Nutrition Claims on Fruit Drinks Are Inconsistent Indicators of Nutritional Profile: A Content Analysis of Fruit Drinks Purchased by Households With Young Children

BackgroundFruit drinks are the most commonly consumed sugar-sweetened beverage among young children. Fruit drinks carry many nutrition-related claims on the front of package (FOP). Nutrition-related claims affect individuals’ perceptions of the healthfulness of products and purchase intentions, often creating a “health halo” effect.ObjectiveThe aims of this study were to describe the prevalence of FOP nutrition-related claims on fruit drinks purchased by households with young children and to examine the association between claims and the nutritional profile of fruit drinks.DesignThe sample included 2059 fruit drinks purchased by households with children 0 to 5 years old participating in Nielsen Homescan in 2017. FOP labels were obtained from 2 databases that contain bar code–level information on all printed material on product labels. A codebook was used to code for presence of FOP nutrition-related claims. The coded claims data were linked by bar code with Nutrition Facts label data. Claim type prevalence was calculated, and the association between claim types and median calories and total grams of sugar per 100 mL was analyzed using Wilcoxon rank-sum tests. The percentages of products containing noncaloric sweeteners (NCSs) with and without each claim type were also calculated and compared.ResultsAlmost all (97%) fruit drinks sampled had at least 1 nutrition-related FOP claim. Implied natural claims such as “natural flavors” were the most common (55% of products), followed by claims about the presence of juice or nectar (49%). Claims about vitamin C (33%), sugar (29%), and calories (23%) were also common. Fruit drinks with vitamin C, juice or nectar, fruit or fruit flavor, and overt natural claims were higher in calories and sugar and less likely to contain NCSs compared with products without these claims. Fruit drinks with calorie, sugar, NCS, implied natural, and other claims were lower in calories and sugar and more likely to contain NCSs compared with products without these claims.ConclusionsClaims are prevalent on fruit drinks purchased by households with young children. This is concerning given prior research demonstrating that claims can mislead consumers. Regulatory actions such as requiring a warning or disclosure on drinks that contain added sugars or NCSs should be considered.     

Impact of Fruit and Vegetable Protein vs. Milk Protein on Metabolic Control of Children with Phenylketonuria: A Randomized Crossover Controlled Trial

Fruits and vegetables containing phenylalanine ≤ 75 mg/100 g (except potatoes) have little impact on blood phenylalanine in phenylketonuria (PKU). In a randomized, controlled, crossover intervention trial, we examined the effect of increasing phenylalanine intake from fruits and vegetables, containing phenylalanine 76–100 mg /100 g, compared with milk protein sources on blood phenylalanine control. This was a five-phase study (4 weeks each phase). In Phase A, patients remained on their usual diet and then were randomly allocated to start Phase B and C (an additional phenylalanine intake of 50 mg/day, then 100 mg from fruits and vegetables containing phenylalanine 76–100 mg/100 g) or Phase D and E (an additional phenylalanine intake of 50 mg/day then 100 mg/day from milk sources). There was a 7-day washout with the usual phenylalanine-restricted diet between Phase B/C and D/E. Blood phenylalanine was measured on the last 3 days of each week. If four out of six consecutive blood phenylalanine levels were >360 μmol/L in one arm, this intervention was stopped. Sixteen patients (median age 10.5 y; range 6–12 y) were recruited. At baseline, a median of 6 g/day (range: 3–25) natural protein and 60 g/day (range: 60–80) protein equivalent from protein substitute were prescribed. Median phenylalanine levels were: Phase A—240 μmol/L; Phase B—260 μmol/L; Phase C—280 μmol/L; Phase D—270 μmol/L and Phase E—280 μmol/L. All patients tolerated an extra 50 mg/day of phenylalanine from fruit and vegetables, containing phenylalanine 76–100 mg/100 g, but only 11/16 (69%) tolerated an additional 100 mg /day. With milk protein, only 8/16 (50%) tolerated an extra 50 mg/day and only 5/16 (31%) tolerated an additional 100 mg/day of phenylalanine. Tolerance was defined as maintaining consistent blood phenylalanine levels < 360 μmol/L throughout each study arm. There was a trend that vegetable protein had less impact on blood phenylalanine control than milk protein, but overall, the differences were not statistically significant (p = 0.152). This evidence supports the PKU European Guidelines cutoff that fruit and vegetables containing 76–100 mg phenylalanine/100 g should be calculated as part of the phenylalanine exchange system. Tolerance of the ‘free use’ of these fruits and vegetables depends on inter-patient variability but cannot be recommended for all patients with PKU.     

