The National Food Guide: development of dietetic criteria and nutritional characteristics

Despite the wide availability of health education materials and the intensive media interest in food and health, the number of individuals changing their diets has been insufficient to shift average population intakes towards current recommendations. The Nutrition Task Force document 'Eat Well!' indicated that the development of a nationally recognized, authoritative and consistently used guide to food selection was a priority. The provision of practical information, via a simple model for nutrition education suitable for wide use, would help to provide the general public with a consistent message on food and health. The National Food Guide: The Balance of Good Health illustrates an agreed core structure of food groupings based on dietetic criteria and the nutritional characteristics of foods within each of the groups. The guide has been developed giving due consideration to the provision of nutritional adequacy, cultural variations, educational needs and requirements for flexibility. This paper outlines the general and specific nutritional objectives of the National Food Guide. It details the criteria for the inclusion of foods within each of the five illustrated food groups, describes the key characteristics of foods within those groups and the rationale for the space allocated for each food group section.     

An investigation into school children's knowledge and awareness of food and nutrition

With the diet and exercise behaviours of UK school children showing little improvement over recent years, the need for dietary change is clearly indicated. This study aimed to assess the nutritional knowledge and understanding of primary school children in order to identify the most effective format for future nutrition messages. A qualitative methodology was employed and 114 children, aged 7–11 years, took part in 23 focus groups separated by age, gender and socio-economic status (SES). Issues discussed included parental food rules, children's perceptions of `good' and `bad' foods, diet–disease links and food groupings.
Across the groups restrictive food rules were most frequently reported whilst between groups gender and SES differences were apparent in relation to parental control over food and children's nutritional knowledge. The limitations of the children's cognitive development could be seen in their conceptualization of food groups, where concrete grouping schemes were frequently used, and in the lack of understanding inherent in their food–health or food–nutrient associations. Taste and preference were confirmed as consistent influences in children's food classification.
Primary school children may be receptive to food based dietary guidelines based on familiar, concrete food classifications. These should be cognitively appropriate and possibly need to be gender specific.     

A standardised approach towards PROving the efficacy of foods and food constituents for health CLAIMs (PROCLAIM): providing guidance

Diet is well known to have beneficial health properties that extend beyond traditionally accepted nutritional effects. The approach involved in elucidating these beneficial physiological effects is becoming more important, as reflected by increasing research being undertaken. With growing consumer awareness of foods and food constituents and their relationship to health, the key questions for regulators, scientists and the food industry continue to relate to: (1) how consumers could be protected and have confidence that the health claims on foods are well supported by the evidence; (2) how research on physiological effects of food (constituents) and their health benefits could be stimulated and supported; (3) how research findings could be used in the development of innovative new food products. The objectives of this paper are to provide a set of recommendations on the substantiation of health claims for foods, to develop further guidance on the choice of validated markers (or marker patterns) and what effects are considered to be beneficial to the health of the general public (or specific target groups). Finally, the case for developing a standardised approach for assessing the totality of the available scientific data and weighing the evidence is proposed.     

Le curseur nutritionnel: un nouvel outil visuel d’information nutritionnelle

The nutritional cursor is a new nutritional information tool which allows food of the same category to be classified into three groups: “nutritional pleasure”, “classical pleasure” and “great pleasure”. The classification will be determined following the product composition on the basis of a factorial analysis method followed by an automatic classification. It will then be checked a posteriori by experts. The classification is based on nutritional criteria which are specific for each category of food. The nutritional cursor provides a nutritional profile of the product but, contrary to the other proposals the classification, it is built a posteriori according to market reality. Categories are defined pragmatically on the basis of consumer attitudes. Buying food will thus be simplified for the consumer and the new labelling scheme will heighten his awareness of food variety. It also enables him to adopt a healthy diet as well as make him be conscious of what he buys without feeling guilty. The cursor will be changing gradually according to the market evolution and public health recommendations.     

Practices,beliefs and knowledge of international and U.S. students regarding food supplements and health foods

Behavioral and cognitive parameters associated with food supplement and health food use were surveyed among a convenience sample of 142 international and 100 U.S. students.

Among the international students, 140 used at least one product in the home country and 135 reported doing so in the university community. Ninety‐seven U.S. students used at least one supplement or health food in the university community. U.S. students used a significantly greater number of products (p < 0.001).

The products used by the greatest number of international students overseas and in the university community and by the greatest number of U.S. respondents were vitamin C, calcium, and yogurt.

Reasons for food supplement use reflected beliefs by both groups that these products prevented or cured specific medical conditions. Health foods in contrast were popular primarily for their taste and culinary attributes.

International and U.S. students gave high accuracy ratings to academic/medical/scientific sources of nutrition information and low ratings to television and radio commercials, newspaper and magazine advertisements, friends and parents.

