40th Anniversary Briefing Paper: Food availability and our changing diet

Influencing Factors for Sustainable Dietary Transformation—A Case Study of German Food Consumption

In a case study of Germany, we examine current food consumption along the three pillars of sustainability to evaluate external factors that influence consumers’ dietary decisions. We investigate to what extent diets meet nutritional requirements (social factor), the diets’ environmental impact (ecological factor), and the food prices’ influence on purchasing behavior (economic factor). For this, we compare two dietary recommendations (plant-based, omnivorous) with the status quo, and we examine different consumption styles (conventional, organic produce). Additionally, we evaluate 1446 prices of food items from three store types (organic store, supermarket, and discounter). With this, we are able to evaluate and compare 30 different food baskets along their health, environmental, and economic impact. Results show that purchasing decisions are only slightly influenced by health-related factors. Furthermore, few consumers align their diet with low environmental impact. In contrast, a large share of consumers opt for cheap foods, regardless of health and environmental consequences. We find that price is, arguably, the main factor in food choices from a sustainability standpoint. Action should be taken by policy makers to financially incentivize consumers in favor of healthy and environmentally friendly diets. Otherwise, the status quo further drives especially underprivileged consumers towards unhealthy and environmentally damaging consumption.

Superfood: Value and Need

Abstract:

Superfood is the name coined by the marketing industries to segregate the food which is claimed to have an edge over the common food, having increased nutritional efficiency, and possessing more amounts of antioxidants which lead to the prevention of many coronary heart diseases. The history and introduction of the superfood have been discussed through brief instances, and nutritional analysis of some of the most popularly available superfoods like quinoa, goji berry, acai berry, etc. has been done. Some of the indigenous superfood nutritional benefits have also been stated. The need and value with respect to the therapeutic and economic aspects of the superfood are reported in the present review in accordance with the current and relevant data.

Nature of the evidence base and frameworks underpinning dietary recommendations for prevention of non-communicable diseases: a position paper from the Academy of Nutrition Sciences

This Position Paper from the Academy of Nutrition Sciences is the first in a series which describe the nature of the scientific evidence and frameworks that underpin nutrition recommendations for health. This first paper focuses on evidence which underpins dietary recommendations for prevention of non-communicable diseases. It considers methodological advances made in nutritional epidemiology and frameworks used by expert groups to support objective, rigorous and transparent translation of the evidence into dietary recommendations. The flexibility of these processes allows updating of recommendations as new evidence becomes available. For CVD and some cancers, the paper has highlighted the long-term consistency of a number of recommendations. The innate challenges in this complex area of science include those relating to dietary assessment, misreporting and the confounding of dietary associations due to changes in exposures over time. A large body of experimental data is available that has the potential to support epidemiological findings, but many of the studies have not been designed to allow their extrapolation to dietary recommendations for humans. Systematic criteria that would allow objective selection of these data based on rigour and relevance to human nutrition would significantly add to the translational value of this area of nutrition science. The Academy makes three recommendations: (i) the development of methodologies and criteria for selection of relevant experimental data, (ii) further development of innovative approaches for measuring human dietary intake and reducing confounding in long-term cohort studies and (iii) retention of national nutrition surveillance programmes needed for extrapolating global research findings to UK populations.

Nutritional Implications of Trade-Offs Between Fresh and Processed Potato Products in the United Kingdom (UK)

The UK ranks eleven among world potato producing countries with annual per capita production of about 102 kg. Since 2007, the price of potatoes has increased by 44 per cent and UK households have shown a decreasing trend on their purchases of potatoes. At the same time, retailers and manufacturers have been introducing processed potato products, which also has affected the demand for fresh potatoes. This has shifted demand from fresh potatoes to processed potatoes suggesting that consumers substitute fresh potatoes for processed ones. However, the extent to which this affect individual weekly nutritional composition is unknown. The objective of this study is to estimate the nutritional trade-offs between fresh and processed potatoes consumed in the UK using home scanner panel dataset for Great Britain in 2018. Price and expenditure elasticities were estimated using the linearized version of the Exact Affine Stone Index (EASI) Demand System. Using estimated elasticities, we analyzed the implications of substituting fresh potatoes for processed potatoes on nutrient intake. The results, in terms of the degree of substitution between fresh potatoes and processed potato products, suggest that consumers consider new potatoes baby and baking potatoes as substitutes for mashed potatoes. Maris piper potatoes and new potatoes baby are substitutes for frozen chips and other potatoes whilst white old potatoes and other vegetables and salads are complements to frozen chips and other potatoes. Finally, price reductions in the processed potatoes will increase average weekly caloric intake as well as the intakes of saturated fat and sodium. The latter has implications for public health as they are the major causes of cardiovascular diseases and certain cancers.

