Dietary Intake and Status of Vitamin B12 in Slovenian Population

Vitamin B12 deficiency poses a health concern, especially in vulnerable populations. Dietary vitamin B12 intake was obtained by two 24 h dietary recalls and food propensity questionnaires in a representative Slovenian cross-sectional food consumption survey, SI.Menu (n = 1248 subjects; 10–74 years). For a subgroup of 280 participants, data on serum vitamin B12 were available through the Nutrihealth study. The estimated usual population-weighted mean daily vitamin B12 intakes were 6.2 µg (adults), 5.4 µg (adolescents), and 5.0 µg (elderly). Lower intakes were observed in females. Inadequate daily vitamin B12 intake (<4 µg) was detected in 37.3% of adolescents, 31.7% of adults, and 58.3% elderlies. The significant predictors for inadequate daily vitamin B12 intake were physical activity score in all age groups, sex in adolescents and adults, financial status and smoking in elderly, and employment in adults. Meat (products), followed by milk (products), made the highest vitamin B12 contribution in all age groups. In adolescents, another important vitamin B12 contributor was cereals. The mean population-weighted serum vitamin B12 levels were 322.1 pmol/L (adults) and 287.3 pmol/L (elderly). Low serum vitamin B12 concentration (<148 nmol/L) and high serum homocysteine (>15 µmol/L) were used as criteria for vitamin B12 deficiency. The highest deficiency prevalence was found in elderlies (7.0%), particularly in males (7.9%). Factors associated with high serum homocysteine were also investigated. In conclusion, although vitamin B12 status was generally not critical, additional attention should be focused particularly to the elderly

Dietary Iron Intake and Biomarkers of Iron Status in Slovenian Population: Results of SI.Menu/Nutrihealth Study

Inadequate iron intake and iron deficiency are recognised as a public health problem in the population at large, and particularly in specific subpopulations. Dietary iron intake was analysed using data of the national Slovenian food consumption study, SI.Menu (n = 1248 subjects; 10–74 years), while iron status was evaluated with laboratory analyses of blood haemoglobin, serum ferritin, and iron concentration in samples, collected in the Nutrihealth study (n = 280, adults). The estimated daily usual population-weighted mean iron intakes ranged from 16.0 mg in adults and the elderly to 16.7 in adolescents, and were lower in females for all three age groups. The main dietary iron sources in all the age groups were bread and bakery products, meat (products), fruit, and vegetables. The highest prevalence of haemoglobin anaemia was observed in females aged 51–64 years (6.7%). Critically depleted iron stores (ferritin concentration < 15 µg/L) were particularly found in premenopausal females (10.1%). Factors influencing low haemoglobin, ferritin, and iron intake were also investigated. We observed significant correlations between iron status with meat and fish intake, and with iron intake from meat and fish, but not with total iron intake. We can conclude that particularly premenopausal females are the most fragile population in terms of inadequate iron intake and iron deficiency, which should be considered in future research and public health strategies

Evaluation of selected nutrients content in available and advertised foods on Slovenian market

Hranilna sestava živil je še posebej pomembna predvsem z vidika vsebnosti določenih hranil, katerih prekomerno uživanje lahko dolgoročno predstavlja zdravstvene težave. Eno takšnih hranil je tudi natrij. V raziskavah smo ugotavljali, kakšna je povprečna vsebnost natrija v posameznih skupinah živil, ki so na voljo na slovenskem tržišču v letu 2011 in 2015 ter kakšna je sestava živil, ki se oglašujejo v medijih. Podatke o povprečni vsebnosti natrija smo utežili s podatki o prodaji posameznih izdelkov. Ugotovili smo, da so z vidika vsebnosti natrija najbolj kritične predvsem skupine živil kot so mesni izdelki, kruh in pekovski izdelki, siri in gotove jedi. S prodajnimi podatki utežena povprečna vsebnost natrija, je bila tako v letu 2011 kot tudi v 2015 v večini skupin živil nižja od povprečja znotraj posamezne skupine živil. Statistično značilnega znižanja povprečne vsebnosti natrija med letoma 2011 in 2015 nismo ugotovili v nobeni skupini živil, ki pomembno prispevajo k prehranskemu vnosu natrija, torej proizvajalci prostovoljno ne zmanjšujejo vsebnosti natrija v živilih. Ugotovili smo tudi, da ima večina živil, ki se oglašujejo otrokom na televiziji in v tiskanih medijih manj ugodno hranilno sestavo. Kot metoda celostnega vrednotenja hranilne sestave živil se uporablja profiliranje živil z različnimi modeli. V naši raziskavi smo uporabili Ofcom in SZO model profiliranja živil, ki sta namenjena omejevanju oglaševanja živil otrokom v medijih in na ta način ovrednotili sestavo oglaševanih živil. Glede na rezultate raziskav bi bila v Sloveniji nujna zakonska ureditev tega področja, ne samo na televiziji, ampak na ostalih medijskih kanalih.Nutritional composition of foods is crucial especially in terms of certain nutrients, which can present health issues whean consumed in excess amounts for longer time periods. Such nutrient is also sodium. In this study, we examined what is the average amount of sodium in specific food categories in pre-packed foods, available on Slovenian market in years 2011 and 2015. Sales-weighted average sodium content was used. The results showed that from sodium content perspective, the most critical food categories were meat and derivatives, bread, cheese and ready meals. Sales-weighted sodium content was lower than average sodium content in most food categories in 2011 as well as in 2015. We observed no statistically significant difference in average sodium content between 2011 and 2015 in any of food categories. The results show that most foods which are advertised to children on television and in print media have poor nutritional composition. As a method for integrated evaluation of nutritional composition of foods, method of nutritional profiling was found useful. We used Ofcom and WHO nutrient profiling model, which are being used for limiting food advertising to children in media. From this point of view, legal regulation of this area would be necessary in Slovenia, not only on television, where it was recently applied, but also in all other media

