DIETARY EVOLUTION OVER TIME IN EUROPE, BETWEEN CYCLOPS AND PHAECIANS . AN OUTLOOK ON THE ROLE OF SUPPLY-SIDE FACTORS IN DRIVING CHANGES IN THE FOOD PATTERNS

The present study intends to shed light, both from a descriptive and investigative point of view on the dietary evolution taking place in Europe during last 45 years, using secondary data from FAO FBS, which can cover the entire time span considered and allow for several extrapolation and timeseries analysis, differently than single survey data.. After a clustering of selected european national diets, using specific metrics with respect both to internal and external variety (as measured by appropriate indicators), we intended to check the actual distance that average, national diets have in front of the so called Food Pyramid, which consists in a balance of several food items in adequate proportions and in fact glorifies the healthy virtues of the Mediterranean Diet as a reference model among food patterns. Furthermore, if several studies focussed strictly on the evolution of diet per-se, from a nutritional perspective- our purpose was to put it in context with economic and materialistic factors which could have a part in the explanation. In particular, our intention was to provide a focus on trade factor as explaining the changing diets. We tested with causality tests the hypothesis behind, in order to find relationship between economic factors and nutritional aspects. Eventually, we propose a preliminary investigation about the role of GIs (Geographic Indication food products, such as PDO) in relation to globalised food patterns. The results are interesting, and let the doors open for interpretations and further research.diets, evolution, clustering, food pyramid, Europe, trade, GI, Agricultural and Food Policy, Consumer/Household Economics, Demand and Price Analysis, Food Consumption/Nutrition/Food Safety, Food Security and Poverty, Health Economics and Policy, E37, Q18,

Out-of-home eating frequency, causal attribution of obesity and support to healthy eating policies from a cross-European survey

Background: The relation between the increased out-of-home food consumption and the rising of overweight and obesity prevalence rates has been widely assessed, and the a key role played by the catering sector in ensuring healthy food choices has been recognised. Governments’ healthy eating policies have a wide range of action, influencing consumer behavior, and the socioeconomic and  food environments, with specific actions for the catering sector. Information on the public support for these policies could help policy makers in planning decisions. This study aims to investigate the relationship of out-of-home eating frequency with beliefs about obesity causes, support to healthy eating policies, and with socio-demographic factors. Methods: Data on 3003 individuals from Belgium, Denmark, Italy, Poland and United Kingdom, of both sexes, aged ≥16 years, were employed, from the European survey on policy preferences (Eatwell). Data were analysed through Chi-square test and logistic regression analysis. Results: Out-of-home eating varied with gender, age, marital status, education, BMI, and by country. Convenience food consumption was positively associated with obesity attribution to genetics, and inversely associated with attribution to lack of willpower. Attributions of obesity to lack of time, and to lack of self-control were associated with increased likelihood to consume fast-food and ready-prepared food respectively. Out-of-home eating people expressed higher support for information-based prevention, and actions aimed at healthier out-of-home eating, and lower support for restrictions and regulations of the food supply environment. Conclusion: Future research on out-of-home food consumers and their support towards public interventions for the catering sector, could have important implications for effective strategies to promote healthy eating

Food Composition at Present: New Challenges

Food composition data is important for stakeholders and users active in the areas of food, nutrition and health. Newchallenges related to the quality of food composition data reflect the dynamic changes in these areas while the emerging technologies create new opportunities. These challenges and the impact on food composition data for the Mediterranean region were reviewed during the NUTRIMAD 2018 congress of the Spanish Society for Community Nutrition. Data harmonization and standardization, data compilation and use, thesauri, food classification and description, and data exchange are some of the areas that require new approaches. Consistency in documentation, linking of information between datasets, food matching and capturing portion size information suggest the need for new automated tools. Research Infrastructures bring together key data and services. The delivery of sustainable networks and Research Infrastructures in food, nutrition and health will help to increase access to and effective use of food composition data. EuroFIR AISBL coordinates experts and national compilers and contributes to worldwide efforts aiming to produce and maintain high quality data and tools. A Mediterranean Network that shares high quality food composition data is vital for the development of ambitious common research and policy initiatives in support of the Mediterranean Diet

