Is the List of Ingredients a Source of Nutrition and Health Information in Food Labeling? A Scoping Review.

Nutrition labelling is any description intended to inform consumers about the nutritional properties of a food product and has focused primarily on nutrients. However, literature has shown that the nutritional quality of packaged foods is not limited to the amount of nutrients, considering that individuals do not consume only nutrients separately, but rather the entire food matrix. Therefore, to analyze the nutritional quality of a packaged food, it is necessary to read its ingredients. This scoping review aims to discuss (1) the list of ingredients as a source of health and nutrition information in food labelling; (2) opportunities to improve the nutrition labeling policies around the world. The study was carried out through a systematic search on Codex Alimentarius meeting reports. Results show that the list of ingredients is used as a source of nutritional and health information on food labelling; however, this label item is not considered in the regulatory field as a nutrition labelling requirement. It is suggested that nutrition labelling be discussed as a tool for food choices in the context of public health from a broader, consistent, convergent perspective, considering the list of ingredients as an item of nutrition labelling requirement to be included in public policies around the world.

Qualitative menu labelling in university restaurants and its influence on food choices: A systematic review and synthesis without meta-analysis.

Qualitative menu labelling can be defined as descriptive or non-numerical interpretive labels (e.g. traffic light labelling, healthy food symbols, messages or ingredient lists). Qualitative information seems to have a positive influence on consumers' food choices, particularly in institutional food service establishments, such as in universities. The aim of this systematic review was to assess the influence of different formats of qualitative menu labelling on food choices in university restaurants. This systematic review was guided by the Preferred Reported Items for Systematic Reviews and Meta-Analyses (PRISMA) and Synthesis Without Meta-Analysis (SWiM) and conducted vote counting of studies based on the direction of effect. Studies were retrieved from Cochrane Library, Scopus, MEDLINE, LILACS, SciELO and Web of Science databases and reference lists of selected articles. Experimental and quasi-experimental studies were included. Two independent researchers searched and extracted the data and assessed the methodological quality using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies. From the initial search (460 records), four papers were selected, plus one paper identified in a previous study and a further six from an update search, totalling 11 included studies, reporting 14 different interventions (n = 499 174). Types of interventions included the use of symbols and the inclusion of traffic light labelling. Outcomes of interest were food choice, expressed as mean, median or percent healthy food choices or purchases. Qualitative menu labels increased healthy food choices and/or purchase behaviour, with 10 of 12 interventions favouring the intervention (83%; 95%CI 55-95%; p = 0.0386). Most of the studies favouring the intervention used healthy food symbols for healthier foods or food components, alone or in association with another intervention and were of moderate and weak quality. These findings may serve as a basis for the implementation of nutrition information policies in university restaurants.

Influence of sugar label formats on consumer understanding and amount of sugar in food choices: a systematic review and meta-analyses.

CONTEXT: Reducing population intakes of sugar has become a focus of many national and international public health policies. Packaged foods and beverages are key contributors to sugar intakes, and food labels can be an effective tool to reduce sugar consumption. OBJECTIVE: The aim of this systematic review was to examine the influence of sugar label formats on 2 outcomes: consumers' understanding of sugar information, and the amount of sugar in consumers' food choices. DATA SOURCES: Scopus, Web of Science, PubMed, CAB Abstracts, SciELO, and the Cochrane Library databases were searched up until February 4, 2020. STUDY SELECTION: Randomized experiments or quasi-experiments were included if they investigated the influence of sugar label formats on consumers' understanding of sugar information or on the amount of sugar in consumers' food choices. DATA EXTRACTION: Data were extracted independently by 2 authors. Mean differences (MDs), standardized mean differences (SMDs), and odds ratios (ORs) plus 95%CIs were used to describe between-group differences for intervention label formats using random-effects models. RESULTS: Twenty-three studies, which examined 39 comparisons, were included. Label formats using "high in sugar" interpretative texts (traffic light labels [MD 41.6; 95%CI 37.9-45.4] and warning signs [OR 1.33; 95%CI 1.0-1.78]) were most effective in increasing consumers' understanding of the sugar content in packaged foods. Health warning messages (SMD -0.32; 95%CI -0.43 to -0.22), graphical depictions of sugar content in teaspoons (SMD -0.32; 95%CI -0.48 to -0.17), and warning signs (SMD -0.24; 95%CI -0.35 to -0.13) were most effective for influencing consumers to choose products with lower sugar content. CONCLUSIONS: Formats that provide an interpretation of sugar information, particularly those indicating if a product is high in sugar, were more helpful than only numerical information for improving consumer understanding and promoting food choices with less sugar. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number CRD42018081222.

Serving Size and Nutrition Labelling: Implications for Nutrition Information and Nutrition Claims on Packaged Foods.

The presentation of nutrition information on a serving size basis is a strategy that has been adopted by several countries to promote healthy eating. Variation in serving size, however, can alter the nutritional values reported on food labels and compromise the food choices made by the population. This narrative review aimed to discuss (1) current nutrition labelling legislation regarding serving size and (2) the implications of declared serving size for nutrition information available on packaged foods. Most countries with mandatory food labelling require that serving size be presented on food labels, but variation in this information is generally allowed. Studies have reported a lack of standardisation among serving sizes of similar products which may compromise the usability of nutrition information. Moreover, studies indicate that food companies may be varying serving sizes as a marketing strategy to stimulate sales by reporting lower values of certain nutrients or lower energy values on nutrition information labels. There is a need to define the best format for presenting serving size on food labels in order to provide clear and easily comprehensible nutrition information to the consumer.

