The new EP Library Catalogue allows you to search the EP collection for:
- Journals, books and articles in paper or electronic format
- EPRS and Policy Department publications
Abstract by authors: Front-of-pack labels (FOPLs) aim at communicating to consumers the health value of food items in support of public health policies. Two main types can be discerned: directive and semidirective FOPLs using color schemes (e.g., Nutri-Score) and informative FOPLs (e.g., Nutrinform Battery). Directive approaches tend to show a “wear-out effect” and, additionally, they tend to have various underlying conceptual problems. Usually, their nutritional scores are calculated using changing, arbitrary algorithms and involve a reductionist set of parameters of debatable validity. Thus, they overstate the effects of selected nutritional factors, such as saturated fat and energy, while overlooking the food matrix and the more holistic aspects of nourishment. Moreover, they do not reflect the portion that is consumed, ignore the preparation steps at home, and fail to serve as a useful basis for composing a healthy diet. Also, so long as the nutritional formulations match the algorithmic standards, they tend to allow ultra-processed products. Thus, this might confuse and mislead consumers. Overconfidence in green-colored labels could even result in unbalanced dietary choices, whereas avoidance of red products may eliminate certain foods from the diet that are rich in essential nutrients (e.g., cheese), leading to opposite results than aimed for. The latter is particularly relevant to vulnerable populations, such as the young, pregnant women, and older adults, or for individuals with specific needs. Taken together, directive FOPLs such as Nutri-Score contradict the declared intent of the European Commission to empower consumers to undertake healthy and balanced diets based on easily accessible and robust information. Although informative systems usually also keep the focus on a few selected nutritional parameters, they have are less paternalizing and obviate the need to classify foods as healthy or unhealthy. They also focus attention on the individual portions that are consumed (even if the definition of portion size remains contentious). Given the importance of dietary patterns, rather than individual foods or nutrients, directiveFOPLs of the Nutri-Score type represent a regretful case of nutritionism. Finally, attempts to associate the adoption of a FOPL with an improvement in the health status are few and mainly applied in virtual settings; none of which are longitudinal, nor have they been able to identify a causal link.
Abstract by the authors: Food reformulation, the process of redesigning processed food products to make them healthier, is considered a crucial step in the fight against noncommunicable diseases. The reasons for reformulating food vary, with a common focus on reducing the levels of harmful substances, such as fats, sugars, and salts. Although this topic is broad, this review aims to shed light on the current challenges faced in the reformulation of food and to explore different approaches that can be taken to overcome these challenges. The review highlights the perception of consumer risk, the reasons for reformulating food, and the challenges involved. The review also emphasizes the importance of fortifying artisanal food processing and modifying microbial fermentation in order to meet the nutrient requirements of people in developing countries. The literature suggests that while the traditional reductionist approach remains relevant and yields quicker results, the food matrix approach, which involves engineering food microstructure, is a more complex process that may take longer to implement in developing economies. The findings of the review indicate that food reformulation policies are more likely to succeed if the private sector collaborates with or responds to the government regulatory process, and further research is conducted to establish newly developed reformulation concepts from different countries. In conclusion, food reformulation holds great promise in reducing the burden of noncommunicable diseases and improving the health of people around the world.
Abstract by the author: In recent years, the interest in food and nutrition insecurity in high-income countries has skyrocketed. However, its recognition in Europe is still developing. This perspective summarizes the evidence on food and nutrition insecurity across Europe in terms of prevalence, consequences, and current mitigation strategies, with the aim of outlining the challenges and opportunities for dietitians. Prevalence in the general population ranges between 5% and 20%, with higher rates identified in women, children, older adults, single-parent households, those with low educational attainment, and on low or unstable income and/or employment. In users of food aid, the prevalence of food insecurity is above 70%. Responses to food and nutrition insecurity include welfare policies and food assistance programs at regional and national levels. However, most current strategies are not successful in tackling the structural drivers of food and nutrition insecurity, nor do they guarantee diet quality. Despite limited involvement to-date, dietitians can play an important role in addressing food and nutrition insecurity across Europe. This narrative identifies 4 areas: 1) create awareness of the existence and severity of food and nutrition insecurity, 2) advocate for comprehensive, robust data on the determinants and prevalence, 3) partner with diverse stakeholders, social assistance providers, local authorities, and nongovernmental organizations in a comprehensive, intersectoral, and integrated manner, 4) participate in the development of political instruments and interventions that ensure equitable access to high-quality safe food.