The Promotion of Eating Behaviour Change through Digital Interventions

Diet-related chronic disease is a global health epidemic giving rise to a high incidence of morbidity and mortality. With the rise of the digital revolution, there has been increased interest in using digital technology for eating behavioural change as a mean of diet-related chronic disease prevention. However, evidence on digital dietary behaviour change is relatively scarce. To address this problem, this review considers the digital interventions currently being used in dietary behaviour change studies. A literature search was conducted in databases like PubMed, Cochrane Library, CINAHL, Medline, and PsycInfo. Among 119 articles screened, 15 were selected for the study as they met all the inclusion criteria according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) search strategy. Four primary digital intervention methods were noted: use of personal digital assistants, use of the internet as an educational tool, use of video games and use of mobile phone applications. The efficiency of all the interventions increased when coupled with tailored feedback and counselling. It was established that the scalable and sustainable properties of digital interventions have the potential to bring about adequate changes in the eating behaviour of individuals. Further research should concentrate on the appropriate personalisation of the interventions, according to the requirements of the individuals, and proper integration of behaviour change techniques to motivate long-term adherence.

Temporal Trends in Maternal Food Intake Frequencies and Associations with Gestational Diabetes: The Cambridge Baby Growth Study

Previous studies have suggested that in the first decade of this century the incidence of gestational diabetes (GDM) in pregnancy rose worldwide. In the Cambridge Baby Growth Study cohort we observed that this temporal trend was associated with an index of multiple deprivation and reductions in indices of insulin secretion. Deprivation level was not directly associated with GDM, suggesting that the temporal trend may relate more to other factors linked to it, such as dietary composition. In this study we investigated temporal trends in perceived food intake frequencies, derived from a qualitative, short questionnaire, in 865 pregnant Cambridge Baby Growth Study (CBGS) recruits. A number of food frequency ranks showed both temporal trends and associations with GDM, but of note is the frequency of egg consumption (negative temporal trend p = 0.03, slope = -6.2 ranks/year; negative association with GDM p = 3.0 × 10-8, slope = -0.002 increased risk/rank) as it was also positively associated with the insulin disposition index (p = 1.17 × 10-3, slope = 0.42 ranks. L/mmoL). These results are consistent with a potential protective effect of factors related to the frequency of egg consumption in pregnancy. Such factors may have contributed to the observed temporal trend in GDM risk but the overall detectable effect appears to have been small.

Altered Salivary Flow, Protein Composition, and Rheology Following Taste and TRP Stimulation in Older Adults

Taste and smell perceptions diminish in older age, impacting upon quality of life and nutrition, yet the causes of taste loss are largely unknown. Transient receptor potential channels (TRP) found on the oral mucosa are also involved in oral sensations including cooling and burning and may contribute to the eating experience of older people. Older adults often have reduced salivary flow and the physical properties of saliva may change, but the role of saliva in oral sensations of older adults is yet to be elucidated. Here, the effect of older age on subjective (perception) and objective (stimulated salivary response) measures of TRP stimulants, odors, and basic tastants was investigated. Whole mouth saliva was collected from younger (mean age 24 years) and older adults (mean age 72 years) following stimulation of taste [mono sodium glutamate (MSG) and caffeine], olfaction (menthol), and TRP receptors (capsaicin). Participants rated perceived intensity of each stimulus, and salivary properties were assessed. Older age was associated with 15% lower umami taste and 26% lower menthol odor perception, coupled with 17% lower salivary response to MSG. Interestingly, there were no differences for perception of TRP stimulants, so chemo-sensation was not affected by age. Younger adults had four times greater elasticity (Spinnbarkeit) with MUC7 levels almost double and 66% greater resting salivary flow rate. Stimulated salivary responses in the younger group were also higher compared to the older group, with changes in protein and viscoelasticity in response to taste and TRP stimulation. These results show the impact of older age upon taste and smell sensation which may lead to changes in the physical and compositional properties of saliva in response to taste/odor stimulation. Measurement of stimulated salivary flow and rheology provides an objective measure of taste in addition to subjective perceptions which can be influenced by participant bias. Chemo-sensation may be retained with age and trigeminal stimuli such as chili could be employed in future studies to enhance meals for an age group at risk of malnutrition. Alteration in salivary properties due to advanced age could impact on ability to taste due to poor diffusion of tastants and reduced oral surface protection.