The mean score for the international students on the nutrition knowledge test was 17.6 points, that for the U.S. students was 30.9 points.

Low mean scores, together with widespread use of nutritional supplements and a strong belief in unsubstantiated health claims made on behalf of these products suggest that the students surveyed in this study take nutritional supplements without being able to justify their use. Both groups would benefit from accurate nutrition information regarding these products.     

The Role of Food Advertising in Adolescents‘ Nutritional Health Socialization

ABSTRACT

Adolescents are heavily exposed to food advertising in their daily lives. Food ads tend to juxtapose unhealthy food products with overly thin models who promote these foods. This paradoxical presentation of food and body raises important questions about adolescents’ perceptions of food ads and the body, as part of the larger realm of nutritional health. The study sheds light on adolescents’ nutritional health socialization by exploring the role of food advertising as it intersects with other socialization agents, namely parents and peers. Adolescent’s perceptions of and reactions to food ads, and the food products and models in these ads, are examined using the media practice model as the theoretical framework. In-depth interviews were conducted with 82 adolescents in middle- and high-school, taking into consideration their development, heightened vulnerability to messages about the body and appearances, and their lived experiences. The study’s findings suggest that adolescents, though skeptical of ads, internalize the mediated thin ideal and expect models in ads to be thin, beautiful, and famous. Parents emerged as positive role models for nutritional health whereas peers are more paradoxical, emphasizing the importance of exercising along with a socially-oriented consumption of junk food. Socialization messages from parents, peers, and the media interact in shaping adolescents’ reactions to food ads. Only minimal gender differences were found in adolescents’ reactions to food ads and their approach to nutritional health. Mostly, female models are expected to meet more stringent standards of thinness and beauty than male models, especially among female adolescents.     

Current Food Classifications in Epidemiological Studies Do Not Enable Solid Nutritional Recommendations for Preventing Diet-Related Chronic Diseases: The Impact of Food Processing

To date, observational studies in nutrition have categorized foods into groups such as dairy, cereals, fruits, and vegetables. However, the strength of the association between food groups and chronic diseases is far from convincing. In most international expert surveys, risks are most commonly scored as probable, limited, or insufficient rather than convincing. In this position paper, we hypothesize that current food classifications based on botanical or animal origins can be improved to yield solid recommendations. We propose using a food classification that employs food processes to rank foods in epidemiological studies. Indeed, food health potential results from both nutrient density and food structure (i.e., the matrix effect), both of which can potentially be positively or negatively modified by processing. For example, cereal-based foods may be more or less refined, fractionated, and recombined with added salt, sugars, and fats, yielding a panoply of products with very different nutritional values. The same is true for other food groups. Finally, we propose that from a nutritional perspective, food processing will be an important issue to consider in the coming years, particularly in terms of strengthening the links between food and health and for proposing improved nutritional recommendations or actions.     

Processes of sharing issues among participating groups in the form of a food and nutrition education network: the case of the "S Network"

OBJECTIVE: To review processes of sharing issues among participating groups in the form of a food and nutrition education network and elucidate how organizations develop commitment and how individuals change their attitudes. METHODS: (1) Process regarding the form of a food and nutrition education network: After discussions by administrative public health nutritionists at public health centers and meetings with faculty members at J University, we encouraged three groups to participate in a network to share information on food and nutrition issues and gave them opportunities to interact with each other. Group A primarily provided food and nutrition information, group B primarily provided foods, and group C provided both. Specifically, these activities included two open community programs and eight volunteer activities. In the first open community program, they identified capacity to be developed through food and nutrition education and volunteers explored possible cooperation among organizations on the basis of the categorization and classification of issues. To provide feedback on the results, a workshop was held during the second open program. (2) Analysis of the process: We documented organizations involved in the form of a food and nutrition education network from 2003 through 2006, the processes and details of their activities, and activities and remarks by participants. These documents were classified by issue, broken down into categories, and listed chronologically with titles for characteristic entries, thereby reviewing the processes. On the basis of these results, we asked participants who were involved in the entire process of the construction of the food and nutrition education network to review their own activities, and we then investigated the changes in their attitudes. RESULTS: (1) A total of 63 persons in 34 organizations participated in open community programs. Local food issues included changing dietary behaviors along with diversification of lifestyle; problems with cooking, eating, and continuation of tradition because of the lack of nutritional knowledge and experience; and the uncontrolled flood of information. Participating organizations were found to engage in different activities to address nutritional issues. In addition, insufficient or low efficiency activities were identified, indicating the need for cooperation. (2) Issue-sharing processes consisted of the following three steps: identification of local nutritional issues, characterization of group activities to address food and nutritional problems, and exploration of possible cooperation among groups. Analysis of attitudes of three persons participating in the entire process of network construction revealed their interest in other organization activities and sympathy with other organizations. DISCUSSION: Factors for promotion of sharing issue include (1) our support to allow them to share food and nutrition issues in the early stages and thereafter, and (2) repeated deliberations within open community programs involving information and feedback from prior identification and analysis of problems, as well as selection of activities.     

