Identifying Sustainable Foods: The Relationship between Environmental Impact,Nutritional Quality,and Prices of Foods Representative of the French Diet

BackgroundSustainable diets, as defined by the Food and Agriculture Organization, need to combine environment, nutrition, and affordability dimensions. However, it is unknown whether these dimensions are compatible, and no guidance is available in the official recommendations.ObjectiveTo identify foods with compatible sustainability dimensions.MethodsFor 363 of the most commonly consumed foods in the Second French Individual and National Study on Food Consumption, environmental impact indicators (ie, greenhouse gas [GHG] emissions, acidification, and eutrophication), and prices were collected. The nutritional quality of the foods was assessed by calculating the score for the nutritional adequacy of individual foods (SAIN) to score for disqualifying nutrients (LIM) ratio. A sustainability score based on the median GHG emissions, price, and SAIN:LIM was calculated for each food; the foods with the best values for all three variables received the highest score.ResultsThe environmental indicators were strongly and positively correlated. Meat, fish, and eggs and dairy products had the strongest influence on the environment; starchy foods, legumes, and fruits and vegetables had the least influence. GHG emissions were inversely correlated with SAIN:LIM (r=–0.37) and positively correlated with price per kilogram (r=0.59); the correlation with price per kilocalorie was null. This showed that foods with a heavy environmental impact tend to have lower nutritional quality and a higher price per kilogram but not a lower price per kilocalorie. Using price per kilogram, 94 foods had a maximum sustainability score, including most plant-based foods and excluding all foods with animal ingredients except milk, yogurt, and soups. Using price per kilocalorie restricted the list to 42 foods, including 52% of all starchy foods and legumes but only 11% of fruits and vegetables (mainly 100% fruit juices).ConclusionsOverall, the sustainability dimensions seemed to be compatible when considering price per kilogram of food. However, this conclusion is too simplistic when considering price per kilocalorie, which highlights the need to integrate the data at the diet level.     

Improvement of the nutritional quality of foods as a public health tool

Objectives

To assess the potential contribution of improving the nutritional quality of processed foods on individuals’ nutritional intake and food supply. This paper also discusses the means to encourage firms to implement these reformulations, particularly in public/private partnerships.

Study design

The French Observatory of Food Quality was created by the Government for the quantification and follow-up of food reformulation by the food industry. This nutritional composition database on branded products was matched with two consumption databases: TNS Kantar Worldpanel, which provides details on quantities bought and food expenditures; and INCA 2, an individuals’ food consumption survey completed by the French Food Safety Agency. Three food groups were considered: breakfast cereals (355 items in 2008), biscuits and pastries (1805 items in 2008), and bread-based products (620 items in 2009).

Methods

First, the variability in nutrient composition within food categories was determined, which made it possible to consider several food composition modification scenarios within each category. The formulation of the food items with the lowest nutritional quality was modified to three different levels to improve the overall level of quality in a given category. Second, the quantities of sugars, fat, fibre and sodium delivered to the French market through breakfast cereals, biscuits, pastries and bread-based products were calculated for each scenario. Finally, the distribution of individuals’ nutrient consumption from the three food groups among the French population was assessed.

Results

These scenarios generated important improvements of 1–22% (increase in the amount of fibre or decrease in the amounts of sugars, fat and sodium delivered to the market), depending on the scenario, the food group and the nutrient considered. Improvement of the products with the lowest nutritional quality would also lead to significant variation in individuals’ nutrient consumption for the average adult and child consumers of the three groups (range 4.2–18.8%, depending on the scenario, the food group and the nutrient considered).

Conclusion

Encouraging the reformulation of foods, especially for products with the lowest nutritional quality in each category of processed foods, is a worthy target for health policy makers. The methodology presented in this paper provides information for negotiations between policy makers and firms to quantify commitments in terms of their potential impacts on individuals’ nutrient intake, and to check that the firms’ commitments are actually met.     

Creating partnership with the food industry in the Stockholm cancer prevention program.

