Ultra-processed foods in institutional food services: what are diners eating?

Introduction. Frequent use of ultra-processed foods (UPF) leads to poor health outcomes, and the population must avoid their consumption. Objective. To assess the occurrence of ultra-processed foods (UPFs) in culinary lunch menus from various institutional food services. Materials and methods. Over one month, the five institutional food services analyzed served 1,128 culinary preparations; and a total of 3,863 ingredients were classified according to the extent and purpose of processing using the NOVA classification system. Associations between the occurrence of UPFs and the type, size, and management of food service establishments were analyzed. Five institutional food services in three municipalities (Bauru, Limeira, and Campinas), Brazil. Results. We found 8.4 % up to 12.6 % UPF ingredients used in culinary preparations. The highest frequency of UPFs was associated with private cafeterias (p = 0.002). Most UPFs were part of the recipe or the main ingredient in protein dishes and desserts (p < 0.05) and in university and hospital food services, respectively. UPF use was associated with food service size and type of management (p ≤ 0.003) and was more prevalent in protein dishes (p = 0.003) and large-size institutional food services (28.8 %). Self-managed units (p = 0.03) also use high amounts of UPFs in protein dishes (20.3 %). Conclusions. The presence of UPF rounded 10%; the validity of this value needs further studies. There are no comparative data in the scientific literature regarding the use of these ingredients in institutional food service culinary preparations. Therefore, it is necessary to stimulate reflection to promote healthy food habits and adequate nutrition for diners(AU)

Introducción. El uso frecuente de alimentos ultraprocesados (UPF) conduce a complicaciones de salud, y la población debe evitar su consumo. Objetivo. Evaluar la presencia de alimentos ultraprocesados (UPFs) en los menús de almuerzos de diversos servicios de alimentación institucionales. Materiales y métodos. Durante un mes, los cinco servicios de alimentación institucionales analizados sirvieron 1.128 preparaciones culinarias; y se clasificaron un total de 3.863 ingredientes según el alcance y el propósito del procesamiento, utilizando el sistema de clasificación NOVA. Se analizaron las asociaciones entre la ocurrencia de UPFs y el tipo, tamaño y gestión de los establecimientos de servicio de alimentos. Cinco servicios institucionales de alimentación en tres municipios (Bauru, Limeira y Campinas), Brasil. Resultados. Se encontró entre un 8,4 % hasta un 12,6 % de ingredientes UPF utilizados en las preparaciones culinarias. La mayor frecuencia de UPF se asoció a cafeterías privadas (p = 0,002). La mayoría de los UPFs formaban parte de la receta o eran el ingrediente principal en platos proteicos y postres (p < 0,05) y en los servicios de alimentación universitarios y hospitalarios, respectivamente. El uso de UPFs se asoció con el tamaño del servicio de alimentación y el tipo de gestión (p≤ 0,003) y fue más frecuente en platos proteicos (p = 0,003) y servicios de alimentación institucional de gran tamaño (28,8 %). Las unidades autogestionadas (p = 0,03) también utilizan altas cantidades de UPF en platos proteicos (20,3 %). Conclusiones. La presencia de UPF ronda el 10 %; la validez de este valor necesita más estudios. No existen datos comparativos en la literatura científica sobre el uso de estos ingredientes en las preparaciones culinarias de los servicios de alimentación institucional. Por ello, es necesario estimular la reflexión para promover hábitos alimentarios saludables y una adecuada nutrición de los comensales(AU)

Progress in the legislations regarding school nutrition lunch and nutrition status in China and some other countries / 上海预防医学

This paper summarized the school nutrition lunch legislations and nutrition status in China and abroad. School lunch system is relatively well-established and mature in Japan， the United States and Sweden and the lunch system has been gradually as an important part of basic education， which is worth learning by other countries and regions. China started its pilot school nutrition lunch program in 1987， and has improved the nutritional status of students， especially the students in rural areas， significantly. However， there still exists certain gaps compared with developed countries. We should actively learn from those countries， so as to provide reference for the formulation and improvement of China’s nutritional lunch policies.

Aceptabilidad de los almuerzos del Programa de Alimentación Escolar y estimaciones de pérdidas económicas asociadas en la comuna de Coquimbo, Chile

RESUMEN Una nutrición adecuada es fundamental para el crecimiento y desarrollo óptimo de la infancia. En Chile, el Programa de Alimentación Escolar tiene como propósito disminuir la brecha asociada con el acceso a la cantidad y calidad de los alimentos en la población de estudiantes vulnerables. El objetivo de este estudio fue determinar el grado de aceptabilidad de los almuerzos que el Programa ofrece a los estudiantes y sus pérdidas económicas asociadas. Se realizó un estudio descriptivo transversal en 528 estudiantes primarios y secundarios de 5 colegios públicos de la comuna de Coquimbo, quienes evaluaron 6 almuerzos mediante la escala sensorial hedónica de 9 puntos, encuesta de características organolépticas, test de ordenación y determinación de porcentaje de ingesta para establecer pérdidas económicas. Se realizó muestreo probabilístico estratificado, ANOVA para análisis de la escala hedónica y porcentaje de ingesta, tablas de contingencia, Chi cuadrado para características organolépticas (p<0,05). Se encontró que la carne de res con fideos tuvo la mayor preferencia y las más bajas aceptaciones fueron frijoles con fideos y pastel de pescado con puré de papas (p<0,05). Las preparaciones con menor aceptabilidad representaron el 82,2% de las pérdidas económicas, principalmente frijoles. Los resultados confirman una baja ingesta de pescado y verduras, que las características de sabor por bajo contenido de sal afectan las preferencias y que existe una relación directa entre la ingesta y la pérdida económica.

