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Evidence demonstrates that food packaging attracts consumers to purchase and has the potential to nudge consumers towards healthy choices, including reducing portion size. However, food purchasing decisions are often automatic and packaging features may go unnoticed. Therefore, it is important to understand what consumers identify as most salient about packaging: what they notice and why, and which elements might nudge consumers towards healthy options and smaller portions of high-energy-density foods. This study explored consumer perception of food packaging, investigated specific features associated with portion control and elicited design ideas to improve packaging for healthy eating and downsizing. A qualitative approach was adopted applying a participant-driven photo-elicitation (PDPE) task with in-depth interviews. Participants were 25 adults living in the UK (aged 20-32 years; 17 females, 8 males

BACKGROUND: Smaller serving sizes of alcoholic drinks could reduce alcohol consumption across populations thereby lowering the risk of many diseases. The effect of modifying the available range of serving sizes of beer and cider in a real-world setting has yet to be studied. The current study assessed the impact on beer and cider sales of adding a serving size of draught beer and cider (2/3 pint) that was between the current smallest (1/2 pint) and largest (1 pint) standard serving sizes. METHODS: Twenty-two licensed premises in England consented to taking part in the study. The study used an ABA reversal design, set over three 4-weekly periods, with A representing the non-intervention periods, during which standard serving sizes were served and B the intervention period when a 2/3 pint serving size of draught beer and cider was added to the existing range, along with smaller 1/2 pint and larger 1 pint serving sizes. The primary outcome was the daily volume of beer and cider sold, extracted from sales data. RESULTS: Fourteen premises started the study, of which thirteen completed it. Twelve of those did so per protocol and were included in the primary analysis. After adjusting for pre-specified covariates, the intervention did not have a significant effect on the volume of beer and cider sold per day (3.14 ml; 95%CIs -2.29 to 8.58; p = 0.257). CONCLUSIONS: In licensed premises, there was no evidence that adding a smaller serving size for draught beer and cider (2/3 pint) when the smallest (1/2 pint) and largest (1 pint) sizes were still available, affected the volume of beer and cider sold. Studies are warranted to assess the impact of removing the largest serving size. TRIAL REGISTRATION: ISRCTN: https://doi.org/10.1186/ISRCTN33169631 (08/09/2021), OSF: https://osf.io/xkgdb/ (08/09/2021).

The first step in quantitative microbial risk assessment (QMRA) is to determine the distribution of pathogen contamination among servings of the food in question at some point in the farm-to-table chain. In the present study, the distribution of Salmonella contamination among servings of chicken liver for use in the QMRA was determined at meal preparation. Salmonella prevalence (P), most probable number (MPN, N), and serotype for different serving sizes were determined by use of a combination of five methods: (i) whole sample enrichment; (ii) quantitative PCR; (iii) culture isolation; (iv) serotyping; and (v) Monte Carlo simulation. Epidemiological data also were used to convert serotype data to virulence (V) values for use in the QMRA. A Monte Carlo simulation model based in Excel and simulated with @Risk predicted Salmonella P, N, serotype, and V as a function of a serving size of one (58 g) to eight (464 g) chicken livers. Salmonella P of chicken livers was 72.5% (58 of 80) per 58 g. Four Salmonella serotypes were isolated from chicken livers: (i) Infantis (P = 28%, V = 4.5); (ii) Enteritidis (P = 15%, V = 5); (iii) Typhimurium (P = 15%, V = 4.8); and (iv) Kentucky (P = 15%, V = 0.8). Salmonella N was 1.76 log MPN/58 g (median) with a range of 0 to 4.67 log MPN/58 g, and the median Salmonella N was not affected (P > 0.05) by serotype. The model predicted a nonlinear increase (P ≤ 0.05) of Salmonella P from 72.5%/58 g to 100%/464 g, a minimum N of 0 log MPN/58 g to 1.28 log MPN/464 g, and a median N from 1.76 log MPN/58 g to 3.22 log MPN/464 g. Regardless of serving size, predicted maximum N was 4.74 log MPN per serving, mean V was 3.9 per serving, and total N was 6.65 log MPN per lot (10,000 chicken livers). The data acquired and modeled in this study address an important data gap in the QMRA for Salmonella and whole chicken liver. HIGHLIGHTS

Sarcopenia is a core contributor to several health consequences, including falls, fractures, physical limitations and disability. The pathophysiological processes of sarcopenia may be counteracted with the proper diet, delaying sarcopenia onset. Dietary pattern analysis is a whole diet approach used to investigate the relationship between diet and sarcopenia. Here, we aimed to investigate this relationship in an elderly Chinese population. A cross-sectional study with 2423 participants aged more than 60 years was performed. Sarcopenia was defined based on the guidelines of the Asian Working Group for Sarcopenia, composed of low muscle mass plus low grip strength and/or low gait speed. Dietary data were collected using a FFQ that included questions on 100 food items along with their specified serving sizes. Three dietary patterns were derived by factor analysis: sweet pattern, vegetable pattern and animal food pattern. The prevalence of sarcopenia was 16·1 %. The higher vegetable pattern score and animal food pattern score were related to lower prevalence of sarcopenia (Ptrend = 0·006 and < 0·001, respectively); the multivariate-adjusted OR of the prevalence of sarcopenia in the highest v. lowest quartiles were 0·54 (95 % CI 0·34, 0·86) and 0·50 (95 % CI 0·33, 0·74), separately. The sweet pattern score was not significantly related to the prevalence of sarcopenia. The present study showed that vegetable pattern and animal food pattern were related to a lower prevalence of sarcopenia in Chinese older adults. Further studies are required to clarify these findings.

We evaluated the accuracy of the estimated serving size using digital photographs in a newly developed food atlas. From 209 food items in the food atlas, we selected 14 items with various appearances for evaluation. At the study site, fifty-four participants aged 18–33 years served fourteen foods in the amount they usually ate. After they left, each food item was weighed by a researcher. The following day, the participants estimated the quantity of each food they served based on food photographs using a web-based questionnaire. We compared the weights of the foods the participants served (true serving sizes) and those determined based on the photographs (estimated serving sizes). For ten of the fourteen food items, significant differences were observed between the estimated and true serving sizes, ranging from a 29⋅8 % underestimation (curry sauce) to a 34⋅0 % overestimation (margarine). On average, the relative difference was 8⋅8 %. Overall, 51⋅6 % of the participants were within ±25 % of the true serving size, 81⋅9 % were within ±50 % and 93⋅4 % were within ±75 %. Bland–Altman plots showed wide limits of agreement and increased variances with larger serving sizes for most food items. Overall, no association was found between estimation errors and participant characteristics. The food atlas has shown potential for assessment of portion size estimation. Further development, refinement and testing are needed to improve the usefulness of the digital food photographic atlas as a portion size estimation aid.

This review summarises the evidence on the impact of serving and container size on how much people drink, interventions that have the potential to reduce alcohol consumption across populations, thereby improving health. A rapid search identified 10 published reports of 15 studies and 1 review. Four studies focused on serving size, eight studies and the review on glass size, two studies on bottle size and one on both glass and bottle size. Twelve studies and the review focused on wine, one study on beer and two on both. All were conducted in England, by just two research groups. Removing the largest serving size of wine decreased wine sales by 7.6% (95% CI −12.3%, −2.9%) in a study in 21 licenced premises, reflecting findings from two prior studies in semi-naturalistic settings. Adding a serving size for beer that was a size smaller than the largest was assessed in one study in 13 licenced premises, with no evident effect. Reducing the size of wine glasses in restaurants decreased wine sales by 7.3% (95% CI −13.5%, −1.5%) in a mega-analysis of eight datasets from studies in five licensed premises. Using smaller wine glasses at home may also reduce consumption, but the evidence from just one study is less certain. No studies have assessed the impact of glass size for drinking beer. The effect of bottles smaller than the standard 750 mL on wine consumed at home was assessed in two studies: 500 mL bottles reduced consumption by 4.5% (95% CI −7.9%, −1.0%) in one study, but in another, using 375 mL bottles there was no evident effect. No studies assessed the impact of bottle or other container size for drinking beer. Reducing the size of servings, glasses and bottles could reduce wine consumption across populations. The impact of similar interventions for reducing consumption of other alcoholic drinks awaits evaluation. Further studies are also warranted to assess the generalisability of existing evidence.