Vitamin D intake and risk of CVD and all-cause mortality: evidence from the Caerphilly Prospective Cohort Study

Objective

Prospective data on the associations between vitamin D intake and risk of CVD and all-cause mortality are limited and inconclusive. The aim of the present study was to investigate the associations between vitamin D intake and CVD risk and all-cause mortality in the Caerphilly Prospective Cohort Study.

Design

The associations of vitamin D intake with CVD risk markers were examined cross-sectionally at baseline and longitudinally at 5-year, 10-year and >20-year follow-ups. In addition, the predictive value of vitamin D intake for CVD events and all-cause mortality after >20 years of follow-up was examined. Logistic regression and general linear regression were used for data analysis.

Setting

Participants in the UK.

Subjects

Men (n452) who were free from CVD and type 2 diabetes at recruitment.

Results

Higher vitamin D intake was associated with increased HDL cholesterol (P=0·003) and pulse pressure (P=0·04) and decreased total cholesterol:HDL cholesterol (P=0·008) cross-sectionally at baseline, but the associations were lost during follow-up. Furthermore, higher vitamin D intake was associated with decreased concentration of plasma TAG at baseline (P=0·01) and at the 5-year (P=0·01), but not the 10-year examination. After >20 years of follow-up, vitamin D was not associated with stroke (n72), myocardial infarctions (n142), heart failure (n43) or all-cause mortality (n281), but was positively associated with increased diastolic blood pressure (P=0·03).

Conclusions

The study supports associations of higher vitamin D intake with lower fasting plasma TAG and higher diastolic blood pressure.

Nutritional deficiencies in homeless persons with problematic drinking: a systematic review

Background

A significant proportion of homeless people drink alcohol excessively and this can lead to malnutrition and consequent medical problems. The aim of this review was to assess the evidence on the range of nutritional deficiencies in the homeless problem-drinking populations.

Methods

We conducted a comprehensive search of nine scientific literature databases and 13 grey literature sources. We included studies of any design that included homeless population with problem-drinking and reported measures of nutritional deficiencies in urine or blood. Study selection and data extraction was done by one reviewer and checked by another. Data on malnutrition profile were summarized narratively.

Results

We found nine studies reporting nutritional deficiencies in homeless populations with problem-drinking. The oldest study was from the 1950s and the most recent from 2013. The following nutrients were reported across studies: vitamins B1, B2, B6, B9, B12, C, A, and E; haemoglobin; and albumin. The most common deficiencies reported were of vitamin B1 (prevalence of deficiency was 0, 2, 6, 45, and 51% in five studies) and vitamin C (29, 84, and 95% in three studies). None of the studies were assessed to be at a low risk of bias.

Conclusions

The limited, low quality and relatively old evidence suggests that homeless people who drink heavily may be deficient in vitamin C, thiamine, and other nutrients. New, well conducted studies are needed in order to optimally inform public health interventions aimed at improving deficiencies in this population.

Trial Registration

PROSPERO CRD42015024247

Electronic supplementary material

The online version of this article (doi:10.1186/s12939-017-0564-4) contains supplementary material, which is available to authorized users.

Dietary Patterns in Relation to Cardiovascular Disease Incidence and Risk Markers in a Middle-Aged British Male Population: Data from the Caerphilly Prospective Study

