Nudging is a strategy used in behavioral economics to influence consumer decision-making through subtle changes in the choice environment. Recently, behavioral economists have been testing the use of nudge techniques to encourage healthier foods for high risk individuals. Food insecure individuals have an elevated risk of obesity and non-communicable diseases and would benefit from eating more nutrients dense foods for prevention and treatment. To promote more nutrient dense foods for food insecure individuals, Feeding America created a list of Foods to Encourage (F2E). This study evaluated the efficacy of nudge interventions in promoting two selected F2E at client-choice food pantries in Massachusetts. The objective of this study was to determine if the nudge interventions increased the take-rate of the targeted F2E: carrots and brown rice. Nudge interventions were implemented at three client-choice food pantries. Carrots were subjected to a “recipe nudge” in which recipe cards were placed next to the product. Brown rice underwent a placement nudge, which entailed moving the product to the proximal end of the display at waist height within easy reach and line of sight. Data was collected three times pre-intervention and three times post-intervention at each site to determine if the nudge had an impact on take rate. This study took place at three suburban food pantries in the Greater Boston area. The total number of shoppers observed before intervention was 402 and after intervention was 417. The main outcome was the take-rate of the products determined by the number of shoppers who selected the foods before and after intervention. Analyses were performed using IBM SPSS Version 24 (Armonk, NY). Odds ratios were calculated to determine the effect of the intervention with a logistic regression controlling for the site. The take-rate of brown rice increased significantly post-placement intervention. The odds ratio for brown rice was 1.940 (95% CI = 1.318 to 2.857). The take rate of other types of rice did not change post-intervention. The take rate for fresh carrots also increased significantly post recipe card intervention. The odds ratio for carrots was 1.519 (95% CI = 1.129 to 2.044). The results of this study indicate a favorable effect of nudges on the take rate of nutrient dense products and could support the use of nudges as a strategy to promote the distribution of healthy food in client-choice food pantries.

Vegetables and fruits should form the basis of everyday diet. In some countries one of five recommended daily portions of vegetables and fruit can be a glass (200 ml) of juice. The aim of the study was to analyse the composition of orange juice from concentrate and compare it with the content of selected nutrients in oranges.

The study material were orange juices from concentrate, commercially available in Poland. The study was carried out in 2010–2018 at the Agriculture and Food Industry Biotechnology Institute and the Horticulture Institute in Skierniewice, Poland. The content of the following nutrients was investigated: vitamin C, folates, b-carotene, sodium, potassium, calcium, magnesium, glucose, fructose, sucrose, dietary fiber as well as energy content.

The content of vitamin C in orange juice from concentrate was 35 mg/100 ml. Folate content was 23 mg/100 ml of juice. The studied juice contained the following amounts of minerals: sodium (3 mg/100 ml), potassium (185 mg/100 ml), calcium (13 mg/100 ml) and magnesium (11 mg/100 ml). The total amount of sugars contained in the analysed juice was 8.8 g/100 ml. Compared to fresh oranges, the content of sodium, potassium, magnesium, b-carotene and sugars was similar. The content of vitamin C, folates and calcium was slightly higher in fruits. Dietary fiber amount was much higher in orange fruit than in juice. The energy value of both products was similar: 42 kcal/100 ml in juice and 47 kcal/100 g in oranges.

The study showed that orange juice from concentrate is a source of important nutrients: vitamin C, folate and potassium. Their content in orange juice from concentrate is similar to that in fresh oranges. Dietary fiber amount was much higher in orange fruit than in juice.

Over half of the Irish population is overweight or obese. The Obesity Policy and Action Plan 2016–2025 will set reformulation targets for fat, saturated fat and sugar in Ireland and review progress. In 2016, the Food Safety Authority of Ireland undertook a cross-sectional market scan of yoghurts to evaluate the energy, fat, saturated fat and sugar content based solely on declared nutrition labels. The aims of this 2018 study were to verify the accuracy of declared nutrition information on yoghurts and to confirm the suitability of declared nutrition labels for energy, fat, saturated fat and sugar reformulation monitoring.

Yoghurts identified in the 2016 market scan (n578) were weighted based on categorisation of manufacturer type (branded, own brand), product category (natural, flavoured and luxury) and declared nutrition content. Samples (n200) were randomly selected from these weighted groups and tested by a laboratory accredited for energy, fat, saturated fat, and sugar analysis. Data was analysed using IBM SPSS (version25). As data was not normally distributed, median values were investigated for declared and tested energy, fat, saturated fat and sugar content using Wilcoxon Signed-Rank Test and Spearman Rank-Order Correlation.