Dietary trends in Western Europe

The documentation available on prevailing dietary trends and of relative nutritional status of the various populations in Western Europe, particularly in the European Economic Community (EEC) countries, is not homogenous, somewhat sparse, and often incomplete. It has been possible, however, to tentatively compare and evaluate the main trends of food consumption and to determine the areas and/or population groups potentially at risk for nutritional disorders. Although almost every country has drawn up national nutritional standards or allowances, there is no common agreement on criteria for the dietary typology adequate to maintain health and well-being, while respecting traditional food habits of the different areas. However, while it is evident that quantitative food consumption in Western Europe exceeds average need, marginal situations or qualitative imbalances are often observed. It would first be necessary, therefore, to promote nutritional surveillance programs in order to establish baseline values for the most vulnerable population groups and the relationships between food habits and epidemiology of nutrition related disorders, and subsequently to monitor their evolution over time and with economic changes.     

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.     

Health and social factors affecting the food choice and nutritional intake of elderly people with restricted mobility

Background: Little is known about the magnitude of social and health factors which affect the food choices and nutritional intake of elderly people with restricted mobility. Design: Semistructured taped interviews were used to capture expressions used in the identification of health and social factors which affect food choices and nutritional intake of 13 female subjects and three male subjects living in the community with restricted mobility. Twenty-four-hour recall assessment was used to establish their dietary intake and meal patterns. Results: There was an inadequate intake of fluid, fruit and vegetables and nonstarch polysaccharide by the subjects. In addition, there was an infrequent consumption of cooked meals. Health and social factors which affect the food choices and nutritional intake of older people were identified as being inadequate money, inadequate food storage facilities, physical disabilities affecting food preparation, poor access to shops, difficulties in undertaking the shopping, type of cooking facilities, loneliness and bereavement. Conclusion: Elderly people living in the community with restricted mobility may be unable to consume an optimum nutritional intake due to the health and social factors identified which affect their food choices and nutritional intake.     

The eating patterns and problems of homeless women

While inadequate nutrition has been identified as a factor affecting the health of the homeless, there has been little research to identify the extent to which inadequate nutrition is a problem. The goal of this paper is to document the eating patterns and problems of single homeless women and to locate the determinants of nutritional adequacy in their diets. Our findings are based on a random sample of 84 single homeless women using hostels and drop-in centers. For 85.5% of the women food was provided primarily by hostels and supplemented by the drop-ins. When their daily food intake was compared to the Canada's Food Guide recommendations, the average number of servings in each of the four food groups was below the recommended. The women in our sample indicated that their problems with food consumption were rooted in their poverty and further analysis indicated that the provision of food by social agencies was an important factor in the nutritional adequacy of their diets. Hostels and drop-in centers not only provide shelter, they have also assumed most of the responsibility for feeding the homeless. It is their poverty which burdens these women and structures their eating patterns.     

Child health and nutrition in a Teréna indigenous community, Mato Grosso do Sul, Brazil

This paper describes the health and nutritional situation of South American Indian children from a Teréna community, characterizing their nutritional status, food consumption, and socioeconomic and environmental conditions. The sample included 100 children, ranging from 0 to 59 months of age and living in Aldeia Córrego do Meio, Mato Grosso do Sul. Prevailing nutritional deficits were: 8.0% for the weight-for-age index, 16.0% for height-for-age, and 5.0% for weight-for-height. The growth deficit rate was higher than that of the Brazilian population as a whole, probably reflecting the precarious socioeconomic, environmental, and health conditions in this Teréna community. Analysis of the average nutrient sufficiency in the infant diet showed that nutritional recommendations for the different groups were not complied with. New studies, characterized as transdisciplinary and longitudinal, are necessary to better understand this process.     

A method to improve the nutritional quality of foods and beverages based on dietary recommendations

OBJECTIVE: The increasing consumer interest in health prompted Unilever to develop a globally applicable method (Nutrition Score) to evaluate and improve the nutritional composition of its foods and beverages portfolio. METHODS: Based on (inter)national dietary recommendations, generic benchmarks were developed to evaluate foods and beverages on their content of trans fatty acids, saturated fatty acids, sodium and sugars. High intakes of these key nutrients are associated with undesirable health effects. In principle, the developed generic benchmarks can be applied globally for any food and beverage product. Product category-specific benchmarks were developed when it was not feasible to meet generic benchmarks because of technological and/or taste factors. RESULTS: The whole Unilever global foods and beverages portfolio has been evaluated and actions have been taken to improve the nutritional quality. The advantages of this method over other initiatives to assess the nutritional quality of foods are that it is based on the latest nutritional scientific insights and its global applicability. CONCLUSIONS: The Nutrition Score is the first simple, transparent and straightforward method that can be applied globally and across all food and beverage categories to evaluate the nutritional composition. It can help food manufacturers to improve the nutritional value of their products. In addition, the Nutrition Score can be a starting point for a powerful health indicator front-of-pack. This can have a significant positive impact on public health, especially when implemented by all food manufacturers.     

