The 2006–2007 Food Label and Package Survey (FLAPS): Nutrition labeling,trans fat labeling

Since the 1970s, the Center for Food Safety and Applied Nutrition at the United States (US) Food and Drug Administration (FDA) has studied product labels from the US food supply through the Food Label and Package Survey (FLAPS). The sampling frame for the latest survey, FLAPS 2006–2007, was the ACNielsen Strategic Planner food sales database. As the newest addition to the Nutrition Facts label, this latest FLAPS included trans fat and was utilized to characterize the prevalence of foods reporting trans fat information. For this survey, FDA used a new probability-based sample design to draw a list of food products. Products were purchased from retail stores across the US, and label information was recorded to create the FLAPS 2006–2007 database. Results of initial data analyses show that an estimated 96.3% of FDA-regulated processed, packaged foods have nutrition labeling, with an additional 3.7% exempt from mandatory nutrition labeling requirements. FLAPS data show that 12% of products provide a nutrient content claim about the amount of trans fat on the principal display panel, with over 75% displaying “0 g trans fat.” FDA will continue to analyze FLAPS data as a tracking mechanism to monitor the market response to food label regulations and to support policy, regulatory, economic, and food safety decisions.     

Food Composition Programme of ASEANFOODS 1995–1999

ASEANFOODS was established in 1986, with six member countries including Brunei Darussalam, Indonesia, Malaysia, the Philippines, Singapore and Thailand. Institute of Nutrition, Mahidol University (INMU) was designated as the Regional Centre. In 1996, Vietnam was included as a new country member. This report emphasizes the main activities carried out in 1995–1999 at the regional centre to fulfill the specific objectives of ASEANFOODS. To strengthen the analytical performance of food analysis laboratories in ASEAN, a new set of reference materials, weaning food (AS-FRM5) and fish flour (AS-FRM6) with consensus values of mandatory nutrients for nutrition labelling was developed. The reference materials were used as test materials for the third round of laboratory performance study, including government and private laboratories in ASEANFOODS member countries and laboratories in other regions. A collaborative programme involving three countries — Indonesia (LIPI, Bandung), Thailand (INMU) and Australia (QHSS) was conducted in 1997–1998, with support from AusAID to strengthen the technical and analytical capabilities and quality assurance programme in Indonesia. This programme can eventually strengthen laboratories to generate good quality food composition data. Such activities will be extended to other member countries. In keeping with the need of the members, the first regional food composition data are being developed. Current activities on development of national food composition tables are also summarized.     

Food Allergies–Finding Help on the Internet

ABSTRACT

Food allergies present real challenges to those who must deal with them on a daily basis. When food provokes an immune response, perhaps inducing a severe condition such as anaphylactic shock, it becomes the enemy and an obstacle to be overcome. For some this is a problem of infancy soon outgrown, but for many others it is a life-long problem requiring special diets, emergency medication kits, and a perpetual vigilance regarding all food consumed. The Internet enables those afflicted with food hypersensitivities to learn about their condition as well as methods for dealing with it in their daily lives. This paper describes Web sites that provide information and support for those with food allergies.     

Brazilian Network of Food Data Systems and LATINFOODS Regional Technical Compilation Committee: Food composition activities (2006–2009)

The Brazilian Network of Food Data Systems (BRASILFOODS) has been keeping the Brazilian Food Composition Database-USP (TBCA-USP) (http://www.fcf.usp.br/tabela) since 1998. Besides the constant compilation, analysis and update work in the database, the network tries to innovate through the introduction of food information that may contribute to decrease the risk for non-transmissible chronic diseases, such as the profile of carbohydrates and flavonoids in foods. In 2008, data on carbohydrates, individually analyzed, of 112 foods, and 41 data related to the glycemic response produced by foods widely consumed in the country were included in the TBCA-USP. Data (773) about the different flavonoid subclasses of 197 Brazilian foods were compiled and the quality of each data was evaluated according to the USDAs data quality evaluation system. In 2007, BRASILFOODS/USP and INFOODS/FAO organized the 7th International Food Data Conference “Food Composition and Biodiversity”. This conference was a unique opportunity for interaction between renowned researchers and participants from several countries and it allowed the discussion of aspects that may improve the food composition area. During the period, the LATINFOODS Regional Technical Compilation Committee and BRASILFOODS disseminated to Latin America the Form and Manual for Data Compilation, version 2009, ministered a Food Composition Data Compilation course and developed many activities related to data production and compilation.     