Of the tested yoghurts, 3% (n6), 5% (n9) and 19% (n31) were outside the recommended European Commission (EC) labelling tolerance for fat, saturated fat and sugar, respectively. Tested nutrient content was consistently lower than declared. There was a statistically significant difference in declared vs. tested energy (87kcal vs. 84kcal p = 0.03), fat (2.7 g vs. 2.5 g p < 0.001), and sugar (9.9 g vs. 8.7 g p < 0.001) content per 100 g yoghurt. Declared vs. tested sugar content per 100 g yoghurt was statistically significant across all yoghurt types, including natural (4.8 g vs. 3.4 g p < 0.001), flavoured (9.7 g vs. 8.6 g p < 0.001) and luxury (15 g vs. 13.6 g p = 0.002). There was a statistically significant difference between declared vs. tested fat (2.8 g vs. 2.5 g p < 0.001) and saturated fat (1.9 g vs.1.6 g p = 0.017) content of own brand yoghurts per 100 g. There was a positive correlation between energy content and portion size (r = .2,p < 0.01).

There was a high level of agreement between declared vs. tested fat and saturated fat content of yoghurts, but a lower level of agreement between declared vs. tested sugar content of yoghurts. This indicates that declared nutrition labels are suitable for reformulation monitoring of fat and saturated fat, but may not be suitable for sugar. This finding will be further investigated and tested in future work planned for nutrition label verification of other food categories.

Childcare settings are ideal for health promotion; however, they may not provide food environments that support children's healthy eating behaviours. To address this problem, researchers and practitioners have designed interventions with the aid of Theories, Models and Frameworks (TMFs) with the aim to improve centre-based childcare food environments. Considering the many TMFs that exist, the question of which TMF to select remains a challenge. As such, one of the objectives of our scoping review was to explore the selection criteria used in studies that aimed to promote healthy eating in centre-based childcare.

We utilized the scoping review steps outlined by Arksey & O'Malley (2005), and Levac, Colquhoun, & O'Brien (2012). We searched Medline, Embase, CINAHL, ERIC, PsycINFO, Scopus, CAB Abstracts, Agricola, ProQuest Dissertations and Theses, Prospero, and Cochrane library of SR for studies published from January 1990 to October 2018. We also consulted subject matter experts and hand searched reference lists. First level screening was completed by two reviewers (Kappa > 0.8). Second level was completed by one reviewer and questions were addressed through discussion with a second reviewer. TMF categorisation (i.e., individual, community, process and evaluation-focused) was informed by Nilsen (2015) and Rimer (2005). We used direct content analysis to organize the reported criteria used by authors to select TMFs. The rationales presented by authors were coded using Birken et al. (2017) criteria and definitions, which were based on seminal articles and an iterative consensus process. The categorization was completed by one reviewer (MV) and verified by a second reviewer (AF).

We retained 38 studies and identified 28 TMFs. TMFs were used to design implementation strategies, steps and outcomes, identify implementation factors and stakeholders, explain findings, and provide recommendations. Of the total of 14 criteria for selecting TMFs identified, the most frequently used were for describing a change process (n = 12; 23%), providing process guidance (n = 8; 15%), and TMFs use in empirical studies (n = 7; 13%).

TMF selection was most often based on descriptive rather than predictive or explanatory characteristics. Increasing childcare researchers’ and practitioners’ awareness of existing TMFs and tools to guide TMF selection might reduce selection based on convenience or where limited evidence for TMF effectiveness exist.

Dietary salt intake in most countries is far beyond the recommended level and many countries have initiated national programs to decrease salt intake. However, potential adverse effects of reducing salt intake in the general population are currently discussed. Hence some randomized studies have shown adverse effects on plasma lipids, the renin-angiotensin-aldosterone system and the sympathetic nervous system, which may again increase risk of CVD. These findings are however mainly based on short-term studies with a very large acute salt reduction. This study aims to explore the effect of gradually reducing salt intake in a real life setting according to recommendations, and to examine the effect of different salt reduction strategies among families.

The study was a 4-month cluster randomized controlled trial with families randomly assigned to either A) salt reduced bread, B) salt reduced bread and dietary counselling or C) standard bread (control) Participants in intervention A received bread gradually reduced in salt content from 1.2 g salt/100 g (regular) to 0.6 g salt/100 g in ryebread and 0.4 g salt/100 g in wheat bread. Participants in intervention B received the same salt reduced bread and in addition, they received dietary advise on how to further reduce their salt intake and promote potassium. The control group received regular bread. Changes in outcomes were assessed using linear mixed models.

Under Regulation (EC) No 1924/2006 the usage of nutrition and health claims are permitted, however foods that are high in fat, sugars and salt are advised not to use such claims as foods promoted with these claims may influence consumer food choice. The use of nutrient profiles has been proposed as a means of avoiding the potential of such claims masking the overall nutritional status of a product. Ready to eat breakfast cereals (RTEBC) often display nutrition claims whilst also contributing significantly to total sugar and energy intake. The aim of this study was to profile a variety of RTEBC and compare nutrient composition and claim information between nutrient profile categories.

