Search

Sustainable livestock production requires links between farm characteristics, animal performance and animal health to be recognised and understood. In the pig industry, respiratory disease is prevalent, and has negative health, welfare and economic consequences. We used national-level carcass inspection data from the Food Standards Agency to identify associations between pig respiratory disease, farm characteristics (housing type and number of source farms), and pig performance (mortality, average daily weight gain, back fat and carcass weight) from 49 all in/all out grow-to-finish farms. We took a confirmatory approach by pre-registering our hypotheses and used Bayesian multi-level modelling to quantify the uncertainty in our estimates. The study findings showed that acquiring growing pigs from multiple sources was associated with higher respiratory condition prevalence. Higher prevalence of respiratory conditions was linked with higher mortality, and lower average daily weight gain, back fat and pig carcass weight. Our results support previous literature using a range of data sources. In conclusion, we find that meat inspection data are more valuable at a finer resolution than has been previously indicated and could be a useful tool in monitoring batch-level pig health in the future.

Background: The term “nutrient profile” (NP) has been associated with several concepts arising from the need to regulate the choice of food products, and to allow consumers to make informed and healthier food choices. The use of NP models as a policy tool to improve public health nutrition and reduce the prevalence of non-communicable diseases, is receiving increasing attention. Scope and approach: To clarifying the importance of NP models as tools to establish public health interventions concerning consumers’ food choices, a literature review of the guiding principles to implement NP models was conducted. The covered topics include main characteristics, advantages, disadvantages, and associated gaps of the considered NP models. Key findings and conclusions: From the selected studies, a total of 85 documents were included. Nutrient profiling has a wide range of applications including front-of-pack (FoP) food labelling, regulation of food marketing to children, regulation of health and nutrition claims and school food standards. Sodium, saturated fatty acids (SFA), and total sugars were the nutrients most frequently to limit; on the contrary fibre was the most used qualifying nutrient. This review gathers, through a holistic approach, the scientific basis behind the development of the NP model, reinforcing the importance of these tools, and enabling regulators with information to establish an appropriate model. Highlights: A ‘healthy’ diet requires informed and healthy food choices by the consumers; Nutrient Profile (NP) models result from the need to promote healthier food choices; NP models can be a useful tool to help consumers choose healthier food; Different nutrient profile models are needed for different purposes; Key points should be considered in the development and sustainable application of NP models. Ricardo Assunção thanks FCT/MCTES for the financial support to CESAM (UIDP/50017/2020+UIDB/50017/2020), through national funds. info:eu-repo/semantics/publishedVersion

Over the past two decades, the rapid rise of social media has revolutionized the way we communicate and share information online. Social media platforms are not now only used extensively by individuals but also by businesses, governmental agencies, educational institutions, and many other organizations to deliver information to the public and, in return, collect information from that same audience. The preliminary study presented here offers valuable insights into how social media may be used to improve food safety standards. Today, food safety is still a major health challenge in the country, which occasionally faces unsafe food supply chains, an increased number of food borne outbreaks, and poor hygiene education. Social media may be used as a very valuable tool for people to access important information and more knowledge about food safety. The limited-scope survey presented here was conducted over the western part of Saudi Arabia and included 295 individuals of both genders, among various age groups. Participants responded to an online questionnaire about their use of social media to obtain information about food safety. Results showed that social media was indeed a major outlet for individuals to access information on food safety, with the top-ranked social media platforms being WhatsApp (M = 2.99) followed by Snapchat (M = 3.72), YouTube (M = 4.08), Instagram (M = 4.46), and Facebook (M = 4.81). Additionally, we found that the most trusted sources of information was the Saudi Food and Drug Authority (72.6%) and the Saudi Ministry of Health (55.4%). Participants most frequently sought epidemiological information (52.5%), quantitative risk estimates (23.1%), and information on the various types of foodborne infections (15.3%); they preferred the information to be in video format (67.5%), articles (57.6%), infographics (55.3%). Trustworthiness clearly emerged from the survey as an important consideration for individuals when accessing food safety information on social media.

Objective:To consider the principal effect of an interaction between year (pre- and post-Universal Infant Free School Meals (UIFSM)) and school on pupil’s dietary intakes.Design:A repeated cross-sectional survey using dietary data from 2008 to 2009 (pre-) and 2017 to 2018 (post-UIFSM)Setting:Two primary schools, NE England.Participants:Pupils aged 4–7 years (2008–2009 n 121; 2017–2018 n 87).Results:At lunchtime, there was a statistically significant decrease in pupils non-milk extrinsic sugars intake (%E NMEs) pre- to post-UIFSM (mean change –4·6 %; 95 % CI –6·3, –2·9); this was reflected in total diet (–3·8 %; –5·2, –2·7 %). A year and school interaction was found for mean Ca intakes: post-UIFSM pupils in School 2 had a similar mean intake as pre; in School 1 intakes had increased (difference of difference: –120 mg; 95 % CI –179, –62); no reflection in total diet. Post-UIFSM mean portions of yogurt decreased in School 2 and remained similar in School 1 (–0·25; –0·46, –0·04); this was similar for ‘cake/pudding’ and fruit.Conclusions:Within the limitations, these findings highlight positives and limitations following UIFSM implementation and demonstrate the role of school-level food practices on pupil’s choices. To facilitate maximum potential of UIFSM, national levers, such as discussions on updating school food standards, including sugars, could consider removing the daily ‘pudding’ option and advocate ‘fruit only’ options 1 d/week, as some schools do currently. Small school-level changes could maximise positive health impacts by decreasing NMEs intake. A more robust evaluation is imperative to consider dietary impacts, equitability and wider effects on schools and families.

We commissioned this survey to better understand how food allergies, intolerances and coeliac disease affect people across the UK, and the factors associated with higher or lower quality of life. It will also inform our ongoing work to monitor and evaluate the success of the FSA’s food hypersensitivity programme. The FSA will be running a second wave of the survey in autumn this year, and we will use this to observe any differences in the eating out and quality of life data collected across the two timepoints.