To facilitate the supply of healthful foods in institutional kitchens and restaurants, the Stockholm Cancer Prevention Program (SCPP) produced a cookbook in collaboration with the food industry and the SCPP. Fifty different organizations participated in this work. The development of the cookbook was made in several steps and started with a recipe contest to engage chefs and employees in restaurants and institutional kitchens. Criteria for the recipes were that they should present low-fat/high-fiber meals. Complementary recipes were received from the food industry. All recipes were tested in 20 restaurants and institutional kitchens and 11,000 lunch guests assessed the palatability of the dishes. The cookbook was presented in conjunction with a food fair in 1989 and has until now been sold in about 4,000 copies. Production of a cookbook can thus be a focal point for involving food industry, restaurants and institutional kitchens in a community intervention program aiming at a change of dietary habits.     

Obesity prevention and personal responsibility: the case of front-of-pack food labelling in Australia

Background  

In Australia, the food industry and public health groups are locked in serious struggle for regulatory influence over the terms of front-of-pack food labelling. Clear, unambiguous labelling of the nutritional content of pre-packaged foods and of standardized food items sold in chain restaurants is consistent with the prevailing philosophy of 'personal responsibility'. An interpretive, front-of-pack labelling scheme has the capacity to encourage healthier patterns of eating, and to be a catalyst for improvements in the nutritional quality of food products through re-formulation. On the other hand, the strength of opposition of the Australian Food and Grocery Council to 'Traffic Light Labelling', and its efforts to promote a non-interpretive, voluntary scheme, invite the interpretation that the food industry is resistant to any reforms that could destabilise current (unhealthy) purchasing patterns and the revenues they represent.     

Nickelodeon markets nutrition-poor foods to children

BACKGROUND: While many factors contribute to childhood obesity and children's poor diets, food marketing affects children's food choices, preferences, their diets, and their health. The purpose of this study was to assess the nutritional quality of the foods marketed by one of the largest companies that markets food to children, Nickelodeon. METHODS: In fall 2005, the nutritional quality of foods advertised via Nickelodeon media and with Nickelodeon characters was assessed. The cross-sectional sample included food ads on the Nickelodeon television station and in Nickelodeon magazine, product packages with Nickelodeon characters found in one large urban grocery store, and meals at restaurants with promotions tied to Nickelodeon programs or characters. RESULTS: Of 168 television food ads, 148 (88%) were for foods of poor nutritional quality. Of 21 magazine food ads, 16 (76%) were for foods of poor nutritional quality. Fifteen grocery store products were identified with Nickelodeon characters on the packaging; nine (60%) were foods of poor nutritional quality. In addition, of the 48 possible children's meal combinations at restaurants with promotional offers tied to Nickelodeon programs, 45 (94%) were of poor nutritional quality. CONCLUSIONS: Through its food marketing, the Nickelodeon entertainment company influences the diets of millions of American children. Unfortunately, eight of ten foods, beverages, and restaurant meals advertised on Nickelodeon's television station, in its magazine, or tied to its characters are of poor nutritional quality. Rather than undermining parents' efforts to feed their children healthfully, Nickelodeon should support parents by setting nutrition standards and marketing to children only foods that meet those standards.     

Nutritional composition of dishes commonly consumed by Japanese Brazilians in São Paulo,Brazil

Abstract

Primary objective To calculate the nutritional composition of commonly consumed Brazilian foods and beverages to analyze dietary intake data obtained with a quantitative food frequency questionnaire in a colorectal adenoma case–control study in Japanese Brazilians.

Methods and procedures Weighed recipes were collected in São Paulo, Brazil and analyzed using NutriBase Clinical Nutrition Manager.

Main outcomes and results A total of 387 recipes for 76 dishes commonly consumed by Japanese Brazilians were collected: 30 composite main course dishes, 26 composite vegetable dishes, 19 snack foods and desserts, and one beverage. The nutritional composition (energy and 32 macronutrients and micronutrients) was calculated per 100 g for each dish.

Conclusions We provided, for the first time, complete and up-to-date calculated nutritional composition data for commonly consumed Brazilian food items, which are essential to assess the current dietary intake among Japanese Brazilians.     