Autism disorders can reduce the ability to communicate, socialize, and respond to the environment. Some children with autism disorders are allergic to gluten. This study aims to analyze the characteristics of gluten-free cookies from corn flour and mung bean flour. The experimental design used was a Randomized Block Design. The formulation of corn flour: mung bean flour was 60%: 40%, 55%: 45%, 50%: 50%, 45%: 55%, 40%: 60%, each treatment was repeated 5 times. The best treatment is the formulation of 50% corn flour + 50% mung bean flour. The nutrient content of cookies (per 100g) was 18.47 kcal energy, 4.94 grams of protein, 6.93 grams of fat, 25.33 grams of carbohydrates. The serving size for autism children aged 4-6 years is 8 pieces (± 80 grams) per day with 2 feeds. Keywords: Autism, Cookies, Corn flour, Mung bean

Gluten-free and vegan bakery items have been gaining popularity. Their demand has increased over the past few years, with India being one of the largest gluten-free food consumers. The gluten-free pieces of bread available in the market are crumbly in nature and have a dry mouthfeel, reducing its overall acceptability among consumers. Therefore, the present study was undertaken to develop gluten-free and vegan bread and enrich it with a functional component such as flaxseeds and assess its overall acceptability and nutritional value compared to gluten-free bread available in the market. Once the product was standardized for its serving size and yield, various sensory evaluation trials were conducted using 9 points hedonic scale on bread attributes with the help of semi-trained(n=30)and trained panellists(n=3). Proximate analysis of macronutrients was conducted along with the microbial analysis. The proximate analysis showed that the experimental product had a higher protein content(18.26g)and a lower fat content (5.58g) as compared to the market-bought control sample of gluten-free bread (Total protein content was 3.44g and total fat content was 9.20g). The experimental bread microbial analysis indicated that the total plate count, yeast and mold count, and coli form count were in the acceptable range. Salmonella and E.coli were absent in the sample Statistical analysis using paired t-test was performed found a significant difference between the experimental and control group among the following characteristics: taste/flavour, texture/mouth feel, and overall acceptability (p≤0.05). A shelf-life study of the bread was conducted, and it was seen that the bread remained sensorial acceptable for three days at a refrigerated temperature and four days at room temperature. The bread had a higher nutritional profile than the control sample and received higher overall acceptability.

Adopting a sustainable diet is an alternative to address the pandemics of obesity, undernutrition and climate change that are threatening human health. Sustainable diet considers the health aspect as well as the environmental impact of diets. There is a scarcity of research on sustainable diet and lack validated tools for its measurement. This article aimed to describe the protocol on the development and validation of a Sustainable Diet Index (SDI) among Malaysian adults. A Sustainable Diet Index (SDI) was developed based on previous studies and available dietary guidelines on sustainable diet. Five indicators (rice, animal-based food, plant-based food, food waste and packaging) were included in the SDI. The index will be validated among Malaysian adults using mobile food record as the dietary assessment tool. The index has the potential to measure the level of healthy and sustainable diet behaviour of an individual. The use of mobile food record provides images of each eating occasion for the evaluation of serving size and the information on waste management. Health and environmental impacts from the diet can be evaluated through the integration of all indicators in the SDI. The index developed is novel and expected to provide a feasible measurement to assess the level of sustainable diet of an individual.

Background and aims Food preferences are often modified in populations during stressful, unanticipated events. We examined how a U.S. population's food choices changed during the beginning of the COVID-19 stay-at-home orders, specifically during the spring of 2020. Methods and results Daily dietary intake data from a digital behavior change weight loss program, which includes an interface for logging meals, beverages, and snacks, were analyzed to assess self-reported food choices from March 5-March 11, 2020 ("Start-COVID") and during the first week of the COVID-19 lockdown (March 12-March 18, 2020; "during-COVID"). The final sample consisted of 381,564 participants: 318,076 (83.4%) females, the majority who were aged 45–65 years (45.2%). Results indicate that self-reported servings of fresh fruit and vegetable intake decreased from start-to during-COVID, while intake of red meat and starchy vegetables increased. More men than women increased their intake of red meat and processed meat. Less overall change in fruit and vegetable consumption was seen in those 66 and older, compared to aged 18–35. Lean meat and starchy vegetable intake increased in older participants, but the change was negligible in younger subjects. More subjects aged 18–35 years reduced their intake of caffeine, desserts, lean meat, and salads compared to older participants. No changes were observed in snack or alcohol intake logged. Conclusion This study revealed that particular food groups were altered according to age and gender during the first weeks of COVID lockdown. Understanding changes in food choices during a crisis may be useful for preparing supply chains and public health responses.

Guided by the theoretical frameworks of the "health halo effect" and consumer expertise, this research was undertaken to determine how two individual factors, health consciousness and health literacy, differentially influence evaluations of nutrient-content claimed messaging for an unhealthy food (i.e., chocolate) and whether such evaluations are moderated by the reading of the food's Nutrition Facts Label displaying different serving sizes. The research found that health consciousness positively influenced evaluative responses to unhealthy food messaging, and that the positive influence persisted following the reading of a Nutrition Facts label listing a large quantity of unhealthy ingredients per serving size. In contrast, health literacy negatively influenced perceived healthiness and purchase intention when the nutrition label communicated a higher serving size, indicating that subjective and objective expertise work differently. The results advance understanding of the information processing of nutrient-claimed unhealthy foods, and suggest implications for food marketing communication and public health policy.

Background\ud Alcohol consumption is influenced by the characteristics of drinking occasions, for example, location, timing, or the composition of the drinking group. However, the relative importance of occasion characteristics is not yet well understood. This study aims to identify which characteristics, and combinations of characteristics, are associated with units consumed within drinking occasions. It also tests whether accounting for occasion characteristics improves the prediction of consumption compared to using demographic information only.\ud \ud Methods\ud The data come from a cross‐sectional, nationally representative, online market research survey. Our sample includes 18,409 British drinkers aged 18 + who recorded the characteristics of 46,072 drinking occasions using 7‐day retrospective drinking diaries in 2018. We used decision tree modeling and nested linear regression to predict units consumed in occasions using information on drinking location/venue, occasion timing, company, occasion type (e.g., a quiet night in), occasion motivation, drink type and packaging, food eaten and entertainment/ other activities during the occasion. We estimated models separately for 6 age‐sex groups and controlled for usual drinking frequency, and social grade in nested linear regression models. Open Science Framework preregistration: https://osf.io/42epd.\ud \ud Results\ud Our 6 final models accounted for between 55% and 71% of the variance in drinking occasion alcohol consumption. Beyond demographic characteristics (1 to 9%) and occasion duration (24 to 60%), further occasion characteristics and combinations of characteristics accounted for 31 to 70% of the total explained variance. The characteristics most strongly associated with heavy alcohol consumption were long occasion duration, drinking spirits as doubles, and drinking wine. Spirits were also consumed in light occasions, but as singles. This suggests that the serving size is an important differentiator of light and heavy occasions.\ud \ud Conclusions\ud Combinations of occasion duration and drink type are strongly predictive of alcohol consumption in adults’ drinking occasions. Accounting for characteristics of drinking occasions, both individually and in combination, substantially improves the prediction of alcohol consumption.