"Clean eating" is an increasingly popular diet trend in Western countries with links to disordered eating behaviors. However, the definition of "clean" is a highly contentious issue. Negowetti, Ambwani, Karr, Rodgers, and Austin explore this important issue from a U.S. perspective conducting a scoping review of the public health implications of the use of "clean" labels on food, including legal and policy implications. The review showed that the U.S. Food and Drug Administration (FDA) has taken little action to address regulation of the use of "clean" dietary labels. Our own brief investigations suggest that the landscape in Australia under the Food Standards Australia New Zealand authority is similar. We discuss recommendations made by Negowetti et al. to address this issue in the United States, such as the FDA providing industry guidance on the term "clean," and the issuing of warning letters to companies who contravene this guidance. However, we predict that educating consumers to be more critical of unsubstantiated food labels in public health campaigns will be the most efficient way to change consumer behavior and address the "clean eating" diet trend. We also encourage eating disorder researchers and clinicians to be an influential part of this discussion.

Campylobacter is the leading cause of human bacterial diarrheal disease worldwide, and poultry meat products account for the majority of human cases. Based on recent surveys, the Food Standards Agency has estimated the Campylobacter prevalence in fresh retail chicken in the United Kingdom to be 41.2%. However, such surveys have not distinguished between broiler chickens produced for different consumer demographic groups, such as the Halal market. Campylobacter colonization of broilers is difficult to prevent, especially during routine partial depopulation of flocks. Broilers produced for the Halal market may undergo multiple depopulation events, which may increase the risk of Campylobacter colonization and subsequent contamination of chicken meat. This study was conducted to determine the prevalence and levels of Campylobacter contamination in chicken meat produced for the Halal market in the United Kingdom. Campylobacter was identified and enumerated from the neck skin and outer packaging of 405 Halal chickens. Culture isolates were assigned to species via PCR assays, and disk diffusion assays were used to determine antimicrobial susceptibility. Logistic regression analysis was used to assess risk factors for Campylobacter contamination, the level of Campylobacter contamination among positive carcasses, and antimicrobial resistance. Campylobacter spp. were confirmed in 65.4% of neck skin samples and 17.1% of packaging samples. Neck skin samples had the highest level of contamination; 13.8% of samples had >1,000 CFU/g. Large birds had a significantly higher number of samples with >1,000 CFU/g (P < 0.001). and as chicken carcass weight increased, birds were more likely to be Campylobacter positive (P < 0.05). A high prevalence of resistance was seen to ciprofloxacin (42.0% of samples), and 38.5% of samples contained at least one multidrug-resistant Campylobacter isolate. This study revealed that Halal chicken has a higher Campylobacter prevalence than does non-Halal chicken. Interventions should be introduced to reduce this public health risk. HIGHLIGHTS

Background Vending machines represent one way of offering food, but they are overlooked in the efforts to improve people’s eating habits. The aim of our study was to analyse the variety and nutritional values of beverages offered in vending machines in social and health care institution in Slovenia. Methods The available beverages were quantitatively assessed using traffic light profiling and the model for nutrient profiling used by Food Standards Australia New Zealand. Vending machines in 188 institutions were surveyed, resulting in 3046 different beverages consisting of 162 unique product labels. Results Between 51 and 54% of beverages were categorised as unhealthy with regard to sugar content. Water accounted for only 13.7% of all beverages in vending machines. About 82% of beverages in vending machines were devoted to sugar-sweetened beverages, the majority (58.9%) presented in 500-ml bottles. The average sugar content and average calories in beverages sold in vending machines are slightly lower than in beverages sold in food stores. Conclusions We suggest that regulatory guidelines should be included in the tender conditions for vending machines in health and social care institutions, to ensure healthy food and beverage choices.

Background The effect of personalised nutrition advice on discretionary foods intake is unknown. To date, two national classifications for discretionary foods have been derived. This study examined changes in intake of discretionary foods and beverages following a personalised nutrition intervention using these two classifications. Methods Participants were recruited into a 6-month RCT across seven European countries (Food4Me) and were randomised to receive generalised dietary advice (control) or one of three levels of personalised nutrition advice (based on diet [L1], phenotype [L2] and genotype [L3]). Dietary intake was derived from an FFQ. An analysis of covariance was used to determine intervention effects at month 6 between personalised nutrition (overall and by levels) and control on i) percentage energy from discretionary items and ii) percentage contribution of total fat, SFA, total sugars and salt to discretionary intake, defined by Food Standards Scotland (FSS) and Australian Dietary Guidelines (ADG) classifications. Results Of the 1607 adults at baseline, n = 1270 (57% female) completed the intervention. Percentage sugars from FSS discretionary items was lower in personalised nutrition vs control (19.0 ± 0.37 vs 21.1 ± 0.65; P = 0.005). Percentage energy (31.2 ± 0.59 vs 32.7 ± 0.59; P = 0.031), percentage total fat (31.5 ± 0.37 vs 33.3 ± 0.65; P = 0.021), SFA (36.0 ± 0.43 vs 37.8 ± 0.75; P = 0.034) and sugars (31.7 ± 0.44 vs 34.7 ± 0.78; P Conclusions Compared with generalised dietary advice, personalised nutrition advice achieved greater reductions in discretionary foods intake when the classification included all foods high in fat, added sugars and salt. Future personalised nutrition approaches may be used to target intake of discretionary foods. Trial registration Clinicaltrials.gov NCT01530139. Registered 9 February 2012.

In the article there are presented results of a study of the balance of food consumption by the population of the Voronezh region, the assessment of the level of contamination of food products and both carcinogenic and non-carcinogenic and public health risk caused by this contamination. There was evaluated the level of nutrition-dependent diseases. A special feature of this study is a comparative analysis of data obtained during the two five-year periods of 1995-1999 and 2010-2014, that permitted to reveal changes in food consumption, the dynamics of morbidity rate associated with the nutritional factor.

We examined whole-genome–sequenced Campylobacter jejuni and C. coli from 2012–2015 isolated from birds and human stool samples in North East Scotland for the presence of antimicrobial resistance genes. We found that sequence type (ST) 5136 (clonal complex 464) was the most prevalent multidrug-resistant strain of C. jejuni exclusively associated with poultry host reservoirs and recovered from human cases of campylobacteriosis. Tetracycline resistance in ST5136 isolates was due to a tet(O/32/O) mosaic gene, ampicillin resistance was conferred by G → T transversion in the −10 promoter region of blaOXA-193, fluoroquinolone resistance was due to C257T change in gyrA, and aminoglycoside resistance was conferred by aac. Whole-genome analysis showed that the strain ST5136 evolved from ST464. The nationwide emergence of ST5136 was probably due to stepwise acquisition of antimicrobial resistance genes selected by high use of β-lactam, tetracycline, fluoroquinolone, and aminoglycoside classes of drugs in the poultry industry.