Nutrient profiling can help identify foods of good nutritional quality for their price: a validation study with linear programming

Nutrient profiling ranks foods based on their nutrient content. They may help identify foods with a good nutritional quality for their price. This hypothesis was tested using diet modeling with linear programming. Analyses were undertaken using food intake data from the nationally representative French INCA (enquête Individuelle et Nationale sur les Consommations Alimentaires) survey and its associated food composition and price database. For each food, a nutrient profile score was defined as the ratio between the previously published nutrient density score (NDS) and the limited nutrient score (LIM); a nutritional quality for price indicator was developed and calculated from the relationship between its NDS:LIM and energy cost (in euro/100 kcal). We developed linear programming models to design diets that fulfilled increasing levels of nutritional constraints at a minimal cost. The median NDS:LIM values of foods selected in modeled diets increased as the levels of nutritional constraints increased (P = 0.005). In addition, the proportion of foods with a good nutritional quality for price indicator was higher (P < 0.0001) among foods selected (81%) than among foods not selected (39%) in modeled diets. This agreement between the linear programming and the nutrient profiling approaches indicates that nutrient profiling can help identify foods of good nutritional quality for their price. Linear programming is a useful tool for testing nutrient profiling systems and validating the concept of nutrient profiling.     

Assessment of Food Quality in School Canteens: A Comparative Quantitative Study between Primary and Secondary Schools in Malaysia

Schools are an important food environment to cultivate and promote healthy food choices and practices among children and adolescents. The aim of the present study was to assess the type and quality of food and beverages sold in school canteens in public primary and secondary schools in Kelantan, Malaysia. Eligible schools were randomly selected from the list of all schools and detailed information of all food and beverage items sold in the school canteens were collected during school days. Food and beverages were classified based on food groups derived from the Malaysian Food Dietary Guideline and the Recommended Foods for Healthy Cafeteria Guideline. An assessment of the traffic-light nutrition food-labelling system of the total sugar content in all pre-packaged foods was also undertaken. A total of 568 food items were identified, with secondary school canteens selling a greater proportion of food items than the primary schools (55.5% vs. 44.5%). In terms of the main food groups, grains and cereal products represented the largest food group served (33–36%), followed by beverages (21–25%) and confectionary and sweet foods (12–13%). In contrast, the vegetable and fruit group represented the smallest proportion of food items sold (1–3%). Comparisons between primary and secondary schools showed a similar trend and pattern of food types and quality of foods sold, except for animal-based foods. A greater percentage of food items in this category was found among secondary schools (12.1%) versus primary schools (6.7%). When total sugar content of all pre-packaged foods was quantified based on the traffic-light nutrition-labelling system, almost one-third of foods and beverages were classified as high (29.1%). Confectionary (19.1%) and flavoured milk and fruit drinks (10.0%) both exceeded the recommended sugar levels of >22.5 g per 100 g and >11.25 mL per 100 m L, respectively. Only one of these packaged foods and beverages (0.9%) was classified as a healthy food choice. About a quarter of the food items available in school canteens were classified as prohibited based on a new revised list of prohibited food and beverage items. These findings indicate that, despite the Guidelines, a large number of unhealthy food items are being sold in school canteens. Hence, interventions such as sustainable healthy school canteen menus should be implemented to promote healthy food choices amongst school-aged children.     

Street food among children: a study in north Tunisia

As urbanization increases in Tunisia, eating meals outside the home is becoming more frequent. Children are prime consumers for the fast food sold in the streets. Neither their nor their parents' attitude towards street food is well documented as yet. This study was conducted in the city of Bizerte in February 1998. Its aim was to gather information about street food and parents' and children's attitudes towards it to help organize educational sessions with the children, parents, teachers, and vendors. The study interviewed 421 primary school children, ranging in age from 6 to 15 years (mean age: 10 years), from 24 schools. Half received pocket money, a percentage that did not differ by sex. Three quarters of the children used more than 75% of their pocket money to buy street food. The items bought most frequently were candy (27.2%), sandwiches (23.9%), pastries (23.9%), sunflower seeds and peanuts (21%), and either pizza, chocolate, or cheese (20.3%); the largest proportion of money was spent on sandwiches. In more than half the cases (55.7% of the children), the main motivation for buying street food was either to replace or fill out a meal at home, with sandwiches or pastries. The parents' monthly income did not influence the children's purchasing behavior, but the rhythm of receiving pocket money did. Most children were satisfied with the nutritional and hygienic quality of the food available, but their opinion of this quality as well as the reasons for buying the food and the prices spent on it differed considerably from that of their parents. This study highlights the important role of street foods in the daily diet of schoolchildren and the need for appropriate nutrition education in primary schools.     

