The value of food: Savoir vivre = savoir manger

When the concept of functional food was introduced at the end of last century, food manufacturers started to add health claims to their advertising messages, with the aim of influencing the purchasing behaviour of consumers. To protect citizens against misleading or confusing information, new legislative provisions were introduced and imposed formal approval of nutritional health claims. Food companies faced the challenge with confidence, however in many cases their dossiers did not meet the required scientific level. At the same time pharmaceutical industries seized the opportunity to expand their market segments with relatively little effort, as a simple notification procedure is sufficient for marketing vitamin preparations and dietary supplements. From a nutritional point of view, this focus on health effects of specific foods and dietary supplements risks to push into the background the basic principle that a balanced diet allows healthy people to adequately meet their daily nutritional needs. This concern inspired the creation of a new discipline named Nutrition Economics, aiming to better account for the influence of eating patterns on disease burden and on societal and individual socio-economic consequences of insufficient or unbalanced food intake. Since its introduction in 2011, Nutrition Economics has gradually gained recognition as shown by an analysis of the scientific literature covering the period January 2012-December 2021. The continuously increasing prevalence of food-related chronic conditions threatens the sustainability of health systems, the prosperity of societies and the well-being of individual citizens. We need to make a decisive reversal in preventive public health programs. The integration of Citizen Science in the field of Nutrition Economics offers a new way forward for: - strengthening the relevance of collected nutrition-health data in real-life situations - getting a better insight in the most pertinent levers for successful healthy food promotion - narrowing the know-to-do gap between health policies, population health and the health inequalities that hamper the implementation of successful policies. A structured collaboration between scientific researchers, volunteers from the general public and other stakeholders, offers an unparalleled opportunity to better understand the subjective factors that play a key role in eating behaviour. This approach will be adapted to the complexity of nutritional research, characterized by interactions between diet, lifestyle and multiple other factors in daily life. In addition, active participation of citizen volunteers in such research projects will contribute to raising a better awareness about the crucial importance of daily food for personal well-being. This will enhance the willingness to change behaviour in a more sustainable way and, on the longer term, this will not only benefit healthcare resources, but also socio-economic conditions and the wellbeing of the population at large. Furthermore, increased understanding of nutritional issues among laypersons will gradually offer protection against internet misinformation and make people less receptive to unsubstantiated nutritional blog posts and related social media communication. We cannot afford to continue "eating up" our health, resulting in an excessive (but avoidable) pressure on scarce healthcare resources. Nutritional literacy is the beginning of a healthier and socially more equitable world

Corrigendum: Probiotics Reduce Health Care Cost and Societal Impact of Flu-Like Respiratory Tract Infections in the USA: An Economic Modeling Study.

[This corrects the article DOI: 10.3389/fphar.2019.00980.]

Dairy foods and osteoporosis: an example of assessing the health-economic impact of food products

__Abstract__ Osteoporosis has become a major health concern, carrying a substantial burden in terms of health outcomes and costs. We constructed a model to quantify the potential effect of an additional intake of calcium from dairy foods on the risk of osteoporotic fracture, taking a health economics perspective. Introduction: This study seeks, first, to estimate the impact of an increased dairy consumption on reducing the burden of osteoporosis in terms of health outcomes and costs, and, second, to contribute to a generic methodology for assessing the health-economic outcomes of food products. Methods: We constructed a model that generated the number of hip fractures that potentially can be prevented with dairy foods intakes, and then calculated costs avoided, considering the healthcare costs of hip fractures and the costs of additional dairy foods, as well as the number of disability-adjusted life years (DALYs) lost due to hip fractures associated with low nutritional calcium intake. Separate analyses were done for The Netherlands, France, and Sweden, three countries with different levels of dairy products consumption. Results: The number of hip fractures that may potentially be prevented each year with additional dairy products was highest in France (2,023), followed by Sweden (455) and The Netherlands (132). The yearly number of DALYs lost was 6,263 for France, 1,246 for Sweden, and 374 for The Netherlands. The corresponding total costs that might potentially be avoided are about 129 million, 34 million, and 6 million Euros, in these countries, respectively. Conclusions: This study quantified the potential nutrition economic impact of increased dairy consumption on osteoporotic fractures, building connections between the fields of nutrition and health economics. Future research should further collect longitudinal population data for documenting the net benefits of increasing dairy consumption on bone health and on the related utilization of healthcare resources

Does probiotic consumption reduce antibiotic utilization for common acute infections? A systematic review and meta-analysis.

BackgroundOverall reduction of antibiotic use is a widely adopted public health goal. Given evidence that consuming probiotics reduce the incidence, duration and/or severity of certain types of common acute infections, we hypothesized that probiotics are associated with reduced antibiotic use. This systematic review of randomized controlled trials (RCTs) assessed the impact of probiotic supplementation (any strain, dose or duration), compared to placebo, on antibiotic utilization for common, acute infections in otherwise healthy people of all ages.MethodsWe searched 13 electronic databases including MEDLINE, Embase and CENTRAL from inception to 17th January 2017. Backward and forward citation searches were also conducted. Two reviewers independently selected studies for inclusion and extracted study data. We assessed risk of bias for individual studies using criteria adapted from the Centre for Reviews and Dissemination, and the quality of evidence for each outcome was assessed using the GRADE system. Studies that evaluated similar outcomes were pooled statistically in meta-analyses using a random-effects model.ResultsWe screened 1533 citations, and of these, 17 RCTs met our predefined inclusion criteria. All 17 were conducted in infants and/or children with a primary aim of preventing acute respiratory tract infections, acute lower digestive tract infections or acute otitis media. Included studies used 13 probiotic formulations, all comprising single or combination Lactobacillus and Bifidobacterium delivered in a range of food or supplement products. Mean duration of probiotic supplementation ranged from 4 days to 9 months. Trial quality was variable. Meta-analysis demonstrated that infants and children who received probiotics to prevent acute illnesses had a lower risk of being prescribed antibiotics, relative to those who received placebo (Pooled Relative Risk = 0.71, 95% CI: 0.54-0.94). When restricted to five studies with a low risk of bias, the pooled relative risk was 0.46 (95% CI: 0.23-0.97). Significant statistical heterogeneity was present in effect size estimates, which appeared to be due to one trial which could partly be considered as an outlier.ConclusionsProbiotics, provided to reduce the risk for common acute infections, may be associated with reduced antibiotic use in infants and children. Additional well-designed studies are needed to substantiate these findings in children and explore similar findings in other population groups