The aim was to evaluate the influence of an intervention on the nutritional and sensory quality of the menus and on the food waste of a Children's Educational Center. It is a quasi-experimental study that used the Qualitative Assessment of the Menu Preparations method and performed the waste-ingestion quantities and clean leftovers. The intervention was characterized by the inclusion of new recipes and adequacy of portions according to recommendations for the children's age group. Data were analyzed using the Mann Whitney test with a significance level of p < 0.05. The intervention resulted in a reduction in the occurrence of the side dish supply, color monotony, presence of sweets, presence of fried foods, sweets associated with fried foods, and repetition of the main dish cooking technique. In addition, there was a significant reduction in the average quantities of waste-ingestion/child (from 69.02 ± 11.87g to 37.06 ± 15.57g), clean leftovers /child (from 161.47 ± 44.12g to 35.23 ± 33.73 g) and clean leftovers percentage (from 39.56 ± 7.96 to 21.01 ± 17.15). The positive influence of intervention reinforces the importance of adjustments in recipes and portioning of preparations to meet the nutritional recommendations and to control food waste.

Food products suitable for Muslim consumers should behalalcertified, particularly when their origins or production processes are doubtful. However, there is a multiplicity ofhalalstandards. This situation may generate confusion, particularly for producers in Western countries who would like to certify their products in order to export them to Islamic countries. This study analyzed the reasons underlying the multiplicity of standards and reviewed the attempts of harmonization over time. Then, the case study of application to slaughterhouses was considered, by comparing four differenthalalstandards (namely GSO 993:2015, OIC/SMIIC 1:2019, HAS 23103:2012, and MS 1500:2019) representative of different geographic areas. Animal stunning was critically examined, comparing tradition with modernity. The study evidenced that the basic requirements related to slaughtering are common to all thehalalstandards considered, but several differences occur in more specific details. Only a close collaboration between the authorities of all the countries involved in issuinghalalcertifications will lead to a homogeneous regulatory framework with unified certification and accreditation procedures, increasingly required in a globalized market.

Vegetarianism and veganism are increasingly popular. The Food Standards Agency, biennial Food and You Survey of adults aged 16 years and over living in the UK, found that between 2012 and 2018 the proportion of people who reported never consuming dairy products had increased from 2% to 5%. However, veganism risks development of vitamin B12 deficiency as it is not available from plant sources. Moreover, its impact may be slow to be detected because body stores of vitamin B12 can last years. There is currently no published guidance on antenatal diagnosis and management of vitamin B12 deficiency. This paper reviews the metabolism, diagnosis and treatment of vitamin B12 in pregnancy. It concludes that national screening policy makers should consider introducing screening for B12 deficiency into the Antenatal and Newborn Screening Programmes for mothers and their infants if at risk of vitamin B12 deficiency. In the interim, national policy should be developed for prophylactic vitamin B12 supplementation in high risk groups around the time of pregnancy.

The Healthy, Hunger-Free Kids Act (HHFKA) of 2010 made sweeping changes to school nutritional standards. We estimate the impacts of shifts in school nutritional standards on dietary quality as well as dietary quantity of children's food intakes from school and away-from-school food sources. We find the average effect of consuming school food, rather than away-from-school food, on children's overall dietary quality significantly increased from the pre- to post-HHFKA implementation period. This effect was solely driven by substantial improvements in the dietary quality of foods acquired at school, mainly among older and higher-income children. Our indirect effect analysis indicated that children shifted towards consuming lower-quality diets at home in the post-HHFKA period, thereby partially offsetting the positive effects of the HHFKA on their overall dietary quality. Indirect impacts were primarily driven by a subset of children consuming more than a third of their daily calories from school food. Additionally, we find suggestive evidence of a modest decrease in daily calorie intake, particularly among older and higher-income children. Together, our findings imply that the HHFKA, despite its unintended negative indirect effects, led children to consume more-nutritious, less-energy-dense diets.

This cross-sectional study examined how the nutritional quality of meals and snacks was associated with overall diet quality and adiposity measures.Based on 7-d weighed dietary record data, all eating occasions were divided into meals or snacks based on time (meals: 06:00-09:00 h, 12:00-14:00 h, and 17:00-20:00 h; snacks: others) or contribution to energy intake (meals: ≥15%; snacks:15%) in British children aged 4-10 (n = 808) and adolescents aged 11-18 (n = 809). The nutritional quality of meals and snacks was assessed as the arithmetical energy intake-weighted means of the Food Standards Agency (FSA) nutrient profiling system score of each food and beverage consumed, based on the contents of energy, saturated fatty acid, total sugar, sodium, fruits/vegetables/nuts, dietary fiber, and protein.Regardless of the definition of meals and snacks, higher FSA score (lower nutritional quality) of meals was inversely associated with overall diet quality assessed by the Mediterranean diet score in both children and adolescents (P 0.0001), whereas the inverse associations for the FSA score of snacks did not reach statistical significance. The FSA score of meals based on time was inversely associated with body mass index z-score only in children, whereas that of snacks based on time showed a positive association.Lower nutritional quality of meals, but not snacks, assessed by the FSA score was associated with lower overall diet quality, whereas no consistent associations were observed with regard to adiposity measures.