Abstract by the authors: Food type represents higher odds of having obesity (OB), especially in overweight (OW) subjects. Minimally and ultra-processed foods can be associated with the odds of having OB in OW subjects.
Objective: to investigate the association of minimally and ultra-processed food consumption with OB in OW adults. Methods used: we included 15,024 participants (9,618 OW [25.0-29.9 kg/m2], 5,406 OB [≥ 30 kg/m2]) with ages ranging from 18 to 59 years from the 2019 baseline survey of the Surveillance of Risk Factors and Protection for Chronic Diseases by Telephone Survey (VIGITEL, Brazil). Minimally and ultra-processed food daily consumption scores and confounding variables (age, sex, scholarly, physical activity, hypertension, and diabetes) were measured. Binary logistic regression analyzes the association of minimally and ultra-processed food consumption scores with OB (odds ratio [OR]).
Abstract by the authors: Food systems are at the center of a brewing storm consisting of a rapidly changing climate, rising hunger and malnutrition, and significant social inequities. At the same time, there are vast opportunities to ensure that food systems produce healthy and safe food in equitable ways that promote environmental sustainability, especially if the world can come together at the UN Food Systems Summit in late 2021 and make strong and binding commitments toward food system transformation. The NIH-funded Nutrition Obesity Research Center at Harvard and the Harvard Medical School Division of Nutrition held their 22nd annual Harvard Nutrition Obesity Symposium entitled “Global Food Systems and Sustainable Nutrition in the 21st Century” in June 2021. This article presents a synthesis of this symposium and highlights the importance of food systems to addressing the burden of malnutrition and noncommunicable diseases, climate change, and the related economic and social inequities. Transformation of food systems is possible, and the nutrition and health communities have a significant role to play in this transformative process.
Abstract by the authors: Despite substantial attention to dietary interventions on the management of obesity, there are no consensus guidelines for dietetic management of obesity in Europe. Two surveys among European dietitians have demonstrated inconsistencies in the approaches recommended within national obesity treatment guidelines. Only a small number of the guidelines include concrete actionable targets for recommended energy deficit, weight loss and weight-loss maintenance. On the other hand, dietitians frequently use 5–15% weight loss as their intervention outcome. However, they fail to monitor changes in body composition beyond weight status and to successfully monitor and prevent weight regain. Europewide guidelines on the dietary treatment of obesity are an overdue requirement for consistent dietetic practice.
Abstract by the authors: The role of the immune system is to protect the individual against pathogenic organisms. Nutrition is one of multiple factors that determines the immune response and good nutrition is important in supporting the immune response. Immunity can be impaired in older people, particularly those who are frail, in those living with obesity, in those who are malnourished and in those with low intakes of micronutrients. The immune impairments associated with nutritional inadequacy increase susceptibility to infection and permit infections to become more severe, even fatal. The adverse impact of poor nutrition on the immune system, including its inflammatory component, may be one of the explanations for the higher risk of more severe outcomes from infection with SARS-CoV-2 seen in older people and in those living with obesity. Studies of individual micronutrients including vitamin D and zinc suggest roles in reducing severity of infection with SARS-CoV-2. Good nutrition is also important in promoting a diverse gut microbiota, which in turn supports the immune system. The importance of nutrition in supporting the immune response also applies to assuring robust responses to vaccination. There are many lessons from the study of nutrition and immunity that are relevant for the battle with SARS-CoV-2.