Intake of selected nutrients from foods, from fortification and from supplements in various European countries

Background: Recent European Union regulation requires setting of maximum amount of micronutrients in dietary supplements or foods taking into account the tolerable upper intake levels (ULs) established by scientific risk assessment and population reference intakes. Objective: To collect and evaluate recently available data on intakes of selected vitamins and minerals from conventional foods, food supplements and fortified foods in adults and children. Intake of calcium, copper, iodine, iron, magnesium, phosphorus, selenium, zinc, folic acid, niacin and total vitamin A/retinol, B6, D and E was derived from nationally representative surveys in Denmark, Germany, Finland, Ireland, Italy, the Netherlands, Poland, Spain and the United Kingdom. Intake of high consumers, defined as the 95th percentile of each nutrient, was compared to the UL. Results: For most nutrients, adults and children generally consume considerably less than the UL with exceptions being retinol, zinc, iodine, copper and magnesium. The major contributor to intakes for all nutrients and in all countries is from foods in the base diet. The patterns of food supplements and voluntary fortification vary widely among countries with food supplements being responsible for the largest differences in total intakes. In the present study, for those countries with data on fortified foods, fortified foods do not significantly contribute to higher intakes for any nutrient. Total nutrient intake expressed as percentage of the UL is generally higher in children than in adults. Conclusion: The risk of excessive intakes is relatively low for the majority of nutrients with a few exceptions. Children are the most vulnerable group as they are more likely to exhibit high intakes relative to the UL. There is a need to develop improved methods for estimating intakes of micronutrients from fortified foods and food supplements in future dietary surveys

A Consensus Proposal for Nutritional Indicators to Assess the Sustainability of a Healthy Diet: The Mediterranean Diet as a Case Study

BACKGROUND: There is increasing evidence of the multiple effects of diets on public health nutrition, society, and environment. Sustainability and food security are closely interrelated. The traditional Mediterranean Diet (MD) is recognized as a healthier dietary pattern with a lower environmental impact. As a case study, the MD may guide innovative inter-sectorial efforts to counteract the degradation of ecosystems, loss of biodiversity, and homogeneity of diets due to globalization through the improvement of sustainable healthy dietary patterns. This consensus position paper defines a suite of the most appropriate nutrition and health indicators for assessing the sustainability of diets based on the MD. METHODS: In 2011, an informal International Working Group from different national and international institutions was convened. Through online and face-to-face brainstorming meetings over 4 years, a set of nutrition and health indicators for sustainability was identified and refined. RESULTS: Thirteen nutrition indicators of sustainability relating were identified in five areas. Biochemical characteristics of food (A1. Vegetable/animal protein consumption ratios; A2. Average dietary energy adequacy; A3. Dietary Energy Density Score; A4. Nutrient density of diet), Food Quality (A5. Fruit and vegetable consumption/intakes; A6. Dietary Diversity Score), Environment (A7. Food biodiversity composition and consumption; A8. Rate of Local/regional foods and seasonality; A9. Rate of eco-friendly food production and/or consumption), Lifestyle (A10. Physical activity/physical inactivity prevalence; A11. Adherence to the Mediterranean dietary pattern), Clinical Aspects (A12. Diet-related morbidity/mortality statistics; A13. Nutritional Anthropometry). A standardized set of information was provided for each indicator: definition, methodology, background, data sources, limitations of the indicator, and references. CONCLUSION: The selection and analysis of these indicators has been performed (where possible) with specific reference to the MD. Sustainability of food systems is an urgent priority for governments and international organizations to address the serious socioeconomic and environmental implications of short-sighted and short-term practices for agricultural land and rural communities. These proposed nutrition indicators will be a useful methodological framework for designing health, education, and agricultural policies in order, not only to conserve the traditional diets of the Mediterranean area as a common cultural heritage and lifestyle but also to enhance the sustainability of diets in general