This study aimed to describe the development of a Thai semiquantitative food frequency questionnaire (Thai semi-FFQ) for people at risk people for metabolic syndrome. Data from the Thailand National Food Consumption Survey was used to analyze food lists and portion sizes of single food items. Data for Thai mixed dishes were lacking. Hence, data on mixed dishes were collected from five cafeterias at Siriraj Hospital in Thailand. Three samples of each food item were used to weigh the major ingredients. The nutritive values were calculated using Thai food composition software. Nutrient profiling criteria (NP) were used to classify the selected food items. Ninety-one food items of eight food groups and five serving sizes were included in the Thai semi-FFQ. The food groups were fruits (n = 18), beverages (n = 10), snacks and desserts (n = 29), a la carte (n = 7), noodles (n = 11), rice with toppings (n = 8), eggs (n = 3), and salads (n = 5). The Thai mixed dishes were classified into three groups: a la carte, noodles, and rice with toppings. All mixed dishes were scored by NP criteria, with 13% receiving a ‘grade A’ (score > 16). Thirty four percent were classified as ‘grade B’ (score 12–16), and 53% were given a ‘grade C’ (score

Currently there is little research investigating awareness or use of dietary guidelines in Saudi Arabia. This study aims to investigate Saudi Arabian mother’s knowledge of current dietary guidelines regarding food groups and portion sizes and to investigate its relation to the sociodemographic factors. This cross-sectional study used community-based family events to recruit mothers and children. Health stands offering nutrition information and advice were used at these events for study recruitment and nutritional advices to attract them. A short online questionnaire was used to interview mothers during the events to measure their knowledge of dietary guideline and portion sizes. The questionnaire included questions to assess knowledge of dietary guidelines and portion sizes. Questions about the serving size of each food groups and the dietary guideline ‘MyPlate’ were included; the study recruited a convenience sample of 101 participants. Quantitative analysis using Chi-square and Kruksan-Wallis tests. We found 29.1 % of the participants were aware of the MyPlate guidelines and 51.5 % said that they are affected by healthy plate choices. Being married was significantly associated with knowing about the MyPlate Image (P= 0.004). Correct identification of food groups on the MyPlate Image and correct identification of serving sizes of food group was less than 50% for most food groups. A significantly greater percentage of those with a postgraduate education were accurate about the correct servings of fruit, vegetables and grains (P=0.049). Nutrition knowledge of food groups and serving sizes was poor in the sample of Saudi Arabian women. This research provides evidence that nutrition education is needed in the Saudi Arabia and the finding are relevant for future health promotion strategies. The study has also identified sociodemographic groups that possibly may need to be targeted with more attention in future nutrition education programs such as those with low income, lower education level and unmarried women.

Background Since 1950, the portion size of many snack foods has more than doubled and obesity rates have tripled. Portion size determines energy intake, often unwittingly. Purpose This paper tests whether salient visual cues to portion size on the packaging of high fat, sugar, or salty (HFSS) snacks can reduce consumption. Methods Two preregistered randomized controlled trials (N = 253 and N = 674) measured consumption in a lab and the home environment. Cues were salient, labeled stripes that demarcated single portions. Participants were randomized to cue condition or control. Consumption was measured without awareness. Results The main preregistered effect of the visual cue was not statistically significant. There was some variation by subgroup. In Study 1, men were more likely to eat the whole can of potato chips than women but significantly reduced consumption when visual cues were on the pack. The effect size was large: the number of men eating more than the recommended portion fell by 33%. Study 2 monitored household consumption of chocolate biscuits (cookies) sent to family homes in gift packs. Again, the main effect was nonsignificant but there was significant subgroup variation. When the person receiving the biscuits was female, households were more likely to eat more than the recommended portion per person per day, but less likely when the visual cues were displayed. The gender of the eaters was not known. The effect size was again large: the number of households eating more than the recommended portion fell by 26%. Households with children were also less likely to open packs with visual cues compared to control packs. Both studies recorded significant increases in the likelihood of observing serving size information, together with confusion about what it means. Conclusions The studies offer some evidence that salient visual cues could play a role in tackling the high consumption of unhealthy snacks, but the effects are confined to specific subgroups and warrant further investigation.

PurposeThe purpose of this paper is to assess the effect of involvement in food preparation on estimated calorie content, perception of portion size and desirability of the food item.Design/methodology/approachTo test the hypotheses, three between-subjects experiments (one online, two in a laboratory setting) were conducted. Across the three experiments, participants were presented with a food item either ready for consumption (low involvement) or with the individual ingredients in need of assembly prior to consumption (high involvement).FindingsResults showed that when a consumer is involved in the preparation of their food, they perceive the food to be lower in calories and smaller in portion size than when the same food is presented fully prepared and ready-to-eat. In addition, the effect of food preparation involvement on perception of portion size has negative downstream consequences on food desirability, as a smaller perceived portion resulted in a less desirable food item.Originality/valueTo the authors’ knowledge, the results of this research are the first to focus on the impact of preparation involvement on perceptions of the specific product attributes of calorie content and portion size, and the downstream effect on desirability.

Cakes are one of the most commonly consumed product by kids and adults and are consumed even more during special occasions. Packaged cake products have a lot of sugar content in them and sugar is one of the main factors causing dental caries in children. Keeping all this in mind this research was done to evaluate the correlation between the amount of cakes consumed and the incidence of dental craie in children. The data was collected from products packaging nutrition labelling provided by the company and also included the products name, pack weight, serving size, total sugars per 100 gms as well as per suggested serving size. A questionnaire was used to obtain the information on the correlation with dental caries. The data was collected and tabulated in excel sheet. The data analysis was done using SPSS software by IBM. A total of 40 products were collected and tabulated. The average sugar content in cakes was 22.5 g. There was a large variation in sugar content between different cakes of the different categories within the same categories. Among the 40 products, 36 products showed a high sugar content when compared to the normal recommended dose for children. The study showed that the sugar content present in cakes was high and there can be a reduction in the amount of sugar present in it and thus reduce the risk of obesity and dental caries.

Salmonella is a leading cause of foodborne illness (i.e., salmonellosis) outbreaks, which on occasion are attributed to ground turkey. The poultry industry uses Salmonella prevalence as an indicator of food safety. However, Salmonella prevalence is only one of several factors that determine risk of salmonellosis. Consequently, a model for predicting risk of salmonellosis from individual lots of ground turkey as a function of Salmonella prevalence and other risk factors was developed. Data for Salmonella contamination (prevalence, number, and serotype) of ground turkey were collected at meal preparation. Scenario analysis was used to evaluate effects of model variables on risk of salmonellosis. Epidemiological data were used to simulate Salmonella serotype virulence in a dose-response model that was based on human outbreak and feeding trial data. Salmonella prevalence was 26% (n = 100) per 25 g of ground turkey, whereas Salmonella number ranged from 0 to 1.603 with a median of 0.185 log per 25 g. Risk of salmonellosis (total arbitrary units (AU) per lot) was affected (p ≤ 0.05) by Salmonella prevalence, number, and virulence, by incidence and extent of undercooking, and by food consumption behavior and host resistance but was not (p > 0.05) affected by serving size, serving size distribution, or total bacterial load of ground turkey when all other risk factors were held constant. When other risk factors were not held constant, Salmonella prevalence was not correlated (r = -0.39; p = 0.21) with risk of salmonellosis. Thus, Salmonella prevalence alone was not a good indicator of poultry food safety because other factors were found to alter risk of salmonellosis. In conclusion, a more holistic approach to poultry food safety, such as the process risk model developed in the present study, is needed to better protect public health from foodborne pathogens like Salmonella.

The chicken chili sauce was made by sautéing chili, onion, garlic, salt, sugar, monosodium glutamate, and chicken using palm oil. The chili sauce nutrition was improved by adding chicken meat because it contains animal protein which was liked by the community. This study was examined the chemical content, daily values, and microbiology of chicken chili sauce. The chemical content parameters tested included water content, fat, protein, carbohydrate, energy, and vitamin C. The nutritional adequacy rate was calculated based on the chemical content of chili sauce with a serving size of 20 g. The microbiological parameters tested were total plate count, Salmonella, Staphylococcus, and Coliform. The data obtained were analyzed descriptively. The results showed that the chemical content of chicken chili sauce consisted of 12.18% water, 0.88% ash, 7.88% protein, 55.91% fat, 3.14% carbohydrate, 3.69% sugar, 627 kcal energy, 41 mg sodium, 5 mg vitamin C, and 7 mek O2/kg peroxide numbers. The daily values of chicken chili sauce were calculated based on the average energy sufficiency of 2,150 kcal per person per day with a serving size of 20 g then by consuming chili sauce per serving can meet the daily needs of fat 16.69%, protein 2.63%, carbohydrate 1.42%, sodium 0.55%, and vitamin C 1.11%. The chicken chili sauce was safe for consumption because the bacterial contamination was still low with a total plate count of 1.4x102 CFU/mg, Salmonella, Staphylococcus, and Coliform were negative.

Food choices with high antioxidant and low glycemic values may benefit the body's health. High total phenolic content will influence the antioxidant activity that works as a body shield from free radicals. On the other hand, higher glycemic values will increase the risk of non-communicable disease, specifically diabetes mellitus. It will be thoughtful to know the antioxidant activity and glycemic values of the food that consumed. Such in the case of non-meat products, including patty burger, which intended for meat patty burger substitution. This study aims to analyze the values of total phenolic content, antioxidant activity, glycemic response, glycemic index, and glycemic load of the non-meat burger patty. This is an experimental study with a completely randomized design. The total phenolic content was determined by Folin-ciocalteu method. Antioxidant activity was determined by DPPH method. The glycemic values were determined by an incremental area under the curve (iAUC) method. The values of total phenolic content and antioxidant activity of non-meat patty burger was in line. More phenolic content results in a higher antioxidant activity. Non-meat patty burger has a lower glycemic response compared to a reference food. Its glycemic index is high. However, it has a low glycemic load. Non-meat burger patty has phenolic substances result in antioxidant activity, while its consumption with the right serving size may contribute a low glycemic effect and protect blood glucose stability.