Abstract by the authors: The Mediterranean diet (MedDiet) is one of the most widely described and evaluated dietary patterns in scientific literature. It is characterized by high intakes of vegetables, legumes, fruits, nuts, grains, fish, seafood, extra virgin olive oil, and a moderate intake of red wine. A large body of observational and experimental evidence suggests that higher adherence to the MedDiet is associated with lower risk of mortality, cardiovascular disease, metabolic disease, and cancer. Current mechanisms underlying the beneficial effects of the MedDiet include reduction of blood lipids, inflammatory and oxidative stress markers, improvement of insulin sensitivity, enhancement of endothelial function, and antithrombotic function. Most likely, these effects are attributable to bioactive ingredients such as polyphenols, monounsaturated and polyunsaturated fatty acids, or fibre. This review will focus on both established and less established mechanisms of action of biochemical compounds contained in a MedDiet. LINKED ARTICLES: This article is part of a themed section on The Pharmacology of Nutraceuticals.
Abstract by the authors: Poor nutrition may be a causal factor in the experience of low mood, and improving diet may help to protect not only the physical health but also the mental health of the population.
Abstract by the authors: Nearly one fifth of the world’s children are experiencing overweight or obesity – that is, an estimated 39 million children younger than five years and 340 million children aged 5–19 years. The toll of unhealthy diets and overweight in terms of health, social and financial costs are significant, representing almost an estimated 3% of global gross domestic product – a similar economic impact to that of smoking or armed violence, war and terrorism.
Abstract by authors: Snacks are inconsistently defined in nutrition research and dietary guidelines for young children, challenging efforts to improve diet quality. Although some guidelines suggest that snacks include at least two food groups and fit into an overall health promoting dietary pattern, snacks high in added sugars and sodium are highly marketed and frequently consumed. Understanding how caregivers perceive “snacks” for young children may aid in development of effective nutrition communications and behaviourally-informed dietary interventions for obesity prevention. We aimed to synthesize caregivers' perceptions of snacks for young children across qualitative studies. Four databases were searched for peer-reviewed qualitative articles including caregiver perceptions of “snacks” for children ≤5 years. We conducted thematic synthesis of study findings, concluding with the development of analytical themes. Data synthesis of fifteen articles from ten studies, conducted in the U.S., Europe, and Australia, revealed six analytical themes that captured food type, hedonic value, purpose, location, portion size, and time. Caregivers perceived snacks as both “healthy” and “unhealthy” foods. Less healthy snacks were described as highly liked foods, which required restriction and were consumed outside the home. Caregivers used snacks to manage behavior and curb hunger. Snack portions were described as “small”, although caregivers reported various methods to estimate child portion size. Caregivers' perceptions of snacks revealed opportunities for targeted nutrition messaging, especially supporting responsive feeding and nutrient-dense food choices. In high-income countries, expert recommendations should consider caregivers’ perceptions of snacks, more clearly defining nutrient-dense snacks that are enjoyable, achieve dietary requirements, reduce hunger, and promote healthy weight.
