Scientific advice related to nutrient profiling for the development of harmonised mandatory front-of-pack nutrition labelling and the setting of nutrient profiles for restricting nutrition and health claims on foods

Contribution of different vitamin D forms and fortified foods to vitamin D intake in Europe: A narrative review

In the current narrative review, the bioavailability of the main vitamin D forms is evaluated. The mean intakes and main contributing forms of vitamin D in the European diet are estimated, as well as the major contributing dietary sources. The literature is reviewed for studies reporting on the proportion of users and non-users of fortified food with vitamin D intakes below reference intakes. In addition, the availability of vitamin D-fortified prepackaged retail products and fortification levels in the European market is assessed. Previously, vitamins D2 and D3 forms were considered the primary forms in the diet. Recent analytical methods suggest that dietary 25(OH)D3, when adjusted for higher bioequivalence, significantly contributes to total vitamin D intakes. When also considering 25(OH)D3 from foods, the estimated vitamin D intake from an average European diet was 3.8 µg/d of total Vitamin D Equivalents: vitamin D3, vitamin D2 and 25(OH)D3, contributing about 71 %, 2 %, and 27 %, respectively. Animal foods, fortified fats and spreads contributed most to total intakes. Literature suggests that 94-100 % of Europeans aged ≥ 13 y fail to meet the vitamin D reference intake of 10 µg/d. About 98-100 % of vitamin D-fortified food users and 99-100 % of non-users in the UK and Netherlands consumed less than 10 µg/d of vitamin D. About 1.2 % of prepackaged foods and drinks were voluntary fortified with vitamin D, margarine and plant-based drinks providing most of the daily vitamin D. Encouraging fortification and other strategies may support closing the gap between current and recommended vitamin D intakes.

Ultra-Processed Foods in the Food Supply: Prevalence, Nutritional Composition and Use of Voluntary Labelling Schemes

BACKGROUND

Ultra-processed foods (UPFs) represent a substantial part of modern diets, with a growing prevalence in food environments worldwide. Their unfavourable nutritional composition and adverse health effects present growing public health concerns.

METHODS

This study examines the prevalence of UPFs in the Slovenian food supply, their nutritional quality and the use of different food symbols and labelling schemes on food packaging. A cross-sectional analysis was conducted using the representative Slovenian branded foods database. A total of 23,173 prepacked foods and beverages were categorised into levels of processing according to the NOVA classification system. The nutritional composition of UPFs was compared to less processed products within 16 narrow subcategories. Additionally, the prevalence in the use of front-of-package nutrition labelling (FOPNL) and subjectively nutrition-related elements (SNREs) (such as EU Organic, Vegan labels etc.) were assessed across different food categories and processing levels.

RESULTS

Results show that UPFs represent 54.5% of the available products in the Slovenian food supply, with the highest prevalence in Confectionery (93%), Bread and bakery products (83%), Meat, meat products and alternatives (77%) and Convenience foods (74%). Comparison of nutritional composition indicated that UPFs had significantly poorer nutritional composition compared to less processed counterparts, including higher levels of sugar, salt and saturated fats, and a lower protein content. Breakfast cereals, Snack foods, Meat alternatives and Pre-prepared salads and sandwiches showed the most significant differences between UPFs and less processed counterparts. Analysis of the prevalence of symbols and labelling schemes revealed that 33.8% of products carried at least one FOPNL (15.0%) or SNRE (19.1%), with SNREs being more prevalent on less processed products and FOPNL predominantly used on UPFs (p < 0.05). The most prevalent SNRE was the EU Organic logo (12.7%), followed by the Vegan (4.7%) and Non-GMO (3.1%) logos, whereas the most frequent FOPNL was Reference Intakes (RI), presenting only energy value RI-Energy (12.5%), followed by nutrient-specific RI (1.6%), while other FOPNL were scarce and limited to certain categories. An additional comparison of visual presentation highlighted the potentially selective use of voluntary FOPNL to improve product framing. This raises concerns about their role in guiding consumer choices versus serving as marketing tools, especially when it comes to UPFs.