Impact of Health,Environmental, and Animal Welfare Messages Discouraging Red Meat Consumption: An Online Randomized Experiment

BackgroundReducing red meat consumption is a key strategy for curbing diet-related chronic diseases and mitigating environmental harms from livestock farming. Messaging interventions aiming to reduce red meat consumption have focused on communicating the animal welfare, health, or environmental harms of red meat. Despite the popularity of these 3 approaches, it remains unknown which is most effective, as limited studies have compared them side by side.ObjectiveOur aim was to evaluate responses to red-meat–reduction messages describing animal welfare, health, or environmental harms.DesignThis was an online randomized experiment.ParticipantsIn August 2021, a convenience sample of US adults was recruited via an online panel to complete a survey (n = 2,773 nonvegetarians and vegans were included in primary analyses).InterventionParticipants were randomly assigned to view 1 of the 4 following messages: control (neutral, non–red meat message), animal welfare, health, or environmental red-meat–reduction messages.Main outcome measuresAfter viewing their assigned message, participants ordered hypothetical meals from 2 restaurants (1 full service and 1 quick service) and rated message reactions, perceptions, and intentions.Statistical analyses performedLogistic and linear regressions were performed.ResultsCompared with the control message, exposure to the health and environmental red-meat–reduction messages reduced red meat selection from the full-service restaurant by 6.0 and 8.8 percentage points, respectively (P = .02 and P < .001, respectively), while the animal welfare message did not (reduction of 3.3 percentage points, P = .20). None of the red-meat–reduction messages affected red meat selection from the quick-service restaurant. All 3 red-meat–reduction messages elicited beneficial effects on key predictors of behavior change, including emotions and thinking about harms.ConclusionsRed-meat–reduction messages, especially those describing health or environmental harms, hold promise for reducing red meat selection in some types of restaurants. Additional interventions may be needed to discourage red meat selection across a wider variety of restaurants, for example, by making salient which menu items contain red meat.     

Effect of Raw Milk on Lactose Intolerance: A Randomized Controlled Pilot Study

PURPOSE

This pilot study aimed to determine whether raw milk reduces lactose malabsorption and/or lactose intolerance symptoms relative to pasteurized milk.

METHODS

We performed a crossover trial involving 16 adults with self-reported lactose intolerance and lactose malabsorption confirmed by hydrogen (H₂) breath testing. Participants underwent 3, 8-day milk phases (raw vs 2 controls: pasteurized, soy) in randomized order separated by 1-week washout periods. On days 1 and 8 of each phase, milk consumption was 473 mL (16 oz); on days 2 to 7, milk dosage increased daily by 118 mL (4 oz), beginning with 118 mL (4 oz) on day 2 and reaching 710 mL (24 oz) on day 7. Outcomes were area under the breath H₂ curve (AUC ∆H₂) and self-reported symptom severity (visual analog scales: flatulence/gas, audible bowel sounds, abdominal cramping, diarrhea).

RESULTS

AUC ∆H₂ (mean ± standard error of the mean) was higher for raw vs pasteurized on day 1 (113 ± 21 vs 71 ± 12 ppm·min·10⁻², respectively, P = .01) but not day 8 (72 ± 14 vs 74 ± 15 ppm·min·10⁻², respectively, P = .9). Symptom severities were not different for raw vs pasteurized on day 7 with the highest dosage (P >.7). AUC ∆H₂ and symptom severities were higher for both dairy milks compared with soy milk.

CONCLUSIONS

Raw milk failed to reduce lactose malabsorption or lactose intolerance symptoms compared with pasteurized milk among adults positive for lactose malabsorption. These results do not support widespread anecdotal claims that raw milk reduces the symptoms of lactose intolerance.     