Tratamento dietético da intolerância à lactose infantil: teor de lactose em alimentos / Dietary treatment of the intolerance to the child lactose: lactose text in foods

A lactose está presente em diversos tipos de leite e todos os mamíferos, inclusive o ser humano, quando nascem em condições normais, estão aptos a digerir este açúcar. No entanto, aproximadamente 75 por cento da população mundial é intolerante à lactose. Para a lactose ser assimilada pelo organismo é necessário que seja hidrolisada no intestino delgado, pela ação da enzima lactase, também chamada de beta galactosidase, em: galactose e glicose. Na ausência da lactose na mucosa intestinal, a lactose não pode ser absorvida e utilizada. No cólon os microorganismos a fermentam, resultado em ácidos e gases, aparecendo sintomas clínicos como: diarréia, flatulência, dores de barriga e inchaço no abdômen. O tratamento da intolerância à lactose consiste basicamente na retirada ou diminuição desse açúcar da dieta, o que leva ao desaparecimento progressivo dos sintomas. Uma das grandes preocupações com a redução da lactose da alimentação é a garantia do fornecimento de quantidade apropriada de proteínas, cálcio, riboflavina e vitamina D, cuja maior fonte é o leite e seus derivados. É de fundamental importância um planejamento dietético apropriado em crianças, que assegura um crescimento satisfatório. Com o intuito de propiciar um melhor tratamento nutricional à pacientes intolerantes à lactose este trabalho tem por objetivo apresentar o teor de lactose em alimentos que são geralmente consumidos por crianças obtido através de pesquisa junto à algumas indústrias alimentícias, bem como apresentar um cardápio balanceado e equilibrado para crianças na faixa etária de 4 a 6 anos, que contribua para a prevenção de possíveis carências nutricionais.

Lactose is a sugar present in several types of milk and in all mammals, including human beings. Humans born under normal conditions, are capable of digesting this sugar. However, approximately 75% of the world population are intolerant to lactose. For its assimilation by the organism, lactose I1lUStbe broken into galactose and glucose, in a hydrolysis reaction, catalyzed by the lactase (also called beta galactosidase) enzyme. ln the absence of lactase in the intestinal mucous membrane, lactose cannot be absorbed and used. In the colon, it is fermented by the microorganisms, forming acids and gas, responsible for gastrointestinal symptoms such as: diarrhea, flatulence, cramps and bloating. The treatment of lactose intolerance consists basically of the withdrawal or decrease of lactose content of the diet, what leads to the progressive disappearance of the symptoms. However, one of the major concerns with the reduced lactose diet is the supply of appropriate amount of protein, calcium, riboflavine and vitamin O, to hose main source is milk and its subproducts. In this context, appropriate dietary planning is of fundamental importance in children, where satisfactory growth must be assured. So being, with the intention of propitiating a better nutritional treatment to the lactose intolerant patient, this work's objective was to research the lactose amounts present in foods usually consumed by children (data obtained from industry sources as well as to propose balanced food plans elaborated for children in the age group from 4 to 6 years, as a contribution to the prevention of possible nutritional deficiencies.

Tratamento dietético da intolerância à lactose infantil: teor de lactose em alimentos / Dietary treatment of the intolerance to the child lactose: lactose text in foods

A lactose está presente em diversos tipos de leite e todos os mamíferos, inclusive o ser humano, quando nascem em condições normais, estão aptos a digerir este açúcar. No entanto, aproximadamente 75 por cento da população mundial é intolerante à lactose. Para a lactose ser assimilada pelo organismo é necessário que seja hidrolisada no intestino delgado, pela ação da enzima lactase, também chamada de beta galactosidase, em: galactose e glicose. Na ausência da lactose na mucosa intestinal, a lactose não pode ser absorvida e utilizada. No cólon os microorganismos a fermentam, resultado em ácidos e gases, aparecendo sintomas clínicos como: diarréia, flatulência, dores de barriga e inchaço no abdômen. O tratamento da intolerância à lactose consiste basicamente na retirada ou diminuição desse açúcar da dieta, o que leva ao desaparecimento progressivo dos sintomas. Uma das grandes preocupações com a redução da lactose da alimentação é a garantia do fornecimento de quantidade apropriada de proteínas, cálcio, riboflavina e vitamina D, cuja maior fonte é o leite e seus derivados. É de fundamental importância um planejamento dietético apropriado em crianças, que assegura um crescimento satisfatório. Com o intuito de propiciar um melhor tratamento nutricional à pacientes intolerantes à lactose este trabalho tem por objetivo apresentar o teor de lactose em alimentos que são geralmente consumidos por crianças obtido através de pesquisa junto à algumas indústrias alimentícias, bem como apresentar um cardápio balanceado e equilibrado para crianças na faixa etária de 4 a 6 anos, que contribua para a prevenção de possíveis carências nutricionais.