Total,Free, and Added Sugar Consumption and Adherence to Guidelines: The Dutch National Food Consumption Survey 2007–2010

A high sugar intake is a subject of scientific debate due to the suggested health implications and recent free sugar recommendations by the WHO. The objective was to complete a food composition table for added and free sugars, to estimate the intake of total sugars, free sugars, and added sugars, adherence to sugar guidelines and overall diet quality in Dutch children and adults. In all, 3817 men and women (7–69 years) from the Dutch National Food Consumption Survey 2007–2010 were studied. Added and free sugar content of products was assigned by food composition tables and using labelling and product information. Diet was assessed with two 24-h recalls. Diet quality was studied in adults with the Dutch Healthy Diet-index. Total sugar intake was 22% Total Energy (%TE), free sugars intake 14 %TE, and added sugar intake 12 %TE. Sugar consumption was higher in children than adults. Main food sources of sugars were sweets and candy, non-alcoholic beverages, dairy, and cake and cookies. Prevalence free sugar intake <10 %TE was 5% in boys and girls (7–18 years), 29% in women, and 33% in men. Overall diet quality was similar comparing adults adherent and non-adherent to the sugar guidelines, although adherent adults had a higher intake of dietary fiber and vegetables. Adherence to the WHO free sugar guidelines of <5 %TE and <10 %TE was generally low in the Netherlands, particularly in children. Adherence to the added and free sugar guidelines was not strongly associated with higher diet quality in adults.     

Reducing Traumatic Brain Injuries in Youth Sports: Youth Sports Traumatic Brain Injury State Laws,January 2009–December 2012

Objectives. I sought to describe current state-wide youth sports traumatic brain injury (TBI) laws and their relationship to prevailing scientific understandings of youth sports TBIs, and to facilitate further research by creating an open-source data set of current laws.Methods. I used Westlaw and LexisNexis databases to create a 50-state data set of youth sports TBI laws enacted between January 2009 and December 2012. I collected and coded the text and citations of each law and developed a protocol and codebook to facilitate future research.Results. Forty-four states and Washington, DC, passed youth sports TBI laws between 2009 and 2012. No state’s youth sports TBI law focuses on primary prevention. Instead, such laws focus on (1) increasing coaches’ and parents’ ability to identify and respond to TBIs and (2) reducing the immediate risk of multiple TBIs.Conclusions. Existing youth sports TBI laws were not designed to reduce initial TBIs. Evaluation is required to assess their effectiveness in reducing the risk and consequences of multiple TBIs. Continued research and evaluation of existing laws will be needed to develop a more comprehensive youth TBI-reduction solution.Since the beginning of 2011, 35 US states and Washington, DC, passed legislation designed to reduce the overall impact of traumatic brain injuries (TBIs) among young athletes—bringing the total number of states that have done so since 2009 to 44 (45 including Washington, DC). Given the pace of lawmaking in this area (hereinafter “youth sports TBI laws”), it is an optimal time to compare the content of these laws with current scientific consensus regarding symptoms, impact, and treatment of youth TBIs.There is consensus about basic TBI epidemiology, at least with respect to short-term causes and consequences. A TBI is an injury caused by a blow to the head or rapid acceleration–deceleration forces, and such an injury may lead to decreased levels of consciousness, amnesia, neurologic or neuropsychological abnormalities, or other consequences including death.1 Symptoms and effects of TBIs are wide ranging, from mild headaches to memory loss and significant neurologic deficits.2 There is no agreed-upon TBI diagnostic metric, and there are no uniform national TBI reporting protocols.3 In athletics, individuals who suffer a TBI and resume play too soon may be at greater risk of re-injury. This re-injury could result in second-impact syndrome, which may have serious health consequences, although there is still much to learn about scope of the phenomenon and its consequences.4Although TBIs can result from many activities, sports activities cause an estimated 20% of all TBIs among youths and young adults.5 Children and young teenagers are at the greatest risk of TBIs,6 and TBIs in these populations take longer to heal in part because youths’ brains are still growing and developing.7 Sports activities account for an estimated 300 000 TBIs per year.8 There is an upward trend in emergency room visits for TBIs across all demographics, although whether this is a result of increased awareness of TBIs or an overall rise in injury rates is not certain.9 No state comprehensively tracks TBI data (by state, by age, by sport),10,11 and, therefore, estimates about the scope of the problem vary widely. Finally, because (as of yet) there have been no longitudinal cohort studies that evaluate long-term health outcomes by following athletes with and without TBIs over a multi-decade span, it is impossible to precisely determine the causal relationship, if any, between youth-sports injuries and subsequent early onset dementia that has been observed in former professional athletes.12Despite uncertainty about the best approach to TBI reduction, many sport-specific strategies have been proposed to reduce TBIs in sports. These include changes in equipment, sports rules, or the times and locations in which sports are played.13 Both the National Football League14 and the National Hockey League have changed rules with the explicit intent of reducing TBIs.15 At the collegiate level, the National Collegiate Athletic Association has partnered with the Centers for Disease Control and Prevention (CDC) to promote TBI prevention and best practices.16 In youth sports, similar efforts are underway to establish clear guidelines and recommendations for various sports.17 Most recently, Pop Warner (an umbrella organization for youth football, cheer, and dance programs in 42 states) created new standards to limit contact during football practice and heighten TBI awareness among its participants.18 Despite these efforts by professional, collegiate, and youth sports organizations, during recent years, state-wide legislation has become an increasingly common approach to achieving a reduction in instances of TBIs in youth populations.The proliferation of youth sports TBI laws within the past few years had its genesis in a single galvanizing event. In 2006, Zackery Lystedt, a 13-year-old middle-school student, suffered a severe head injury during a football game after returning to play following a concussion that was not properly diagnosed.19 Public attention to his injury and vigorous support for his recovery led in April 2009 to the passage of Washington State’s Zackery Lystedt Law, the first law that attempted to set general guidelines and standards involving the identification and reduction of TBIs in youth sports.20 The Lystedt law was organized around 3 core elements: (1) annual education of athletes and parents, (2) the mandatory removal from play of athletes suspected of having TBIs, and (3) clearance by a designated health professional before an athlete with a TBI returned to play.In this article, I comprehensively describe the state of youth sports TBI laws now that all but a few states have enacted such laws. I describe the specific features of youth sports TBI laws, postulate their consequences in implementation, and provide guidance, so that those interested in the ostensible goals of such laws can begin to determine whether these laws will significantly reduce youth TBIs. To facilitate future empirical evaluation of these laws, I conducted and evaluated legal research in accord with scientific principles of transparency and reproducibility,21 and the data for this article is embodied in an open-source protocol, code book, and data set available on the Internet (http://lawatlas.org/welcome).     