The Irish National Food Ingredient database (INFID) is a record of brand specific information from food labels collected during the Irish national food surveys. A convenience sub-sample of RTEBC as eaten by Irish children during the National Children's Food Survey 2 (2017/2018) were selected (n = 102). Nutrient profile (NP) scores were calculated using the UK Nutrient Profiling Model (FSA). NP scores were calculated based on a set of negative macronutrient indicators (energy, saturated fat, total sugars and sodium) minus positive indicators (protein, fibre, “fruit, vegetables and nuts”) present per 100 g. Foods scoring four points or more were classified as “less healthy”.

More than half of RTEBC were classed “less healthy” (53%) with a median NP score of 8.0 with “healthy” RTEBC scoring significantly lower at -0.0 (p < 0.001). “Healthy” RTEBC had a median sugar content of 13.4g/100 g compared to 24g/100 g in the “less healthy” (p < 0.001). “Healthy” RTEBC had a higher fibre content of 8.8g/100 g compared to 5.72g/100 g in the “less healthy” (p = 0.001), with 35% of healthy and 28% of less healthy RTEBC making a substantiated “high in fibre” claim. Micronutrient contents of all RTEBC were similar, with only iron significantly higher in “healthy” (13.3mg/100g) compared to “less healthy” (9.5mg/100g) (p = 0.02). The prevalence of substantiated micronutrient related claims was the same between “healthy” and “less healthy” RTEBC.

“Healthy” and “less healthy” RTEBC display similar micronutrient profiles, with most of the nutrition claims on both pertaining to the micronutrient and fibre content, potentially overshadowing the macronutrient contribution of the cereals. This analysis shows the ability of nutrient profiling to distinguish products by macronutrient profiles however it identifies the complexity of application with respect to micronutrient content. Further research is required to investigate the contribution of the profiled RTEBC to total nutrient intakes.

Meat semi-finished products that are portioned or not, meat with the addition of a different composition of spices and oil are a common element of the commercial offer in the convenient ready to cook food segment. During the refrigeration storage in this complex system of meat, oil and spices, there is a number of physicochemical changes, including hydrolytic and oxidative changes of the oil(1). The products of these reactions become integral components of the meat subjected to heat treatment. As a result of heating, secondary oxidation products of lipids may be formed which constitute a serious health risk(2). The study was aimed at determination of the effect of spices containing antioxidants and sulfur-organic compounds on hydrolytic and oxidative changes in the oil that formed the base of the marinade in which meat was kept. Pork neck was minced and formed into burgers (250 g), rapeseed oil (120 g) and spices (5 g) were used. Four research groups were analyzed meat / oil / spices system with rosemary, oregano, garlic or onion. Oil samples were collected on the third, fifth and eighth day of refrigerated storage. The control sample was the oil from the meat / oil system only. The quality of the oil was evaluated on the basis of the acid value, peroxide value and TBARS index. In the oil with onion, garlic, rosemary and oregano the hydrolytic changes on the 8th day of storage were significantly lower compared to the control. On the basis of the average peroxide value in oil marinades with the addition of rosemary and oregano, significantly lower values of this indicator were found when using rosemary (3.61 meq O2/kg) in comparison with oregano (6.01 meq O2/kg). The average of TBARS index in marinade with onions and garlic was lower by 31% and 48%, respectively. Also the use of rosemary and oregano was effective in blocking the formation of secondary oxidation products (rosemary even three times higher than that of oregano).

Insufficient knowledge and improper food handling practices by child caregivers contribute greatly to food borne illnesses among children. Training and certificate programs which can translate into good practice have been found to improve the overall food handling behaviors of the caregivers. Thus the need to intervene on the poorly identified knowledge of food safety among child caregivers in Ogun state, Nigeria. One hundred and seventy (170) child caregivers between the ages 18 to 35years living in Ijebu-Ode Local Government area of Ogun State were involved in the study. These caregivers were initially identified to poor knowledge of food safety and practice in the study area. Informed consent were obtained from the Head of Child Caregivers Centres (CCC) and the caregivers themselves before the commencement of the program. One week intervention program in form of training was then organized for the concerned caregivers. A validated semi structured food safety knowledge (FSK) questionnaires were re-administered to the same food handlers after the training. Scores above 15 were categorized as adequate knowledge while those below 15 were categorized as poor knowledge. Numerical data were analysed using mean, standard deviation while t-test was used to test hypotheses. All the respondents were female (100%) and majority (43.6%) had secondary education. Respondents gained knowledge on the followings after the training: hand washing, procedure for feeding babies, cleaning of utensils and disinfection, handling of breast milk, formula feeding, diapering and general cleaning of the environment with mean scores of 18.25 ± 3.5, 20.18 ± 4.30, 16.38. ± 8.35, 25.68 ± .9.00, 15.79 ± 3.25, 30.00 ± 6.33 and 19.20 ± 4.00 respectively. knowledge of food safety among child caregivers significantly increased after the intervention exercise. Training and other forms of interventions on knowledge of food safety should be organized regularly for child caregivers