Street food is popular in Eastern Europe, but its diversity and nutritional value are unknown. This study aimed to characterise the street food environment in Chişinău, Moldova, including the vending sites and vendors, food availability and nutritional composition of foods and beverages. All street food vending sites (single point of sale) located in a 1-km buffer centred on the main public market were systematically selected (n 439; n 328 participants). Data on vending sites’ characteristics (mobility, type of physical set-up and access to electricity), operating periods and food availability were collected. Samples of the most commonly available foods of unknown composition were collected (twenty-eight home-made and twenty-four industrial). Macronutrients, Na and K were quantified through chemical analysis. Fruits, beverages and food other than fruits were available in 2·5, 74·3 and 80·8 % of the vending sites, respectively. Among the latter, 66·4 % sold only industrial foods (e.g. pretzels, biscuits, wafers, chocolate and ice cream), 21·5 % only home-made (e.g. savoury and sweet pastries) and 12·1 % both. Home-made foods presented larger serving sizes and energy/serving (median kJ/serving: 1312·5 v. 670·3, P = 0·022); industrial foods were more energy-dense (median kJ/100 g: 1797·0 v. 1269·8, P = 0·002). High SFA, trans-fat and Na contents were found, reaching 10·9 g/serving, 1·4 g/serving and 773·7 mg/serving, respectively. Soft drinks and alcoholic beverages were available in 80·7 and 42·0 % of the vending sites selling beverages, respectively. Concluding, industrial snacks and home-made pastries high in Na and unhealthy fat were frequent in Chişinău. Prevention of diet-related diseases in Moldova may benefit from the improvement of the nutritional profile of street food. The FEEDcities project was funded by the World Health Organization Europe (WHO registration 2015/591370 and 2017/698514). This study was funded by national funds through FCT - Fundação para a Ciência e a Tecnologia, I.P., under the projects UIDB/04750/2020 and UID/QUI/50006/2020. Individual PhD grants attributed to G. A. (SFRH/BD/118630/2016) and S. S. (SFRH/BD/130650/2017) were funded by FCT and the ‘Programa Operacional Capital Humano’ (POCH/FSE).

The consumption of sugar-sweetened beverages is a known contributory factor of childhood obesity that is documented around the globe. More importantly, reducing the consumption of sugar-sweetened beverages could reduce weight gain among overweight or obese children. Although sugar is present in many natural foods, artificial sugar is added into sugar-sweetened beverages, which has little or no nutritional value. However, the calories obtained from the sugar-sweetened beverages are linked to overweight and obesity, and an increase serving sizes of sugar-sweetened beverages over the years partly contributed to the alarming rise of childhood obesity around the globe. The sugar-sweetened beverages not only contain a high amount of sugar, but also contain a high amount of phosphate, and the possibility exists for an enhancing dual adverse health effects of sugar and phosphate. Increasing health awareness and limiting marketing approaches targeted towards the younger population are essential to reduce long-term health burdens that are linked to the overconsumption of sugar-sweetened beverages.

BackgroundElevated serum uric acid concentrations have been associated with metabolic syndrome. However, only limited information is available on the prevalence of hyperuricaemia in adolescents. Therefore, the aim of our cross-sectional study was to study the prevalence of hyperuricaemia and dietary patterns in adolescents aged 13–16 years living in Yangzhou, China.MethodsAdolescents were asked to complete a 20-item food frequency questionnaire (FFQ) and provide an overnight fasting finger-prick sample. Principal component analysis (PCA) with varimax rotation was used to derive the dietary patterns that might be associated with high uric acid concentrations.ResultsA total of 1070 adolescents were recruited. Of these, 53.6% (n = 574) were females, and 58.5% (n = 625) were within the normal body mass index (BMI) range. The males had a significantly higher serving size and frequency in their weekly food consumption, including meat, poultry, Chinese cereal staple foods and Western-style fast foods, than the females (all p ConclusionsThe prevalence of hyperuricaemia was relatively high in Chinese adolescents. The prevention of hyperuricaemia measures should be strengthened in adolescents to effectively control for obesity and gout, which tend to persist into adulthood.

To assess sugar content and child-oriented promotional features on packaging among cereals manufactured by companies with varying Children's Food and Beverage Advertising Initiative (CFBAI) participation.Ready-to-eat dry cereals (n = 159) were purchased from southeastern US grocery stores in September 2018. Content analysis of 159 ready-to-eat dry cereal boxes, coded for sugar content and presence of 8 child-oriented features.Frequencies of each promotional feature and number of features per box, level of participation in CFBAI, and sugar content by serving and ounce.Chi-square tests of independence analyzed correspondence between measures of sugar content. Extent of features per box based on sugar content and CFBAI participation were assessed with analyses of variance (ANOVAs).Most cereals (81%) contained13 g of sugar per serving, meeting the sugar content requirement for child-directed advertising. Cereals' sugar content classifications varied between sugar per serving and sugar per ounce metrics (P.001). Among low-sugar per serving cereals, 28% were classified as moderate-sugar per ounce, whereas 55% of moderate-sugar per serving cereals had high-sugar per ounce. Games/activities and trade characters were especially common (62% and 49%, respectively), particularly on high-sugar per ounce cereals (P.001, respectively). Child-oriented features were rare on low-sugar cereals and highest on cereals with higher sugar content per ounce produced by CFBAI-participating companies (F8,158 = 12.33, P.001).Variable cereal-suggested serving sizes may contribute to consumers' misunderstanding of sugar content. CFBAI manufacturers continue to market cereals with high sugar to children. Food and beverage regulatory policy could be strengthened if CFBAI companies apply marketing pledges to brand mascots, adopt standardized metrics for sugar content, and limit added sugar content to the recommended6 g/serving target used by the Special Supplemental Nutrition Program for Women, Infants, and Children program.

Background Reducing sugar in packaged foods and beverages could help protect children's future health. Clear methods for the development of feasible yet impactful sugar reduction program targets are needed. Objectives To outline methods for the development of program targets that would reduce, by 20%, the total sugar content of packaged foods and beverages commonly consumed by children. New Zealand (NZ) is used as a case study. Methods Sugar content and pack size targets were developed using a 6-step process informed by the UK sugar and salt reduction programs. Food groups contributing ≥2% to children's total sugar intake were identified using national dietary survey data. Consumption volume, sugar content, and pack size were obtained from household panel data linked with a packaged food composition database. Category-specific targets were set as 20% reductions in sales-weighted means adjusted for feasibility, i.e., ∼1/3 of products already meeting the target, and alignment with existing, relevant targets. Results Twenty-two food groups were identified as major contributors to NZ children's total sugar intake. Mean reductions required in sugar content and pack size to meet the targets were 5.2 g per 100 g/mL (26%) and 61.2 g/mL/pack (23%), respectively. The percentage of products already meeting the sugar targets ranged from 14% for electrolyte drinks and flavored dairy milk to 50% for cereal bars, and for pack size targets compliance ranged from 32% for chocolate confectionary to 62% for fruit juices and drinks. Estimated reductions in annual household sugar purchases if the sugar and pack size targets were met were 1459 g (23%) and 286 g (6%), respectively. Conclusions Methods for the development of sugar and pack size reduction targets are presented, providing a robust, step-by-step process for countries to follow. The results of the case study provide a suggested benchmark for a potential national sugar reduction program in NZ.