CONCLUSIONS

Our findings highlight the need for monitoring UPFs in the food supply together with harmonised, mandatory labelling regulations to ensure transparency and empower consumers to make healthier choices.

The gut microbiome and dietary fibres: implications in obesity, cardiometabolic diseases and cancer

Dietary fibres constitute a heterogeneous class of nutrients that are key in the prevention of various chronic diseases. Most dietary fibres are fermented by the gut microbiome and may, thereby, modulate the gut microbial ecology and metabolism, impacting human health. Dietary fibres may influence the occurrence of specific bacterial taxa, with this effect varying between individuals. The effect of dietary fibres on microbial diversity is a matter of debate. Most intervention studies with dietary fibres in the context of obesity and related metabolic disorders reveal the need for an accurate assessment of the microbiome to better understand the variable response to dietary fibres. Epidemiological studies confirm that a high dietary fibre intake is strongly associated with a reduced occurrence of many types of cancer. However, there is a need to determine the impact of intervention with specific dietary fibres on cancer risk, therapy efficacy and toxicity, as well as in cancer cachexia. In this Review, we summarize the mechanisms by which the gut microbiome can mediate the physiological benefits of dietary fibres in the contexts of obesity, cardiometabolic diseases and cancer, their incidence being clearly linked to low dietary fibre intake.

Improvements to the Nutri-Score to address challenges identified in a Nordic setting

Background

Front-of-pack nutrition labelling is an important policy tool for public health. The Nutri-Score classifies foods according to nutritional quality from A (high quality) to E (low quality). We have previously identified inconsistencies between Nutri-Score and the Norwegian food-based dietary guidelines. The objective was to propose revisions to the Nutri-Score 2023 algorithms and determine if the revised algorithms better align with the Nordic Nutrition Recommendations 2023 (NNR2023) and the Keyhole label.

Methods

Items in the Norwegian pre-packed foods databases Tradesolution (n = 26,033) and Unil (n = 577) were classified using the Nutri-Score 2023 algorithms. To address carbohydrate quality, a penalty for low-fibre content was introduced, and the sugar scale compressed. The protein cap was removed for fish products to reward their nutritional quality. To improve the scoring of high-fat foods, the scale for saturated fat was extended, fat content determined the inclusion in the algorithm for fats, rather than food categories, and favourable fat quality in oils was rewarded through a fat quality component. Data from the databases guided the identification of specific thresholds. The distribution of Nutri-Score was calculated before and after applying the revisions.

Results

In total, 5.5% of all products received a less favourable Nutri-Score with the revised carbohydrate quality components. Most refined pastas and flour shifted shifted from A to B or C, whilst whole grain pasta largely remained A. Sugar-rich breakfast cereals shifted from B to C or D. For fish, 11% (1% of all products) were moved from D or E to C or D. The variation in scores for cheese and creams increased. Around 5% of all products were affected by the revisions related to fat quality.

Conclusions

The proposed revisions make the Nutri-Score more coherent with the NNR2023 and the Keyhole label. The proposed revisions also hold relevance for other European countries and should therefore be considered in the next revision of the Nutri-Score.

Perspective: Milk and Dairy Provide Affordable High-Quality Protein and Merit Inclusion in the Protein Foods Group

The United States Department of Agriculture (USDA) protein foods group includes meat, poultry, seafood, and several plant-based proteins-but not dairy. Yet milk, yogurt, and cheese provide affordable high-quality protein and multiple priority micronutrients. The present analyses compared dairy with Protein Group foods in terms of protein content and quality, nutrient density, and protein cost, using USDA nutrient composition databases and published national food prices. Protein quality was adjusted using Protein Digestibility Corrected Amino Acid Scores (PDCAAS). Nutrient density was assessed using the Nutrient Rich Food Index calculated per 100 kcal and per serving. Affordability was the cost of providing 1-oz equivalent of PDCAAS-corrected high-quality protein. Servings of milk, yogurt, and cheese provided 7 g of protein and were comparable with eggs and beans in terms of protein cost. The MyPlate 1-oz protein equivalency table ought to consider protein quality and ought to include dairy products as sources of dietary protein.