Regulatory changes in Canada will require food labels to have a benchmark [% Daily Value, %DV] for total sugars, based on 100 g/day, while US labels will require a %DV for added sugars, based on 50 g/day. The objective of this study was to compare two labelling policies, a total sugars DV (100 g/day) and a free sugars DV (50 g/day) on food labels. This cross-sectional analysis of the Food Label Information Program database focussed on top sources of total sugars intake in Canada (n = 6924 foods). Products were categorized as "less healthy" using two sets of criteria: a) free sugars levels exceeding the WHO guidelines (≥10% energy from free sugars); and b) exceeding healthfulness cut-offs of the Food Standards Australia New Zealand Nutrient Profiling Scoring Criterion (FSANZ-NPSC). The proportion of "less healthy" products with ≥15%DV (defined as "a lot" of sugars i.e. high in sugars, based on Health Canada's %DV labelling footnote and educational message for dietary guidance) were compared for each sugar labelling scenario. The free sugars DV showed better alignment with both methods for assessing "healthfulness" than the total sugars DV. The free sugars DV identified a greater proportion of "less healthy" foods with ≥15%DV, based on both the FSANZ-NPSC (70% vs. 45%, p .0001) and WHO guidelines (82% vs. 55%, p .0001); particularly in sweet baked goods, sugars and preserves, chocolate bars, confectionery, and frozen desserts categories. Compared to total sugars DV labelling, using a free sugars DV identified more "less healthy" foods. Findings support the adoption of free sugars labelling.

Purpose The purpose of this paper is to analyze households’ acquisition of healthy food away from home (FAFH) from restaurants. Specifically, determinants of households’ decision to purchase healthy FAFH, the share of households’ FAFH expenditures allocated to healthy FAFH and the share of households’ FAFH calories obtained from healthy items are identified. Design/methodology/approach Using data from the National Household Food Acquisition and Purchase Survey, the UK Food Standards Agency’s Nutrient Profiling Model is used to classify the healthfulness of households’ FAFH purchases. A double-hurdle model is estimated to identify determinants of households’ decision to purchase healthy FAFH and the share of their FAFH expenditures and calories allocated to healthy items. Findings Households’ acquisition of healthy FAFH varies with income, food assistance, FAFH purchase frequency, dieting, restaurant type, household composition, region and season. There is little difference in the impact of these factors on healthy FAFH expenditure shares vs calorie shares, suggesting that healthy FAFH expenditures proxy the contribution of healthy FAFH to a households’ diet. Practical implications Results suggest that increased availability of healthy FAFH may need to be supplemented by targeted advertising and promotions, revisions to nutrition education programs, improved nutrition information transparency and value pricing in order to improve the dietary quality of households’ FAFH acquisitions. Originality/value This study is the first to analyze household acquisition of healthy FAFH.

The objective of this study was to evaluate differences in calories, nutrient content, overall healthfulness, and use of sweetener ingredients between products with and without sugar claims. Consumers assume products with sugar claims are healthier and lower in calories. It is therefore important claims be found on comparatively healthier items. This study is a cross-sectional analysis of the University of Toronto’s 2013 Food Label Database. Subcategories where at least 5% of products (and n ≥ 5) carried a sugar claim were included (n = 3048). Differences in median calorie content, nutrient content, and overall healthfulness, using the Food Standards Australia/New Zealand Nutrient Profiling Scoring criterion, between products with and without sugar claims, were determined. Proportion of products with and without claims that had excess free sugar levels (≥10% of calories from free sugar) and that contained sweeteners was also determined. Almost half (48%) of products with sugar claims contained excess free sugar, and a greater proportion contained sweeteners than products without such claims (30% vs 5%, χ2 = 338.6, p < 0.0001). Overall, products with sugar claims were “healthier” and had lower median calorie, free sugar, total sugar, and sodium contents than products without claims. At the subcategory level, reductions in free sugar contents were not always met with similar reductions in calorie contents. This study highlights concerns with regards to the nutritional composition of products bearing sugar claims. Findings can support educational messaging to assist consumer interpretation of sugar claims and can inform changes in nutrition policies, for example, permitting sugar claims only on products with calorie reductions and without excess free sugar.

The current study used differential reinforcement and shaping to increase the variety of foods accepted by children with autism who demonstrated significant feeding inflexibility. Participants were introduced to four new food items via a hierarchical exposure, which involved systematically increasing the desired response with the food item. Level of food consumption was evaluated using a combined multiple baseline plus changing criterion design. Following intervention, all participants accepted all foods targeted, expanding upon the number of foods consumed.

In Australia, numerous egg-related human Salmonella typhimurium outbreaks have prompted significant interest among public health authorities and the egg industry to jointly address this human health concern. Nationwide workshops on Salmonella and eggs were conducted in Australia for egg producers and regulatory authorities. State and national regulators represented Primary Production, Communicable Disease Control, Public Health and Food Safety, and Food Standards Australia and New Zealand. All attendees participated in discussions aimed at evaluating current evidence-based information, issues related to quality of egg production, and how to ensure safe eggs in the supply chain, identifying research gaps and practical recommendations. The perceptions from egg producers and regulatory authorities from various states were recorded during the workshops. We presented the issues discussed during the workshops, including Salmonella in the farm environment, Salmonella penetration across eggshell, virulence in humans, food/egg handling in the supply chain, and intervention strategies. We also discussed the perceptions from egg producers and regulators. Recommendations placed emphasis on the future research needs, communication between industry and regulatory authorities, and education of food handlers. Communication between regulators and industry is pivotal to control egg-borne S. typhimurium outbreaks, and collaborative efforts are required to design effective and appropriate control strategies.

ObjectiveTo investigate socio-economic differences in children’s diet, activity and inactivity and changes in these differences over 4 years during which new policies on food in schools were introduced.DesignTwo cross-sectional surveys in which diet was assessed by FFQ and physical activity and inactivity were assessed by interviewer-administered questionnaire. Socio-economic status was assessed by the area-based Scottish Index of Multiple Deprivation.SettingScotland, 2006 and 2010.SubjectsChildren aged 3–17 years (n 1700 in 2006, n 1906 in 2010).ResultsIn both surveys there were significant linear associations between socio-economic deprivation and intakes of energy, non-milk extrinsic sugars (NMES) as a percentage of food energy, sugar-sweetened beverages, confectionery, crisps and savoury snacks and leisure-time screen use (all higher among children in more deprived areas), while intakes of fruit, fruit juice and vegetables showed the opposite trend. In 2010 children in more deprived areas engaged in more physical activity out of school than those in more affluent areas, but between 2006 and 2010 there was an overall reduction in physical activity out of school. There were also small but statistically significant overall reductions in intakes of confectionery, crisps and savoury snacks, energy and NMES and saturated fat as a percentage of food energy, but no statistically significant change in socio-economic gradients in diet or activity between the two surveys.ConclusionsInterventions to improve diet and physical activity in children in Scotland need to be designed so as to be effective in all socio-economic groups.