Evaluating a Food Pantry–Based Intervention to Improve Food Security,Dietary Intake,and Quality in Midwestern Food Pantries

BackgroundVoices for Food was a longitudinal community, food pantry–based intervention informed by the social ecological model, and designed to improve food security, dietary intake, and quality among clients, which was carried out in 24 rural food pantries across 6 Midwestern states.ObjectiveOur objective was to evaluate changes in adult food security, dietary intake, and quality from baseline (2014) to follow-up (2016), and to assess the role of adult food security on dietary outcomes.DesignA multistate, longitudinal, quasi-experimental intervention with matched treatment and comparison design was used to evaluate treatment vs comparison group changes over time and changes in both groups over time.Participants/settingAdult food pantry clients (n = 617) completed a demographic food security survey, and up to three 24-hour dietary recalls at baseline (n = 590) and follow-up (n = 160).InterventionCommunity coaching served as the experimental component, which only “treatment” communities received, and a food council guide and food pantry toolkit were provided to both “treatment” and matched “comparison” communities.Main outcome measuresChange in adult food security status, mean usual intakes of nutrients and food groups, and Healthy Eating Index-2010 scores were the main outcome measures.Statistical analyses performedLinear mixed models estimated changes in outcomes by intervention group and by adult food security status over time.ResultsImprovements in adult food security score (–0.7 ± 0.3; P = .01), Healthy Eating Index-2010 total score (4.2 ± 1.1; P < .0001), and empty calories component score (3.4 ± 0.5; P <.0001) from baseline to follow-up were observed in treatment and comparison groups, but no statistically significant changes were found for adult food security status, dietary quality, and usual intakes of nutrients and food groups between the 2 groups over time. The intervention effect on dietary quality and usual intake changes over time by adult food security status were also not observed.ConclusionsFood pantry clients in treatment and comparison groups had higher food security and dietary quality at the follow-up evaluation of the Voices for Food intervention trial compared with baseline, despite the lack of difference among the groups as a result of the experimental coaching component.     

Food Biotechnology: Boon or Threat?

The use of techniques of genetic engineering in the food system is the source of some debate. Proponents stress the potential biotechnology has for reducing the need for agricultural chemicals and improving the production, quality, safety, cost, and convenience of food products. They consider special labeling unnecessary and potentially misleading. Opponents raise a variety of food safety, ecological, social, and ethical issues and call for labeling, sometimes at any cost. Both ranges of views make valid points and overlook important realities. Nutrition education professionals, who are seen as trusted sources of information about food biotechnology, can help consumers understand issues raised by genetic engineering and facilitate cooperative dialogue among consumer, industry, and regulatory groups with the ultimate goal of promoting a safe, nutritious, and sustainable food system.