Abstract by the authors: As one of the core elements of the European Human Biomonitoring Initiative (HBM4EU) a human biomonitoring (HBM) survey was conducted in 23 countries to generate EU-wide comparable HBM data. This survey has built on existing HBM capacity in Europe by aligning national or regional HBM studies, referred to as the HBM4EU Aligned Studies. The HBM4EU Aligned Studies included a total of 10,795 participants of three age groups: (i) 3,576 children aged 6–12 years, (ii) 3,117 teenagers aged 12–18 years and (iii) 4,102 young adults aged 20–39 years. The participants were recruited between 2014 and 2021 in 11–12 countries per age group, geographically distributed across Europe. Depending on the age group, internal exposure to phthalates and the substitute DINCH, halogenated and organophosphorus flame retardants, per- and polyfluoroalkyl substances (PFASs), cadmium, bisphenols, polycyclic aromatic hydrocarbons (PAHs), arsenic species, acrylamide, mycotoxins (deoxynivalenol (total DON)), benzophenones and selected pesticides was assessed by measuring substance specific biomarkers subjected to stringent quality control programs for chemical analysis. For substance groups analyzed in different age groups higher average exposure levels were observed in the youngest age group, i.e., phthalates/DINCH in children versus teenagers, acrylamide and pesticides in children versus adults, benzophenones in teenagers versus adults. Many biomarkers in teenagers and adults varied significantly according to educational attainment, with higher exposure levels of bisphenols, phthalates, benzophenones, PAHs and acrylamide in participants (from households) with lower educational attainment, while teenagers from households with higher educational attainment have higher exposure levels for PFASs and arsenic. In children, a social gradient was only observed for the non-specific pyrethroid metabolite 3-PBA and di-isodecyl phthalate (DiDP), with higher levels in children from households with higher educational attainment. Geographical variations were seen for all exposure biomarkers. For 15 biomarkers, the available health-based HBM guidance values were exceeded with highest exceedance rates for toxicologically relevant arsenic in teenagers (40%), 3-PBA in children (36%), and between 11 and 14% for total DON, Σ(PFOA + PFNA + PFHxS + PFOS), bisphenol S and cadmium. The infrastructure and harmonized approach succeeded in obtaining comparable European wide internal exposure data for a prioritized set of 11 chemical groups. These data serve as a reference for comparison at the global level, provide a baseline to compare the efficacy of the European Commission's chemical strategy for sustainability and will give leverage to national policy makers for the implementation of targeted measures.
Abstract by the authors: Childhood obesity pandemic, a form of malnutrition including undernutrition, and other food-regime associated risks, has universally been on the rise during the chronic period of the past 4–5 decades and is now acknowledged as one of the most “toxic fuel” accounting for poor health in the majority of countries. In order to find remedies to heal this alarming issue, a corpus of European interventions have been brought to light in the recent years. Since the vague influence and effectiveness of these measures / policies is to be further identified, their evaluation screening is underlined as a pivotal necessity. Within this framework this paper aims to critically report on the development and evaluation of the implementation of the European Union, World Health Organization Regional Office for Europe, and European Union countries' national public health policy interventions and action plans in the fight against childhood obesity. Thus, this is a narrative review synthesizing the results -following a qualitative interpretation and analysis- of recent scientific epidemiological research and review studies evidence concerning European public health interventions tackling childhood obesity, through computer-assisted literature search -via PubMed, Scopus, and Google Scholar- scientific databases. According to the literature data, it is concluded that despite the unprecedented public health challenge of addressing childhood obesity, the extent to which related European policies and programs targeting healthy nutrition, increased physical activity, and healthy lifestyle ethos are truly efficacious is still under inquiry.
Abstract by the authors: According to the NOVA classification, ultra-processed foods are products made through physical, biological and chemical processes and typically with multiple ingredients and additives, in which whole foods are mostly or entirely absent. From a nutritional point of view, they are typically energy-dense foods high in fat, sugar, and salt and low in fiber. The association between the consumption of ultra-processed food and obesity and adiposity measurements has been established in adults. However, the situation remains unclear in children and adolescents.
Abstract by the authors: The prevalence of childhood obesity has increased across the globe and millions of the school children are either obese or overweight. This has happened due to rapid nutritional transition over the past few decades. As childhood obesity is multi-factorial in origin and unhealthy foods, packaged foods, high calorie foods are considered as important behavioral risk factors. The aim of this article is to opine whether appropriate food labeling is one of the preventable methods in prevention of childhood obesity.