ABSTRACT Adequate nutrition is a fundamental factor for optimal early childhood growth and development. In Chile, the School Nutritional Program aims to diminish the gap associated with access to the quantity and quality of food. The objective of this study was to determine the degree of acceptability of prepared lunches that are given to students by the School Nutritional Program and its association with economic losses. A descriptive cross-sectional study was carried out among 528 primary and secondary students from 5 public schools in the Coquimbo commune, who evaluated 6 lunches using the 9-point hedonic sensory scale, a survey of organoleptic characteristics, a ranking test and determination of the intake percentage to establish economic losses. Stratified probability sampling was performed, ANOVA for analysis of the hedonic scale and percentage of intake, contingency tables, Chi square tests were used for organoleptic characteristics (p<0.05). The thin sliced beef with noodles was found to have the highest preference and the lowest ranked meals were beans with noodles and fish cake with mashed potatoes (p<0.05). Preparations with lower acceptability represented 82.2% of economic losses and were mainly beans. The results confirm a low intake of fish and vegetables, that taste characteristics due to low salt content affect preferences and that there was a direct relationship between intake and economic loss.

Evaluación de la cobertura de la merienda escolar en 4 departamentos de Paraguay. Años 2016-2018

RESUMEN Introducción: La merienda escolar contribuye con la nutrición y rendimiento escolar, es importante conocer su alcance. Objetivo: Evaluar la merienda escolar en Concepción, Cordillera, Paraguarí y Central, en cuanto implementación y cobertura. Materiales y Métodos: Estudio observacional descriptivo retrospectivo de licitaciones para merienda escolar entre 2016-2018 en Concepción, Cordillera, Paraguarí y Central. Fueron caracterizadas las instituciones incluidas, días cubiertos del calendario escolar (180 días) y cantidad de beneficiarios. Resultados: Fueron incluidas 15 licitaciones. En Concepción 90% fueron instituciones públicas, 6% privadas, 3% sin datos; Cordillera 88% fueron públicas, 8% privadas, 4% sin datos; Paraguarí 91% fueron públicas, 3% privadas, resto sin datos; Central 12% fueron privadas 11% sin datos, resto públicas. En Concepción fueron 30.112 beneficiarios en 2016/2017 y 27.514 en 2018, en Cordillera aumentó de 37.167 (2017) a 44.375 (2018); en Paraguarí varió de 30.339 (2016) a 29.761 (2018), en Central fueron 180.535 beneficiarios en 2017-2018. En Concepción en 2016/2017 se planificó merienda para 80 días, 133 días en 2018, en Cordillera 160 días en 2017, 117 días en 2018; en Paraguarí en 2016 fueron 122 días, 110 en 2017 y 117 días en 2018; en Central fueron 216 días en 2017-2018.Los beneficiarios cubiertos según Registro Único de Estudiantes al 2018 fue 78,5% en Concepción, 87% en Cordillera, 90% en Paraguarí, 75% en Central. Conclusiones: En provisión de merienda escolar, la mayoría fueron instituciones públicas, hubo descenso de beneficiarios en el 2018 excepto Cordillera. 2/3 de los beneficiarios registrados fueron incluidos y se proveyó durante poco más de la mitad del año escolar.

ABSTRAC Introduction: The school meal contributes to nutrition and school performance, it is important to know its reach. Objective: To evaluate school meals in Concepción, Cordillera, Paraguarí and Central, in terms of implementation and reach. Materials and Methods: This was a retrospective, descriptive, observational study of awarded contracts for school meals between 2016-2018 in Concepción, Cordillera, Paraguarí and Central. We characterized the included institutions, covered days of the school calendar (180 days) and number of beneficiaries. Results: 15 contracts were included. In Concepción, 90% of schools were public institutions, 6% private, 3% without data; in Cordillera 88% were public, 8% private, 4% without data; in Paraguarí 91% were public, 3% private, the rest without data; in Central 12% were private, 11% without data, the rest public. In Concepción there were 30,112 beneficiaries in 2016/2017 and 27,514 in 2018, in Cordillera it increased from 37,167 (2017) to 44,375 (2018); in Paraguarí it varied from 30,339 (2016) to 29,761 (2018), in Central there were 180,535 beneficiaries in 2017-2018. In Concepción in 2016/2017 meals were planned for 80 days, 133 days in 2018, in Cordillera 160 days in 2017, 117 days in 2018; in Paraguarí in 2016 there were 122 days, 110 in 2017 and 117 days in 2018; In Central there were 216 days in 2017-2018. The beneficiaries covered according to the Single Student Registry in 2018 were 78.5% in Concepción, 87% in Cordillera, 90% in Paraguarí, 75% in Central. Conclusions: In the provision of school meals, the majority of schools were public institutions, there was a decrease in beneficiaries in 2018 except in Cordillera. 2/3 of the registered beneficiaries were included and meals were provided for just over half the school year.

Descriptive Study of School Feeding Practices in Nigerian Children and the Risk of Dental Caries

Background:Nutrition is important in development, growth and maintenance of overall well being of an individual andplays a significant role in children’s cognitive, behavioural and emotional development. Poor diets may initiate or exacerbate chronic diseases including dental caries which has dietary fermentable carbohydrates as one of its aetiologies.Objectives:To describe the school feeding practice in Nigerian schools and relate the contents of their lunch boxes to risk of having dental caries and determine the relationship between socioeconomic factors and the content of lunch boxes.Study Design:This was a descriptive cross sectional study.Methodology:Multistage sampling technique was used in selecting participants from 12 schools in Southern Nigeria. Information on socio-demographic characteristics and contents of lunch boxes were elicited using structured questionnaires. The contents of lunch boxes were categorized as balanced (cooked meals with vegetables or fruits), overloaded (one cooked meal and snacks) and unbalanced-over loaded (no lunchbox, or greater than one snacks). Information elicited were analyzed using SPSS version 22 and the level of significance was set at <0.05 Results:There were 152 (49.8%) males and 153 (50.2%) females with a mean age of 10.1 (+2.2) years who participated in the study. One hundred and fifty two (49.8%) pupils brought lunch boxes to school. The category of meals taken during lunch breaks was mostly [157 (51.5%)]unbalanced-overloaded. There were statistically significant associations between the mothers’ occupation (<0.001), number of siblings (p<0.001), type of school (p=0.001) and the presence of lunch boxes. There was also statistically significant associationbetween the types of schools and contents of lunch packs. Multivariate regression analysis showed that age (OR=0.116, CI=0.030-0.447;p=0.002) and number of siblings (OR=0.286; CI=0.097-0.841; p=0.023) were significant predictors of bringing lunch box to school.Conclusion:Type of school, age of the children, their mothers’ social class/occupation and family size were significantly associated with possessing lunch packs. Their lunch meals were majorly confectioneries thus a high risk to dental caries