Marketing of Foods to Children through Food Packaging Is Almost Exclusively Linked to Unhealthy Foods

The nutritional composition of foods marketed to children is important, as it can significantly influence children’s preferences. The objective of this research was to evaluate the presence of child-oriented food products in the food supply and to investigate their nutritional composition. The sample included 8191 prepacked foods in the Slovenian food supply available in the market in 2015. The nutrient profile (World Health Organisation Regional Office for Europe nutrient profile model) of the products with child-targeted promotions was compared to the nutrient profile of those without child-targeted promotions. Food categories with the highest proportion of products with child-focused promotions were “Breakfast Cereals” (17%), “Chocolate and Sugar Confectionery” (15%) and “Edible Ices” (13%). Altogether, 93% of all products with child-focused promotions and 73% of products without such promotions were classified as “not permitted”. The proportion of “not permitted” foods was significantly higher in products with child-targeted promotions, compared with products without child-targeted promotions (p < 0.0001), and this trend was observed in a majority of food categories. To protect children from exposure to the marketing of foods with less favourable nutritional compositions, public health strategies should be focused also towards limiting promotions of unhealthy foods to children on product packaging, not only in media

Nutritional Challenges in Nursing Homes: Pilot Study on Macronutrient Intake and Status of Vitamins D and B12

Older adults living in nursing homes (NH) are considered a population group that could be at risk in terms of nutrition, even more so than their community-dwelling peers. Evidence on the nutritional status of NH residents is scarce, as they are commonly excluded from population-based dietary studies. This is also the case in Slovenia. In the presented pilot study, we assessed the intake of macronutrients as well as the intake and status of vitamin D and vitamin B12 on a sample of NH and NH daycare center users to explore the need for a larger representative study. The pilot study included 37 participants from three Slovenian NH (20 participants) and their daycare centers (17 participants). Daycare centers offer daytime care services for older adults, where users are also provided with major meals during their stay. Intakes of energy and nutrients were estimated by three 24 h dietary records. Fasting blood samples were collected for the assessment of vitamin D and vitamin B12 status. Over 90% of the participants had daily energy and protein intakes below recommendations (reference values: energy intake: males 2100 kcal and females 1700 kcal; protein intake > 1 g/kg body mass). The males’ median daily intakes of vitamin D were 1.7 µg (1.5 µg females), and 2.3 µg for vitamin B12 (2.0 µg females). None of the participants had adequate vitamin D intake (>20 µg), and 92.3% males and 87.5% females had inadequate vitamin B12 intake (<4 µg). The prevalence of vitamin D deficiency (serum 25-OH-D conc. < 30 nmol/L) was 100% among NH residents and 53% among NH daycare center users. The prevalence of vitamin B12 deficiency was found in 20% of NH residents. The study results highlighted that certain nutrients might be critical in this population, especially among NH residents; however, a more thorough investigation with the inclusion of other important markers of nutritional status should be performed on a larger, representative sample to support the development and implementation of appropriate public health interventions

Changes in Average Sodium Content of Prepacked Foods in Slovenia during 2011–2015