The Australia New Zealand Food Standards Code (the Code) requires a declaration of the presence of 11 different allergens made through the label on a food product. Most food recalls in Aust...

Within the European Union (EU), microbiological criteria (MC) sampling for Salmonella in poultry was introduced in 2005. In particular, processors had to meet a target of fewer than seven positive samples out of 50. However, processors producing small amounts of poultry meat did not have to sample if national authorities determined this was an acceptable risk. The U.K. Food Standards Agency (FSA) thus has a sampling regime based on throughput that allows smaller processors not to sample. In 2011, the limit of 7/50 was reduced to 5/50. Given the current uncertainty regarding U.K. trade relations with the EU, the U.K. FSA decided to conduct a new risk assessment of the risks of Salmonella produced by smaller processors, to determine whether sampling was now necessary. Current evidence suggests that an MC sampling regime in smaller slaughterhouses is not warranted from a national public health perspective. Because of the insensitivities of the MC sampling scheme, the introduction of MC sampling into smaller slaughterhouses would only be necessary if the suspected carcass prevalence was 15% or more. While our analysis is prone to uncertainty, we estimated that the carcass prevalence in smaller processors is below this. Thus, we recommended that the current sampling framework, allowing smaller processors not to sample, was still applicable.

Objectives. To assess the effects of the Nutri-Score label (relative to the Reference Intakes label or no label) on the nutritional quality of students’ food purchases. Methods. A 3-arm randomized controlled trial was conducted in France in 2017; 2907 participants were randomized into 1 of the 3 study arms (Nutri-Score, Reference Intakes, no label) and invited to purchase groceries from an experimental Web-based supermarket. The main outcome was the overall nutritional quality of purchases, measured according to a modified version of the Food Standards Agency Nutrient Profiling System (FSAm-NPS/HCSP) score. Results. The mean (±SD) FSAm-NPS/HCSP score was lower in the Nutri-Score group (2.02 ±3.56) than in the Reference Intakes group (2.69 ±3.44), reflecting higher nutritional quality; however, there was no significant difference between the Nutri-Score and no-label (2.45 ±3.28) groups or between the Reference Intakes and no-label groups. Shopping cart content was lower in calories and saturated fatty acids and higher in fruits and vegetables in the Nutri-Score arm than in the other arms. Conclusions. The Nutri-Score label appeared to improve the nutritional composition of students’ food purchases relative to the Reference Intakes label or no label.

The paper outlines the ‘complete arc’ of a range of modelling activities initiated by UK's Food Standards Agency (FSA). Norovirus produces infectious intestinal disease in humans via both person-to-person contact (P2P) and foodborne (FB) transmission. The FSA commissioned a research study to improve understanding of FB mechanisms, and of where it might target its efforts. In response, an existing P2P model with a single, exogenous parameter for FB transmission was transformed into a System Dynamics model of FB processes. The modelling involved individual interviews and a facilitated group modelling session, the FSA providing access to relevant experts. Contamination routes modelled concerned: bi-valve shellfish; sludge; some fruits and vegetables; other foodstuffs. This large model showed it was possible to give an account of the underlying causal mechanisms; and it facilitated a categorisation of parameters in a manner useful in agenda-setting for future research and in identifying policy levers. Some creative thinking extended the work in an unexpected but significant way. Data and mathematical analysis made it possible to calibrate a P2P model for the first time. Sensitivity analysis then suggested that small changes in human behaviour could explain the tenfold seasonal variation in Norovirus cases, and also offered an understanding of the relative importance of FB and P2P vectors. The range of consequences of the study included an increased understanding by the FSA of the different means of trying to control Norovirus, practical actions and ideas for further work.

Background The mean intake of vitamin A of Australians aged 2 y and older was 300 µg retinol equivalents lower in the 2011-2012 national nutrition survey than in 1995 and decreases preponderated in adults rather than young children. Objective This aim of this study was to identify the foods associated with this change and to examine how the method used to adjust for within-person variability affects the estimated prevalence of inadequate intakes in both surveys. Methods Foods contributing to vitamin A intake were calculated from the first day of data. The prevalence of inadequate intakes was calculated using a 2-d average, the Iowa State University method, and the National Cancer Institute (NCI) method and either taken from the published reports or calculated using Food Standards Australia New Zealand's in-house software. Results In adults, lower consumption of liver, yellow fat spreads, milk products, and carrots and similar root vegetables accounted for most of the change in intake. Vitamin A intake data were less right-skewed in 2011-2012 than in 1995. The prevalence of inadequate vitamin A intake depended on the adjustment method chosen: for example, in 2011-2012 it ranged between 3% and 55% in men aged 19-30 y. The NCI method prevalence (21% for this group) is taken as the preferred estimate of inadequacy because the method adjusts around the mean and accounts for several other sources of variance. However, the NCI method could not be used to analyze the 1995 survey. Conclusions The lower vitamin A intake in Australia was related to changes in retinol intake rather than carotenoid intake and to lower consumption of several different types of food. The estimated prevalence of inadequate intake depends on the statistical method chosen for analysis. A direct measure of vitamin A status is needed to allow conclusions about the implications of the decreasing intake of this vitamin.

Background: Sodium intake is related to several adverse health outcomes, such as hypertension and cardiovascular diseases. Processed foods are major contributors to the population&rsquo, s sodium intake. The aim of the present study was to determine sodium levels in Mexican packaged foods, as well as to evaluate the proportion of foods that comply with sodium benchmark targets set by the United Kingdom Food Standards Agency (UK FSA) and those set by the Mexican Commission for the Protection of Health Risks (COFEPRIS). We also evaluated the proportion of foods that exceeded the Pan American Health Organization (PAHO) targets. Methods: This was a cross-sectional study that comprised data collected from the package of 2248 processed foods from selected supermarkets in Mexico. Results: Many processed food categories contained an excessive amount of sodium. Processed meats, ham, bacon and sausages, had the highest concentrations. The proportion of foods classified as compliant in our sample was lower for international targets (FSA UK and PAHO) compared to the Mexican COFEPRIS criteria. Conclusions: These data provided a critical baseline assessment for monitoring sodium levels in Mexican processed foods.