Prevalence of protein intake below recommended in community‐dwelling older adults: a meta‐analysis across cohorts from the PROMISS consortium

European Horizon 2020 PROMISS Project ‘PRevention Of Malnutrition In Senior Subjects in the EU’, (grant agreement no. 678732). The content only reflects the author’s view and the commission is not responsible for any use that may be made of the information it contains.Background: Lower protein intake in older adults is associated with loss of muscle mass and strength. The present study aimed to provide a pooled estimate of the overall prevalence of protein intake below recommended (according to different cut-off values) among community-dwelling older adults, both within the general older population and within specific subgroups. Methods: As part of the PRevention Of Malnutrition In Senior Subjects in the EU (PROMISS) project, a meta-analysis was performed using data from four cohorts (from the Netherlands, UK, Canada, and USA) and four national surveys [from the Netherlands, Finland (two), and Italy]. Within those studies, data on protein and energy intake of community-dwelling men and women aged ≥55 years were obtained by either a food frequency questionnaire, 24 h recalls administered on 2 or 3 days, or food diaries administered on 3 days. Protein intake below recommended was based on the recommended dietary allowance of 0.8 g/kg body weight (BW)/d, by using adjusted BW (aBW) instead of actual BW. Cut-off values of 1.0 and 1.2 were applied in additional analyses. Prevalences were also examined for subgroups according to sex, age, body mass index (BMI), education level, appetite, living status, and recent weight loss. Results: The study sample comprised 8107 older persons. Mean ± standard deviation protein intake ranged from 64.3 ± 22.3 (UK) to 80.6 ± 23.7 g/d [the Netherlands (cohort)] or from 0.94 ± 0.38 (USA) to 1.17z ± 0.30 g/kg aBW/d (Italy) when related to BW. The overall pooled prevalence of protein intake below recommended was 21.5% (95% confidence interval: 14.0–30.1), 46.7% (38.3–55.3), and 70.8% (65.1–76.3) using the 0.8, 1.0, and 1.2 cut-off value, respectively. A higher prevalence was observed among women, individuals with higher BMI, and individuals with poor appetite. The prevalence differed only marginally by age, education level, living status, and recent weight loss. Conclusions: In community-dwelling older adults, the prevalence of protein intake below the current recommendation of 0.8 g/kg aBW/d is substantial (14–30%) and increases to 65–76% according to a cut-off value of 1.2 g/kg aBW/d. To what extent the protein intakes are below the requirements of these older people warrants further investigation.publishersversionpublishe

Dietary choices and environmental impact in four European countries

Effective food policies in Europe require insight into the environmental impact of consumers’ diet to contribute to global nutrition security in an environmentally sustainable way. The present study therefore aimed to assess the environmental impact associated with dietary intake across four European countries, and to explain sources of variations in environmental impact by energy intake, demographics and diet composition. Individual-level dietary intake data were obtained from nationally-representative dietary surveys, by using two non-consecutive days of a 24-h recall or a diet record, from Denmark (DK, n = 1710), Czech Republic (CZ, n = 1666), Italy (IT, n = 2184), and France (FR, n = 2246). Dietary intake data were linked to a newly developed pan-European environmental sustainability indicator database that contains greenhouse gas emissions (GHGE) and land use (LU) values for ∼900 foods. To explain the variation in environmental impact of diets, multilevel regression models with random intercept and random slopes were fitted according to two levels: adults (level 1, n = 7806) and country (level 2, n = 4). In the models, diet-related GHGE or LU was the dependent variable, and the parameter of interest, i.e. either total energy intake or demographics or food groups, the exploratory variables. A 200-kcal higher total energy intake was associated with a 9% and a 10% higher daily GHGE and LU. Expressed per 2000 kcal, mean GHGE ranged from 4.4 (CZ) to 6.3 kgCO2eq/2000 kcal (FR), and LU ranged from 5.7 (CZ) to 8.0 m2*year/2000 kcal (FR). Dietary choices explained most of the variation between countries. A 5 energy percent (50 g/2000 kcal) higher meat intake was associated with a 10% and a 14% higher GHGE and LU density, with ruminant meat being the main contributor to environmental footprints. In conclusion, intake of energy, total meat and the proportion of ruminant meat explained most of the variation in GHGE and LU of European diets. Contributions of food groups to environmental footprints however varied between countries, suggesting that cultural preferences play an important role in environmental footprints of consumers. In particular, Findings from the present study will be relevant for national-specific food policy measures towards a more environmentally-friendly diet.</p