Alimentos seleccionados por los padres para los refrigerios de sus hijos en etapa de educación básica en Reynosa, Tamaulipas / Lunch box contents of elementary school children in Reynosa, Tamaulipas

Resumen Los refrigerios que consumen los niños durante el recreo complementan su dieta diaria, y pueden representar un riesgo de obesidad si los padres los preparan con base en alimentos procesados, elevados en azúcar, sal y grasa. El objetivo de este estudio fue identificar el contenido de los refrigerios empacados en casa, así como el estado nutricio de escolares de Reynosa, Tamaulipas, México. Se realizó un estudio descriptivo y transversal. Se trabajó con 769 niños de 12 escuelas públicas de educación básica. Se tomaron peso y talla. Se registraron durante una semana los refrigerios por observación directa, mediante una lista de cotejo. El 44.7 % de los escolares presentó sobrepeso u obesidad. Los alimentos contenidos en los refrigerios fueron el sándwich (50.0 %), tacos (29.5 %) y tortas (14.5 %). Las bebidas azucaradas incluyeron jugo (44 %) y agua saborizada (38.2 %). El 18.8 % llevó frutas, 13.5 % verduras y 31.6 % agua. En promedio, el contenido de energía fue de 327 kcal, por lo tanto, sobrepasaron la recomendación de calorías, e incluían alimentos no saludables (alto contenido de azúcar y grasa en relación a su aportación nutrimental), siendo necesario realizar intervenciones de educación nutricional para promover el consumo de agua y alimentos saludables dentro del entorno escolar, para mejorar la calidad de los hábitos alimenticios, tanto en escuelas de medio tiempo, como de tiempo completo, las cuales, brindan el servicio de alimentación.

Abstract School lunch supplements children's dailydiet and may pose a risk of obesity if they are prepared based on processed foods high in sugar, salt and fat. The aim of this study was to identify the content of lunch packs, as well as the nutritional status of scholars from Reynosa, Tamaulipas, Mexico. To that aim, a descriptive and transversal study was conducted. We worked with 769 children from 12 public elementary schools. Students' size and weight were taken. The contents of their lunch packs were recorded for one week by direct observation through a checklist. 44.7 % of school children were overweight or obese. The foods contained in the lunch packs were sandwich (50.0 %), tacos (29.5 %) and big sandwich (14.5 %). Sugary drinks included juice (44 %) and flavored water (38.2 %). They also contained fruits (18.8 %), vegetables (13.5 %) and water (31.6 %). On average, the energy content was 327 kcal. Therefore, they exceeded the calorie recommendation and included unhealthy foods (high content of sugar and fat in relation to their nutritional contribution). This suggests the need to implement nutrition education intervention programs to promote the consumption of drinking water and healthy foods within the school environment to improve the quality of eating habits.

Percepción de satisfacción entre beneficiarios del programa de alimentación escolar en Bucaramanga-Colombia / Perception of satisfaction among beneficiaries of the school food program of Bucaramanga-Colombia

Resumen Introducción: El Programa de Alimentación Escolar PAE en Colombia es uno de los más antiguos orientado a la protección de la población infantil para potenciar su desarrollo y disminuir la deserción escolar; sin embargo, no hay investigación suficiente que permita evidenciar avances y logros del programa. Objetivo: Determinar la prevalencia en la percepción de satisfacción de los beneficiarios del Programa de Alimentación Escolar - PAE en Bucaramanga, Colombia y sus factores asociados. Metodología: Se realizó en 2017 un estudio cuantitativo de corte transversal analítico. La población correspondió al universo de escolares beneficiarios del PAE en la ciudad (N= 31.230) y la muestra a 401 escolares la cual se dividió en dos grupos según edad: grupo 1 (de 5 a 8 años) y grupo 2 (de 9 a 17 años). Las encuestas para evaluar los componentes sensorial, organizacional y social, fueron sometidas a prueba piloto para validación aparente o facial y ajustadas según resultados. Una vez recogidos los datos se hizo análisis descriptivo a características de interés; para corroborar diferencias estadísticamente significativas se usó la prueba de chi2 y T de Student y se realizaron análisis bivariados y multivariados entre las características de interés y la percepción de satisfacción usando regresión lineal simple y múltiple. Resultados: Los estudiantes mostraron un nivel alto de percepción de satisfacción frente a las raciones recibidas, siendo los más satisfechos los de nivel socioeconómico bajo y medio bajo (Coef B 2,43; IC 95%: 1,61-3,25) y los que recibieron ración preparada en sitio (niños de 5 a 8 años), (Coef B 8,36; IC 95%: 7,08-9,64). Se encontró que el 25% de los estudiantes de nivel socioeconómico medio-medio y medio-alto botaba los alimentos a la basura. Conclusiones: Estos hallazgos mostraron la necesidad prioritaria de ser más rigurosos en la focalización de los beneficiarios del programa, así como llevar a cabo otros ajustes planteados en el estudio, para incrementar la calidad del programa PAE de Bucaramanga.

