 1332 adult participants in the French National INCA1 Study. Nutrient profiles were based on the presence of 23 qualifying nutrients, expressed as the percentage of nutrient adequacy per 8 MJ, and 3 negative or disqualifying nutrients, expressed as the percentage of the maximal recommended values for saturated fatty acids, added sugar, and sodium per 1.4 kg. Calculated cost of energy (euro/8 MJ) was based on the mean retail price of 619 foods in the nutrient composition database. The meat and the fruit and vegetables food groups had the highest nutritional quality but were associated with highest energy costs. Sweets and salted snacks had the lowest nutritional quality but were also one of the least expensive sources of dietary energy. Starches and grains were unique because they were low in disqualifying nutrients yet provided low-cost dietary energy. Within each major food group, some subgroups had a higher nutritient-to-price ratio than others. However, the fact that food groups with the more favorable nutrient profiles were also associated with higher energy costs suggests that the present structure of food prices may be a barrier to the adoption of food-based dietary guidelines, at least by low-income households.     

Alcohol and prisons: report of a workshop held by WHO HIPP at the Eurocare Bridging the Gap Conference, Helsinki, November 2006

A major European Alcohol Policy Conference, Bridging the Gap,was held in Helsinki, Finland from 20th to 22nd of November2006. The World Health Organisation Health in Prison Project(WHO HIPP)¹ convened a workshop on the subject of Alcohol inPrisons. The workshop was led by Dr Alex Gatherer, WHO HIPP;Dr Andrew Fraser, Director of Health and Care, Scottish PrisonService; Dr Lesley Graham, Public Health Specialist, ScottishPrison Service and Dr Heikki Vartiainen, Medical Director, PrisonHealth Services, Helsinki, Finland. Major strategic objectives of WHO HIPP were outlined, namely,to harmonize and integrate public health with prison healthand to promote international awareness and best practice. Arecent development in global public health thinking is the underpinningof human rights, and therefore the right to health, as a driverfor health development and health for all.     

Assessment of the intake of dietary fibre from cereal foods: an epidemiological approach.

In a study evaluating the intake of dietary fibre from cereal foods the results obtained from a standard 7-day weighed record were compared with simpler methods. This showed that weighing was unnecessary to obtain a valid measure of intake. There was also a low ratio of within-subject to between-subject variation: thus four days of recording are all that are required. The 4-day unweighed record is cheaper, less complex, and may be expected to produce higher completion rates than the 7-day weighed record.     

Assessing exposure in epidemiologic studies to disinfection by-products in drinking water: report from an international workshop

The inability to accurately assess exposure has been one of the major shortcomings of epidemiologic studies of disinfection by-products (DBPs) in drinking water. A number of contributing factors include a) limited information on the identity, occurrence, toxicity, and pharmacokinetics of the many DBPs that can be formed from chlorine, chloramine, ozone, and chlorine dioxide disinfection; b) the complex chemical interrelationships between DBPs and other parameters within a municipal water distribution system; and c) difficulties obtaining accurate and reliable information on personal activity and water consumption patterns. In May 2000, an international workshop was held to bring together various disciplines to develop better approaches for measuring DBP exposure for epidemiologic studies. The workshop reached consensus about the clear need to involve relevant disciplines (e.g., chemists, engineers, toxicologists, biostatisticians and epidemiologists) as partners in developing epidemiologic studies of DBPs in drinking water. The workshop concluded that greater collaboration of epidemiologists with water utilities and regulators should be encouraged in order to make regulatory monitoring data more useful for epidemiologic studies. Similarly, exposure classification categories in epidemiologic studies should be chosen to make results useful for regulatory or policy decision making.     

Variations in the apparent nutrient content of foods: a study of sampling error.

1. Successive portions of boiled and mashed potatoes, roast pork, cooked, freeze-dried peas and ice-cream were taken in order to determine the total (sampling and experimental) error involved in the 'duplicate analysis' method of dietary survey. 2. These samples were analysed for water, nitrogen, fat, iron and energy. 3. The experimental error of the methods was also studied separately. 4. The sampling and experimental errors ranged from 0-3% for water in potatoes, to 23% for Fe in ice-cream. Sampling error was significantly greater than experimental error for all nutrients studied. 5. It is concluded that in reporting the results from dietary surveys, it is necessary to take account of the erros inherent even in the most precise methods.     

Big Data in Israeli healthcare: hopes and challenges report of an international workshop

In September 2015, the Israel National Institute for Health Policy Research (NIHP) organized a workshop to address the hopes and challenges of Big Data in healthcare in the Israeli context. The paper provides an overview of the challenges and hopes raised by data driven science and Big Data, along with a summary of Israel’s strengths and weaknesses regarding Big Data, as discussed by the speakers in the course of the conference. It concludes with some hints on how Israel’s advantages in this field might be leveraged.     

Summary of an NIH workshop to identify research needs to improve the monitoring of iodine status in the United States and to inform the DRI

The Office of Dietary Supplements (ODS) at the NIH sponsored a workshop on May 12-13, 2011, to bring together representatives from various NIH institutes and centers as a first step in developing an NIH iodine research initiative. The workshop also provided an opportunity to identify research needs that would inform the dietary reference intakes for iodine, which were last revised in 2001. Iodine is required throughout the life cycle, but pregnant women and infants are the populations most at risk of deficiency, because iodine is required for normal brain development and growth. The CDC monitors iodine status of the population on a regular basis, but the status of the most vulnerable populations remains uncertain. The NIH funds very little investigator-initiated research relevant to iodine and human nutrition, but the ODS has worked for several years with a number of other U.S. government agencies to develop many of the resources needed to conduct iodine research of high quality (e.g., validated analytical methods and reference materials for multiple types of samples). Iodine experts, scientists from several U.S. government agencies, and NIH representatives met for 2 d to identify iodine research needs appropriate to the NIH mission.     

Pneumococcal disease in Australia: current status and future challenges. A report of the workshop held at the National Centre for Immunisation Research and Surveillance, 8-9 November, 2002.

In relation to surveillance, the predominant issue discussed was universal versus sentinel enhanced surveillance of IPD. In northern Australia, it will be important for enhanced surveillance to continue and to be as complete as possible. There are a number of reasons for this. First, the high incidence and high serotype diversity of IPD in Indigenous children in these areas has prompted the recommendation for boosters with 23vPPV to increase serotype coverage. This makes high quality, comprehensive surveillance essential for national policy. It is also important internationally as such as vaccine program has not been implemented anywhere else but is potentially applicable to other comparable populations. Secondly, the small absolute numbers of cases require data to be accumulated as comprehensively as possible. In relation to vaccine issues, both 23vPPV and 7vPCV policy are important. There was strong support from the meeting for the recent recommendation from the Australian Technical Advisory Group on Immunisation that both 23vPPV (for those over 65 years) and 7vPCV (for those less than 2 years) be publicly funded as universal programs. With respect to the current programs, there were important issues for Aboriginal and Torres Strait Islander people for both 23vPPV and 7vPCV. For 23vPPV, research is required into both the utility and frequency of boosters in adults as well as any potential role for 7vPCV in adults. Improving the identification of Aboriginal and Torres Strait Islander children is important, especially in urban areas.