Research and innovation as a catalyst for food system transformation.

BACKGROUND: Food systems are associated with severe and persistent problems worldwide. Governance approaches aiming to foster sustainable transformation of food systems face several challenges due to the complex nature of food systems. SCOPE AND APPROACH: In this commentary we argue that addressing these governance challenges requires the development and adoption of novel research and innovation (R&I) approaches that will provide evidence to inform food system transformation and will serve as catalysts for change. We first elaborate on the complexity of food systems (transformation) and stress the need to move beyond traditional linear R&I approaches to be able to respond to persistent problems that affect food systems. Though integrated transdisciplinary approaches are promising, current R&I systems do not sufficiently support such endeavors. As such, we argue, we need strategies that trigger a double transformation - of food systems and of their R&I systems. KEY FINDINGS AND CONCLUSIONS: Seizing the opportunities to transform R&I systems has implications for how research is done - pointing to the need for competence development among researchers, policy makers and society in general - and requires specific governance interventions that stimulate a systemic approach. Such interventions should foster transdisciplinary and transformative research agendas that stimulate portfolios of projects that will reinforce one another, and stimulate innovative experiments to shape conditions for systemic change. In short, a thorough rethinking of the role of R&I as well as how it is funded is a crucial step towards the development of the integrative policies that are necessary to engender systemic change - in the food system and beyond.

Identifying sources of measurement error in assessing dietary intakes - Results of a multi-country ring-trial.

BACKGROUND AND AIMS: Epidemiological investigations include dietary intakes as primary exposures or potential confounders. To reduce bias, data collection protocols include the administration of questionnaires together with measurements of biomarkers. Some error, however, remains and needs to be considered in the analysis and interpretation of results. The European Food Safety Authority supported a ring-trial to compare the precision and reproducibility of dietary assessment methods applied in Europe. METHODS AND RESULTS: Software applications used to collect 24-hour recalls and food records in six countries (Estonia, Italy, Latvia, Portugal, Spain, and Sweden) were assessed. The intake of 256 foods was identically reported to each method. Experienced interviewers participated and were instructed to repeat national protocols closely. The error in recording quantities, compared with reference values, was variable but in about 60% of recorded quantities was in the range of ±20%. Errors were however unsystematic and independent of the food type or quantification method used - although food pictures performed better. The reproducibility of some tools was limited. The methods generally captured additional ingredients (usually flavoring agents), but not sweetening agents or fortification and failed to record packaging information in about 60% of the cases. CONCLUSION: In a design that eliminated respondent bias, this study indicates that softwares, supporting databases and interviewers generally introduce random error in dietary assessments. The inclusion of large sample sizes and food pictures to quantify portions, together with enhanced attention on interviewers' training, standardisation of procedures and regular tool upgrades are essential in assuring a study's quality and comparability.

Mapping low intake of micronutrients across Europe.

Achieving an understanding of the extent of micronutrient adequacy across Europe is a major challenge. The main objective of the present study was to collect and evaluate the prevalence of low micronutrient intakes of different European countries by comparing recent nationally representative dietary survey data from Belgium, Denmark, France, Germany, The Netherlands, Poland, Spain and the United Kingdom. Dietary intake information was evaluated for intakes of Ca, Cu, I, Fe, Mg, K, Se, Zn and the vitamins A, B1, B2, B6, B12, C, D, E and folate. The mean and 5th percentile of the intake distributions were estimated for these countries, for a number of defined sex and age groups. The percentages of those with intakes below the lower reference nutrient intake and the estimated average requirement were calculated. Reference intakes were derived from the UK and Nordic Nutrition Recommendations. The impact of dietary supplement intake as well as inclusion of apparently low energy reporters on the estimates was evaluated. Except for vitamin D, the present study suggests that the current intakes of vitamins from foods lead to low risk of low intakes in all age and sex groups. For current minerals, the study suggests that the risk of low intakes is likely to appear more often in specific age groups. In spite of the limitations of the data, the present study provides valuable new information about micronutrient intakes across Europe and the likelihood of inadequacy country by country.

Capacity development in food composition database management and nutritional research and education in Central and Eastern European, Middle Eastern and North African countries.