Abstract Introduction: The PAE School Feeding Program in Colombia is one of the oldest oriented to the protection of the child population to enhance their development and decrease school dropouts; however, there is not enough research to show progress and achievements of the program. Objective: To determine the prevalence of perception of satisfaction of the beneficiaries of the School Feeding Program, in Bucaramanga, Colombia and its associated factors. Methodology: An analytical cross-sectional study was carried out in 2017 with an empirical non-experimental analytical approach. The population corresponded to the universe of PAE schoolchildren in the city (N = 31,230) and the sample to 401 students which was divided into two groups according to age: group 1 (from 5 to 8 years) and group 2 (from 9 to 17 years). The surveys to evaluate the sensory, organizational and social components were submitted to a pilot test for apparent or facial validation and adjusted according to results. Once the data was collected, a descriptive analysis was made to the characteristics of interest; To corroborate statistically significant differences, the chi2 and Student's T test were used and bivariate and multivariate analyzes were performed between the characteristics of interest and the perception of satisfaction using simple and multiple linear regression. Results: The students showed a high level of satisfaction perception compared to the rations received, being the most satisfied those low and medium low socioeconomic status (Coef B 2.43; 95%CI: 1.61-3.25) and those who received ration prepared on site (children 5 to 8 years old), (Coef B 8.36; 95%CI: 7.08-9.64). Conclusions: These findings showed the priority need to be more rigorous in the targeting of the beneficiaries of the program, as well as carry out other adjustments proposed in the study, to increase the quality of the PAE program in Bucaramanga.

Comparison of lunch quality through home meals, institutional meals, and eating-out in Chinese adults: analysis of the data from the 2011 China Health and Nutrition Survey / 한국영양학회지

PURPOSE: This study evaluated the dietary quality of lunches consumed through home meals, institutional meals, and eating-out at restaurants in Chinese adults.METHODS: The total of 3,708 people (aged 20 ~ 64) were selected from the data of the 2011 China Health and Nutrition Survey and divided into three groups: the home (HM, 2,845 people), institutional (IM, 579 people), and eating-out (EO, 284 people) meal groups. Dietary intakes of eight food groups, the frequency of eating certain foods, food group intake pattern, dietary diversity and the variety score of lunches were analyzed.RESULTS: The meat intake of IM and EO were higher than that of HM (p < 0.05), and the vegetable intake was the highest in HM, followed by IM and EO (p < 0.05). The intake of fruit and milk · dairy products were extremely low in all the groups. Compared with 1/3 daily recommended intake, the meat intake was above the standard in all the groups and the vegetable intake was insufficient only in EO. The most frequently consumed food in all the groups was rice, followed by pork. The relatively desirable food group pattern, “grain + meat + vegetable”, was highest in IM (66.0%) and lowest in EO (48.2%). The “grain + vegetable” pattern in HM and the “grain + meat” pattern in EO were relatively higher than that in the other groups. The dietary diversity score (p < 0.001) and dietary variety score (p < 0.001) were significantly higher in IM than that in the HM or EO.CONCLUSION: The lunches of Chinese adults had common problems in excess meat intake and a severe lack of fruit and milk · dairy products. Even institutional meals were not ideal as single meals for Chinese adults, although they were better in food diversity. Customized dietary educational programs based on balanced meal plans need to be established, especially for those Chinese people having lunch at home or eating out. In addition, a systematic food service program should be developed and firmly implemented.

Agreement between two Meal Quality Indexes adapted to evaluate food consumption of institutionalized elderly / Concordância entre dois Índices de Qualidade da Refeição adaptados para avaliar o consumo alimentar de idosos institucionalizados

ABSTRACT Objective To assess agreement between two meal quality indexes adapted for elderly people, evidencing their similarities and differences Methods Agreement study with 322 institutionalized elderly individuals. Food consumption data were collected by the method of weighted food record, in two nonconsecutive days. The Meal Quality Index and the Main Meal Quality Index of each older adult were calculated for the lunch meal. Agreement between methods was tested by cross-classification in quartiles and weighted kappa (Kw), and the difference between medians by the Wilcoxon test. Results The Meal Quality Index median was 54.67 points and the Main Meal Quality Index 53.51 points (p=0.723). When the components of each index were assessed, those associated to the consumption of carbohydrates, total fat and saturated fat were similar. The consumption of fruits separated from vegetables in the Main MealQuality Index evidenced low consumption of vegetables by the elderly. Cross-classification by quartiles showed good agreement; the exact one being 48.8% and the disagreement 3.4% (Kw=0,447). The proportion of elderlyindividuals in the same exact or adjacent quartile was greater than 85.0%. Agreement was higher in males (89.4%, Kw=0.475); in the age range of 70 to 79 years (91.1%; Kw=0.562) and in non-profit nursing homes(96.7%; Kw=0.622). Conclusion The two indexes reviewed show a good agreement between them and common characteristics. The number of components is higher in the MMQI and may represent a more detailed assessment of meal quality.

RESUMO Objetivo Avaliar a concordância entre dois índices de qualidade da refeição adaptados para idosos, evidenciando suas semelhanças e diferenças. Métodos Estudo de concordância realizado com 322 idosos institucionalizados. Os dados de consumo alimentar foram coletados pelo método de registro alimentar por pesagem, em dois dias não consecutivos. Foram calculados o Índice de Qualidade da Refeição e o Main Meal Quality Index de cada idoso para a refeição do almoço. Aconcordância entre os métodos foi testada pela classificação cruzada em quartis e kappa ponderado (Kp), e a diferença entre medianas pelo teste de Wilcoxon. Resultados A mediana do Índice de Qualidade da Refeição foi de 54,67 pontos e do Main Meal Quality Index foi de 53,51 pontos (p=0,723). Quando avaliado os componentes de cada índice, os relacionados ao consumo de carboidratos, gordura total e gordura saturada foram semelhantes. O componente frutas, separado das verdurasno Main Meal Quality Index evidenciou o baixo consumo de verduras pelos idosos. A classificação cruzada por quartis mostrou boa concordância, sendo a exata de 48,8% e a discordância de 3,4% (Kp=0,447). A proporção de idosos no mesmo quartil ou quartil adjacente foi de mais de 85,0%. A concordância foi maior no sexo masculino (89,4%; Kp=0,475); na faixa etária de 70 a 79 anos (91,1%; Kp=0,562) e nas instituições sem fins lucrativos (96,7%; Kp=0,622). Conclusão Os dois índices analisados tem uma boa concordância entre si e características em comum. O número de componentes é maior no MMQI, podendo representar avaliação mais detalhada da qualidade da refeição.