Abstract by the authors: Plant-based diets (PBDs) are increasingly recommended for human and planetary health. However, comprehensive evidence on the health effects of PBDs in children remains incomplete, particularly in vegans. All results are reported relative to omnivores. Vegetarians had lower gluteofemoral adiposity but similar total fat and lean mass. Vegans had lower fat indices in all regions but similar lean mass. Both groups had lower bone mineral content (BMC). The difference for vegetarians attenuated after accounting for body size but remained in vegans (total body minus the head: –3.7%; 95% CI: –7.0, –0.4; lumbar spine: –5.6%; 95% CI: –10.6, –0.5). Vegetarians had lower total cholesterol, HDL, and serum B-12 and 25-hydroxyvitamin D [25(OH)D] without supplementation but higher glucose, VLDL, and triglycerides. Vegans were shorter and had lower total LDL (–24 mg/dL; 95% CI: –35.2, –12.9) and HDL (–12.2 mg/dL; 95% CI: –17.3, –7.1), high-sensitivity C-reactive protein, iron status, and serum B-12 (–217.6 pmol/L; 95% CI: –305.7, –129.5) and 25(OH)D without supplementation but higher homocysteine and mean corpuscular volume. Vitamin B-12 deficiency, iron-deficiency anemia, low ferritin, and low HDL were more prevalent in vegans, who also had the lowest prevalence of high LDL. Supplementation resolved low B-12 and 25(OH)D concentrations.
Abstract by the authors: Vegetarians exclude all meat from their diet. Most vegetarians eat eggs and dairy products, and are called “ovo-lacto-vegetarians” whereas vegans do not eat or use any animal products. Flexitarians exclude processed meat, and eat small amounts of red meat and moderate amounts of other animal-source foods. This article focuses on vegetarian diets in industrialized countries and does not address vegan or flexitarian diets in children.
Abstract by the authors: Food type represents higher odds of having obesity (OB), especially in overweight (OW) subjects. Minimally and ultra-processed foods can be associated with the odds of having OB in OW subjects.
Objective: to investigate the association of minimally and ultra-processed food consumption with OB in OW adults. Methods used: we included 15,024 participants (9,618 OW [25.0-29.9 kg/m2], 5,406 OB [≥ 30 kg/m2]) with ages ranging from 18 to 59 years from the 2019 baseline survey of the Surveillance of Risk Factors and Protection for Chronic Diseases by Telephone Survey (VIGITEL, Brazil). Minimally and ultra-processed food daily consumption scores and confounding variables (age, sex, scholarly, physical activity, hypertension, and diabetes) were measured. Binary logistic regression analyzes the association of minimally and ultra-processed food consumption scores with OB (odds ratio [OR]).
Abstract by the authors: Emotions that differ in valence are uniquely associated with eating. In our previous study with an online sample of adults with overweight/obesity, eating in response to depression was the type of emotional eating most closely associated with negative psychosocial correlates (Braden et al., 2018). The current study extended this research by examining associations between emotional eating types (eating in response to depression, anxiety, boredom, happiness) and psychological correlates among treatment-seeking adults. The present study was a secondary analysis of adults (N = 63; 96.8% female) with overweight/obesity and self-identified emotional eating who completed a baseline assessment for a behavioral weight loss intervention. Emotional eating in response to depression (EE-depression), anxiety/anger (EE-anxiety/anger), and boredom (EE-boredom) were assessed with the revised Emotional Eating Scale (EES-R), and positive emotional eating (EE-positive) was assessed with the positive emotions subscale of the Emotional Appetite Questionnaire (EMAQ). The Eating Disorder Examination Questionnaire (EDE-Q), Binge Eating Scale (BES), Difficulties in Emotion Regulation Scale (DERS), and Patient Health Questionnaire-9 (PHQ-9; depressive symptoms) were also administered. Frequencies showed the most endorsed emotional eating type was EE-depression (44.4%; n = 28). Four multiple regression analyses examined associations between emotional eating (EE-depression, EE-anxiety/anger, EE-boredom, and EE-positive) and dependent variables (EDE-Q, BES, DERS, and PHQ-9). Results showed that depression was the emotional eating type most closely related to disordered eating, binge eating, and depressive symptoms. Eating in response to anxiety was closely related to emotion regulation difficulties. Positive emotional eating was related to less depressive symptoms. Exploratory analyses showed that lower levels of positive emotional eating were related to higher depressive symptoms among adults with greater emotion regulation difficulties. Researchers and clinicians may consider tailoring weight loss treatment based on unique emotions that trigger eating.
