Development of the Food Boost Challenge: A Participatory Action Research Approach to Enhance Vegetable and Fruit Consumption among Adolescents.

Prevention of non-communicable diseases through, among other factors, increasing vegetables and fruit (V&F) intake is a cost-effective strategy for risk reduction but requires behavioral change. Such changes in adolescents benefit from their active involvement. The Food Boost Challenge (FBC) was developed using a participatory action research approach to enhance healthy eating behaviors, namely V&F products among adolescents. The FBC is an innovation process, involving adolescents, (peer) researchers, and food system partners, like non-governmental and commercial organizations. In 2021-2022, 34 partners provided both cash and in-kind contributions to join the FBC community. Phase 1 involved 200 students identifying barriers and drivers for consumption of F&V products among 1000 pre-vocational adolescents, aged 12-20 years. In phase 2, student teams submitted innovative ideas, resulting in 25 concepts fitting into ≥1 of 4 routes: (I) innovative technology for a healthy diet, (II) new food products/concepts for adolescents, (III) hotspots improving the F&V product experience, and (IV) new routes to market. In phase 3, consortia of adolescents, students, and partners were formed to develop 10 selected concepts into prototypes, and phase 4 offered teams a national platform. Results show that the FBC resonates with all stakeholders, generating valuable insights to increase F&V intake. Prototypes in all four routes have been developed. Additionally, other regions in the Netherlands have adopted the FBC approach. Overall, the FBC is an approach that transforms ideas into actionable measures and shows potential to be adapted to promote various healthy eating behaviors among school students.

A micronutrient-fortified young-child formula improves the iron and vitamin D status of healthy young European children: a randomized, double-blind controlled trial.

BACKGROUND: Iron deficiency (ID) and vitamin D deficiency (VDD) are common among young European children because of low dietary intakes and low compliance to vitamin D supplementation policies. Milk is a common drink for young European children. Studies evaluating the effect of milk fortification on iron and vitamin D status in these children are scarce. OBJECTIVE: We aimed to investigate the effect of a micronutrient-fortified young-child formula (YCF) on the iron and vitamin D status of young European children. DESIGN: In this randomized, double-blind controlled trial, healthy German, Dutch, and English children aged 1-3 y were allocated to receive either YCF (1.2 mg Fe/100 mL; 1.7 µg vitamin D/100 mL) or nonfortified cow milk (CM) (0.02 mg Fe/100 mL; no vitamin D) for 20 wk. Blood samples were taken before and after the intervention. The primary and secondary outcomes were change from baseline in serum ferritin (SF) and 25-hydroxyvitamin D [25(OH)D], respectively. ID was defined as SF <12 µg/L in the absence of infection (high-sensitivity C-reactive protein <10 mg/L) and VDD as 25(OH)D <50 nmol/L. Statistical adjustments were made in intention-to-treat analyses for sex, country, age, baseline micronutrient status, and micronutrient intake from food and supplements (and sun exposure in the case of vitamin D outcomes). RESULTS: The study sample consisted of 318 predominantly Caucasian (∼95%) children. The difference in the SF and 25(OH)D change between the treatment groups was 6.6 µg/L (95% CI: 1.4, 11.7 µg/L; P = 0.013) and 16.4 nmol/L (95% CI: 9.5, 21.4 nmol/L; P < 0.001), respectively. The probability of ID (OR 0.42; 95% CI:0.18, 0.95; P = 0.036) and VDD (OR 0.22; 95% CI: 0.01, 0.51; P < 0.001) after the intervention was lower in the YCF group than in the CM group. CONCLUSION: Micronutrient-fortified YCF use for 20 wk preserves iron status and improves vitamin D status in healthy young children in Western Europe. This trial was registered at www.trialregister.nl as NTR3609.

Iron and Vitamin D Deficiency in Healthy Young Children in Western Europe Despite Current Nutritional Recommendations.

BACKGROUND AND AIM: Iron deficiency (ID) and vitamin D deficiency (VDD) are the 2 most common micronutrient deficiencies in young children worldwide and may lead to impaired neurodevelopment and rickets, respectively. Risk factors for ID and VDD differ between populations. The objective of this study was to determine the prevalence of and risk factors for ID and VDD in 12- to 36-month-old children in Western Europe. METHODS: This study took place in Germany, the Netherlands, and the United Kingdom from 2012 to 2014. A venous blood sample was taken to establish iron and vitamin D status. ID was defined as serum ferritin <12 µg/L in the absence of infection (high sensitivity C-reactive protein <10 mg/L). VDD was defined as serum 25-hydroxyvitamin D <50 nmol/L (20 ng/mL). Furthermore, parents were asked to fill out a questionnaire regarding their child's demographic- and socioeconomic characteristics, food intake, sun exposure, and medical history. RESULTS: In 325 children (white race 95%, boys 56%, mean age 20.7 months) the overall prevalence of ID and VDD was 11.8% and 22.8%, respectively. The use of primarily cow's milk as major type of milk was associated with ID (odds ratio [OR] 3.20, 95% confidence interval [CI] 1.12-8.53) and VDD (OR 7.17, 95% CI 3.10-16.57). The use of vitamin D supplements (OR 0.20, 95% CI 0.07-0.56) was associated with a lower prevalence of VDD. CONCLUSION: Despite current nutritional recommendations, ID and VDD are common in healthy young white children. Health programs focusing on adequate iron and vitamin D intake at an early age should be implemented to prevent deficiencies.

Plasma carotenoid concentrations in relation to acute respiratory infections in elderly people.

A high plasma carotenoid concentration could improve the immune response and result in decreased risk of infectious diseases. However, data on the relationship of plasma carotenoid concentration with acute respiratory infections, which occur frequently in elderly people, are scarce. We investigated, therefore, the relationship of plasma concentrations of six major carotenoids (beta-carotene, alpha-carotene, beta-cryptoxanthin, lycopene, lutein and zeaxanthin) with the incidence and severity of acute respiratory infections. Baseline data from an intervention trial were used. Participants were 652 non-institutionalized elderly people (> or =60 years old) enrolled via two community-based sampling strategies in the Wageningen area of The Netherlands in 1998-99. Plasma carotenoid concentrations were divided into quartiles, the lowest being the reference. Frequency and severity of episodes during the previous 1 year, i.e. staying in bed, medical consultation and episode-related medication, were self-reported by means of a questionnaire. On average 1.6 episodes per person were recorded. The incidence rate ratio of acute respiratory infections at high beta-carotene status was 0.71 (95 % CI 0.54-0.92) as compared with the low beta-carotene concentration group. No association was observed between beta-carotene and illness severity. alpha-Carotene, beta-cryptoxanthin, lycopene, lutein and zeaxanthin were not related to incidence or severity of the infections. We conclude that elderly people with a high plasma beta-carotene concentration may have a lower occurrence of acute respiratory infections.