The Nutritional Value of Children's Menus in Chain Restaurants in the United Kingdom and Ireland

ObjectiveObesity in the United Kingdom and the Republic of Ireland is rising, as is the frequency of eating out in restaurants. The aim of this study was to investigate the nutritional quality of children's menus in restaurants.DesignCross-sectional review of menus aimed at children from 20 popular chain restaurants in the United Kingdom and Ireland.Main Outcome MeasuresTotal energy, fat, saturated fat, and salt were collected from every food item on the menu in each restaurant. All potential meal combinations were created. A total of 39,266 meals were analysed.AnalysisMeals were compared with UK nutritional guidelines. Meals from fast food and full-service restaurants and main meals and meal deals were compared.ResultsThe average meal for younger children (aged 2–5 years) contained 609 ±117 kcal, and for older children (6–12 years) 653 ± 136 kcal compared with guidelines of 364 and 550 kcal, respectively. A total of 68% of younger children's and 55% of older children's meals contained more total fat than recommended and more than 4 times the amount of saturated fat. Fast food restaurant meals contained less energy, fat, and salt than did full-service restaurants, and meal deals were less likely to meet dietary guidelines than were main meals alone.Conclusion and ImplicationsEating in chain restaurants, in particular meal deals, does not contribute positively to the diet of children in the United Kingdom and Ireland.     

The role of chain pharmacies to promote healthy food retail: Current trends,legal limits,and policy opportunities

Abstract

Chain drug stores have increased their health care role through expanded pharmacy services and retail health clinics. They also are major food retailers. This creates a tension between health promotion and sales of unhealthy foods and beverages to pharmacy customers. This article explores opportunities to improve the nutritional quality of foods sold at chain drug stores that differ from general healthy food retail approaches. It considers the legal limits on marketing to pharmacy customers; the potential roles of health insurers, pharmacy benefit managers and retail health clinics to voluntarily improve food offerings; and formal policymaking legal considerations and approaches.     

Feasibility study on mathematically estimating food commodity intake using the limited sources of food recipes in Korea

Pesticide-containing food intake data are used to assess the extent of exposure to pesticide residues through food intake. But they still are not available in Korea. Therefore we attempted to build a database of the food commodity intake. Several mathematical methods were developed to build food recipes and estimate the food commodity intake by segregating the food mixtures. All unknown recipes were classified into three groups: food mixtures, foods with a single ingredient whose moisture content simply changes during processing or preparation, and foods whose parts are lost during processing. The mathematical principles for computation of ingredient proportions were based on the mass balance between ingredients and the finished foods, in terms of water and nutritional components such as carbohydrate, protein, lipid, ash, etc. Some reference books were used to obtain information associated with recipes of processed or prepared foods, and nutritional components. This approach was based on mathematical principles used with limited sources of food recipe information. The results were deemed preliminary data that could help in obtaining quality food commodity intake data that could be used in the exposure assessment to pesticide residues.     

Quantifying the contribution of foods with unfavourable nutrient profiles to nutritionally adequate diets

That 'all foods can fit' into a healthy diet is a long-standing principle of dietetic practice. The present study quantified the relative contributions of foods to encourage and foods to limit, using new techniques of individual diet optimisation and nutrient profiling. Individual foods from every food group were assigned to four nutrient profile classes based on the French SAIN,LIM system. Foods with the most favourable nutrient profiles were in class 1, and foods with the least favourable nutrient profiles were in class 4. An optimised diet that met the recommendations for thirty-two nutrients and that respected the existing eating habits was designed for each adult in the nationally representative 'Enquête Individuelle et Nationale sur les Consommations Alimentaires 1' dietary survey (n 1171). The relative proportions of the four nutrient profiling classes were assessed before and after the optimisation process. The contribution of fruits and vegetables, whole grains, milk and fish was significantly increased, whereas the contribution of refined grains, meats, mixed dishes, sugars and fats was decreased. The optimised diets derived more energy (30 v. 21?% in the observed diets) from class 1 foods and less energy (41 v. 56?%) from class 4 foods. They also derived a higher amount of class 1 foods (61 v. 51?%) and a lower amount of class 4 foods (22 v. 32?%). Thus, nutrient adequacy was compatible with the consumption of foods with an unfavourable nutrient profile (one-fifth the basket weight), provided that the diet also contained almost two-thirds of foods with the most favourable profile. Translating these results into concrete and quantified advice may have very tangible public health implications.     