Healthier Traditional Green Natural Aloreña de Málaga Table Olives Through Mineral Chlorides Fortification During Packaging

Table olive processing implies losses of mineral nutrients and increased sodium levels due to using brine during fermentation and storage. This study investigated fortifying traditional Aloreña de Málaga table olives with mixtures of KCl, CaCl2, and MgCl2 during packaging to enhance mineral content while reducing NaCl. This research analyses the distribution of cations between olives and brines and employed the Response Surface Methodology (RSM) to model mineral content and their contributions to the Reference Daily Intake (RDI). These models also facilitated the identification of optimal salt combinations for specific goals. Potassium, calcium, and magnesium contents in the olives increased from 657 mg/kg pulp (traditional) to 2578-6349 mg/kg pulp (experimental), from 858 mg/kg pulp to 858-5801 mg/kg, and from 41 mg/kg pulp to 41-2010 mg/kg pulp, respectively. Meanwhile, sodium decreased markedly, from 11,915 mg/kg pulp to about 6665 mg/kg. These changes represent a substantial improvement in the nutritional profile of these olives. Additionally, Principal Component Analysis (PCA) and clustering techniques were used to group treatments based on their mineral nutrient profiles, facilitating the selection of formulations for industrial application. These findings promote the development of nutritionally enriched natural table olives, processed without lye treatment and washing.

Mineral composition in mussel Mytilus galloprovincialis and clam Tapes decussatus from Faro Lake of Messina: risk assessment for human health

Bivalve are exposed to a wide range of contaminants, some of which may be toxic to human health. The aim of this study was to detect essential and non-essential elements such as Na, Ca, Mg, Cr, Mn, Fe, Ni, Cu, Zn, As, Cd, Pb, Hg, Be and Co in water, sediments, and Mytilus galloprovincialis and Tapes decussatus from Faro Lake. It is a lake of marine origin located on the northern coast of Messina (Sicily), where shellfish farming has been practiced for many years. Metals were analysed by a single quadrupole inductively coupled plasma mass spectrometer (ICP-MS), except for Hg, which was quantified using a direct mercury analyser (DMA-80). The study evaluated the nutritional intake of elements through the ingestion of clams and mussels and the potential health risks to consumers. The lead levels found in M. galloprovincialis were below the LOQ, while in T. decussatus the concentrations were below the limit indicated by European Regulation 915/2023. Statistical analysis was carried out on M. galloprovincialis and T. decussatus samples using SPSS 27 and the data showed highly significant differences between the two species (p < 0.001). Cadmium (Cd) and mercury (Hg) concentrations were also below the legal limit in all samples analyzed. This study has shown that clams and mussels are a source of sodium (Na) with a Recommended Dietary Allowance (RDA) of 36% in M. galloprovincialis and 77% in T. decussatus. The percentages obtained for calcium (Ca) and magnesium (Mg) were 17%-19% and 18%-8%, respectively. The RDA of chromium (Cr) was of 191% for M. galloprovincialis and of 405% for T. decussatus. The Fe percentages were 92% and 169% for M. galloprovincialis and T. decussatus, respectively. The concentrations of the other metals observed in the two bivalve species of Lake Faro were generally lower than the Tolerable Weekly Intake (TWI) values estimated as a risk to human health.