Reliable and valid measurements of meat intake are needed to advance understanding of its health effects and to evaluate interventions to reduce meat consumption. Here, we describe the development and reliability of the Oxford Meat Frequency Questionnaire (MFQ). It asks individuals to report the number of servings of meat and seafood products they consumed in the last 24 h and is administered daily over 7 days. The MFQ combines food portion size data from the UK Food Standards Agency with estimates of meat content in composite dishes from the UK’s National Diet and Nutrition Survey. Adults who self-reported to eat meat (n = 129) completed a 3-week web-based test–retest reliability study assessing the MFQ twice, with a wash-out week in the middle. Two-way random intraclass correlation coefficients (ICC) revealed moderate to good agreement on all meat outcomes (total meat ICC = 0.716, minimum–maximum individual components = 0.531–0.680), except for fish and seafood (ICC = 0.257). Participants reported finding the questionnaire easy to use and, on average, completed it in less than 2 min. This new MFQ offers a quick, acceptable, and reliable method to measure changes in an individual’s meat intake in a UK population.

Objectives. To examine changes in competitive foods (items sold in à la carte lines, vending machines, and school stores that “compete” with school meals) in Massachusetts middle and high schools before and after implementation of a statewide nutrition law in 2012. Methods. We photographed n = 10 782 competitive foods and beverages in 36 Massachusetts school districts and 7 control state districts to determine availability and compliance with the law at baseline (2012), 1 year (2013), and 2 years (2014) after the policy (overall enrollment: 71 202 students). We examined availability and compliance trends over time. Results. By 2014, 60% of competitive foods and 79% of competitive beverages were compliant. Multilevel models showed an absolute 46.2% increase for foods (95% confidence interval = 36.2, 56.3) and 46.8% increase for beverages (95% confidence interval = 39.2, 54.4) in schools’ alignment with updated standards from 2012 to 2014. Conclusions. The law’s implementation resulted in major improvements in the availability and nutritional quality of competitive foods and beverages, but schools did not reach 100% compliance. This law closely mirrors US Department of Agriculture Smart Snacks in School standards, suggesting that complying with strict nutrition standards is feasible, and schools may experience challenges and improvements over time.

This study was conducted to determine the residual amount of veterinary drugs such as meloxicam, flunixin, and tulathromycin in animal products (beef, pork, horsemeat, and milk). Veterinary drugs have been widely used in the rearing of livestock to prevent and treat diseases. A total of 152 samples were purchased from markets located in major Korean cities (Seoul, Busan, Incheon, Daegu, Daejeon, Gwangju, Ulsan and Jeju), including Jeju. Veterinary drugs were analyzed by liquid chromatography-tandem mass spectrometry according to the Korean Food Standards Code. The resulting data, which are located within 70-120% of recovery range and less than 20% of relative standard deviations, are in compliance with the criteria of CODEX. A total of five veterinary drugs were detected in 152 samples, giving a detection rate of approximately 3.3%; and no food source violated the guideline values. Our result indicated that most of the veterinary drug residues in animal products were below the maximum residue limits specified in Korea.

THE EFFECT OF NON-DIET FOOD STANDARDS MODIFICATION ON WASTED FOOD COSTS IN CLASS III GERIATRIC PATIENTS AT RSUP dr. SOERADJI TIRTONEGORO KLATEN ABSTRACT Background: Decreasing food intake in geriatric patients due to physical and psychological conditions has an impact on the high percentage of food plate waste and wasted food costs. This study aims to determine the effect of non-diet food standards modification on the cost of food wasted on class III geriatric patients at RSUP dr. Soeradji Tirtonegoro Klaten. Methods: This experimental study used a post test only with control group design. The sample consisted of 34 people divided into 2 groups, the treatment group that received food standard modification and the control group that received food according to hospital standards. The food plate waste of each group was observed for 2 days using the Comstock visual estimation method. Wasted food costs were calculated by multiplying the percentage of food plate waste per menu item with food prices. The effect of non-diet food standards modification on wasted food costs was analyzed using the Mann Whitney test with a confidence degree of 95% (α = 0.05) Results: The average wasted food cost in the treatment group was Rp 2.806,34 and the control group was Rp 3.443,43. The results of the analysis of the effect of non-diet food standards modification on wasted food cost by the Mann Whitney test showed a p-value of 0.109 (> 0.05) Conclusion: There is no significant effect of non-diet food standards modification on wasted food costs in class III geriatric patients at RSUP dr. Soeradji Tirtonegoro Klaten.

(1) Background: The Food Agricultural Organization/World Health Organization (FAO/WHO) International Food Standards Codex Alimentarius CXS 192e International Food Standards (hereafter, CODEX) declares additives non-toxic, but they have been associated with changes to the microbiota changes and thinning of the mucus layer of the gut. Their widespread use has occurred in parallel with increased inflammatory bowel disease (IBD) incidence. This paper reports on the development and validation of surveys to estimate additive intake. (2) Methods: Dietitians created a food-additive database, with a focus on additives that have been associated with IBD. For each additive, information on the CODEX food-category they are permitted in and the associated maximum permissible levels (mg/kg) was recorded. Based on the database, questions to assess early life (part 1) and recent (part 2) additive intake were written. Forward&ndash, backward translation from English to Chinese was undertaken. Thirty-one individuals were evaluated to assess understandability. A further fifty-seven individuals completed the tool on two occasions, a fortnight apart, agreement was assessed using Cohen&rsquo, s kappa coefficient or the intra-class correlation coefficient (ICC). (3) Results: The participants reported that it was difficult to remember food intake and estimate portion sizes. The participants also noted confusion around the term &lsquo, home-grown&rsquo, Instructions and definitions were added, after this, respondents judged the questionnaires as clear. The average kappa coefficient for part 1 and part 2 questions were 0.61 and 0.67, respectively. The average ICC ranged from 0.30 to 0.94, three food lists were removed due to low reliability. (4) Conclusions: Two tools have been created and validated, in two languages, that reliably assess remote and recent food additive intake.

