Periodic revisions of the international choices criteria: Process and results

Unhealthy diets contribute to an increased risk of non-communicable diseases, which are the leading causes of deaths worldwide. Nutrition policies such as front-of-pack labeling have been developed and implemented globally in different countries to stimulate healthier diets. The Choices Programme, including the International Choices criteria, is an established tool to support the implementation of such policies. The Choices criteria were developed to define the healthier choices per product group, taking saturated fatty acids, trans fatty acids, sodium, sugars, energy, and fiber into account. To keep these criteria updated, they are periodically revised by an independent international scientific committee. This paper explains the most important changes resulting from revisions between 2010 and 2016 and describes the process of the latest revision, resulting in the International Choices criteria version 2019. Revisions were based on national and international nutrition and dietary recommendations, large food composition databases, and stakeholders’ feedback. Other nutrient profiling systems served as benchmarks. The product group classification was adapted and new criteria were determined in order to enhance global applicability and form a credible, intuitively logical system for users. These newly developed criteria will serve as an international standard for healthier products and provide a guiding framework for food and nutrition policies. © 2020 by the authors. Licensee MDPI, Basel, Switzerland

Cross-Sectional Study to Map Nutritional Quality of Meat, Fish, and Dairy Alternatives in Dutch Supermarkets According to the Dutch Food-Based Dietary Guidelines and Nutri-Score

Due to a growing challenge to feed the world’s population and an increased awareness to minimize the impact of our food choices on climate change, a more plant-based diet has gained popularity with a growing number of plant-based products on the market. To stimulate a plant-based diet that also improves long-term health, data are needed to monitor whether these products are healthy alternatives to animal-based foods. Therefore, this study inventoried 916 plant-based meat, fish, and dairy alternatives from eight Dutch supermarkets. The nutritional quality of each product was assessed by (1) the Dutch food-based dietary guidelines and (2) the Nutri-Score. The results show that over 70% of meat, fish, and dairy alternatives have an A/B Nutri-Score (indicating high nutritional quality), but do not comply with the Dutch dietary guidelines. This is mainly due to high salt and low vitamin B12 and iron content (meat and fish alternatives) or low protein and calcium levels (dairy alternatives). In conclusion, the majority of plant-based products are nutritionally not full alternatives of the animal-based equivalents; however, there are still opportunities for reformulation. To aid the consumer in making healthy plant-based food choices, a better alignment between the Nutri-Score and the recommended dietary guidelines is needed

Nutri-Score of Meat, Fish, and Dairy Alternatives: A Comparison between the Old and New Algorithm

Nutri-Score is a front-of-pack label that visualizes the nutritional quality of food products from most healthy (A, dark green) to least healthy (E, red). However, concerns have been raised about discrepancies between Nutri-Score labels and dietary recommendations. Therefore, the Nutri-Score algorithm has recently been adapted. To investigate the effect of the new algorithm, the Nutri-Score of plant-based meat, fish, and dairy alternatives (n = 916) was calculated with the old and new algorithms. In addition, the nutritional values of meat and milk alternatives with Nutri-Score labels A and B were compared under the old and new conditions and subsequently assessed for alignment with the criteria of Dutch dietary guidelines. The new algorithm resulted in a reduction in the number of products with labels A and B, ranging from 5% (cold cuts alternatives) to 55% (milk alternatives). The nutritional composition of products with labels A and B improved for meat alternatives (lower energy and saturated fatty acid contents; higher protein content) and milk alternatives (lower energy, salt, and sugar contents; higher protein and fiber contents). Overall, the new Nutri-Score algorithm is more in line with the Dutch dietary guidelines for plant-based meat and dairy alternatives, though challenges remain with respect to micronutrient (iron, calcium, vitamin B12), salt, and protein contents

Le stockage des céréales à la ferme

Dossier technique expliquant le stockage des céréales à la ferme (nettoyage, tri des grains, séchage, ventilation, stockage