Comparison of nutrients and food intakes of young children according to lunch places: based on the fifth Korea National Health and Nutrition Examination Survey / 한국영양학회지

PURPOSE: This study examined whether there was a difference in the nutrients and food intake of young children depending on their lunch places. METHODS: The dietary survey data of the fifth Korea National Health and Nutrition Examination Survey (2010 ~ 2012) were used. The children were grouped into either a child care center lunch group (n = 728) or home lunch group (n = 592) and their nutrients and food intakes were compared. RESULTS: No differences in the 24-hr energy intake and energy intakes from lunch and dinner according to the lunch places were observed. The percentage of breakfast energy was lower in the child care center lunch group, whereas the percentage of snack energy was higher. In children aged 3 ~ 5 years, the sodium, potassium, and vitamin C intakes were high in the child care center lunch group. The 1 ~ 2 years and 3 ~ 5 year old children's vegetable intake from lunch was significantly higher in the child care center lunch group than in the home lunch group. Children aged 3 ~ 5 years in the child care center lunch group consumed more beans and fish at lunch. The adequacy of nutrients and food diversity of child care center lunch appear better than home lunch. CONCLUSION: Parents and care providers need to make efforts to use diverse foods, such as vegetables and fish, in children's meals to provide balanced diets and promote healthy eating behaviors to their children.

Association of Descriptive Menu Names and Number of Correctly Vegetable Names with Factors Regarding Vegetable Intake in Elementary School Children

Children's exposure to various vegetables has been associated with higher preferences and intake of vegetables. Attractive names have been reported to increase children's vegetable intake in school lunches. This study hypothesized that the number of vegetables identified correctly may be used as a measure of exposure to vegetables. The survey was administered to students (n=368) at an elementary school located in Gyeonggi-do to determine the association of number of vegetables identified correctly with factors regarding vegetable intakes and effects of descriptive menu names on consumption intentions in school lunches. Students were asked to identify the correct names for nine vegetables and rate their desire to eat six vegetable dishes labeled with general names and two different descriptive names. Descriptive menu names did not consistently increase subjects' desire to eat vegetables compared to general menu labels. Children who ate two vegetable dishes and more per meal tended to identify the names of more vegetables than those who ate less, without reaching statistical significance (P=0.057). Moreover, 5th graders who answered that they ate more than two vegetable dishes each meal had significantly higher scores in identifying vegetable names than those who did rarely (P < 0.05). There was no significant association between the number of correctly identified vegetable names and children's vegetable preferences and frequency of being served vegetable dishes. Mother's vegetable preference showed a significant positive association with vegetable preferences of children (r=0.147, P < 0.01) and fathers (r=0.340, P < 0.01) as well as the number of correctly identified vegetables by children (r=0.183, P < 0.01). The results of this study cannot support the advantage of descriptive menu labels over general menu labels. However, it suggests that the number of correctly identified vegetable names could serve as a measure of children's exposure to vegetables associated with factors regarding vegetable intake.

Lunch quality and sociodemographic conditions between Brazilian regions / Qualidade do almoço e condições sociodemográficas entre as macrorregiões brasileiras / Calidad del almuerzo y condiciones sociodemográficas entre regiones brasileñas

The objective of this study was to assess the quality of lunch consumed by adults in Brazil and its sociodemographic determinants in each Brazilian region. A cross-sectional study was carried out and a representative sample of regional populations was used. The sample comprised of 16,096 adults from the Brazilian National Dietary Survey, part of the Brazilian Household Budget Survey (POF). The lunch quality was evaluated by applying the main meal quality index (MMQI), comprised of 10 items of equal weights that resulted in a score that ranged from zero to 100 points. Linear regression models measured the association between lunch quality and sociodemographic factors. The average energy consumption at lunch was 704kcal (SD = 300), and the meal quality score mean was 57 points (SE = 0.30). The North Region had the worst MMQI score (56 points, SE = 0.07), while the Central had the best MMQI adjusted score (59 points, SE = 0.05). The MMQI final score was positively associated with male gender and ages between 20-39 years, and was inversely associated with having eight years or more of education, per capita income of at least three minimum wages, and with the consumption of meals prepared away from home. Despite differences among sociodemographic factors, all Brazilian regions had a lunch composed of foods rich in sugars and fats, with insufficient portions of fruits and vegetables, resulting in a low meal quality.

O estudo teve como objetivo avaliar a qualidade do almoço consumido por adultos brasileiros e os determinantes sociodemográficos em cada macrorregião brasileira, com delineamento transversal e uma amostra representativa das populações regionais. A amostra incluiu 16.096 adultos, participantes do Inquérito Nacional de Alimentação, um componente da Pesquisa de Orçamentos Familiares. A qualidade do almoço foi avaliada através do main meal quality index (MMQI), com 10 itens de pesos iguais que resultaram em um escore que variava entre zero e 100 pontos. Nas análises, modelos de regressão linear mediram a associação entre a qualidade do almoço e fatores sociodemográficos. O consumo energético médio no almoço foi 704kcal (DP = 300), e o escore médio da qualidade do almoço foi 57 pontos (DP = 0,30). A Região Norte teve o pior MMQI (56 pontos, DP = 0,07), enquanto o Centro-oeste teve o melhor MMQI ajustado (59 pontos, DP = 0,05). O escore final do MMQI mostrou associação positiva com o gênero masculino e idade de 20-39 anos, e associação negativa com escolaridade de oito anos ou mais, renda per capita de pelo menos três salários mínimos e consumo de refeições preparadas fora de casa. Apesar das diferenças entre fatores sociodemográficos, em todas a macrorregiões brasileiras os adultos consumiam um almoço rico em alimentos com alto teor de açúcar e gordura e com porções insuficientes de frutas e verduras, resultando em um almoço de baixa qualidade alimentar.