Objective To evaluate the opinions of primary health-care providers and patients regarding the use of the Healthy Heart Score 20-year cardiovascular disease risk assessment tool in the clinical setting. Methods Semi-structured in person or phone interviews among 20 patients with no self-reported cardiovascular disease diagnoses and 20 health-care providers in Central (Columbus) and Southeastern (Athens) regions of Ohio. The researchers independently coded transcribed interviews, discussed codes to resolve discrepancies, and agreed on common themes. Results Participants suggested ways to best utilize and improve the tool, including adding graphics for visual reference of serving size. Patients showed interest in cardiovascular disease primordial prevention and expressed willingness to take the assessment prior to seeing a health-care provider. Health-care providers said that they would recommend the assessment to their patients and would be willing to use the tool in their practice. Health-care providers stated few barriers to using the tool, yet discussed numerous challenges to successful primordial prevention. Conclusions Our findings support the utilization of the Healthy Heart Score as a cardiovascular disease primordial prevention tool in the clinical setting. Additional research implementing the tool into the clinical setting will provide deeper insight into how the tool can impact behavior change and cardiovascular disease prevention.

Objective:To compare the Nutrition Information Panel (NIP) content, serving size and package size of children’s ready-to-eat breakfast cereals (RTEC) available in five different Western countries.Design:NIP label information was collected from RTEC available for purchase in major supermarket chains. Kruskal–Wallis, Mann–WhitneyUandχ2tests were applied to detect differences between countries on manufacturer-declared serving size, total energy (kJ), total protein, fat, saturated fat, carbohydrate, total sugar, Na and fibre content. The Nutrient Profiling Scoring Criterion (NPSC) was used to evaluate the number of products deemed to be ‘unhealthy’.Setting:Supermarkets in Australia, Canada, New Zealand, the UK and the USA.Participants:Children’s breakfast cereals (n636), including those with and without promotional characters.Results:The majority of children’s RTEC contained substantial levels of total sugar and differences were apparent between countries. Median sugar content per serving was higher in US cereals than all other countries (10·0v. 7·7–9·1 g;P< 0·0001). Median fat and saturated fat content were lowest in Australia and New Zealand RTEC, while the Na content of RTEC was 60–120 % higher in the USA and Canada than in Australia and the UK (allP≤ 0·01).Conclusions:Across all countries, there was a high proportion of RTEC marketed for children that had an unhealthy nutrient profile. Strategies and policies are needed to improve the nutrient value of RTEC for children, so they provide a breakfast food that meets nutrition guidelines.

Introduction: Elderly population is more likely to suffer from malnutrition, thereby requiring appropriate nutrition education as part of nutrition intervention to overcome this issue. This review aims to identify content suitable for developing a nutrition resource kit that provides nutritional guidance to combat malnutrition among malnourished and at-risk elderly in health clinics setting, particularly in Malaysia. Methods: A literature search was conducted up to 15th December 2019 in four databases: PubMed, Scopus, COCHRANE, and ProQuest Health & Medical Collection. Potential literature on nutrition education, suitable dietary guidelines and existing educational materials for elderly in the community, in English and Malay languages, were searched to identify suitable content for the nutrition resource kit. All relevant documents were included based on inclusion and exclusion criteria. Data were extracted and analysed according to the PRISMA-ScR guidelines. Results: A total of 27 documents consisting of articles, printed materials and guidelines were included for analysis. Suitable content included information related to malnutrition such as definition, signs and symptoms, cause-consequences, and nutrition management, which included food plate, serving size, menu suggestion, examples of recipes, tips to increase energy and protein intakes through food or drink, texture modification, a guide to using oral nutritional supplements, tips for maintaining nutrient content in food and drink, tips to encourage to eat, and oral health. Conclusion: A nutrition resource kit tailored for malnourished and at-risk elderly would be a beneficial nutrition intervention. There is a need to incorporate these information in the development of a nutrition resource kit to improve their dietary intake.

Background: Dietary supplements promoted for brain health and enhanced cognitive performance are widely available. Claims made for these products are directed not only to the elderly wishing to prevent or mitigate cognitive decline, but also young healthy populations looking to boost their cognitive performance. It is unclear whether these claims made on product bottles and through advertising match the science. Objectives: To explore the evidence on the efficacy and safety of single dietary supplement ingredients frequently marketed with claims of enhanced cognitive performance among healthy adults. Design: A systematic review. Results: Nine of 54 dietary supplement ingredients identified through a scoping review met the eligibility criteria with at least 3 published studies identified per ingredient, yielding 69 unique publications. Ingredients evaluated included Bacopa monnieri, choline, creatine, omega-3 fatty acids, Ginkgo biloba, ginseng, Rhodiola rosea, tyrosine, and valerian root, all in supplement form and compared with a placebo, at various serving sizes and durations of use. Conclusions: The low level of certainty in the state of the science, coupled with not always knowing what is in a dietary supplement product, make weighing risks and benefits difficult; these data hinder the ability to develop recommendations about using such ingredients for consumers interested in boosting their cognitive performance. Whereas certain trends regarding promising serving sizes or duration for use, are pointed to in this synthesis, when combined, studies are inconsistent and imprecise, and many are methodologically flawed. Potential solutions to address research gaps are offered, for future research next steps, which is needed to strengthen the evidence and inform decisions.

Consumption of diet beverages (DB) containing low-calorie sweeteners (LCS) is widespread in the United States. LCS are ingested by nursing infants upon maternal DB consumption, which may impact infants’ weight and health. This study aims to examine cross-sectional associations between infants’ LCS exposure via maternal DB intake during lactation and infants’ health outcomes. Six hundred and eighty-two mother–infant dyads at three months postpartum, from the Infant Feeding Practices Study II, 2005–2007, were included in the analysis. Maternal DB consumption during lactation was estimated using the serving size and frequency of DB consumption reported on the diet history questionnaire. Infants’ LCS exposure was estimated by multiplying maternal DB consumption and breastfeeding intensity. Infant outcomes included weight, weight-for-age and BMI-for-age z-scores, overweight, and gastrointestinal (GI) symptoms including diarrhea, reflux, and vomiting. Associations between infants’ LCS exposure and continuous and categorical outcomes were examined using linear and logistic regressions adjusting for confounders, respectively. Forty-three percent of lactating women reported DB consumption. While no significant associations were observed between infants’ LCS exposure and BMI-for-age or risk of overweight, infants’ LCS exposure was associated with a 2.78-fold increased risk of vomiting (95% confidence interval 1.05–7.34). Potential adverse effects of LCS exposure on GI symptoms require further study, and null findings on infant weight should be interpreted with caution, given the small sample size. Additional research is needed to inform recommendations for or against DB consumption during lactation.

Celiac disease and nonceliac gluten sensitivity are provoked by the consumption of gluten from wheat, barley, rye, and related grains. Affected individuals are advised to adhere to gluten-free diets. Recently, gluten-free foods have become a marketing trend with gluten-free options both in packaged foods and in restaurants and food service establishments. Pasta is one of the primary gluten-containing foods in diets in North America and Europe. Gluten-free pasta formulations are commercially available. In restaurants, multiple pasta dishes are often prepared simultaneously in large pots with multiple compartments and shared cooking water. The objective of this study was to determine whether gluten transfer occurs between traditional and gluten-free pasta when cooked simultaneously in the same water. Pasta was boiled in a commercial, four-compartment, 20-qt (18.9-L) cooking pot containing three batches of traditional penne pasta and one batch of gluten-free penne pasta. The amount of pasta (dry weight) was either 52 g (recommended serving size) or 140 g (typical restaurant portion). Five consecutive batches of pasta were boiled, and cooking water and gluten-free pasta were sampled at completion of cooking. Water and gluten-free pasta samples were tested for gluten with the Neogen Veratox for Gliadin enzyme-linked immunosorbent assay kit. Gluten concentrations were low (20 ppm) in both water and gluten-free pasta samples through five 52-g batches. Gluten concentrations in the 52-g gluten-free pasta samples slowly increased through five batches but were never20 ppm. During cooking of the 140-g gluten-free pasta samples, the gluten concentrations in the cooking water increased with each batch to50 and80 ppm after the fourth and fifth batches, respectively. The gluten concentrations in the 140-g gluten-free pasta samples approached 20 ppm by the fourth batch and reached nearly 40 ppm after the fifth batch. Although gluten transfer does not occur at a high rate, gluten-free pasta should be prepared in a separate cooking vessel in restaurant and food service establishments.

