Mapping of National School Food Policies across the EU28 plus Norway and Switzerland

Background: With childhood obesity prevalence on the rise in many European countries, schools may serve as a protected environment for children to learn healthy diet and lifestyle habits. Policy makers, educators and researchers would benefit from a comprehensive overview of European school food policies. Methods: We screened public databases, EU level reports, national ministerial websites and the scientific literature to collate official school food policies across Europe. Member States representatives checked that all appropriate documents (total of 34 policies) had been identified and referenced, and they reviewed and confirmed the extracted data. Results: Mandatory standards are defined in 18 of the policies (53%), the remainder offering voluntary guidelines. Top 3 policy aims are to improve child nutrition (97%), teach healthy dietary/lifestyle habits (94%) and reduce/prevent obesity (88%). Variations mainly relate to the types of meals targeted (e.g. lunch, breakfast, snack, dinner); whether standards/recommendations are nutrient- and/or food-based; and if vending machines and the wider food environment (kiosks near schools, packed lunches from home, etc.) are considered. Conclusion: We provide an up-to-date overview of European school food policies. The next step will be to assess the need and feasibility for developing best practice guidelines for school food policies in Europe, bearing in mind cultural and structural differences between countries.JRC.I.2-Public Health Policy Suppor

Front-of-pack nutrition labelling schemes: a comprehensive review

This JRC Science for Policy report was produced in support of a Commission report on front-of-pack (FOP) nutrition labelling. It provides a review of the scientific literature concerning FOP nutrition labelling and its effects on consumers, food business operators, and the single market. A major emphasis is placed on consumer attention, preferences, and understanding of different FOP schemes, as well as effects on food purchasing and implications for diet and health. The report also considers in how far producer efforts on food reformulation and innovation may be affected by the introduction of FOP nutrition labelling schemes, describes potential unintended consequences of introducing FOP nutrition labelling, and highlights knowledge gaps and directions for future research. An extensive, yet non-exhaustive overview of FOP schemes around the globe complements the literature review.JRC.F.1-Health in Societ

Mapping and zooming in on childhood obesity

Overweight and obesity are a challenge for children and adolescents worldwide and in the EU. This report shows the dimension of the challenge at the EU level and tells a series of stories, illustrated through maps, that highlight and make the case for the importance of showing data disaggregated at various levels (by socio-economic status or by region – NUTS2, and even NUTS3). The data and maps presented show that education level for example, is an important determinant of obesity. Data collected at local level are a powerful source of knowledge that can and should be used for evidence-informed and truly tailor-made targeted actions and policies. This is illustrated by the comprehensive yearly evaluation of children's health that the Portuguese city of Gaia organises and the actions that stem from it. Interventions at local level based on local data have immediacy and deliver a sense of action and empowerment that is hardly achievable at national level. The stories selected here are mere examples; other stories, using other disaggregated data sets, could have been told. There is room and need for deepening data collection relevant to children's health and childhood obesity and to make it more accessible and comparable. This will benefit decision-makers at every level, public health practitioners and researchers. And most importantly, it will benefit the health of children and adolescents in our continent.JRC.F.1-Health in Societ

Use and understanding of nutrition information on food labels in six European countries

Aim: The goal of the study was to investigate the use of nutrition information on food labels and understanding of guideline daily amount (GDA) front-of-pack nutrition labels in six European countries. Subjects and methods: In-store observations and in-store interviews were conducted in major retailers in the UK (n = 2019), Sweden (n = 1858), France (n = 2337), Germany (n = 1963), Poland (n = 1800) and Hungary (n = 1804), supplemented by questionnaires filled out at home and returned (overall response rate 50.3%). Use of labels was measured by combining in-store observations and in-store interviews on concrete purchases in six product categories. Understanding of GDA front-of-pack nutrition labels was measured by a variety of tasks dealing with conceptual understanding, substantial understanding and health inferences. Demographics, nutrition knowledge and interest in healthy eating were measured as potential determinants. Results: Across six product categories, 16.8% of shoppers were found to have looked for nutrition information on the label, with the nutrition grid (table or list), GDA labels and the ingredients list as the main sources consulted and calories, fat and sugar the information most often looked for. Understanding of GDA labels was high in the UK, Sweden and Germany, and more limited in the other countries. Regression analysis showed that, in addition to country-specific differences, use and understanding are also affected by differences in interest in healthy eating and in nutrition knowledge and by social grade. Conclusion: Understanding of nutrition information seems to be more widespread than use, suggesting that lack of use is a question of not only understanding, but also motivation. Considerable national differences exist in both understanding and use, some of which may be attributed to different histories of the role of nutrition in the public debate