El objetivo de este estudio fue evaluar la calidad del almuerzo que consumen los adultos en Brasil y sus determinantes sociodemográficos en cada región brasileña. Se trata de un estudio transversal con una muestra representativa de las poblaciones regionales. La muestra comprendió a 16.096 adultos de la Encuesta Nacional sobre Dieta, Encuesta sobre Presupuestos Familiares en Brasil. La calidad del almuerzo fue evaluada aplicando el main meal quality index (MMQI), que comprendía 10 ítems de pesos equivalentes que resultaron en un marcador que abarcaba de cero a 100 puntos. El análisis se realizó mediante modelos de regresión lineal que midieron la asociación entre el almuerzo de calidad y sus factores sociodemográficos. El promedio de consumo de calorías en el almuerzo fue 704kcal (SD = 300), y la media del índice de calidad de la comida fue 57 puntos (SE = 0,30). La región Norte tuvo el peor índice de MMQI (56 puntos, SE = 0,07), mientras que el Centro-oeste tuvo el mejor índice de MMQI ajustado (59 puntos, SE = 0,05). El índice final de MMQI se asoció positivamente al género masculino y edades comprendidas entre los 20-39 años, y fue inversamente asociado con contar con ocho años o más de educación, unos ingresos per cápita de al menos tres salarios mínimos, y un consumo de comidas preparadas fuera de casa. A pesar de las diferencias entre los factores sociodemográficos, todas las regiones brasileñas contaron con un almuerzo compuesto por comidas ricas en azúcares y grasas, con insuficiente porciones de frutas y verduras, constituyendo una comida de baja calidad.

Adecuación y aceptación de almuerzos escolares en dos escuelas públicas de Asunción

Introducción: El Programa de Alimentación Escolar consiste en la entrega directa de alimentos nutritivos y culturalmente aceptados a los niños matriculados en el sistema educativo tanto público como subvencionado, con el objetivo de promover el ingreso, la permanencia, la asistencia regular a clases, la promoción y las mejoras en el rendimiento académico de los escolares. Objetivo: Evaluar el grado de aceptación y porcentaje de adecuación a los requerimientos nutricionales del almuerzo escolar de niños y niñas de dos escuelas públicas de Asunción. Materiales y Métodos: Estudio observacional descriptivo de corte transverso, realizado en 102 escolares de ambos sexos, matriculados en dos escuelas públicas durante el periodo 2013. Se les realizó evaluación antropométrica mediante Índice de Masa Corporal para la edad (IMC/Edad) y Talla/Edad. Se evaluó el grado de aceptación de tres menús ofrecidos mediante los métodos de Escala Hedónica Facial y Porcentaje de Sobras; y también se determinó el porcentaje de adecuación a los requerimientos nutricionales del almuerzo escolar. Resultados: El 39,2% de la población estudiada presentó malnutrición por exceso y un 2,8% riesgo de desnutrición. Mediante la Escala Hedónica Facial y Porcentaje de sobras, para evaluar la aceptación de los menús se demostró que el de mejor aceptación fue el pollo con verduras con puré de papas y de menor preferencia el guiso de poroto con arroz. En cuanto a la adecuación energética, se observó un mayor porcentaje de déficit y en la ingesta de proteínas, se constató un exceso según los requerimientos establecidos por la Organización Mundial de la Salud y por el Ministerio de Educación y Cultura. Conclusión: La evaluación de aceptación de los menús escolares constata que sólo a 3 de cada 10 niños les agradan las comidas que les sirven. La adecuación de energía y proteínas no se ajustan a los requerimientos recomendados.

Introduction: School Feeding Program is the direct delivery of nutritious and culturally acceptable foods to children enrolled in the public school and subsidized system, with the aim of promoting the entry, permanency, regular school attendance, promotion and improvements in the academic performance of school children. Objective: To evaluate the degree of acceptance and percentage of nutritional requirements adequacy of the scholar lunch of children from two public schools from Asunción. Materials and Methods: A descriptive cross-sectional, observational study conducted on 102 students of both genders enrolled in two public schools in 2013. Children underwent Nutritional Assessment by BMI/A & Height/A, the degree of acceptance from three offered menus was evaluated by the methods of Facial Hedonic Scale and Leftovers Percentage, in addition, the percentage of adequacy to nutritional requirements of the school lunch was determined. Results: 39,2% of the studied population was overnourished and only 2,8%. had risk of undernourishment. The Facial Hedonic Scale and Leftovers Percentage, used to evaluate the acceptability of the menus showed that best accepted menu was chicken with vegetables and mashed potatoes; and the less preferred was bean stew with rice. Regarding energy adequacy, we observed a high percentage of deficit; and protein intake excess was found, according to the requirements established by the World Health Organization and the Ministry of Education and Culture. Conclusion: We found that just 3 out of 10 children like the meals that they serve. The adequacy of energy and protein do not meet the recommendations

Current Status of Parents' Monitoring of and Level of Trust in School Lunch Programs / 대한지역사회영양학회지