The taxation on sugar sweetened beverages (SSB), known as the health promotion levy (HPL) was implemented in South Africa in April 2018. The aim of the taxation was to reduce the excessive intake of sugar in the SA population. Many studies have linked a high intake of sugar, particularly SSB to an increased energy intake, increasing the risk of overweight and obesity. The aim of this study was to investigate the perspectives of dietitians on the HPL.

In 2015, World Health Organization (WHO) has issued guidelines to reduce the consumption of free sugars to no more than 10% of the total daily energy intake, with additional health benefits achieved when aiming to less than 5%. For the general population, following these recommendations has proven difficult due to the massive amount of free sugar available in pre-packed products on the market. In Slovenia, a series of actions have been undertaken to reduce the availability and consumption of foods high in free sugar, including food industry responsibility pledges from soft drink and dairy industry (in 2015 and 2017, respectively).

To monitor the efficacy of those actions as well as general trends in free sugar content on the Slovenian food market, the cross-sectional study from 2015 was repeated in 2017. Data from 21,115 pre-packed food items were systematically collected from major retailer shops in Ljubljana, Slovenia. All products were photographed and their European/International Article (EAN) codes scanned to assemble an online database. The products were later assigned to one of the 49 pre-defined food categories, matching those from 2015. The categories that contributed to free sugar consumption in 2015 the most were re-analysed in 2017.

Results showed that in the category of Chocolate and sweets, which in 2015 contributed one third of all free sugar sold on Slovenian market, mean free sugar content increased by 4.7 %. Among Soft drinks, which followed shortly after, free sugar content dropped by 8 %. The decrease was also observed among Jellies (10.7 %) Yogurt products (5.7 %), Breakfast cereals (1.7 %), Biscuits (0.9 %), as well as Fruit and vegetable juices (0.9 %). On the other hand, large increase was observed among Ice creams and edible ices (31.3 %) and in the category of Jam and spreads, in which mean free sugar content increased by 20.3 %.

The data showed some favourable trends in free sugar content in many food categories that contribute an important share to an overall free sugar consumption. However, free sugar in certain food categories such as Chocolate and sweets is still on the rise, exposing the need for additional actions that would encourage industry to reformulate products with a lesser amount of free sugar. Moreover, industry self-regulation may be one of, but not the only measure to efficiently reduce free sugar consumption among general population.

WHO guidelines on sugars strongly recommend reducing free sugar intake to below 10% of total energy, also their guidance on ‘Ending the inappropriate promotion of foods for infants and young children (IYC)’ recommends avoiding free sugars. Information on the sugar content of commercially available complementary foods (CACFs) for infants is limited, and the levels of added, free, and total sugar in baby foods is not fully addressed in existing guidelines. Up-to-date data is needed to inform recommendations for revising European regulations and guidelines. Front and back of pack information for baby foods from countries across the WHO European Region was collected. Mean sugar content per 100 g product and percentage energy from total sugar by food category were determined. The percentage of products containing added sugars by food category was calculated; as was the percentage of savoury meals containing pureed fruit, which is often used to sweeten products. The creation of the product categories was part of WHO work to develop a Nutrient Profile Model for CACFs marketed as suitable for IYC aged 6–36 months. A literature review of current issues also informed the process. 2642 CACFs from 10 countries were summarised; 768 products sold in the UK; over 200 each from Denmark (319), Spain (241), Italy (430) and Malta (243) and between 100–200 from Hungry, Norway, Portugal and Slovenia. About a third of energy in CACFs in these European countries came from total sugar and the mean contribution of total sugar for most food categories in the countries was higher than 10%. The amount of added and free sugar content was not labelled. However, added sugars listed as ingredients were widespread across product categories, and the type varied across countries and products, though concentrated fruit juice was most common. Savoury meal purees did not contain added sugars except in UK and Malta; however fruit puree as an ingredient was found in 7% of those examined across Europe and were most likely in UK savoury meals: in 15% on average and 41% of pureed meals with meat as the first named food. In conclusion, the sugar content of baby foods across Europe is high and updated regulations and reformulation are needed. Sugars can be restricted in a variety of ways, but first consultation with WHO Europe Member States is required to support the establishment of effective legal and policy measures to avoid inappropriate manufacture and selling of infant foods.