Sociodemographic and behavioural differences between frequent and non-frequent users of convenience food in Germany

IntroductionConvenience foods are a double-edged sword in that they provide quick and easy nutrition but may promote non-communicable diseases related to excess intakes of sugar, fat, and salt. To inform the German national reduction and innovation strategy for less sugar, fat, and salt in processed foods, the present study sought to analyse the consumption frequency of selected convenience foods and to determine sociodemographic and behavioural factors that characterise frequent users.MethodsIn a representative computer-assisted telephone interview survey in the adult German population (N = 3,997) conducted in 2018, consumption frequency of 21 convenience foods was assessed. To characterise frequent in contrast to non-frequent users, data on sociodemographics and behavioural aspects were compared. Statistical analyses comprised chi-square tests with Bonferroni correction as well as Spearman’s rank correlation. Cramer’s V was used to determine the strength of an association.ResultsOverall and among frequent users (7.7% of the sample) sweet convenience foods and savoury cooking aids were consumed most frequently. Around 75% of the participants indicated little-to-no consumption of 19 of the 21 convenience foods. Male gender (p < 0.001), younger age (p < 0.001), and not having a high level of education (p = 0.017) were identified as key characteristics of frequent users. Furthermore, frequent users were more likely than non-frequent users to live in a family household (p = 0.003) or without a partner (p < 0.001), and to work in shifts (p = 0.002). Additionally, they showed significantly lower cooking skills (p < 0.001).ConclusionPublic health interventions to limit excess intakes of sugar, fat, and salt from convenience food in Germany should target people of male gender, younger age, and having a lower level of education. On the behavioural side, developing the skills to cook from scratch emerged as major point of focus. Simultaneously, reformulation of the food offer should continue in order to help transition to a more health-promoting food environment

Public Procurement of Food for Health: TECHNICAL REPORT ON THE SCHOOL SETTING

An urgent call to action Childhood and adolescence are periods of development when establishing healthful diet and lifestyle habits is essential. A look at the current prevalence rates of overweight (approx. 15%) and obesity (approx. 5%) among children and youths in the EU shows an urgent need for improvement. Considering the amount of time that children spend at school, as well as the fact that in many European countries students consume at least one daily main meal there, schools are an ideal environment for supporting healthy behaviours. It is laudable that all EU Member States have school food policies and guidelines in place to define healthy diets and nutritious food offerings. The implementation of such policies through a procurement process for school food that is health-sensitive can have a number of both short- and long-term benefits including improved student health and performance at school, increased societal awareness about the links between food and health, and reduced healthcare costs. It can also help steer the market and create economies of scale and spill-over effects in other sectors or age groups. Harnessing the power of public procurement of food for health At an estimated €82 billion, the European social food service market is sizeable both in reach and sheer force. Progressive and targeted public procurement of food for health can reward food business operators who provide nutritionally balanced meals and food products, prompting innovation, food reformulation and social responsibility to achieve better diets and positively impact public health. In fact, success stories are already visible, for example, with articles about the health benefits of better school food provision via procurement, beginning to emerge in the scientific literature. Another favourable trend is that schools have been quick to apply green public procurement criteria. The same forward-thinking and flexibility should be expected and promoted for public procurement of food for health. Supporting Member States While the EU legal framework offers substantial scope for health-sensitive public procurement of food, authorities face a number of challenges. In schools, a major obstacle is the translation of school food standards into adequate procurement contract language. In order to ensure the smooth implementation of public procurement of food for health, it is important to set clear specifications about the foods and food services to be procured. This technical report meets this need. The specification sheets included in this document are based on the recommendations from the national school food policies mapped in 2014. They include specifications and other considerations for key food groups and nutrients as well as specifications regarding food preparation and the catering service in general. This report provides a strong justification for action and supports Member States in the real-life tasks necessary to effectively translate national school food policies into healthy school food environments. In doing so, it also raises awareness about the importance of promoting healthy diets for the benefit of children and schools, and for health systems and the economy. After all, schools are not just places to learn about mathematics, history, science and languages, but also places where children should be given the opportunity to thrive by developing good eating and lifestyle habits that can last a lifetime.JRC.F.1-Health in Societ