Guidance on the scientific requirements for an application for authorisation of a novel food in the context of Regulation (EU) 2015/2283

The European Commission requested EFSA to update the scientific guidance for the preparation of applications for authorisation of novel foods, previously developed following the adoption of Regulation (EU) 2015/2283 on novel foods. This guidance document provides advice on the scientific information needed to be submitted by the applicant towards demonstrating the safety of the novel food. Requirements pertain to the description of the novel food, production process, compositional data, specifications, proposed uses and use levels and anticipated intake of the novel food. Furthermore, information needed in sections on the history of use of the novel food and/or its source, absorption, distribution, metabolism, excretion, toxicological information, nutritional information and allergenicity is also described. The applicant should integrate and interpret the data presented in the different sections to provide their overall considerations on how the information supports the safety of the novel food under the proposed conditions of use. Where potential health hazards have been identified, they are to be discussed in relation to the anticipated intake of the novel food and the proposed target populations. On the basis of the information provided, EFSA will assess the safety of the novel food under the proposed conditions of use.

Bioaccessibility of Mineral Nutrients in Plain Green Spanish-Style Manzanilla Table Olives Packaged in Nutrient Salt Mixtures

Table olives are high in salt, which can negatively impact cardiovascular health. It is essential to reduce their salt content to mitigate such risk. The objectives of the study were to develop an appropriate protocol to determine mineral bioaccessibility in green Spanish-style Manzanilla table olives and to use it to evaluate, for the first time, the effects of replacing 50% NaCl in the packaging brine with KCl, CaCl2, and MgCl2 on this characteristic. After testing, Miller's protocol with a post-digestion re-extraction was chosen. The mineral bioaccessibility found was as follows: Na, 93-98%; K, 94-100%; Ca, 19-27% (the lowest accessibility); Mg, 78-91% (moderately accessible); and non-added P, 55-67%. Bioaccessible amounts (mg/100 g pulp) of added minerals in runs were 151-503 for K, 53-109 for Ca, and 54-143 for Mg. The bioaccessible mineral vs. salt concentrations were modelled and plotted using RSM, illustrating the possible predictions from the tested range of combinations. The bioaccessibility of Ca and Mg was approximately 70% and 15% lower than the values indicated on the label based on the chemical analysis. The results discourage Ca fortification in packaging and suggest including bioaccessibility, markedly influenced by the food matrix, on the label for accurate nutritional information.

How food matrices modulate folate bioaccessibility: A comprehensive overview of recent advances and challenges

The incomplete absorption of dietary folate makes it crucial to understand how food matrices affect folate bioaccessibility. Bioavailability encompasses bioaccessibility, which depicts the proportion that is liberated from the food matrix during digestion and becomes available for absorption. Bioavailability studies are expensive and difficult to control, whereas bioaccessibility studies utilize in vitro digestion models to parameterize the complex digestion, allowing the evaluation of the effect of food matrices on bioaccessibility. This review covers the folate contents in various food matrices, the methods used to determine and the factors affecting folate bioaccessibility, and the advances and challenges in understanding how food matrices affect folate bioaccessibility. The methods for determining bioaccessibility have been improved in the last decade. Current research shows that food matrices modulate folate bioaccessibility by affecting the liberation and stability of folate during digestion but do not provide enough information about folate and food component interactions at the molecular level. In addition, information on folate interconversion and degradation during digestion is scant, hindering our understanding of the impact of food matrices on folate stability. Moreover, the role of conjugase inhibitors should not be neglected when evaluating the nutritional value of food folates. Due to the complexity of food digestion, holistic methods should be applied to investigate bioaccessibility. By synthesizing the current state of knowledge on this topic, this review highlights the lack of in-depth understanding of the mechanisms of how food matrices modulate folate bioaccessibility and provides insights into potential strategies for accurate evaluation of the nutritional value of dietary folate.