Aim: To examine whether the nutritional quality of children's packaged food products available in Australian supermarkets improved between 2013 and 2016, and whether any change could be detected in product reformulation since the introduction of the Health Star Rating (HSR) labelling scheme. Methods: Packaged food products marketed towards children were purchased from three Australian supermarkets in July 2013 (for a previous study) and July 2016. Nutritional quality was assessed using the Food Standards Australian New Zealand Nutrient Profiling Scoring Criterion. Comparisons were made between the nutrient composition and formulation of products (a) available in 2013 and 2016; and (b) with and without HSR graphics. Results: Of the 252 children's packaged products analysed, 53.6% were classified as ‘less healthy’. HSR‐labelled products had a significantly higher proportion classified as ‘healthy’ than those without the HSR (χ2 = 26.5; P < 0.0001; 73.8% and 59.0%, respectively). Overall, 28.5% displayed the HSR; the majority (81.5%) having a rating of ≥3.0 stars. Cereal‐based products had the greatest uptake of the scheme, with HSR‐labelled products having significantly lower mean energy and saturated fat content (P < 0.01) and higher mean protein and fibre content (P < 0.001) than non‐HSR products. Reformulation of products that were available in 2013 had occurred in 100% of HSR‐labelled products in comparison to 61.3% of non‐HSR labelled products. Conclusions: Despite the introduction of the HSR, more than half of children's packaged foods sampled are ‘less healthy’. However, early indications suggest that the HSR may stimulate healthier product reformulation.

BACKGROUND: Food and nonalcoholic beverage companies spend millions of dollars on professional sports sponsorships, yet this form of marketing is understudied. These sponsorships are valuable marketing tools but prompt concerns when unhealthy products are associated with popular sports organizations, especially those viewed by youth. METHODS: This descriptive study used Nielsen audience data to select 10 sports organizations with the most 2–17 year old viewers of 2015 televised events. Sponsors of these organizations were identified and assigned to product categories. We identified advertisements promoting food and/or nonalcoholic beverage sponsorships on television, YouTube, and sports organization Web sites from 2006 to 2016, and the number of YouTube advertisement views. The nutritional quality of advertised products was assessed. RESULTS: Youth watched telecasts associated with these sports organizations over 412 million times. These organizations had 44 food and/or nonalcoholic beverage sponsors (18.8% of sponsors), second to automotive sponsors (n = 46). The National Football League had the most food and/or nonalcoholic beverage sponsors (n = 10), followed by the National Hockey League (n = 7) and Little League (n = 7). We identified 273 advertisements that featured food and/or nonalcoholic beverage products 328 times and product logos 83 times (some advertisements showed multiple products). Seventy-six percent (n = 132) of foods had unhealthy nutrition scores, and 52.4% (n = 111) of nonalcoholic beverages were sugar-sweetened. YouTube sponsorship advertisements totaled 195.6 million views. CONCLUSIONS: Sports sponsorships are commonly used to market unhealthy food and nonalcoholic beverages, exposing millions of consumers to these advertisements.

Objectives. To evaluate a community-level sodium-reduction intervention in Boston, Massachusetts. Reducing sodium in the food offerings of community settings may help reduce hypertension disparities. Methods. We examined changes in the proportion of prepackaged foods with greater than 200 milligrams of sodium in 7 hospitals, 8 YMCAs, 4 community health centers, and 2 organizations serving homeless populations. Research assistants documented prepackaged items in cafeterias, kiosks, and vending machines before and after the intervention (2013–2015). We assessed intervention change via linear mixed models accounting for repeated observations. Results. There were 161 access points at baseline (4347 facings) and 171 (4996 facings) at follow-up. The percentage of prepackaged products with greater than 200 milligrams of sodium decreased from 29.0% at baseline to 21.5% at follow-up (P = .003). Changes were driven by improvements in hospital cafeterias and kiosks (P = .003). The percentage of products with greater than 200 milligrams of sodium in YMCA vending decreased 58% (from 27.2% to 11.5%; P = .017); other organizations had nonsignificant declines. Conclusions. We found modest reductions in the percentage of higher-sodium prepackaged products across community institutions. Community-level interventions may increase availability of lower-sodium products in the food supply.

The UK Eatwell Plate is consumer based advice recommending the proportions of five food groups for a balanced diet: starchy foods, fruit and vegetables, dairy foods, nondairy sources of protein and foods and drinks high in fat or sugar. Many foods comprise ingredients from several food groups and consumers need to consider how these fit with the proportions of the Eatwell Plate. This involves disaggregating composite dishes into proportions of individual food components. The present study aimed to match the diets of adults in Scotland to the Eatwell Plate dietary recommendations and to describe the assumptions and methodological issues associated with estimating Eatwell Plate proportions from dietary records.Foods from weighed intake records of 161 females and 151 males were assigned to a single Eatwell group based on the main ingredient for composite foods, and the overall Eatwell Plate proportions of each subject's diet were calculated. Food group proportions were then recalculated after disaggregating composite foods.The fruit and vegetables and starchy food groups consumed were significantly lower than recommended in the Eatwell Plate, whereas the proportions of the protein and foods high in fat or sugar were significantly higher. Failing to disaggregate composite foods gave an inaccurate estimate of the food group composition of the diet.Estimating Eatwell Plate proportions from dietary records is not straightforward, and is reliant on methodological assumptions. These need to be standardised and disseminated to ensure consistent analysis.

Objective(i) To determine the Na content of commonly consumed fast foods in New Zealand and (ii) to estimate Na intake from savoury fast foods for the New Zealand adult population.DesignCommonly consumed fast foods were identified from the 2008/09 New Zealand Adult Nutrition Survey. Na values from all savoury fast foods from chain restaurants (n 471) were obtained from nutrition information on company websites, while the twelve most popular fast-food types from independent outlets (n 52) were determined using laboratory analysis. Results were compared with the UK Food Standards Agency 2012 sodium targets. Nutrient analysis was completed to estimate Na intake from savoury fast foods for the New Zealand population using the 2008/09 New Zealand Adult Nutrition Survey.SettingNew Zealand.SubjectsAdults aged 15 years and above.ResultsFrom chain restaurants, sauces/salad dressings and fried chicken had the highest Na content (per 100 g) and from independent outlets, sausage rolls, battered hotdogs and mince and cheese pies were highest in Na (per 100 g). The majority of fast foods exceeded the UK Food Standards Agency 2012 sodium targets. The mean daily Na intake from savoury fast foods was 283 mg/d for the total adult population and 1229 mg/d for fast-food consumers.ConclusionsTaking into account the Na content and frequency of consumption, potato dishes, filled rolls, hamburgers and battered fish contributed substantially to Na intake for fast-food consumers in New Zealand. These foods should be targeted for Na reduction reformulation.