Prevalence of Nutrition and Health-Related Claims on Pre-Packaged Foods: A Five-Country Study in Europe

This study is part of the research undertaken in the EU funded project CLYMBOL (“Role of health-related CLaims and sYMBOLs in consumer behaviour”). The first phase of this project consisted of mapping the prevalence of symbolic and non-symbolic nutrition and health-related claims (NHC) on foods and non-alcoholic beverages in five European countries. Pre-packaged foods and drinks were sampled based on a standardized sampling protocol, using store lists or a store floor plan. Data collection took place across five countries, in three types of stores. A total of 2034 foods and drinks were sampled and packaging information was analyzed. At least one claim was identified for 26% (95% CI (24.0%–27.9%)) of all foods and drinks sampled. Six percent of these claims were symbolic. The majority of the claims were nutrition claims (64%), followed by health claims (29%) and health-related ingredient claims (6%). The most common health claims were nutrient and other function claims (47% of all claims), followed by disease risk reduction claims (5%). Eight percent of the health claims were children’s development and health claims but these were only observed on less than 1% (0.4%–1.1%) of the foods. The category of foods for specific dietary use had the highest proportion of NHC (70% of foods carried a claim). The prevalence of symbolic and non-symbolic NHC varies across European countries and between different food categories. This study provides baseline data for policy makers and the food industry to monitor and evaluate the use of claims on food packaging.     

The Impact of Milk Fat Globule Membrane with Exercise on Age-Related Degeneration of Neuromuscular Junctions

Morphological changes in neuromuscular junctions (NMJs), which are synapses formed between α-motor neurons and skeletal muscle fibers, are considered to be important in age-related motor dysfunction. We have previously shown that the intake of dietary milk fat globule membrane (MFGM) combined with exercise attenuates age-related NMJ alterations in the early phase of aging. However, it is unclear whether the effect of MFGM with exercise on age-related NMJ alterations persists into old age, and whether intervention from old age is still effective when age-related changes in NMJs have already occurred. In this study, 6- or 18-month-old mice were treated with a 1% MFGM diet and daily running wheel exercise until 23 or 24 months of age, respectively. MFGM treatment with exercise was effective in suppressing the progression of age-related NMJ alterations in old age, and even after age-related changes in NMJs had already occurred. Moreover, the effect of MFGM intake with exercise was not restricted to NMJs but extended to the structure and function of peripheral nerves. This study demonstrates that MFGM intake with exercise may be a novel approach for improving motor function in the elderly by suppressing age-related NMJ alterations.     

Nutrition and Health Claims Spectra of Pre-Packaged Foods on Serbian Supermarket Shelves: A Repeated Cross-Sectional Study

Nutrition and health claims (NHCs) are a powerful tool that influence consumers’ final decision on the choice of food products. The purposes of this repeated cross-sectional study were to (i) assess the prevalence of pre-packaged food products containing nutrition and health claims among different food categories, (ii) to determine the type of NHCs labelled on the examined food products, and (iii) to evaluate the trend in the use of NHCs in comparison to the 2012 survey. The survey was conducted immediately before the full enforcement of the new national legislation on NHCs in 2020. It comprised 3141 pre-packaged food products from 10 product categories. In total, 21.2% of food products contained any claim (19.4% contained any nutrition claim; 8.2% contained any health claim). In comparison to the 2012 survey, we observed a rising trend in the presence of NHCs; the use of nutrition claims on food products increased three times and the use of health claims increased 1.3 times in the 2020 survey. Bearing in mind that NHCs are a powerful tool guiding consumers’ food purchase decisions, NHCs should be supported by precise legislation and strict surveillance by the public health authorities.     

The Impact of Household Chaos and Dietary Intake on Executive Function in Young Children

Children’s executive functions (EFs) emerge over time and can be shaped by household environments and dietary intake. However, there is a lack of knowledge about how these factors influence EFs in children aged 18–24 months. This study tested a model exploring the relations between parent-reported dietary intake, household chaos, and child EF. The sample consisted of 294 families participating in the STRONG Kids2 birth cohort study of nutrition and child health. Caregivers completed the Food Frequency Questionnaire (FFQ), the Confusion, Hubbub, and Order Scale (CHAOS), and the Behavior Rating Inventory of Executive Function^®-Preschool Version (BRIEF-P) to assess model variables. Regression analyses revealed a significant and independent association between assorted snacks and processed foods and two EF subscales. There were also significant associations between household chaos and each EF subscale. There was no significant moderation effect. These findings suggest that family households characterized by dysregulation are associated with children’s EF difficulties during early childhood and that the role of unhealthy dietary intake in child EF should be explored further. Future longitudinal studies that include multi-method approaches are needed to document the mechanisms through which household chaos impacts child EF over time.     