Report 4: The Dissemination Potential of a European Network

The report that follows represents an extraordinary and unique exchange of information. Unfolding here are the capabilities for dissemination and exploitation in the EU-funded Thematic Network ‘Dietitians Implementing Education and Training Standards’ in Europe (DIETS). At the beginning of the Network there were 112 Partners and about 500 registered users of the DIETS website, but over a three-year period this has increased to 123 Partners and well over 1000 users. The activity of these Partners and their determination to publicise the Network and, more importantly, the role of the dietitian, has been immense and sometimes difficult to capture. However, captured in this report are the learning and change to practice that has resulted, as well as closer engagement between HEIs and their dietetic departments across Europe. Some of the good practice described here will be of value to others starting this type of journey. This network of HEIs, their dietetic colleagues and others will endure long after the DIETS Network has finished its work, largely due to the enthusiasm of the Partners and the social network that has been built and embedded. The ultimate benefit to dietitians, through education, lifelong learning and their contribution to nutritional health in Europe will continue to unfold

Report 1: building a technologically informed information and communication network in europe

This report represents an extraordinary and unique exchange of information across Europe through the creation of a website and learning how to use technology more effectively. Over the three-year period the capabilities conducted as part the EU funded Thematic Network „Dietitians Implementing Education and Training Standards‟ in Europe (DIETS) are presented here. The number of users registered to access the intranet (password-protected) section of the website grew rapidly from 0 at launch to 965 by the end of the third year. A great deal of learning and change to practice has resulted as well as closer engagement between HEIs and their dietetic departments across Europe. This Network of HEIs and their dietetic colleagues will endure long after the DIETS Network has finished its work, largely due to the enhanced ITC capabilities. The ultimate benefit to the dietetic profession, their education and lifelong learning and their contribution to nutritional health in Europe will continue to unfol

Unfavorable food consumption in children up to school entry age: results from the nationwide German KiESEL study

IntroductionEvidence points toward the early life being crucial for preventing nutrition-related diseases. As promotion of healthier food preferences in toddlerhood and preschool age might still modulate the trajectories of disease risk, understanding diet in these age groups is necessary. The objective was to analyze food consumption and diet quality of 1–5-year-old children living in Germany in relation to age and sex.MethodsData from 890 children, a subsample of the representative, cross-sectional Children’s Nutrition Survey to Record Food Consumption (KiESEL) conducted by the German Federal Institute for Risk Assessment in 2014–2017, were analyzed. Dietary data were collected using food records (3 consecutive plus 1 independent day). Diet quality was evaluated against the German food-based dietary guidelines (FBDG).ResultsConsumption of unfavorable foods (e.g., sweets, soft drinks) exceeded the recommended maximum of 10% of energy intake (E%) by a multiple in all age and sex groups (medians: 24.8–35.8 E%). Preschoolers consumed more unfavorable foods than toddlers and boys more than girls. More than half of the children exceeded the recommendation for meat intake (medians: 2.3–3.2% of the total food consumption (%TFC) vs. 2 %TFC), especially preschoolers. In nearly all children, vegetable consumption was too low (medians: 4.2–4.5 %TFC vs. 12 %TFC). Also, milk/milk product consumption was below recommendations, more so in preschoolers (median: 12.0 %TFC ♂, 11.9 %TFC ♀ vs. 18 %TFC) than in toddlers (median: 16.1 %TFC ♂, 19.6 %TFC ♀). In toddlers and preschoolers with overweight or obesity, adherence to dietary recommendations of these food groups was largely similar to that of the total sample. Overall, 5-year-olds showed an unhealthier dietary pattern than 1-year-olds, which already emerged at age 2 years and became more evident at age 3 years.DiscussionAn adverse dietary pattern arises and even deteriorates at a very young age, showing sex-specific aspects. High attention from public health and research needs to be given to toddlerhood and even earlier life phases, e.g., to develop more age-specific FBDGs, aiming at reducing unhealthy food consumption