Visite de la filière brassicole bretonne bio

Le 8 et 9 février derniers, le Collège des producteurs, en collaboration avec Biowallonie, le Centre wallon de Recherches agronomiques (CRA-W) et DiversiFerm, organisait un séjour d'étude en Bretagne, sur le thème de l'orge brassicole, du (micro)maltage et de la brasserie. Trois entreprises ont été visitées: le négociant/stockeur bio "SA Pinault Bio", la ferme-brasserie-malterie "La Bambelle" et la malterie bio "Malt Fabrique"

La meunerie

Dossier technique sur la meunerie, les différents types de farines, le décorticage, les types de moulin, les moutures, le blutag

INNOVATIONS EN Néphrologie QUE RETENIR DE 2016 ?

Le service de Néphrologie vous présente 3 innovations particulièrement marquantes de 2016. La première concerne la prise en charge de la polykystose rénale autosomique dominante, et notamment le tolvaptan, un médicament enregistré et remboursé, qui ralentit la progression de la maladie. Les 2 autres concernent d’une part les progrès dans le diagnostic des glomérulonéphrites extramembraneuses idiopathiques, en réalité souvent auto-immunes, et d’autre part l’espoir apporté par les programmes d’échanges de reins de donneurs vivants aux patients en attente de transplantation rénale

Effect of general anaesthesia on functional outcome in patients with anterior circulation ischaemic stroke having endovascular thrombectomy versus standard care: a meta-analysis of individual patient data

Background: General anaesthesia (GA) during endovascular thrombectomy has been associated with worse patient outcomes in observational studies compared with patients treated without GA. We assessed functional outcome in ischaemic stroke patients with large vessel anterior circulation occlusion undergoing endovascular thrombectomy under GA, versus thrombectomy not under GA (with or without sedation) versus standard care (ie, no thrombectomy), stratified by the use of GA versus standard care. Methods: For this meta-analysis, patient-level data were pooled from all patients included in randomised trials in PuMed published between Jan 1, 2010, and May 31, 2017, that compared endovascular thrombectomy predominantly done with stent retrievers with standard care in anterior circulation ischaemic stroke patients (HERMES Collaboration). The primary outcome was functional outcome assessed by ordinal analysis of the modified Rankin scale (mRS) at 90 days in the GA and non-GA subgroups of patients treated with endovascular therapy versus those patients treated with standard care, adjusted for baseline prognostic variables. To account for between-trial variance we used mixed-effects modelling with a random effect for trials incorporated in all models. Bias was assessed using the Cochrane method. The meta-analysis was prospectively designed, but not registered. Findings: Seven trials were identified by our search; of 1764 patients included in these trials, 871 were allocated to endovascular thrombectomy and 893 were assigned standard care. After exclusion of 74 patients (72 did not undergo the procedure and two had missing data on anaesthetic strategy), 236 (30%) of 797 patients who had endovascular procedures were treated under GA. At baseline, patients receiving GA were younger and had a shorter delay between stroke onset and randomisation but they had similar pre-treatment clinical severity compared with patients who did not have GA. Endovascular thrombectomy improved functional outcome at 3 months both in patients who had GA (adjusted common odds ratio (cOR) 1·52, 95% CI 1·09–2·11, p=0·014) and in those who did not have GA (adjusted cOR 2·33, 95% CI 1·75–3·10, p<0·0001) versus standard care. However, outcomes were significantly better for patients who did not receive GA versus those who received GA (covariate-adjusted cOR 1·53, 95% CI 1·14–2·04, p=0·0044). The risk of bias and variability between studies was assessed to be low. Interpretation: Worse outcomes after endovascular thrombectomy were associated with GA, after adjustment for baseline prognostic variables. These data support avoidance of GA whenever possible. The procedure did, however, remain effective versus standard care in patients treated under GA, indicating that treatment should not be withheld in those who require anaesthesia for medical reasons