A Pilot Study on Donor Human Milk Microbiota: A Comparison with Preterm Human Milk Microbiota and the Effect of Pasteurization

Human milk (HM) is the best feeding option for preterm infants; however, when mother’s own milk (MOM) is not available, pasteurized donor human milk (DHM) is the best alternative. In this study, we profiled DHM microbiota (19 samples) using 16S rRNA amplicon sequencing and compared its compositional features with the MOM microbiota (14 samples) from mothers who delivered prematurely (PT-MOM). As a secondary study aim, we assessed the specific effect of pasteurization on the characteristics of the DHM microbiota. DHM showed significantly higher alpha diversity and significant segregation from PT-MOM. Compositionally, the PT-MOM microbiota had a significantly higher proportion of Staphylococcus than DHM, with Streptococcus tending to be and Pseudomonas being significantly overrepresented in DHM compared with the PT-MOM samples. Furthermore, pasteurization affected the HM microbiota structure, with a trend towards greater biodiversity and some compositional differences following pasteurization. This pilot study provided further evidence on the HM microbial ecosystem, demonstrating that the DHM microbiota differs from the PT-MOM microbiota, possibly due to inherent differences between HM donors and mothers delivering prematurely, and that pasteurization per se impacts the HM microbiota. Knowledge about HM microbiota needs to be acquired by investigating the effect of DHM processing to develop strategies aimed at improving DHM quality while guaranteeing its microbiological safety.     

健康教育对蓝光照射治疗中患儿家长的作用

对蓝光照射治疗黄疸患儿家属实施健康教育的工作实践，证实了采用正确的教育方法，选择适宜的教育时期，提高了家属对黄疸患儿蓝光照射治疗意义的认识，促进护患家属间的交流，获得患儿及家属最大程度的配合与支持，有效地预防新生儿核黄疸的发生。     

健康教育对蓝光照射治疗中患儿家长的作用

对蓝光照射治疗黄疸患儿家属实施健康教育的工作实践,证实了采用正确的教育方法,选择适宜的教育时期,提高了家属对黄疸患儿蓝光照射治疗意义的认识,促进护患家属间的交流,获得患儿及家属最大程度的配合与支持,有效地预防新生儿核黄疸的发生。     

The Impact of Gestational Diabetes Mellitus on Human Milk Metabolic Hormones: A Systematic Review

Gestational diabetes mellitus (GDM) is a common pregnancy complication with short- and long-term health consequences for the infant and mother. Breastfeeding is the recommended mode of feeding as it offers an opportunity to reduce the risk of GDM consequences, likely partially mediated through changes in human milk (HM) composition. This review systematically reviewed 12 identified studies that investigated the impact of GDM on concentrations of HM metabolic hormones. Meta-analysis was not possible due to significant heterogeneity in study designs and hormone measurement techniques. The risk of bias was assessed using the National Institute for Clinical Excellence (NICE) tool. The methodological qualities were medium in half of the studies, while 25% (3/12) of studies carried a high risk of bias. Significant relationships were reported between GDM and concentrations of HM ghrelin (3/3 studies), insulin (2/4), and adiponectin (2/6), which may play an integral role in infant growth and development. In conclusion, preliminary evidence suggests that GDM may alter HM metabolic hormone concentrations; however, these relationships may be limited to the early lactation stage.     