The imprecision of micronutrient requirement values: the example of vitamin D

Food, not nutrients, is the fundamental unit in nutrition. Nutrient requirement values and recommended daily intakes have long been determined and organized in tables by several regulators. These figures, however, overlook the complexity of mixing different foods in a diet and the mediation by human gut microbiota on digestion, metabolism, and health. The microbiome molecular mechanisms and its potential influence on nutrient requirements are far from clear. Guidelines should depend on the sort of intake, along with the dietary habits, rather than focusing on single nutrients. Despite many decades of attempts to investigate the proximate nutrient composition of foods consumed by different world populations, there are still neither standardization of food composition databases nor harmonized dietary intake methods of assessment of nutrients. No all-inclusive attempt was yet made to emphasize the requirements of the various micronutrients, phytonutrients, and non-nutrients on gut microbiota and vice versa, and thereafter reflected into dietary guidelines. New multifaceted methods have been advanced to reevaluate the way nutrients and nutrient requirements are assessed within the intricate biological systems. Our main goal here was to enhance the fact that existing food guidelines hold inherent strengths and limitations but fail, in many aspects, namely, in not taking into account essential geographical, ethnic and cultural differences, and the different stages of life, infant nutrition, and the microbiota impact on several micronutrient requirements. Vitamin D is given as an illustration on present inaccuracy of its requirements. Defining dietary reference intakes is therefore an ongoing process specific for each population.

How does the updated Nutri-Score discriminate and classify the nutritional quality of foods in a Norwegian setting?

BACKGROUND

The Nutri-Score is a candidate for the harmonized mandatory front-of-pack nutrition label enabling consumers in the European Union to make healthier food choices. Nutri-Score classifies foods (including beverages) from A (high nutritional quality) to E (low nutritional quality) based on the foods' qualifying and disqualifying components. We aimed to evaluate the updated Nutri-Score for foods (2022) and beverages (2023) in a Norwegian setting by exploring its ability to discriminate the nutritional quality of foods within categories. Additionally, we assessed Nutri-Scores' ability to classify foods in accordance with the Norwegian food-based dietary guidelines (FBDGs).

METHODS

The updated Nutri-Score was calculated for 1,782 foods in a Norwegian food database. The discriminatory ability of the updated Nutri-Score was considered by exploring the distribution of Nutri-Score within categories of foods using boxplots and frequency tables, and by examining which qualifying and disqualifying components that contributed most to the Nutri-Score class. Accordance with the Norwegian FBDGs was assessed by exploring Nutri-Score for foods specifically mentioned in the guidelines.

RESULTS

Overall, the updated Nutri-Score seemed to discriminate the nutritional quality of foods within categories, in a Norwegian setting. The foods' content of salt and the beverages' content of sugar were components contributing the most to Nutri-Scores' discriminatory ability. Furthermore, in most cases the updated Nutri-Score classified foods in accordance with the Norwegian FBDGs. However, there were minor inconsistencies in how Nutri-Score classified certain foods, such as the inabilities to discriminate between full-fat and low-fat/leaner cheeses, cremes and processed meats (sausages), and between whole grain and refined pasta/rice.

CONCLUSIONS

We observed an overall acceptable discriminatory performance of the updated Nutri-Score in a Norwegian setting and in most cases the updated Nutri-Score classified foods in accordance with the Norwegian FBDGs. However, minor inconsistencies were observed. Together with the FBDGs, the updated Nutri-Score could be a useful tool in guiding consumers towards healthier food choices in Norway, but consumer evaluations are warranted to fully assess the performance of the updated Nutri-Score in a Norwegian context.

Eggs: Healthy or Risky? A Review of Evidence from High Quality Studies on Hen's Eggs

Hen's eggs (from Gallus gallus domesticus) provide choline, folate, vitamin D, iodine, B vitamins and high-quality protein and are no longer viewed by national bodies as a risk factor for hypercholesterolaemia and cardiovascular disease (CVD). Yet, questions remain about the benefits and risks of eating eggs regularly. This review evaluates recent high-quality evidence from randomised controlled trials (RCT) and meta-analyses of observational studies and considers new areas of interest, such as weight management, protein metabolism, allergy risk and sustainability. In several RCT, eggs increased muscle protein synthesis and lowered fat mass, which could support optimal body composition. Eggs within a meal improved satiety, which could translate into lower energy intakes, although more RCT are needed. In observational studies, higher egg consumption was associated with a null effect or a modest reduced risk of CVD. For type 2 diabetes (T2D) incidence and risk of CVD in people with T2D, there were inconsistencies between observational and RCT data, with the former noting positive associations and the latter seeing no effect of higher egg intake on markers of T2D and CVD. Sustainability metrics suggest that eggs have the lowest planetary impact amongst animal proteins. To lower allergy risk, earlier introduction of eggs into weaning diets is warranted. In conclusion, the balance of evidence points to eggs being a nutritious food suggesting there are broad health benefits from including eggs in the diet at intakes higher than that currently consumed by European populations.