Dietary behaviour is an important modifiable factor in cardiovascular disease (CVD) prevention. The study aimed to identify dietary patterns (DPs) and explore their association with CVD incidence and risk markers. A follow-up of 1838 middle-aged men, aged 47–67 years recruited into the Caerphilly Prospective Cohort Study at phase 2 (1984–1988) was undertaken. Principal component analysis identified three DPs at baseline, which explained 24.8% of the total variance of food intake. DP1, characterised by higher intakes of white bread, butter, lard, chips and sugar-sweetened beverages and lower intake of wholegrain bread, was associated with higher CVD (HR 1.35: 95% CI: 1.10, 1.67) and stroke (HR 1.77; 95% CI: 1.18, 2.63) incidence. DP3, characterised by higher intakes of sweet puddings and biscuits, wholegrain breakfast cereals and dairy (excluding cheese and butter) and lower alcohol intake, was associated with lower CVD (HR 0.76; 95% CI: 0.62, 0.93), coronary heart disease (HR: 0.68; 95% CI: 0.52, 0.90) and stroke (HR: 0.68; 95% CI: 0.47, 0.99) incidence and a beneficial CVD profile at baseline, while DP1 with an unfavourable profile, showed no clear associations after 12 years follow-up. Dietary pattern 2 (DP2), characterised by higher intake of pulses, fish, poultry, processed/red meat, rice, pasta and vegetables, was not associated with the aforementioned outcomes. These data may provide insight for development of public health initiatives focussing on feasible changes in dietary habits.

Childhood socioeconomic disadvantage is associated with lower mortality in older Japanese men: the JAGES cohort study

BACKGROUND

Childhood socioeconomic disadvantage has been previously linked to increased mortality risk in adulthood. However, most previous studies have focused on middle-aged adults in Western contexts. Here, we sought to examine the association between childhood socioeconomic status (SES) and mortality among healthy older Japanese adults.

METHODS

We conducted a 3-year follow-up of participants in the Japan Gerontological Evaluation Study (JAGES), a population-based cohort of 65- to 103-year-old Japanese adults. Childhood SES was assessed by survey at baseline. Mortality from 2010 to 2013 was analysed for 15 449 respondents (7143 men and 8306 women). Cox regression models were used to estimate hazard ratios (HR) for risk of death.

RESULTS

A total of 754 deaths occurred during the 3-year follow-up. Lower childhood SES was significantly associated with lower mortality in men, but not in women. Compared with men growing up in more advantaged childhood socioeconomic circumstances, the age-adjusted HR for men from low childhood SES backgrounds was 0.75 [95% confidence interval (CI): 0.56-1.00]. The association remained significant after adjustment for height, education, adult SES, municipalities of residence, health behaviours, disease status and current social relationships (HR = 0.64; 95% CI 0.47-0.87). This association was stronger among men aged 75 years or older, HR = 0.67 (95% CI: 0.47-0.95), compared with men aged 65-74 years, HR = 0.90 (95% CI: 0.54-1.51).

CONCLUSIONS

Childhood socioeconomic disadvantage is associated with lower mortality among men aged 75 years or older, which may be due to selective survival, or alternatively to childhood physical training or postwar calorie restriction in this generation of Japanese males.

Cross-linking of interfacial casein layer with genipin prevented pH-induced structural instability and lipase digestibility of the fat droplets

The present study provided a new approach to enhance the stability of protein-emulsified nanoemulsions and to control the lipase digestibility of lipid droplets through spontaneous cross-linking of the interfacial layer with genipin, a functional ingredient isolated from the fruit of Gardenia jasminoides E. Cross-linking casein-emulsified nanoemulsions under different genipin/casein mass ratios (1:20, 1:10, 1:5) significantly (p < 0.05) or very significantly (p < 0.01) enhanced their stability under harsh gastric pH environments and prevented nanoemulsion flocculation. As observed by transmission electron microscope (TEM), under the pH 1.2 condition, the genipin cross-linked nanoemulsion showed more compact microstructure with clear and defined contour as well as "core-shell" structure caused by the swelling of the surface protein film. Interestingly, the intestinal digestibility of lipid droplets was delayed very significantly (p < 0.01) after cross-linking the interfacial casein layer with genipin, which was enhanced by the increase in genipin/casein mass ratio and cross-linking time.

Climate change and food security: health impacts in developed countries

BACKGROUND

Anthropogenic climate change will affect global food production, with uncertain consequences for human health in developed countries.

OBJECTIVES

We investigated the potential impact of climate change on food security (nutrition and food safety) and the implications for human health in developed countries.

METHODS

Expert input and structured literature searches were conducted and synthesized to produce overall assessments of the likely impacts of climate change on global food production and recommendations for future research and policy changes.