The Usefulness of Information Gathered from Parents in the Identification of Young Children with Handicaps: A Review and Discussion

ABC checklists (Adults Behaviors in Caregiving) have been created in three versions to assess caregivers of younger and older infants and caregivers of preschoolers. Two master teachers of younger infants were observed with ABC I during 46 half‐hours of observation, across daycare settings, time of day and day of week. Two master caregivers of toddlers were observed with ABC II during 59 half‐hours of observation. Piagetian activities were provided for younger infants during 1/5 of times sampled, and for older infants during 1/10 of times sampled. Master teachers practically never ignored babies who needed attention. Verbal criticisms or scolds were emitted in fewer than 1% of the times sampled. Isolation as a behavior modification technique was very rare with younger babies but occurred in 1/6 of sampled intervals with toddlers. Positive socioemotional interaction comprised 1/4 of teacher repertoire with younger babies. Language interactions represented 1/3 of the teachers’ repertoire with younger babies and almost 1/2 of the toddler teachers’ repertoire. ABC inputs varied somewhat as a function of time of day. There were no indications that caregivers became more negative later in the week. Thus, ABC proved to be a sensitive, easy to use instrument that is useful in monitoring the transactions of infant/ toddler caregivers and the effects of any inservice training procedures.     

Effect of Soy Milk on Metabolic Status of Patients with Nonalcoholic Fatty Liver Disease: A Randomized Clinical Trial

Objective: Studies in experimental models of nonalcoholic fatty liver disease (NAFLD) have reported positive effects of soy components in improving metabolic parameters. Whether such effects could be achieved through consumption of whole soy foods in patients with NAFLD is still unclear. Therefore, this trial was conducted to assess the effects of soy milk on metabolic parameters of patients with NAFLD.

Methods: This parallel randomized clinical trial was conducted on 70 patients with NAFLD. Patients in the soy milk group consumed 240?ml of soy milk daily as a part of low-calorie diet (i.e., 500-deficit calorie diet) for 8?weeks. Patients in the control group just followed the low-calorie diet. Grade of fatty liver, liver enzymes, lipid profile, serum high-sensitivity C-reactive protein (hs-CRP), and anthropometric indices were measured at baseline and the end of the trial.

Results: At the end of the trial, the soy milk group had significantly higher reduction in serum alanine aminotransferase (ALT) (–12.06?±?17.61?IU/L in the soy milk group versus –5?±?8.58?IU/L in the control group, p?=?0.04) and hs-CRP (–1.32?±?1.60?mg/L in the soy milk group versus –0.36?±?1.54?mg/L in the control group, p?=?0.01) compared to the control group. However, changes in fatty liver grade and other liver enzymes, including aspartate aminotransferase, alkaline phosphatase, and gamma-glutamyl transferase, as well as lipid profile and anthropometric indices were not significantly different between the treatment groups.

Conclusion: Consumption of soy milk in the context of a restricted-calorie diet for 8?weeks had favorable effects on serum ALT and hs-CRP in patients with NAFLD.     

The Impact of Work on the Mental Health of Parents of Children with Disabilities

There is a growing literature examining the impact of work and family responsibilities on the psychological well‐being of parents of children with disabilities and other special needs. A number of studies using small, nonprobability samples of mothers find that work provides a respite from the stressful effects of caregiving. Using data from the National Survey of American Families, this study found higher mental health among working mothers of older children with disabilities compared to their nonworking counterparts and mothers of typically developing children, a result consistent with caregiver‐specific positive spillover. No significant differences in mental health were found among working and nonworking mothers of younger children with disabilities or among fathers. Results also indicate that caregiver mothers who are experiencing high levels of parent‐role stress benefit more from work, and that the beneficial effects from work persist until rather high levels of work (50 or more hours per week).     

Predictors of Baby Video/DVD Ownership: Findings from a National Sample of American Parents with Young Children

This study examines demographic and attitudinal predictors of parents reported ownership of baby DVDs among a national sample of US parents with children under age three. Results indicate few associations with demographic variables. Fathers report greater ownership of baby videos/DVDs, and parents with more videos/DVDs report more satisfaction with these products. Parent attitudes toward early childhood education are related to owning more videos/DVDS, while promotion-focused orientation (i.e., propensity to pursue possible rewards when outcomes are uncertain) predicts satisfaction with baby videos/DVDs. Furthermore, results indicate that parents' belief in the educational value of media for young children is a strong predictor of both ownership and satisfaction with these products. In light of the controversy surrounding baby videos/DVDs and growing number and variety of screen media for infants and toddlers, implications of these findings for policy and further research are discussed.