Monitoring immune modulation by nutrition in the general population: identifying and substantiating effects on human health

Optimal functioning of the immune system is crucial to human health, and nutrition is one of the major exogenous factors modulating different aspects of immune function. Currently, no single marker is available to predict the effect of a dietary intervention on different aspects of immune function. To provide further guidance on the assessment and interpretation of the modulation of immune functions due to nutrition in the general population, International Life Sciences Institute Europe commissioned a group of experts from academia, government and the food industry to prepare a guidance document. A draft of this paper was refined at a workshop involving additional experts. First, the expert group defined criteria to evaluate the usefulness of immune function markers. Over seventy-five markers were scored within the context of three distinct immune system functions: defence against pathogens; avoidance or mitigation of allergy; control of low-grade (metabolic) inflammation. The most useful markers were subsequently classified depending on whether they by themselves signify clinical relevance and/or involvement of immune function. Next, five theoretical scenarios were drafted describing potential changes in the values of markers compared with a relevant reference range. Finally, all elements were combined, providing a framework to aid the design and interpretation of studies assessing the effects of nutrition on immune function. This stepwise approach offers a clear rationale for selecting markers for future trials and provides a framework for the interpretation of outcomes. A similar stepwise approach may also be useful to rationalise the selection and interpretation of markers for other physiological processes critical to the maintenance of health and well-bein

Workshop Report: Concepts and methods in the economics of nutrition - Gateways to better economic evaluation of nutrition interventions

Improving health through better nutrition of the population may contribute to enhanced efficiency and sustainability of healthcare systems. A recent expert meeting investigated in detail a number of methodological aspects related to the discipline of nutrition economics. The role of nutrition in health maintenance and in the prevention of non-communicable diseases is now generally recognised. However, the main scope of those seeking to contain healthcare expenditures tends to focus on the management of existing chronic diseases. Identifying additional relevant dimensions to measure and the context of use will become increasingly important in selecting and developing outcome measurements for nutrition interventions. The translation of nutrition-related research data into public health guidance raises the challenging issue of carrying out more pragmatic trials in many areas where these would generate the most useful evidence for health policy decision-making. Nutrition exemplifies all the types of interventions and policy which need evaluating across the health field. There is a need to start actively engaging key stakeholders in order to collect data and to widen health technology assessment approaches for achieving a policy shift from evidence-based medicine to evidence-based decision-making in the field of nutrition

The value of food: Savoir vivre = savoir manger

When the concept of functional food was introduced at the end of last century, food manufacturers started to add health claims to their advertising messages, with the aim of influencing the purchasing behaviour of consumers. To protect citizens against misleading or confusing information, new legislative provisions were introduced and imposed formal approval of nutritional health claims. Food companies faced the challenge with confidence, however in many cases their dossiers did not meet the required scientific level. At the same time pharmaceutical industries seized the opportunity to expand their market segments with relatively little effort, as a simple notification procedure is sufficient for marketing vitamin preparations and dietary supplements. From a nutritional point of view, this focus on health effects of specific foods and dietary supplements risks to push into the background the basic principle that a balanced diet allows healthy people to adequately meet their daily nutritional needs. This concern inspired the creation of a new discipline named Nutrition Economics, aiming to better account for the influence of eating patterns on disease burden and on societal and individual socio-economic consequences of insufficient or unbalanced food intake. Since its introduction in 2011, Nutrition Economics has gradually gained recognition as shown by an analysis of the scientific literature covering the period January 2012-December 2021. The continuously increasing prevalence of food-related chronic conditions threatens the sustainability of health systems, the prosperity of societies and the well-being of individual citizens. We need to make a decisive reversal in preventive public health programs. The integration of Citizen Science in the field of Nutrition Economics offers a new way forward for: - strengthening the relevance of collected nutrition-health data in real-life situations - getting a better insight in the most pertinent levers for successful healthy food promotion - narrowing the know-to-do gap between health policies, population health and the health inequalities that hamper the implementation of successful policies. A structured collaboration between scientific researchers, volunteers from the general public and other stakeholders, offers an unparalleled opportunity to better understand the subjective factors that play a key role in eating behaviour. This approach will be adapted to the complexity of nutritional research, characterized by interactions between diet, lifestyle and multiple other factors in daily life. In addition, active participation of citizen volunteers in such research projects will contribute to raising a better awareness about the crucial importance of daily food for personal well-being. This will enhance the willingness to change behaviour in a more sustainable way and, on the longer term, this will not only benefit healthcare resources, but also socio-economic conditions and the wellbeing of the population at large. Furthermore, increased understanding of nutritional issues among laypersons will gradually offer protection against internet misinformation and make people less receptive to unsubstantiated nutritional blog posts and related social media communication. We cannot afford to continue "eating up" our health, resulting in an excessive (but avoidable) pressure on scarce healthcare resources. Nutritional literacy is the beginning of a healthier and socially more equitable world