RESULTS

Increasing food prices may lower the nutritional quality of dietary intakes, exacerbate obesity, and amplify health inequalities. Altered conditions for food production may result in emerging pathogens, new crop and livestock species, and altered use of pesticides and veterinary medicines, and affect the main transfer mechanisms through which contaminants move from the environment into food. All these have implications for food safety and the nutritional content of food. Climate change mitigation may increase consumption of foods whose production reduces greenhouse gas emissions. Impacts may include reduced red meat consumption (with positive effects on saturated fat, but negative impacts on zinc and iron intake) and reduced winter fruit and vegetable consumption. Developed countries have complex structures in place that may be used to adapt to the food safety consequences of climate change, although their effectiveness will vary between countries, and the ability to respond to nutritional challenges is less certain.

CONCLUSIONS

Climate change will have notable impacts upon nutrition and food safety in developed countries, but further research is necessary to accurately quantify these impacts. Uncertainty about future impacts, coupled with evidence that climate change may lead to more variable food quality, emphasizes the need to maintain and strengthen existing structures and policies to regulate food production, monitor food quality and safety, and respond to nutritional and safety issues that arise.

Development of strategies for effective communication of food risks and benefits across Europe: design and conceptual framework of the FoodRisC project

Background

European consumers are faced with a myriad of food related risk and benefit information and it is regularly left up to the consumer to interpret these, often conflicting, pieces of information as a coherent message. This conflict is especially apparent in times of food crises and can have major public health implications. Scientific results and risk assessments cannot always be easily communicated into simple guidelines and advice that non-scientists like the public or the media can easily understand especially when there is conflicting, uncertain or complex information about a particular food or aspects thereof. The need for improved strategies and tools for communication about food risks and benefits is therefore paramount. The FoodRisC project ("Food Risk Communication - Perceptions and communication of food risks/benefits across Europe: development of effective communication strategies") aims to address this issue. The FoodRisC project will examine consumer perceptions and investigate how people acquire and use information in food domains in order to develop targeted strategies for food communication across Europe.

Methods/Design

This project consists of 6 research work packages which, using qualitative and quantitative methodologies, are focused on development of a framework for investigating food risk/benefit issues across Europe, exploration of the role of new and traditional media in food communication and testing of the framework in order to develop evidence based communication strategies and tools. The main outcome of the FoodRisC project will be a toolkit to enable coherent communication of food risk/benefit messages in Europe. The toolkit will integrate theoretical models and new measurement paradigms as well as building on social marketing approaches around consumer segmentation. Use of the toolkit and guides will assist policy makers, food authorities and other end users in developing common approaches to communicating coherent messages to consumers in Europe.

Discussion

The FoodRisC project offers a unique approach to the investigation of food risk/benefit communication. The effective spread of food risk/benefit information will assist initiatives aimed at reducing the burden of food-related illness and disease, reducing the economic impact of food crises and ensuring that confidence in safe and nutritious food is fostered and maintained in Europe.

Regular users of supermarkets in Greater Tunis have a slightly improved diet quality

Despite the recent and rapid expansion of supermarkets in developing countries, their association with diet quality has been hardly studied. The study took place in Tunisia, where incidences of obesity and nutrition-related diseases are rising. The target population was households of the Greater Tunis area where supermarkets are mostly located. Households (n = 724) were selected by a 2-stage clustered random sampling. A purposely developed quantitative questionnaire assessed food retail habits. Socioeconomic data were collected at individual and household levels. The diet quality index-international (DQI-I) derived from a FFQ specific for Tunisia measured diet quality. Data analysis by regression or logistic regression models adjusted for energy intake and socioeconomic confounders when relevant. Overall, 60% of the households used supermarkets. Most households still used the nearby grocer; only 26% shopped at the market. Characteristics associated with supermarket use were urban milieu, small-sized households, greater educational attainment, higher economic level, steady income, or easy access. Associations between these variables and using supermarkets as a first shopping place (20% of households) were even stronger. After adjustment for energy intake and socioeconomic and access data, using supermarkets chosen as first food shopping place vs. other retail resulted in a slightly higher DQI-I (63.2 vs. 59.6; P = 0.0004). Despite the long-standing presence of supermarkets in Tunis, shopping at supermarkets has not yet spread to the whole population. Supermarkets do not yet markedly modify food consumption in the Greater Tunis. However, a slight improvement of diet quality can be observed among those people who use supermarkets regularly.