Effect of a promotional campaign on heart-healthy menu choices in community restaurants

The research question examined in this study was: Does a promotional campaign impact the sales of heart-healthy menu items at community restaurants? The 8-week promotional campaign used professionally developed advertisements in daily and monthly print publications and posters and table tents in local restaurants. Nine restaurants tracked the sales of selected heart-healthy menu items and comparable menu items sold before and after a promotional campaign. The percentage of heart-healthy items sold after the campaign showed a trend toward a slight increase in heart-healthy menu item selections, although it was not statistically significant. This study and others indicate that dietetics professionals must continue to develop strategies to promote heart-healthy food choices in community restaurants.     

Food and Park Environments: Neighborhood-level Risks for Childhood Obesity in East Los Angeles

PurposeThe rapid increase in obesity over the past two decades suggests that behavioral and environmental influences, including poor nutrition and physical inactivity, are fueling what is now widely recognized as a public health crisis. Yet, limited research has been conducted to examine how environmental factors, such as neighborhood-level characteristics, may be associated with increased risk for obesity.MethodsCommunity-level risk associated with childhood obesity was examined in East Los Angeles, a community with one of the highest rates of childhood obesity in Los Angeles by triangulating: 1) spatial data for the number and location of food establishments relative to the location of schools; 2) observations regarding the availability and quality of fruits and vegetables in local grocery stores; and 3) observations regarding the quality and utilization of local parks.ResultsThe findings revealed that there were 190 food outlets in the study community, of which 93 (49%) were fast-food restaurants. Of the fast-food restaurants, 63% were within walking distance of a school. In contrast, there were 62 grocery stores, of which only 18% sold fresh fruits and/or vegetables of good quality. Of the stores that did sell fruits and/or vegetables, only four were within walking distance of a school. Although well maintained, the five parks in this community accounted for only 37.28 acres, or 0.543 acres per 1000 residents.ConclusionsThese findings suggest that children have easy access to fast food, and limited access to both healthy food options and parks in which to engage in physical fitness activities. This was particularly true in areas around schools. The implications for these findings with regards to policy-related prevention and future research are discussed.     

Multiple pathways from the neighborhood food environment to increased body mass index through dietary behaviors: A structural equation-based analysis in the CARDIA study

ObjectivesTo examine longitudinal pathways from multiple types of neighborhood restaurants and food stores to BMI, through dietary behaviors.MethodsWe used data from participants (n=5114) in the United States-based Coronary Artery Risk Development in Young Adults study and a structural equation model to estimate longitudinal (1985–86 to 2005–06) pathways simultaneously from neighborhood fast food restaurants, sit-down restaurants, supermarkets, and convenience stores to BMI through dietary behaviors, controlling for socioeconomic status (SES) and physical activity.ResultsHigher numbers of neighborhood fast food restaurants and lower numbers of sit-down restaurants were associated with higher consumption of an obesogenic fast food-type diet. The pathways from food stores to BMI through diet were inconsistent in magnitude and statistical significance.ConclusionsEfforts to decrease the numbers of neighborhood fast food restaurants and to increase the numbers of sit-down restaurant options could influence diet behaviors. Availability of neighborhood fast food and sit-down restaurants may play comparatively stronger roles than food stores in shaping dietary behaviors and BMI.     