The public assumes that some foods, such as milk and ground beef from cattle receiving steroidal implants, are associated with estrogenic hormones, while other foods are presumed "safe" or nonestrogenic. Here, we investigate these assumptions by assessing the relative estrogenic activity of a serving size of four foods: skim milk (8 oz), rice (48 g dry wt) in cooking bag, ground beef patties from steers raised with or without hormone implantation (quarter lb each, 114 g), and tofu burgers (isocaloric to beef burger, 198 g), using an in vitro assay (E-Screen). Mean picogram (pg) estradiol equivalents (E2Eqs) on a serving basis were as follows: skim milk 120; rice 400; rice prepared in cooking bag 370; rice boiling bag alone 4 pg per bag, ground beef burger (obtained from the tissue of cattle that had received no hormone implants) 389, beef burger (obtained from cattle that had received hormone implant) 384, and tofu burger 1,020,000. Rice E2Eqs were highly variable, but the plastic cooking bags provided by the manufacturer added negligible E2Eqs. The source of estrogenic activity in rice may have been due to contamination with the mycotoxin zearalenone. The E-Screen E2Eqs of tofu burger extracts agreed with those predicted based on chemical concentrations of the most estrogenic component times their E2Eq factor. While a tofu burger contained around three times the estrogenic activity of a daily dose of estrogen replacement therapy (125 mg, Premarin®, 303,000 pg); the other foods--a quarter pound ground beef burger at approximately equal calorie count, a serving of milk, or rice, were all at least 750-fold less estrogenic. PRACTICAL APPLICATION: When consuming the recognized serving size of a food, how much estrogenic activity can we expect? While the public assumes that some foods, such as milk and ground beef from cattle receiving steroidal implants, are associated with estrogenic hormones, other foods are presumed "safe" or nonestrogenic. Using one assay, a tofu burger contained three times the estrogenic activity of a dose of hormone replacement therapy commonly prescribed for women after hysterectomy or menopause (Premarin®); while other foods--a quarter pound ground beef burger at approximately equal calorie count, a serving of milk, or rice, were all at least 750-fold less estrogenic.

The study analysed differences in nutrition content of various bilih fish flour proportions in bilih fish bar with zinc and calcium as minerals of interest. The study used a Completely Randomized Design (CRD). The proportion of bilih fish flour in the fish bars dough were of three levels, i.e. 30%, 40% and 50% of the total weight of flour. The data obtained were analyzed with one-way ANOVA, followed by Duncan's New Multiple Range test. The level of statistical significance was set at p

Poor diet, resulting from high intake of ultra-processed packaged foods, is increasingly recognised as a key contributing factor to ill health. Food labels provide information on the nutritional content of packaged foods to consumers, which may influence consumption of nutrients such as energy, fat, saturated fat, trans-fats, sodium and added sugars. This review aims to summarise the current evidence for the association between use of food labels and dietary intake. The systematic search was conducted in August 2017 using six databases, with 6325 results. Twenty-six studies were included, including cross-sectional studies (n = 20), a cohort study (n = 1) and randomised controlled trials (n = 5). Studies were assessed using the American Dietetic Association Quality Criteria Checklist. Results were inconsistent in reporting a relationship between diet and food label use but indicated that reading the nutrition facts label is associated with healthier diets, measured by food frequency questionnaires and 24 h recalls. However, there is insufficient research on the association between dietary consumption and use of ingredients lists, serving size information and front-of-pack labels. Using health-related claims may be associated with poor diets, however evidence is inconclusive. Apart from health-related claims, using food labels is associated with healthier diets and should continue to be promoted through policies and education programs. Further research in this area is warranted to provide additional information on the impact of ingredients lists, serving sizes, front-of-pack labels and health-related claims on dietary intake.

Background Diet plays a key role in development of diabetes, and there has been recent interest in better understanding the association of dairy food intake with diabetes. Objective This study examined the associations of full-fat and low-fat dairy food intake with incident diabetes among American Indians-a population with a high burden of diabetes. Methods The study included participants from the Strong Heart Family Study (SHFS), a family-based study of cardiovascular disease in American Indians, free of diabetes at baseline (2001-2003) (n = 1623). Participants were 14-86-y-old at baseline and 60.8% were female. Dairy food intake was assessed using a Block food frequency questionnaire. Incident diabetes was defined using American Diabetes Association criteria. Parametric survival models with a Weibull distribution were used to evaluate the associations of full-fat and low-fat dairy food intake with incident diabetes. Serving sizes were defined as 250 mL for milk and 42.5 g for cheese. Results We identified 277 cases of diabetes during a mean follow-up of 11 y. Reported intake of dairy foods was low [median full-fat dairy food intake: 0.11 serving/1000 kcal; median low-fat dairy food intake: 0.03 serving/1000 kcal]. Participants who reported the highest full-fat dairy food intake had a lower risk of diabetes compared to those who reported the lowest full-fat food dairy intake [HR (95% CI): 0.79 (0.59, 1.06); P-trend = 0.03, comparing extreme tertiles, after adjustment for age, sex, site, physical activity, education, smoking, diet quality, and low-fat dairy food intake]. Low-fat dairy food intake was not associated with diabetes. Conclusions American Indians who participated in the SHFS reported low dairy food intake. Participants who reported higher full-fat dairy food intake had a lower risk of diabetes than participants who reported lower intake. These findings may be of interest to populations with low dairy food intake.

Background This study builds on previous research that seeks to estimate kilocalorie intake through microstructural analysis of eating behaviors. As opposed to previous methods, which used a static, individual-based measure of kilocalories per bite, the new method incorporates time- and food-varying predictors. A measure of kilocalories per bite (KPB) was estimated using between- and within-subjects variables. Objective The purpose of this study was to examine the relationship between within-subjects and between-subjects predictors and KPB, and to develop a model of KPB that improves over previous models of KPB. Within-subjects predictors included time since last bite, food item enjoyment, premeal satiety, and time in meal. Between-subjects predictors included body mass index, mouth volume, and sex. Participants/setting Seventy-two participants (39 female) consumed two random meals out of five possible meal options with known weights and energy densities. There were 4,051 usable bites measured. Main outcome measures The outcome measure of the first analysis was KPB. The outcome measure of the second analysis was meal-level kilocalorie intake, with true intake compared to three estimation methods. Statistical analyses performed Multilevel modeling was used to analyze the influence of the seven predictors of KPB. The accuracy of the model was compared to previous methods of estimating KPB using a repeated-measured analysis of variance. Results All hypothesized relationships were significant, with slopes in the expected direction, except for body mass index and time in meal. In addition, the new model (with nonsignificant predictors removed) improved over earlier models of KPB. Conclusions This model offers a new direction for methods of inexpensive, accurate, and objective estimates of kilocalorie intake from bite-based measures.

Purpose The purpose of this paper is to develop policy recommendations for creating a healthy food environment around convenience stores which has been recently extending beyond the retail to the food retail and even to the foodservice market in South Korea. Design/methodology/approach This study was based on case studies of evaluating the nutritional quality of lunch box products sold by the Korean big 3 convenience store brands (CU, GS25 and 7-Eleven) as meal replacements. Samples of all lunch box products sold during October 2016 in Asan city, South Korea were collected for nutritional quality evaluation. Findings The amount of food items in the “Meats/Fish/Eggs/Legume” food group was 2.4 times the recommended intake, while that in the “Vegetables” food group was even less than one serving size. The most frequent cooking method both for the animal- and plant-based food groups was stir-frying. The average calories fell short of the reference value for men but exceeded it for women. The percentage energy contribution from fats exceeded the reference range. The average amounts of protein, saturated fat, cholesterol and sodium were higher than recommended. Originality/value This study calls attention to the necessity and importance of establishing a healthy food environment around convenience stores, given the ever-growing reliance on these establishments as a go-to spot for a convenient meal. The results may also provide useful insights for developing countries in Asia, which are being spotlighted as the emerging markets for convenience stores.

AIM: Cakes and muffins are commonly consumed discretionary foods that have increased significantly in portion size over the past decades. The present study aimed to (i) investigate serving sizes and energy per serving of cakes and muffins sold in supermarkets and coffee chains, (ii) compare to standard discretionary serves and (iii) propose feasible and appropriate serving size recommendations. METHODS: Serving sizes and energy content of cakes and muffins were collected from four major Australian supermarkets (n = 219) and eight coffee chains (n = 248) between March and April 2017 and classified into eight categories and compared using Mann–Whitney tests. Median energy per serving of cakes and muffins from supermarkets and coffee chains were compared to the Australian Dietary Guidelines standard serve of 600 kJ for discretionary food. RESULTS: The median serving size of cakes and muffins from supermarkets, 58 g (interquartile range, IQR: 47–83) and their energy content, 915 kJ (IQR: 745–1243) were significantly smaller compared with coffee chain equivalents, 148 g (IQR: 115–171, P

People vary dramatically in their calorie estimates of food depending on the information available to them. Prior research has focused on information that is normatively relevant to the number of calories a food contains (e.g., fat content, serving size). The current research examines whether information that is normatively irrelevant to the number of calories a food contains — such as its availability — might also shape people’s calorie estimates. Three studies found that a food perceived as limited in availability leads people to estimate the food to contain more calories. Serial mediation analyses revealed that this effect occurs because scarce food is seen as more valuable and expensive, which subsequently induces feelings of resource deprivation. This sense of resource deprivation, in turn, leads to motivated perception, whereby higher calorie estimates are the result of people wanting to acquire more resources. The findings provide insight into the psychology of scarcity and underscore the importance of understanding how contextual factors shape people’s calorie estimates and the psychological mechanisms that drive them.