A Diet Profiling Algorithm (DPA) to Rank Diet Quality Suitable to Implement in Digital Tools—A Test Study in a Cohort of Lactating Women

Although nutrient profiling systems can empower consumers towards healthier food choices, there is still a need to assess diet quality to obtain an overall perspective. The purpose of this study was to develop a diet profiling algorithm (DPA) to evaluate nutritional diet quality, which gives a final score from 1 to 3 with an associated color (green-yellow-orange). It ranks the total carbohydrate/total fiber ratio, and energy from saturated fats and sodium as potentially negative inputs, while fiber and protein are assumed as positive items. Then, the total fat/total carbohydrate ratio is calculated to evaluate the macronutrient distribution, as well as a food group analysis. To test the DPA performance, diets of a lactating women cohort were analyzed, and a correlation analysis between DPA and breast milk leptin levels was performed. Diets classified as low quality showed a higher intake of negative inputs, along with higher energy and fat intakes. This was reflected in body mass index (BMI) and food groups, indicating that women with the worst scores tended to choose tastier and less satiating foods. In conclusion, the DPA was developed and tested in a sample population. This tool can be easily implemented in digital nutrition platforms, contributing to real-time dietary follow-up of patients and progress monitoring, leading to further dietary adjustment.

Nutri-Score: Its Benefits and Limitations in Children's Feeding

Reducing the burden of noncommunicable diseases (NCDs) is one of the top priorities of public health policies worldwide. One of the recognized means of achieving this objective is to improve the diet quality. The Nutri-Score (N-S) is a [five-color-A, B, C, D, E letters] front-of-pack labeling logo intended to help consumers quickly identify the healthier prepackaged foods within a food category. Available studies have shown that the N-S is an efficient tool to achieve this aim in terms of consumers' awareness, perception, understanding, and purchasing and that its use may help to reduce the prevalence of NCDs. The N-S is currently implemented on a voluntary basis in 7 European countries and a discussion is underway within the European Commission to achieve a harmonized mandatory label. However, no study on the putative impact of the N-S on children's dietary patterns and health is available. The N-S is not applicable to infants' and young children's formulas and to specific baby foods, the compositions of which are already laid down in European Union regulations. The N-S does not replace age-appropriate dietary guidelines. As children consume an increasing number of adult type and processed foods, the relevance of the N-S for children should be evaluated considering the children's high specific requirements, especially in younger children. This is especially necessary for fitting fat and iron requirements, whereas protein-rich foods should be better framed. Moreover, efforts should be made to inform on how to use the N-S and in education on healthy diets.

Comparison of Nutri-Score and Health Star Rating Nutrient Profiling Models Using Large Branded Foods Composition Database and Sales Data