Do Food Blogs Serve as a Source of Nutritionally Balanced Recipes? An Analysis of 6 Popular Food Blogs

ObjectiveTo determine whether sampled food blogs provide nutritionally balanced recipes.MethodsTwo entree recipes per season, per year (2010–2011) were selected from 6 highly ranked food blogs (n = 96). Food Processor Nutrition and Fitness software was used to analyze sodium, saturated fat, and energy content. Analysis was separated by protein type (vegetarian, poultry, red meat, and seafood).ResultsRecipes met energy recommendations but were excessive in saturated fat and sodium. Vegetarian and seafood recipes were significantly lower in risk nutrients compared with red meat and poultry recipes. Red meat recipes were not significantly different from poultry recipes for risk nutrients studied; poultry recipes were higher in sodium and energy compared with red meat recipes.Conclusions and ImplicationsThe public should be aware of the nutritional limitations of popular food blogs; dietitians could assist in modifying blog recipes for individuals and partner with bloggers to improve the nutritional profile of recipes.     

Energy,Sugars, Iron,and Vitamin B12 Content of Commercial Infant Food Pouches and Other Commercial Infant Foods on the New Zealand Market

There has been an important shift in the New Zealand infant food market over the past decade, with the majority of complementary foods now sold in “pouches”. Along with the increasing market share of commercial infant food pouches internationally, there have been growing concerns about their nutritional quality. However, research examining the nutritional quality of these pouches compared to other forms of commercial infant foods in New Zealand has not been undertaken. Nor have any studies reported the free sugars or added sugars content of these foods. To address this knowledge gap, a cross-sectional survey of infant foods sold in New Zealand supermarkets was conducted in 2019–2020. Recipes and nutrient lines were developed for the 266 foods identified (133 food pouches). The energy, iron, vitamin B12, total sugars, free sugars, and added sugars content of infant food pouches and other forms of commercial infant foods per 100 g were compared, both within food groups and by age group. Infant food pouches contained similar median amounts of energy, iron, and vitamin B12 to other forms of commercial infant foods but contained considerably more total sugars (8.4 g/100 g vs. 2.3 g/100 g). However, median free sugars and added sugars content was very low across all food groups except for “dairy” and “sweet snacks”. All “dry cereals” were fortified with iron whereas none of the infant food pouches were. Therefore, consuming food pouches to the exclusion of other commercial infant foods may place infants at risk of iron deficiency if they do not receive sufficient iron from other sources.     

Compatibility of computed and chemically determined macronutrients and energy content of traditional Greek recipes

The analyses of composite recipes are frequently missing in nutrient databases and their inclusion presupposes expensive and fairly complicated chemical analyses. The nutritional composition of traditional Greek composite foods was determined through chemical analyses and by the computerized program, Unilever Dietary Analysis Program (UNIDAP). The chemical analyses followed standard procedures and were also performed on all the raw ingredients used for preparation for the composite foods. The UNIDAP system was originally based on the British Food Composition Tables, but has been enriched over the years with compositional data representative of Greek food items, derived from chemical analyses conducted in the context of research projects.Some discrepancies were observed between the nutrient values of the raw ingredients that were used for the preparation of the recipes and the UNIDAP database nutrient values for the same ingredients, but despite that, a very good agreement was deduced for the macronutrients and energy content of the composite foods. It is concluded that the UNIDAP generates reliable data on macronutrients and energy content of Greek food recipes. This provides the foundation for developing more up-to-date nutrient database in Greece and supplies health professionals with an important tool for dietary planning, nutrient and food database development, and policy implementation.     

Healthy Characters? An Investigation of Marketing Practices in Children's Food Advertising

ObjectiveTo determine the nutritional quality of foods advertised with familiar children's characters and health-related messages.DesignChildren's programming aired on the most popular broadcast and cable channels during 2011 was sampled to form a composite weekday and weekend day. All food advertisements (ads) included in this programming were content analyzed.ParticipantsFive hundred seventy-seven food ads.Variables MeasuredFamiliar characters promoting products were either trade or licensed characters. A product's nutritional quality was determined using the United States Department of Health and Human Services' categorizations, based on the frequency foods should be consumed. Health cues were present when a food was claimed to be healthy, physical activity was depicted, or the product was associated with fruit.AnalysisFrequencies and chi square analyses were conducted; P < .05.ResultsNearly three quarters (73%) of food ads targeting children use a familiar character. The majority of these ads (72%) promote foods of low nutritional quality, yet 53% employ a health-related message.Conclusions and ImplicationsFamiliar characters proliferate in food advertising to children, yet marketers do not adhere to recommendations that characters promote strictly healthy foods. Future research is needed to investigate effects and inform policy decisions in this realm.