Background Food protein–induced enterocolitis syndrome (FPIES) is a non–IgE-mediated food allergy that is diagnosed based on clinical findings, but can be confirmed with oral food challenge (OFC). OFC is more often performed to assess the development of tolerance. Most studies describing OFCs in FPIES are limited in size. Objective We sought to describe our experience with OFCs using our FPIES protocol. Patients were given one-third of serving size with a 4-hour observation period, followed by home titration to full dose. Methods We conducted a retrospective chart review of patients who underwent OFC via the FPIES protocol from 2014 to 2017. Data regarding the history of reaction, age at the time of challenge, and reactions during challenge or with home introduction were collected. Results A total of 169 OFCs were completed under the FPIES protocol, in 119 patients to 19 different foods. Thirty challenges (18%) were positive, with 17 challenges (10%) during initial challenge and 13 (7.7%) during home dosing. Most reactions during initial challenge required intravenous fluids (IVF), but hypotension was uncommon. One hundred thirty-nine (82%) OFCs were negative with home introduction, indicating tolerance to the challenged foods. The mean age of passing a challenge to milk, soy, and grain was earlier than that of other solid foods. Conclusions: Our data suggest that our FPIES OFC protocol is safe. Early administration of IVF may prevent the development of hypotension. It is difficult to stratify the risk of severe or delayed reaction based on patient characteristics, and more data are needed to identify those appropriate for home introduction.

Background: Morbidity and mortality in China are increasingly associated with lifestyle behaviors, e.g., smoking, poor nutritional choices, and physical inactivity. Lifestyle-related non-communicable diseases (e.g., hypertension, stroke, heart disease, lung disease) are at critical levels globally, in turn their socioeconomic burdens. Knowledge of lifestyle-related health behaviors and beliefs of mainland Chinese would help inform the design and targeting of cost-effective health education for individuals and campaigns in the interests of promoting and protecting health, and preventing disease. This study’s objective was to describe the lifestyle behaviors and beliefs of a sample of urban mainland Chinese, and their congruence with evidence-based guidelines for maximal health. Methods: A cross-sectional interview questionnaire study was conducted in which 835 mainland Chinese (55% men, 45% women) from four urban areas participated. Results: About half (52%) reported smoking to some degree with 21% being habitual smokers; 33% being above average weight; 62.1% met physical activity guidelines for health benefits; 92% being sedentary for 5.8 ± 3.40 h/d; 66% experiencing moderate/high stress; and sleeping 7.1 ± 1.31 h nightly with 35% reporting sleeping poorly. When standard serving sizes were considered, daily consumption of grains, fruits, and vegetables was reported to be consistent with dietary recommendations for good health, however, added salt (3.7 ± 7.42 tsp) and sugar (3.9 ± 12.99 tsp) exceeded recommendations. Life stress was rated moderate by 59.6% of respondents, with personal and family health stresses ranking highest (43% and 55%, respectively). Regarding beliefs about importance of lifestyle behaviors to health, respondents’ understanding was not consistent with evidence-based recommendations. Only 64% of participants believed smoking abstinence is highly important to health; 56% regular exercise; and 37% consumption of whole grains, 62% fruit and vegetables; and 54% maintaining a healthy body weight. Conclusion: To be congruent with established guidelines for healthy living, health promotion and disease prevention education for individuals and public campaigns warrants targeting health knowledge and beliefs of urban Chinese as well as lifestyle-related health behaviors. The roles of gender, education and living rurally, on lifestyle behaviors and beliefs of the Chinese, warrant elucidation.Background: Morbidity and mortality in China are increasingly associated with lifestyle behaviors, e.g., smoking, poor nutritional choices, and physical inactivity. Lifestyle-related non-communicable diseases (e.g., hypertension, stroke, heart disease, lung disease) are at critical levels globally, in turn their socioeconomic burdens. Knowledge of lifestyle-related health behaviors and beliefs of mainland Chinese would help inform the design and targeting of cost-effective health education for individuals and campaigns in the interests of promoting and protecting health, and preventing disease. This study’s objective was to describe the lifestyle behaviors and beliefs of a sample of urban mainland Chinese, and their congruence with evidence-based guidelines for maximal health. Methods: A cross-sectional interview questionnaire study was conducted in which 835 mainland Chinese (55% men, 45% women) from four urban areas participated. Results: About half (52%) reported smoking to some degree with 21% being habitual smokers; 33% being above average weight; 62.1% met physical activity guidelines for health benefits; 92% being sedentary for 5.8 ± 3.40 h/d; 66% experiencing moderate/high stress; and sleeping 7.1 ± 1.31 h nightly with 35% reporting sleeping poorly. When standard serving sizes were considered, daily consumption of grains, fruits, and vegetables was reported to be consistent with dietary recommendations for good health, however, added salt (3.7 ± 7.42 tsp) and sugar (3.9 ± 12.99 tsp) exceeded recommendations. Life stress was rated moderate by 59.6% of respondents, with personal and family health stresses ranking highest (43% and 55%, respectively). Regarding beliefs about importance of lifestyle behaviors to health, respondents’ understanding was not consistent with evidence-based recommendations. Only 64% of participants believed smoking abstinence is highly important to health; 56% regular exercise; and 37% consumption of whole grains, 62% fruit and vegetables; and 54% maintaining a healthy body weight. Conclusion: To be congruent with established guidelines for healthy living, health promotion and disease prevention education for individuals and public campaigns warrants targeting health knowledge and beliefs of urban Chinese as well as lifestyle-related health behaviors. The roles of gender, education and living rurally, on lifestyle behaviors and beliefs of the Chinese, warrant elucidation.

We read with great interest the paper Miceli Sopo et al.1 published. The authors described their experience with performing an oral food challenge (OFC) for acute food protein-induced enterocolitis syndrome (FPIES), with a single dose in a full serving size for the age of the culprit food, followed by a 4-hour observation period. The main aim of that study was to assess the safety of their OFC protocol.

Background: Consuming larger portion sizes, i.e., in excess of a typically recommended serving size, has been attributed to the obesity epidemic. The workplace acts as an efficient target for health promotion activities. Aims: To assess the effectiveness of a food portion size educational programme in increasing knowledge among the employees of a software company in Puducherry. Methodology: An interventional study was conducted with a pre-post design. A single group of software company employees (N = 120), age ≥30 years selected by simple random sampling was included in the study. The intervention consisted of a health education programme on the portion sizes of common food items including fruits and vegetables. A self-administered questionnaire was used to collect information on personal and sociodemographic details. Self-regulation on eating was assessed using the Self-Regulation of Eating Behaviour Questionnaire (SREBQ). Results: The mean age of the study participants was 27 ± 5 years. Most of the participants were males, i.e., 72 (60%). Of the total, 55 (47.8%) participants were obese and 18 (15.7%) were overweight. The median number of meals and snacks consumed by the participants was 3 (1–3) and 1 (1–2), respectively. The median (interquartile range [IQR]) knowledge scores of the food portion size significantly increased from 9 (0–16) to 14 (5–19) (P < 0.05). Conclusions: This study has demonstrated that an educational intervention in the workplace setting is feasible and effective in increasing the knowledge of food portion size over a short term.