Analytical Challenges and Metrological Approaches to Ensuring Dietary Supplement Quality: International Perspectives

The increased utilization of metrology resources and expanded application of its’ approaches in the development of internationally agreed upon measurements can lay the basis for regulatory harmonization, support reproducible research, and advance scientific understanding, especially of dietary supplements and herbal medicines. Yet, metrology is often underappreciated and underutilized in dealing with the many challenges presented by these chemically complex preparations. This article discusses the utility of applying rigorous analytical techniques and adopting metrological principles more widely in studying dietary supplement products and ingredients, particularly medicinal plants and other botanicals. An assessment of current and emerging dietary supplement characterization methods is provided, including targeted and non-targeted techniques, as well as data analysis and evaluation approaches, with a focus on chemometrics, toxicity, dosage form performance, and data management. Quality assessment, statistical methods, and optimized methods for data management are also discussed. Case studies provide examples of applying metrological principles in thorough analytical characterization of supplement composition to clarify their health effects. A new frontier for metrology in dietary supplement science is described, including opportunities to improve methods for analysis and data management, development of relevant standards and good practices, and communication of these developments to researchers and analysts, as well as to regulatory and policy decision makers in the public and private sectors. The promotion of closer interactions between analytical, clinical, and pharmaceutical scientists who are involved in research and product development with metrologists who develop standards and methodological guidelines is critical to advance research on dietary supplement characterization and health effects

Geographic and socioeconomic diversity of food and nutrient intakes: a comparison of four European countries

Purpose: Public health policies and actions increasingly acknowledge the climate burden of food consumption. The aim of this study is to describe dietary intakes across four European countries, as baseline for further research towards healthier and environmentally-friendlier diets for Europe. Methods: Individual-level dietary intake data in adults were obtained from nationally-representative surveys from Denmark and France using a 7-day diet record, Italy using a 3-day diet record, and Czech Republic using two replicates of a 24-h recall. Energy-standardised food and nutrient intakes were calculated for each subject from the mean of two randomly selected days. Results: There was clear geographical variability, with a between-country range for mean fruit intake from 118 to 199 g/day, for vegetables from 95 to 239 g/day, for fish from 12 to 45 g/day, for dairy from 129 to 302 g/day, for sweet beverages from 48 to 224 ml/day, and for alcohol from 8 to 15 g/day, with higher intakes in Italy for fruit, vegetables and fish, and in Denmark for dairy, sweet beverages and alcohol. In all countries, intakes were low for legumes ( 80 g/day). Within countries, food intakes also varied by socio-economic factors such as age, gender, and educational level, but less pronounced by anthropometric factors such as overweight status. For nutrients, intakes were low for dietary fibre (15.8–19.4 g/day) and vitamin D (2.4–3.0 µg/day) in all countries, for potassium (2288–2938 mg/day) and magnesium (268–285 mg/day) except in Denmark, for vitamin E in Denmark (6.7 mg/day), and for folate in Czech Republic (212 µg/day). Conclusions: There is considerable variation in food and nutrient intakes across Europe, not only between, but also within countries. Individual-level dietary data provide insight into the heterogeneity of dietary habits beyond per capita food supply data, and this is crucial to balancing healthy and environmentally-friendly diets for European citizens