Abstract by the authors: In recent times, the prevalence of obesity increases, reaching an epidemic scale. Elevated body weight is a risk factor in the development of several diseases such as diabetes, hypertension and cancer. Therefore, obesity management solutions, such as diet therapy, are needed. The key issue is to choose the most appropriate diet to obtain an efficient outcome of losing weight, without experiencing adverse effects and a decrease in general health. A ketogenic diet (KD), an auxiliary therapy for epilepsy, is one of the options recently suggested for losing weight. In this review, the current knowledge about the KD and its application in obesity management are discussed. Moreover, the difficulties encountered in clinical studies with KD intervention are addressed. Finally, the future studies needed to understand the physiological effect of the KD on the human body are underlined. The results of recently published clinical trials indicated that KD can be efficient for losing weight and changing body composition without causing severe adverse effects. However, many studies were conducted with a very-low-calorie regime, which itself may affect the loss of body weight, and in many studies to date, the control diets were missing. To summarize, to be able to recommend a KD for weight management, a more in-depth elucidation of the safety and physiological effects of KD in obese individuals is needed.
Abstract by the authors: Numerous combinations of diets and pharmacological agents, including lifestyle changes, have been launched to treat obesity. There are still ambiguities regarding the efficacies of different approaches despite many clinical trials and the use of animal models to study physiological mechanisms in weight management and obesity comorbidities, Here, we present an update on promising diets and pharmacological aids. Literature published after the year 2005 was searched in PubMed, Medline and Google scholar. Among recommended diets are low-fat (LF) and low-carbohydrate (LC) diets, in addition to the Mediterranean diet and the intermittent fasting approach, all of which presumably being optimized by adequate contents of dietary fibers. A basic point for weight loss is to adopt a diet that creates a permanently negative and acceptable energy balance, and prolonged dietary adherence is a crucial factor. As for pharmacological aids, obese patients with type 2 diabetes or insulin resistance seem to benefit from LC diet combined with a GLP-1 agonist, e.g. semaglutide, which may improve glycemic control, stimulate satiety, and suppress appetite. The lipase inhibitor orlistat is still used to maintain a low-fat approach, which may be favorable e.g. in hypercholesterolemia. The bupropion-naltrexone-combination appears promising for interruption of the vicious cycle of addictive over-eating. Successful weight loss seems to improve almost all biomarkers of obesity comorbidities. Until more support for specific strategies is available, clinicians should recommend an adapted lifestyle, and when necessary, a drug combination tailored to individual needs and comorbidities. Different diets may change hormonal secretion, gut-brain signaling, and influence hunger, satiety and energy expenditure. Further research is needed to clarify mechanisms and how such knowledge can be used in weight management.
Abstract by the authors: Individuals utilize diets as a way to lose weight. Since not all diets work the same nor do all people have the same metabolism some approaches may be more deleterious than beneficial. For dietitians the dieters alike, an understanding of the options that exist in addition to what they entail is advantageous for all. However, not all diets are feasible for all individuals, either for financial reasons or due to co-morbidities. Diets can generally be categorized into five groups: carbohydrate-limiting, Caveman-Like, miscellaneous, commercialized, and lifestyle modification. This review explores how diets grouped into the aforementioned categories work, some clinically supported evidence indicating pros and cons, and finally a discussion on how the Mediterranean and DASH Diets seem to show the most promise in terms of weight loss.
If you are unable to access the article you need, please contact us and we will get it for you as soon as possible.
| Data Protection Notice | Cookie Policy & Inventory |
 |
|
 |
Journals on all devices |
Search the EP Library Catalogue |
Newspapers on all devices |