A voluntary gradual reduction in the salt content of processed foods was proposed Slovenia in 2010. Our objective was to determine the sodium content of prepacked foods in 2015 and to compare these results with data from 2011. Labelled sodium content and 12-month sales data were collected for prepacked foods (N = 5759) from major food stores in Slovenia. The average and sales-weighted sodium content, as well as the share in total sodium sales (STSS) were calculated for different food category levels, particularly focusing on processed meat and derivatives (STSS: 13.1%; 904 mg Na/100 g), bread (9.1%; 546 mg), cheese (5.1%; 524 mg), and ready-to-eat meals (2.2%; 510 mg). Reduced sale-weighted sodium content was observed in cheese (57%), a neutral trend was observed in processed meat and derivatives (99%) and bread (100%), and an increase in sodium content was found in ready meals (112%). Similar trends were observed for average sodium levels, but the difference was significant only in the case of ready meals. No statistically significant changes were observed for the matched products, although about one-third of the matched products had been reformulated by lowering the sodium level by more than 3.8%. Additional efforts are needed to ensure salt reduction in processed foods in Slovenia. Such efforts should combine closer collaboration with the food industry, additional consumer education, and setting specific sodium content targets (limits) for key food categories

Nutritional Composition of Gluten-Free Labelled Foods in the Slovenian Food Supply

The market of gluten-free (GF) foods has been expanding in recent years. GF foods are consumed not only by those with medical predispositions for avoiding gluten, but also by a specific segment of consumers, searching for &ldquo;healthier&rdquo; food choices. For these, such practices can present a serious limitation in the variability of food choices. Considering that GF foods are commonly perceived as healthier alternatives, there is a lack of knowledge on the nutritional profile and content of specific nutrients of GF-labelled foods compared to general food supply. A comparison of nutritional composition of GF/non-GF packed foods in the Slovenian food supply was conducted. The nutrient profiling scoring criterion (NPSC) and content of specific nutrients/energy was compared between GF-labelled and regular foods. The highest proportion of GF-labelled products were found in food categories, which typically do not contain gluten (Cheese imitates, Milk imitates, Yoghurt imitates, Canned fish and seafood and Processed meat). Significant differences in the nutrient profile between GF-labelled and regular products were found in Cakes, muffins and pastry, Crisps and snacks, Desserts and Milk imitates. GF-labelled foods often had lower protein and sugar content. Energy value was comparable in most categories and no significant differences in salt content were found, compared to non-GF products. In conclusion, GF-labelled foods will unlikely bring health benefits to those who are not medically required to follow GF diet. Public health initiatives should aim towards promotion of consuming non-processed foods and provision of reliable information about who is required to consume GF foods

Facilitating consumers choice of healthier foods

Summary indicator front-of-package nutrition labelling schemes are gaining momentum. In Europe, an example of such a scheme is Nutri-Score, which was first introduced in France. Supported by additional research, the scheme has the potential to expand into other countries. Such a scenario opens a series of questions related to the use of Nutri-Score in the territories with pre-existing food labelling schemes. A key question is whether different nutrition labelling schemes would provide conflicting information for consumers when applied to same foods. The goal of our study was, therefore, to evaluate the alignment of different front-of-package nutrition labelling schemes. The study was conducted using cross-sectional data on the composition of selected categories of prepacked foods with high penetration nutrition/health claims and symbols in the Slovenian food supply. We evaluated a variety of existing front-of-package nutrition labelling schemes: three interpretive nutrition rating systems (Nutri-Score, Health Star Rating (HSR), Traffic light system), four health symbols (Protective Food symbol, Choices, Finnish heart, and Keyhole symbol), and also three nutrient profile models developed for other purposes (Office of Communications (United Kingdom, Ofcom), World Health Organization Regional office for Europe (WHOE) and Food Standards Australia New Zealand (FSANZ)). Overall, our results indicate that interpretive nutrition rating systems (i.e., Nutri-Score) are mostly less strict than the nutrient profiles of tested health symbols. A risk of conflicting information would happen in a scenario where food is eligible to carry a health symbol, but is at the same time rated to have lower nutritional quality by an accompanying interpretive nutrition rating system. When Protective Food symbol and Nutri-Score are used together, this would occur for 5% of foods in our sample. To avoid such risks, schemes for health symbols could be adapted to be stricter than interpretive nutrition rating systems used in the same territory/market, but such adaptations are challenging and should be well planned. While our study showed that, in most cases, Nutri-Score is a less strict model than tested health symbols, the rating-system approach might offer useful support and incentive for food producers towards gradual food reformulation