Front-of-package nutrition labelling (FOPNL) is known as an effective tool that can encourage healthier food choices and food reformulation. A very interesting type of FOPNL is grading schemes. Our objective was to compare two market-implemented grading schemes-European Nutri-Score (NS) and Australian Health Star Rating (HSR), using large Slovenian branded foods database. NS and HSR were used for profiling 17,226 pre-packed foods and drinks, available in Slovenian food supply dataset (2020). Alignment between models was evaluated with agreement (% of agreement and Cohen's Kappa) and correlation (Spearman rho). The 12-month nationwide sales-data were used for sale-weighing, to address market-share differences. Study results indicated that both models have good discriminatory ability between products based on their nutritional composition. NS and HSR ranked 22% and 33% of Slovenian food supply as healthy, respectively. Agreement between NS and HSR was strong (70%, κ = 0.62) with a very strong correlation (rho = 0.87). Observed profiling models were most aligned within food categories Beverages and Bread and bakery products, while less aligned for Dairy and imitates and Edible oils and emulsions. Notable disagreements were particularly observed in subcategories of Cheese and processed cheeses (8%, κ = 0.01, rho = 0.38) and Cooking oils (27%, κ = 0.11, rho = 0.40). Further analysis showed that the main differences in Cooking oils were due to olive oil and walnut oil, which are favoured by NS and grapeseed, flaxseed and sunflower oil that are favoured by HSR. For Cheeses and cheese products, we observed that HSR graded products across the whole scale, with majority (63%) being classified as healthy (≥3.5 *), while NS mostly graded lower scores. Sale-weighting analyses showed that offer in the food supply does not always reflect the sales. Sale-weighting increased overall agreement between profiles from 70% to 81%, with notable differences between food categories. In conclusion, NS and HSR were shown as highly compliant FOPNLs with few divergences in some subcategories. Even these models do not always grade products equally high, very similar ranking trends were observed. However, the observed differences highlight the challenges of FOPNL ranking schemes, which are tailored to address somewhat different public health priorities in different countries. International harmonization can support further development of grading type nutrient profiling models for the use in FOPNL, and make those acceptable for more stake-holders, which will be crucial for their successful regulatory implementation.

Reformulation of Processed Yogurt and Breakfast Cereals over Time: A Scoping Review

Poor diet is responsible for a quarter of European non-communicable disease (NCD)-related deaths. The reformulation of sugar, salt, and saturated fat in processed packaged foods offers an opportunity to reduce consumption of nutrients of concern and also support a reduction in energy intake. To date, there have been no publications measuring progress in food reformulation by compiling published evidence for a food category. The aim of this scoping review was to identify, characterize and summarise the findings of studies analysing the reformulation of processed yogurt and breakfast cereals. The review answered the research question: "What is the impact of food reformulation on the nutrient quality of yogurt and breakfast cereals available in the retail environment?" The research protocol was defined based on PRISMA-ScR guidelines. Five databases were searched in May 2022. Thirteen studies, published between 2010 and 2021 and completed across seven countries were eligible for inclusion. There were sufficient eligible studies to identify trends in sodium, salt, and sugar reduction in breakfast cereals. However, there was minimal or no reduction in energy, which may bring into question the use of food reformulation as part of an overall health strategy for obesity reduction.

Front-of-package nutrition labeling as a driver for healthier food choices: Lessons learned and future perspectives

This work aims to provide a comprehensive overview of the use of front-of-package nutritional labeling (FOPL), identify and characterize the major existing FOPL systems, examine the impact of FOPL systems on consumer behavior, and discuss future perspectives. The searched databases were PubMed, Scopus, and Web of Science, and papers in English, Portuguese, Spanish, and French were considered. The integrative review method was used, comprising 68 papers. The FOPL system from more than 47 countries from North America, South America, Africa, Europe, Australia, and Asia was included in this study. The two main ways to characterize FOPL are the level of interpretation and the type of information provided. Interpretive schemes (such as warning labels, multiple traffic lights, and Nutri-Score) appear to lead to better consumer understanding and support healthier food purchases. However, due to the differences among the results and the specificity of the contexts in which they are used, it is impossible to define one FOPL interpretation scheme superior to the others. Some potential factors that influence the effectiveness of FOPL on consumer attitudes have been identified, such as food taste, as a major intrinsic factor. Extrinsic factors, such as price, food category, cultural diversity, politics, and economics, were also relevant. The lack of availability of similar alternatives, lack of understanding of the importance of FOPL, and lower levels of income and education were also some cognitive and social aspects impairing FOPL effectiveness. Prospects for the United States, Europe, Brazil, Colombia, and Argentina were discussed.