OBJECTIVES: The purpose of this study was to investigate the current status of parents' monitoring of school lunch programs and to examine the relationship of parents' school lunch monitoring with their level of trust in school lunch programs. METHODS: During November 2016, a web survey was conducted with 1,283 parents who had participated in monitoring of school lunch programs. A total of 621 parents completed the questionnaires (48.4% response rate) and the responses from 442 parents were analyzed (34.5% analysis rate) for elementary (n=196) and middle/high school parents (n=246), respectively. RESULTS: Both the elementary and middle/high school parents most wanted to participate in monitoring 1~2 times per month, which was less frequent than their current practice. They showed the highest experience rate in ‘food sanitation’ area in both the prior training and actual practice of school lunch monitoring. They most responded ‘increasing trust in school lunch programs’ as a merit and ‘lack of parents participating in monitoring’ as a problem of school lunch monitoring. The average levels of trust did not differ between elementary and middle/high school parents. Multiple regression analyses showed that elementary school parents' level of satisfaction in the monitored school lunch programs was positively associated with the parents' level of trust in general school lunch programs. Monitoring frequency and parents' age, in addition to level of satisfaction in the monitored school lunch program, were associated with level of trust in general school lunch programs among middle/high school parents. CONCLUSIONS: There was room for change in parents' school lunch monitoring programs to meet parents' needs better. Well-managed school lunch monitoring programs contributing to parents' satisfaction with school lunch programs could increase parents' level of trust in school lunch programs.

The Effect of Mothers’ and Fathers’ Food Preferences on Children’s Preferences with Their Attitude.

Aims: Early childhood is most crucial for establishing eating habits; therefore, controlling the preferences of young children is critical. This study investigated the relationship between mothers’ and fathers’ food preferences in their childhood and their children’s present food preferences. Study Design: This was a cross-sectional study. Methods: Questionnaires were provided to the parents of children in the age group of 3-5. The association between children’s preferences, their food concerns and mothers’ and fathers’ preferences during their childhood and the present was examined using a multiple logistic regression analysis. A questionnaire was given to the parents of 1,010 children aged between 3 and -5 years and who attended 5 private kindergartens and nursery facilities in Japan. The children’s preferences were significantly related to their mothers’ and fathers’ preferences during childhood, (but not current parental food preferences), as well as children’s enjoyment of school lunches and their consumption of traditional Japanese food. Results: Primarily, the mother’s preferences during childhood were most intensively related to children’s preferences (4.21 [2.47-7.19], P<0.001: Odds Ratio [95% confidence intervals], probability). The children’s preferences were affected not only by mothers’ and fathers’ preferences during their childhood, which cannot be changed, but also by children’s enjoyment of their school lunches and their consumption of traditional Japanese food. Conclusion: These acts can be modified and may have a key role of improving children’s food preferences.

Nutritional quality of lunches consumed by Korean workers: Comparison between institutional and commercial lunches

BACKGROUND/OBJECTIVES: The nutritional quality of lunches is an important factor related to workers' health. This study examined the nutritional quality of Korean workers' lunches with a focus on comparing institutional and commercial lunches. SUBJECTS/METHODS: The data from a 1-day, 24-hour dietary recall from the 5(th) Korea National Health and Nutrition Examination Survey (2010-2012) were analyzed. A total of 2,192 subjects aged 19 to 64 years, who had consumed lunches served by institutional or commercial food service vendors, were included for analysis. The nutritional quality of the lunches of the institutional lunch group (n=626) and the commercial lunch group (n=1,566) was compared in terms of the number of servings, food groups, nutrient intake, Nutrient Adequacy Ratio (NAR), and Mean Adequacy Ratio (MAR). RESULTS: The NAR and MAR were significantly higher in the institutional lunches than in the commercial lunches, but more than half of workers in both groups obtained over 65% of their energy from carbohydrate. The average sodium intake from the lunches exceeded the daily intake goal (2,000 mg) in both groups. More than half of workers in both groups presented less than one-third of their respective recommended daily intake of riboflavin and calcium. With the exception of riboflavin, the nutrient intake from lunches accounted for more than 35% of the daily nutrient intake. CONCLUSIONS: The overall nutritional quality of institutional lunches was higher than that of commercial lunches. However, institutional lunches had room for improvement in terms of nutritional quality.

Lunch Eating Patterns and Dietary Habits of University Students according to Major Lunch Place

This study was performed to determine lunch eating patterns and compare dietary habits among university students according to major lunch place. The subjects were 800 students from a university in Gyeonggi-do, and information was obtained by self-administered questionnaire. Data were compared among groups according to major lunch place (school cafeteria n=236, off-campus private restaurant n=73, on-campus private food shop n=134, delivery food n=119, convenient store n=238). Compared to male students, more female students ate at convenient stores (37.8% vs. 17.5%, respectively) while less ate at school cafeterias as the major lunch place. The on-campus private food shop group (19.1 year) were younger than the other groups (20.4∼20.8 year). Dietary habits were significantly better in the school cafeteria group (65.55 out of 100) than in the other groups (60.33∼62.66) (P<0.01). However, the satisfaction with school cafeterias was significantly lower than those with the other lunch places (P<0.01), and the most frequently answered reason for dissatisfaction was "not taste good" (51.0%). Despite having the lowest satisfaction among the five lunch places, eating at school cafeterias may be associated with better dietary habits in university students. Therefore, this study is able to provide basis for encouraging school cafeteria utilization for university students and for strategy development to improve university students' lunches.