BACKGROUND/OBJECTIVES: Capacity development (CD) in food and nutrition is much more than formal training and includes human resource development, and organisational, institutional and legal framework development with the aim of enhancing nutrition-relevant knowledge and skills to support infrastructural development. The goal of the European Food Information Resource (EuroFIR) Network of Excellence has been to develop and integrate food composition data throughout Europe. EuroFIR joined forces in CD with the United Nations (UN) University and UN System Standing Committee on Nutrition, the Network for Capacity Development in Nutrition in Central and Eastern Europe, the Central and Eastern European Countries Food Data Systems network and with the Middle East and North African Capacity Building Initiative. The aim of this paper is to discuss an inventory of the status of food composition databases (FCDBs) and the training needs of compilers in non-EuroFIR countries in Central and Eastern Europe (CEE) and in the Middle East and North Africa (MENA), and to present the CD achieved through EuroFIR and other network collaborations. SUBJECTS/METHODS: Two online questionnaires were created addressing the FCDB status and specific training needs in countries of the targeted regions. Data were collected during 2006-2008 and then analysed. Subsequently, CD activities were organised. RESULTS: Contacts were established in 19 CEE and 7 MENA countries, of which several had national food composition tables, but no electronic versions. Education, training, workshops, networking and the sharing of experiences were uniformly requested. Subsequently, CD activities in EuroFIR were organised focussing on food composition courses, exchange visits, workshops and individual training for PhD students, junior scientists and other staff categories, as well as conferences linked to food composition research and food information. To facilitate CD activities, EuroFIR has signed a Memorandum of Understanding with the Czech Republic, Hungary, Slovenia, Croatia and Estonia. CONCLUSIONS: EuroFIR has created training activities that complement national activities. Collaboration with other networks has provided an overview of FCDB status and training needs, providing directions for CD activities in those countries. This provides a platform for new funding and further development and networking for CD, which would be conducive to European Commission objectives and public health strategies for CD.

EURRECA: development of tools to improve the alignment of micronutrient recommendations.

Approaches through which reference values for micronutrients are derived, as well as the reference values themselves, vary considerably across countries. Harmonisation is needed to improve nutrition policy and public health strategies. The EURRECA (EURopean micronutrient RECommendations Aligned, http://www.eurreca.org) Network of Excellence is developing generic tools for systematically establishing and updating micronutrient reference values or recommendations. Different types of instruments (including best practice guidelines, interlinked web pages, online databases and decision trees) have been identified. The first set of instruments is for training purposes and includes mainly interactive digital learning materials. The second set of instruments comprises collection and interlinkage of diverse information sources that have widely varying contents and purposes. In general, these sources are collections of existing information. The purpose of the majority of these information sources is to provide guidance on best practice for use in a wider scientific community or for users and stakeholders of reference values. The third set of instruments includes decision trees and frameworks. The purpose of these tools is to guide non-scientists in decision making based on scientific evidence. This platform of instruments will, in particular in Central and Eastern European countries, contribute to future capacity-building development in nutrition. The use of these tools by the scientific community, the European Food Safety Authority, bodies responsible for setting national nutrient requirements and others should ultimately help to align nutrient-based recommendations across Europe. Therefore, EURRECA can contribute towards nutrition policy development and public health strategies.

European micronutrient recommendations aligned: a general framework developed by EURRECA.

BACKGROUND: In Europe, micronutrient recommendations have been established by (inter)national committees of experts and are used by public health-policy decision makers to monitor and assess the adequacy of the diets of population groups. Current micronutrient recommendations are, however, heterogeneous, whereas the scientific basis for this is not obvious. Alignment of setting micronutrient recommendations is necessary to improve the transparency of the process, the objectivity and reliability of recommendations that are derived by diverse regional and (inter)national bodies. OBJECTIVE: This call for alignment of micronutrient recommendations is a direct result of the current sociopolitical climate in Europe and uncovers the need for an institutional architecture. There is a need for evidence-based policy making, transparent decision making, stakeholder involvement and alignment of policies across Europe. RESULTS: In this paper, we propose a General Framework that describes the process leading from assessing nutritional requirements to policy applications, based on evidence from science, stakeholder interests and the sociopolitical context. The framework envisions the derivation of nutrient recommendations as scientific methodology, embedded in a policy-making process that also includes consumer issues, and acknowledges the influences of the wider sociopolitical context by distinguishing the principal components of the framework: (a) defining the nutrient requirements for health, (b) setting nutrient recommendations, (c) policy options and (d) policy applications. CONCLUSION: The General Framework can serve as a basis for a systematic and transparent approach to the development and review of micronutrient requirements in Europe, as well as the decision making of scientific advisory bodies, policy makers and stakeholders involved in this process of assessing, developing and translating these recommendations into public health nutrition policy.