Red and Processed Meat Consumption in Poland

The aim of the study was to assess the quantity and frequency of meat consumption, especially of red and processed meat, in Poland. The amount of meat consumed was assessed using data from household budget surveys undertaken in 2000, 2010, and 2020. The frequency of consumption was assessed using Food Propensity Questionnaire data from 1831 adults in 2019-2020. Poles consumed 1.35 kg of unprocessed red meat and 1.96 kg of total processed meat per person per month in 2020. The consumption of red meat was lower than in the two previous decades; the consumption of processed meat fluctuated. Pork was the most commonly consumed red meat: 40% of adults consumed pork 2-3 times a week. Beef and other unprocessed red meat were most often consumed less than once a month (29.1%). Processed meat was often consumed: 37.8% of adults ate cold cuts, and 34.9% ate sausages and bacon 2-3 times a week. The consumption of red and processed meat in Poland was high and frequent. In particular, the consumption of processed meat exceeded the recommendations and might increase the risk of chronic diseases. It is necessary to implement activities aimed at reducing the consumption of red and processed meat in Poland.

5-Methyltetrahydrofolate Is a Crucial Factor in Determining the Bioaccessibility of Folate in Bread

This study investigated the bioaccessibility of folate in wheat bread baked with different ingredients and processing methods. Next, different matrices were spiked with 5-methyltetrahydrofolate, gallic acid (GA), or both to investigate the stability of 5-methyltetrahydrofolate during in vitro digestion. The folate bioaccessibility in bread varied from 44 to 96%. The inclusion of whole-grain or faba bean flour significantly improved both folate content and bioaccessibility. Baking with yeast increased the folate content by 145% in bread but decreased folate bioaccessibility compared to the bread without added yeast because of the instability of 5-methyltetrahydrofolate. Spiking experiments confirmed oxidation as a critical reason for 5-methyltetrahydrofolate loss during digestion. However, GA protected this vitamer from degradation. Additionally, 5-methyltetrahydrofolate was less stable in whole-grain wheat matrices than other matrices. This study demonstrated that the stability of 5-methyltetrahydrofolate is crucial for folate bioaccessibility in bread, and methods for stabilizing this vitamer should be further studied.

Food labeling in the European Union: a review of existing approaches

Purpose

This review explores the phenomenon of front-of-pack nutrition labels (FoPNLs) in the European Union (EU). FoPNLs highlight the nutritional quality of food and non-alcoholic beverages and help consumers to make healthier choices. The review explores different types of FoPNLs and evaluates their effectiveness.

Design/methodology/approach

A policy analysis was conducted, relying on extant academic literature, grey literature and policy documents. The use of current FoPNLs is interpreted in light of national and economic interests.

Findings

Our review identifies and describes seven government endorsed FoPNLs that are currently used in the EU. Five are positive endorsement labels (Croatia, Czech Republic, Denmark, Lithuania, Slovenia and Sweden), which only provide a positive indication on more healthy products. The Keyhole is used in three EU countries (Denmark, Lithuania and Sweden), while the others are used in one country each. The Nutri-Score represents a summary label, which provides an overall grade of how healthy a product is. It is used in six countries (Belgium, France, Germany, Netherlands, Spain and Luxembourg). Finally, the Nutrinform battery is a nutrient-specific non-interpretive scheme, indicating the content of nutrients in a portion of a food product. All identified labels are only used on a voluntary basis, encouraging selective use.

Originality/value

This review contributes to a significant discussion about food labeling in the EU. It summarizes existing approaches and evaluates them in terms of their effectiveness. The current schemes in use reflect regional clustering. The most common scheme is the Nutri-Score. This is predominantly found in western EU states. Another major label is the Keyhole, with summary endorsement schemes being prevalent in northern EU states. The least common is Nutrinform, which has some support in southern EU states. The Nutri-score is most effective although economic interests are pushing for the Nutrinform battery in a small number of states. Finally, the review suggests that all existing FoPNLs are voluntary, these labels fail to provide consumers with adequate information about nutrition quality of food products. The EU needs to mobilize support to agree on a single one.