Risk for colorectal cancer (CRC) is increased in adults with poor diet quality, low socioeconomic status, and increased body mass index (BMI). Cooked meats contain high contents of mutagenic compounds related to CRC risk. To explore differences in meat-based carcinogen exposure, a 99-item Qualtrics survey was issued to 1648 US adults. Average monthly serving size, degree of doneness, and cooking methods of meat products were obtained. The National Cancer Institute CHARRED database was used to quantify exposure to HCAs, PAHs, and Ames Predicted and Estimated mutagenicity. Questions from validated instruments assessed food security status (FSS) and demographic variables, while height and weight were self-reported to calculate BMI. Sex, FSS and obesity status (BMI > 30 kg/m2) were compared using two-sample t-tests and multivariate regression models to determine differences in meat intake and carcinogen exposure. Statistical significance was set at P

In food safety, process pathway risk assessments usually estimate the risk of illness from a single hazard and a single food and can inform food safety decisions and consumer advice. To evaluate the health impact of a potential change in diet, we need to understand not only the risk posed by the considered hazard and food but also the risk posed by the substitution food and other potential hazards. We developed a framework to provide decision-makers with a multi-faceted evaluation of the impact of dietary shifts on risk of illness. Our case study explored exposure to inorganic arsenic (iAs) and aflatoxins through consumption of infant cereals and the risk of developing lung, bladder and liver cancer over a lifetime. The estimated additional Disability-Adjusted Life Year (DALY) in the U.S. from exposure to iAs and aflatoxin based on available contamination and consumption patterns of infant rice and oat cereal is 4,921 (CI 90% 414; 9,071). If all infant cereal consumers shift intake (maintaining equivalent serving size and frequency) to only consuming infant rice cereal, the predicted DALY increases to 6,942 (CI 90% 326; 12,931). If all infant cereal consumers shift intake to only consuming infant oat cereal, the predicted DALY decreases to 1,513 (CI 90% 312; 3,356). Changes in contaminant concentrations or percent consumers, that could occur in the future, also significantly impact the predicted risk. Uncertainty in these risk predictions is primarily driven by the dose-response models. A risk-risk analysis framework provides decision-makers with a nuanced understanding of the public health impact of dietary changes and can be applied to other food safety and nutrition questions.

Alternative meat products provide help to reduce the consumption of meat; however, consumers are concerned with the nutritional quality of the novel and traditional plant-based burgers. The objective is to analyse the nutritional profile of commercially available burgers in the U.S. in the categories of beef, imitation, and veggie. We generated a database of burger products by investigating Mintel and company websites, which resulted in the inclusion of imitation (n = 28), veggie (n = 89), and conventional beef (n = 41) burgers. We analysed the nutritional composition (serving size, kcal, macro and micronutrients, vitamins, and minerals) across the three burger types. Beef burgers provided significantly more calories, fat (total fat, saturated fat, trans fat, and cholesterol), and protein while providing less sodium and fibre compared to alternative burgers. As consumers begin to make conscious decisions to reduce meat consumption, either for health or sustainability reasons, they need to be aware that these products are not nutritionally equivalent.

Pasta represents a staple food in many populations and, in recent years, an increasing number of pasta items has been placed on the market to satisfy needs and trends. The aims of this work were: (i) to investigate the nutritional composition of the different types of pasta currently sold in Italy by collecting the nutrition facts on their packaging, (ii) to compare energy, nutrient and salt content per 100 g and serving in fresh and dried pasta, (iii) to compare the nutrition declaration in pairs of products with and without different declarations (i.e., gluten free (GF), organic, and nutrition claims (NC)). A total of 756 items, made available by 13 retailers present on the Italian market, were included in the analysis. Data showed a wide difference between dried and fresh pasta, with high inter-type variability. A negligible amount of salt was observed in all types of pasta, except for stuffed products, which had a median high quantity of salt (&gt, 1 g/100 g and ~1.5 g/serving). Organic pasta had higher fibre and lower protein contents compared to conventional pasta. GF products were higher in carbohydrate and fat but lower in fibre and protein than not-GF products, while only a higher fibre content was found in pasta with NC compared to products not boasting claims. Overall, the results show high variability in terms of nutrition composition among the pasta items currently on the market, supporting the importance of reading and understanding food labels for making informed food choices.

This study aims to design and validate a nutritional recipe for a snack made of Green Banana (Musa paradisiaca) Peel Flour (GBPF) and to assess the nutritional composition and microbiological quality of the flour. Banana peel, a food industry by-product, is a nutritious, low-cost material available for all year. Banana peel flower could be used as a functional ingredient due to its high fiber content and good functional properties. In general, university students have a deficient dietary fiber intake due to altered dietary patterns; thus, this study was focused on this population. The GBPFs were obtained from the peels of pre-climacteric bananas by fluidized bed (FDB) dryer, after which, microbiological, proximate, and dietary fiber analyses were applied. It was designed the nutritional recipe for the snack taking into account the energy and dietary fiber nutritional requirements of the target population. It could be validated and adjusted the recipe following the methodology of Centro Nacional de Alimentación y Nutrición, concluding with the determination of dietary fiber in the end-product. The dietary fiber, total carbohydrate, protein, total fat and energy contents of the GBPF were as following: 38.7 g, 76.3 g, 5.9 g, 3.6 g, and 361.2 kcal, per 100 g of flour. The snack contained 7.74 g of dietary fiber per serving size, having a good acceptance among the university students' panelists based on an organoleptic test. In conclusion, the GBPF showed great potential as a source of dietary fiber, and it was an excellent source of carbohydrates and other nutrients to a lesser degree. When included as a functional ingredient in the nutritional formulation of a snack, it had an overall positive effect on the product’s organoleptic characteristics. Resumo Este estudo tem como objetivo projetar e validar uma receita nutricional para um “snack” feito com farinha de casca de banana verde (Musa paradisiaca), além de avaliar a composição nutricional e a qualidade microbiológica da farinha. A casca de banana, um subproduto da indústria de alimentos, é um material nutritivo e de baixo custo, disponível durante todo o ano. A casca de banana pode ser usada como ingrediente funcional devido ao seu alto teor de fibras e às boas propriedades funcionais. Em geral, os estudantes universitários têm uma ingestão deficiente de fibras alimentares devido a padrões alimentares alterados; assim, esse estudo focou nessa população. A farinha de casca de banana verde foi obtida a partir das cascas de bananas pré-climatéricas por secagem em leito fluidizado; em seguida foram realizadas análises microbiológicas, de composição centesimal e de fibras alimentares. Criou-se a receita nutricional para o ”snack”, levando-se em consideração as necessidades nutricionais de energia e fibras alimentares da população-alvo. A receita foi validada e ajustada seguindo a metodologia do Centro Nacional de Alimentación y Nutrición, concluindo com a determinação da fibra alimentar no produto final. Os teores de fibra alimentar, carboidrato total, proteína, gordura total e energia da farinha de casca banana verde foram, respectivamente: 38,7 g, 76,3 g, 5,9 g, 3,6 g e 361,2 kcal, por 100 g de farinha. O “snack” continha 7,74 g de fibra alimentar por porção, tendo uma boa aceitação entre os participantes universitários, com base em um teste organoléptico. Em conclusão, a farinha de casca de banana verde mostrou grande potencial como fonte de fibra alimentar, sendo uma excelente fonte de carboidratos e, em menor grau, de outros nutrientes. Quando incluída como ingrediente funcional na formulação nutricional de um lanche, teve um efeito geral positivo nas características organolépticas do produto.

Nudge theory predicts that consumers will select smaller portions of high energy density (HED) foods and drinks when packaging presents physical or other limits. To test the feasibility and acceptability of packaging concepts designed to limit portion sizes for children, two mixed methods studies were conducted. Packaging with functional serving size reminders, visual narrative, and metaphor were developed using 3-D prototypes. In each study, packaging prototypes were assessed, either in person (Study 1, n = 50) or via an online survey (Study 2, n = 297). In Study 1, parents visiting a Science museum poured servings for their children of HED foods/drinks and provided feedback on prototypes designed to limit portions of these items. Responses were recorded via questionnaire and interview. In Study 1, parents significantly adjusted amount poured for children based on age and in alignment with recommended portion sizes; they reported that the packaging prototypes would facilitate portion control through education, convenience and autonomy but raised concerns about costs and recyclable/reusable materials. In Study 2 parents responded to the same prototypes online providing measures of willingness to pay (WTP), forced choice and open-ended feedback for each concept. Parents were WTP more for downsizing packaging concepts, choosing them over their regular brand in most cases and confirming a generally positive view of the designs. However, WTP magnitude depended on consumer segmentation (price concerns, health motives). Innovative design concepts can be used to nudge towards smaller portions, but this depends on parental motivation.