Effects of Nutrition Education Providing School Lunch by Personalized Daily Needed Food Exchange Units for Adolescent Athletes in Jeonbuk Province / 대한지역사회영양학회지

OBJECTIVES: The purpose of this study was to investigate effects of nutrition education providing school lunch by personalized daily needed food exchange units using Food Exchange System for adolescent athletes. METHODS: The subjects were 60 sports high school students (educated group, 30 vs. non-educated group 30). Nutrition education was provided for 4 weeks (40 min/lesson/week). In addition, personalized school lunch was served for 4 weeks, nutrition education period. The personalized lunch were provided Food Exchange Units according to personalized daily needed energy. The lessons were '5 Major nutrients, functions and foods', 'My daily needed energy and food exchange units by Food Exchange System', 'My meal plan by food exchange units according to my daily needed energy' and 'Smart choice of healthy snacks and eating outs'. After nutrition education, we examined the differences in anthropometric characteristics, nutrition knowledge, dietary attitude and dietary intake between the educated and the non-educated group. RESULTS: We observed improvements in lean body mass in the educated group. With regard to nutrition knowledge, there were improvements in 'Functions of vitamins', 'Functions of minerals', 'Foods of fat', 'Foods of vitamin', and 'Foods of mineral' in the educated group. In relation to dietary attitude, there were improvements in 'Taking a meal with family and friend', 'Taking a meal at ease', 'Taking a meal with kimchi and vegetables', 'Taking a meal with three kinds of side dishes', 'Priority of choosing snacks' and 'Type of snacks' in the educated group. With regard to dietary intakes according to Dietary Reference Intakes for Koreans, there were improvements in intakes levels of fiber, vitamin A, vitamin C, folate, calcium, iron and zinc. The index of nutrition quality, as indicated by nutrition adequacy ratio also improved in the educated group. CONCLUSIONS: These results showed that a nutrition education program providing education lessons and personalized school lunch by food exchange units according to daily needed energy showed positive changes in nutrition knowledge, dietary attitude and dietary intake of adolescent athletes. Nutrition education program providing personalized school lunch by Food Exchange Units may improve dietary behaviors and dietary intakes of adolescents.

Phenolic compounds content and antioxidant capacity of meals provided to elementary public schools in Chile during 2011 / Contenido de compuestos fenólicos y capacidad antioxidante de alimentos entregados a las escuelas públicas de enseñanza básica en Chile durante 2011

The Chilean National School Feeding Program (NSFP) delivers breakfast and lunch meals that supply 250 and 450 kcal, respectively, along the country. In the last decades, a significant increase of obesity has been observed in primary education children, and it involves risk factors of non-communicable diseases. The dietary intake of foods containing phenolic compounds (PC) exerts favorable effects on health by reducing risk factors of prevalent diseases. The aim of the study was to measure the PC content and antioxidant capacity (AC) [ORAC and DPPH] of meals provided by the NSFP in Quillota, Chile, in 2011. The PC supply of the whole meals served ranged from 362.7 to 1,730 mg GAE. The best breakfast foods include whole grain cookie (2.59±0.3 mg GAE/g), bread with avocado, quince jelly or strawberry jam (1.61±0.13 to 2.05±0.3 mg GAE/g); while the best lunch salads include beetroot, lettuce, and cabbage/fish (1.66±0.3 to 2.35±0.1 mg GAE/g), and main courses contain legumes, or mixed vegetables. The lowest PC contents were observed in pasta and rice preparations (p<0.05). Among desserts, the best source of PC is fruit (1.81±0.04 to 6.91±0.31 mg GAE/g). The correlation between PC and AC varied according to the type of meal. PC content and AC are additional criteria for selecting the best quality meals, in addition to the nutrients and energy content. The results support the recommendation to increase the supply of fruits and vegetable/legumes preparations and fruits instead of starchy foods to scholars.

El Programa de Alimentación Escolar (PAE) para enseñanza básica en Chile distribuye, en todo el país, desayunos y almuerzos que aportan 250 y 450 kcal, respectivamente. En las últimas décadas ha aumentado significativamente la obesidad en escolares, lo que induce factores de riesgo de enfermedades no transmisibles. La ingestión de alimentos que contienen polifenoles (PF) ejerce efectos beneficiosos al reducir factores de riesgo de enfermedades prevalentes. El objetivo del estudio fue determinar el contenido de PF y la capacidad antioxidante (CA) [ORAC y DPPH] de los alimentos entregados por el PAE en Quillota, Chile, en 2011. El aporte de PF en las raciones servidas fluctuó entre 362.7 y 1,730 mg EAG. El mejor desayuno contenía galletón con granos integrales (2.59±0.3 mg EAG/g), pan con palta, dulce de membrillo o de fresas (1.61±0.13 a 2.05±0.3 mg EAG /g) y el mejor almuerzo, ensaladas de remolacha, lechuga, o col/pescado (1.66±0.3 a 2.35±0.1 mg EAG /g), y un plato principal con leguminosas o vegetales mixtos. Los contenidos menores de PF se observaron en platos con pastas y arroz (p<0.05). Entre los postres, la mejor fuente de PF es la fruta (1.81±0.04 a 6.91±0.31 mg EAG/g). La correlación entre PF y CA fluctuó según el tipo de preparación. El contenido de PF y la CA son criterios de calidad adicionales al aporte de energía y nutrientes de las preparaciones. Los resultados apoyan la recomendación de aumentar el aporte a los escolares de frutas y vegetales/leguminosas en lugar de alimentos con alto contenido de almidones.

A survey on the initial response of a local government to a norovirus outbreak / 日本プライマリ・ケア連合学会誌

<b>Objective</b> : To interview related government officials in charge of public health and listen to their opinions about the initial response of the local government to a norovirus outbreak and the challenges faced by them with respect to an increase in the number of affected individuals and school children and students absent from school likely due to bread infected with norovirus served during school lunch.<br><b>Methods</b> : An interview survey was conducted on February 24, 2014 at the Hamamatsu City Hall involving officials at the Health and General Affairs Division and the Environmental Hygiene Division.<br><b>Results</b> : In order to reduce the future incidence of norovirus infections caused by school lunches, it is important to strengthen the food safety inspection by appointing persons in charge of the school lunch program and by other means. Without sufficient data in hand, it is difficult to respond properly to the mass media<br><b>Conclusion</b> : School lunch suppliers must strictly adhere to conducting personal health management. Refresher workshops should be provided specifically for personnel with cooking duties to improve the level of their hygiene management. Challenges and troubles experienced thus far with respect to dealing with the media were not negligible, but in cooperation with the public relations department, efforts have been made to facilitate timely information disclosure, keeping the number of claims received to the minimum.