Prioritizing micronutrients for the purpose of reviewing their requirements: a protocol developed by EURRECA.

BACKGROUND: The EURRECA (EURopean micronutrient RECommendations Aligned) Network of Excellence (http://www.eurreca.org) is working towards the development of aligned recommendations. A protocol was required to assign resources to those micronutrients for which recommendations are most in need of alignment. METHODS: Three important 'a priori' criteria were the basis for ranking micronutrients: (A) the amount of new scientific evidence, particularly from randomized controlled trials; (B) the public health relevance of micronutrients; (C) variations in current micronutrient recommendations. A total of 28 micronutrients were included in the protocol, which was initially undertaken centrally by one person for each of the different population groups defined in EURRECA: infants, children and adolescents, adults, elderly, pregnant and lactating women, and low income and immigrant populations. The results were then reviewed and refined by EURRECA's population group experts. The rankings of the different population groups were combined to give an overall average ranking of micronutrients. RESULTS: The 10 highest ranked micronutrients were vitamin D, iron, folate, vitamin B12, zinc, calcium, vitamin C, selenium, iodine and copper. CONCLUSIONS: Micronutrient recommendations should be regularly updated to reflect new scientific nutrition and public health evidence. The strategy of priority setting described in this paper will be a helpful procedure for policy makers and scientific advisory bodies.

EURRECA nutritional planning and dietary assessment software tool: NutPlan.

BACKGROUND/OBJECTIVES: 'NutPlan' is developed within the EURRECA Network of Excellence (EURopean micronutrient RECommendations Aligned (http://www.eurreca.org). It is a user-friendly software programme with multiple functions: individual and group nutrition planning, recipe calculation, creating food labels, diet planning and nutrient intake assessment. This paper describes the newly developed software and its features. SUBJECTS/METHODS: 'NutPlan' contains the following databases: foods, dish recipes, meals, menus, average menus and glossary. These databases enable diet planning and diet analysis by comparing foods, dishes, meals or menus with currently available nutritional recommendations accessible by a link to EURRECA tool Nutri-RecQuest to meet individual/group nutritional needs.The software is upgraded by inserting new items (for example, foods, dishes, meals) and for a connection to other software programmes, thus allowing more advanced calculations to be completed. CONCLUSION: 'NutPlan' might be the software of choice for individual and group diet planning. It is aimed particularly at Eastern European and West Balkan countries, which currently lack dietary software. It is envisaged for use by small and medium enterprises in the food industry, as well as by health professionals, researchers and policy makers, and can be recommended for educational purposes. Given its characteristics of being upgraded to include new country-specific food data/database, it can be recognized as an important tool in nutritional capacity development in the Central Eastern European and other regions.

Nutri-RecQuest: a web-based search engine on current micronutrient recommendations.

BACKGROUND: The EURRECA (EURopean micronutrient RECommendations Aligned) Network of Excellence collated current micronutrient recommendations. A user-friendly tool, Nutri-RecQuest, was developed to allow access to the collated data and to create a database source for use in other nutritional software tools. METHODS: Recommendations, that is, intakes of micronutrients sufficient to meet the requirements of the majority of healthy individuals of that population, from 37 European countries/organizations and eight key non-European countries/regions comprising 29 micronutrients were entered into a database. General information on the source of the recommendations, as well scientific background information, was added. RESULTS: A user-friendly web-based interface was developed to provide efficient search, comparison, display, print and export functions. CONCLUSION: Easy access to existing recommendations through the web-based tool may be valuable for bodies responsible for setting recommendations, as well as for users of recommendations including scientists, policy makers, health professionals and industry. Adding related dietary reference values such as average nutrient requirements and upper limits may extend the utility of the tool.