Food behaviors of young children: Cognitive and attitudinal factors

Young children's diets are determined to a large degree by their mothers' nutritional knowledge and food attitudes. The primary purpose of this investigation was to determine the effects of mothers' nutritional knowledge and food attitudes on their children's nutritional knowledge and food behavior.

The subjects were 159 children. They ranged in ages from 7 to 9 years old. Their mothers also participated in the study.

Bivariate relationships between pairs of variables were tested using the Pearson product-moment correlation. The major findings were:

(1) Children's nutritional knowledge was related to their mothers' nutritional knowledge and attitudes of sociability.

(2) Mothers' nutritional knowledge was related to their attitudes of sociability and frugality. Nutritional knowledge was negatively correlated with mother's attitudes toward health and social status.

(3) Children's food behavior was related to their nutritional knowledge and their mothers' nutritional knowledge.     

Nutritional knowledge of health food users in Oahu, Hawaii.

A survey to learn the nutritional knowledge and dietary practices of health food users on Oahu was conducted at fourteen health food stores. Most of the participants were under thirty years of age, followed no specific dietary regimen, used health foods in combination with supermarket foods, would seek help from physicians if they became sick, and have obtained nutritional information through popular publications. Reliance on such publications has produced a population which is fairly well informed regarding some nutritional facts but which has acquired a host of incorrect nutritional information. Since this population is dedicated to obtaining proper nutrition and would be guided by their knowledge of nutrition, problems of dietary practices have arisen. Education in schools does not provide young people with tools and knowledge to choose food properly. In general, teaching of nutritional facts and activities, on which health and well-being depend, appears to be low in priority as far as school authorities are concerned. Elementary school teachers do not have the background to teach nutrition. Nutrition teaching should begin during the preschool years and should continue through elementary grades, since they are important growth periods when food habits are formed.     

Defining Nutritional and Functional Niches of Legumes: A Call for Clarity to Distinguish a Future Role for Pulses in the Dietary Guidelines for Americans

Legume food crops can contribute to the solution of diet-related public health challenges. The rich diversity of the botanical family Fabaceae (Leguminosae) allows legumes to fill numerous nutritional niches. Pulses (i.e., a subgroup of legumes including chickpeas, cowpeas, dry beans, dry peas, and lentils) are a nutrient-dense food that could play a key role in eliminating the dramatic underconsumption of dietary fiber and potassium, two dietary components of public health concern, all while maintaining a caloric intake that promotes a healthy weight status. However, incorrect use of terminology—in the commercial and scientific literature as well as in publications and materials prepared for the consuming public—creates confusion and represents a barrier to dissemination of clear dietary guideline messaging. The use of accurate terminology and a simple classification scheme can promote public health through differentiation among types of legumes, better informing the development and implementation of nutritional policies and allowing health care professionals and the public to capitalize on the health benefits associated with different legumes. Although inconsistent grouping of legumes exists across countries, the recently released 2020–2025 Dietary Guidelines for Americans (DGA) were chosen to illustrate potential challenges faced and areas for clarification. In the 2020–2025 DGA, pulses are included in two food groups: the protein food group and ‘beans, peas, lentils’ vegetable subgroup. To evaluate the potential of pulses to contribute to intake of key dietary components within calorie recommendations, we compared 100 kilocalorie edible portions of pulses versus other foods. These comparisons demonstrate the unique nutritional profile of pulses and the opportunity afforded by this type of legume to address public health concerns, which can be greatly advanced by reducing confusion through global harmonization of terminology.     

Korean adolescents' perceptions of nutrition and health towards fast foods in Busan area

Adolescents in Busan area were asked in a survey about their perception and attitudes towards fast food. Most respondents answered that they consume fast food once a month because it is fast, easily accessible and tasty. Although they perceived fast food as unhealthy and less nutritious, they were less aware of its effect on their health and nutritional status. The more knowledgeable respondents were about nutrition and health the less likely they were to choose fast food over other meals. However, respondents who had little or no knowledge about the nutritional factors of fast food accounted for 43.1%. As to their source of dietary information, students relied on themselves (31.0%), parents (20.5%) and friends (19.9%). The medium through which students got the most nutrition and health information was television (66.8%), followed by the Internet (36.7%) and magazines (29.7%). This study will enable educators to plan more effective strategies for improving the dietary knowledge of the adolescent population.