ObjectiveNutrient and food standards exist for school lunches in English primary schools although packed lunches brought from home are not regulated. The aim of the present study was to determine nutritional and dietary differences by lunch type.DesignA cross-sectional survey was carried out in 2007 assessing diet using the Child and Diet Evaluation Tool (CADET), a validated 24 h estimated food diary. The data were analysed to determine nutritional and dietary intakes over the whole day by school meal type: school meals and packed lunches.SettingFifty-four primary schools across England.SubjectsChildren (n 2709) aged 6–8 years.ResultsChildren having a packed lunch consumed on average 11·0 g more total sugars (95 % CI 6·6, 15·3 g) and 101 mg more Na (95 % CI 29, 173 mg) over the whole day. Conversely, children having a school meal consumed, on average, 4·0 g more protein (95 % CI 2·3, 5·7 g), 0·9 g more fibre (NSP; 95 % CI 0·5, 1·3 g) and 0·4 mg more Zn (95 % CI 0·1, 0·6 mg). There was no difference in daily energy intake by lunch type. Children having a packed lunch were more likely to consume snacks and sweetened drinks; while children having a school meal were more likely to consume different types of vegetables and drink water over the whole day.ConclusionsCompared with children having a school meal, children taking a packed lunch to school consumed a lower-quality diet over the whole day, including higher levels of sugar and Na and fewer vegetables. These findings support the introduction of policies that increase school meal uptake.

We examine the impact of serving fruit smoothies during school breakfast on fruit consumption among middle school and high school students. We draw on observational plate-waste data over a 10-week period during which fruit smoothies were introduced for breakfast at two Utah schools. Our total sample includes 2,760 student-day observations. We find that the fraction of students eating a full serving of whole fruit increased from 4.3% to 45.1%. As such, school districts should consider offering fruit smoothies as part of a set of interventions designed to increase fruit consumption at school.

A microbiological survey was undertaken on packaged ready-to-eat red meats available at retail in New Zealand. A total of 1,485 samples (297 lots of five samples each) were collected according to a sampling plan based on market share and regulatory regimes (Animal Products Act 1999 and Food Act 1981) and were tested against the microbiological limits specified in Food Standards Code (FSC) 1.6.1 applicable at the time of sampling. Each lot was tested as a composite for the presence or absence of Salmonella spp., coagulase-producing staphylococci, Listeria monocytogenes, and other Listeria spp. at the end of the manufacturer's stated shelf life. Individual samples within a positive lot were subsequently enumerated for L. monocytogenes. None of the samples contained Salmonella spp. or had coagulase-producing staphylococci counts above the acceptable level specified in FSC 1.6.1 (>100 CFU/g). Data showed that 93.6% (278 of 297 lots) of ready-to-eat red meat complied with the FSC 1.6.1 criteria applicable at the time of the survey. The failure of 19 lots (6.4%) was due to the presence of L. monocytogenes from product obtained from 8 of 33 producers tested. Thirteen samples of 95 positive samples were found to contain between 50 and 500 CFU/g L. monocytogenes, but all of these samples were manufactured by the same operator. Pulsed-field gel electrophoresis typing of all of the L. monocytogenes isolates obtained from the survey identified 12 different pulsotypes. Different pulsotypes were often identified in samples from the same operator sampled on separate occasions. A total of 46 lots (15.5%) contained Listeria spp. (including L. monocytogenes). The detection of Listeria in samples may highlight the existence of problems in operator processing and/or packaging processes and suggests that improvements in good hygienic practice and implementation of more effective risk mitigation strategies are needed.

The purpose of this study was to evaluate differences between how mothers and fathers monitor their children’s sugar-sweetened beverages (SSBs; 7-12 years) using constructs from the integrated behavioral model (IBM). Mothers ( n = 167) and fathers ( n = 117) completed a valid and reliable survey evaluating the extent that they monitored their child’s SSB intake and constructs of the IBM. Results showed significant differences between groups, with mothers consistently having higher levels of monitoring SSBs and IBM constructs. Regression models also showed that the core constructs of the IBM predicted a significant amount of the variance for monitoring SSBs for both mothers and fathers (39.4% and 18.3%, respectively), with intentions being the primary predictor for mothers and skillfulness the primary predictor for fathers. This study provides preliminary evidence that mothers and fathers monitor their children’s SSB intake differently, and factors that determine monitoring SSB intake of children differ between mothers and fathers.

Background Public Health England recently published a tool to help local authorities monitor the density of fast food outlets, with restrictions on access to these ‘unhealthy’ outlets being promoted in the fight against obesity. Secondary data containing the locations of food outlets present valuable resources to guide and evaluate these interventions. However, evidence appraising these data sources is limited. This study therefore seeks to validate two sources of secondary food environment data (SFED): Ordnance Survey Points of Interest (POI) data and food hygiene data from the Food Standards Agency (FSA), against street audits. These data sources are commonly used in research, with the former also being used in the Public Health England tool. Methods Audits were conducted across 54 Lower Super Output Areas in England. All streets within each Lower Super Output Area were covered to identify the name and street address of all food outlets therein. Audit identified outlets were matched to outlets in the SFED to identify true positives (TP: outlets in both the SFED and the audits), false positives (FP: outlets in the SFED only) and false negatives (FN: outlets in the audits only). Agreement was assessed using positive predictive values (PPV: TP/(TP +FP)) and sensitivities (TP/(TP +FN)). Confidence intervals were calculated in Excel using the Agresti-Coull method. Results Overall, the street audits identified 1188 food outlets, compared to 1102 and 1098 for the POI and FSA data respectively. Sensitivity and PPV were significantly higher for FSA data (sensitivity: 0.80, CI: 0.77–0.82; PPV: 0.86, CI: 0.84–0.88) than for the POI data (sensitivity: 0.73, CI: 0.71–0.76; PPV: 0.79, CI: 0.77–0.81). Both datasets had ‘good’ agreement with street audits according to the Paquet classifications (‘good’ defined as PPV and sensitivities between 0.71 and 0.90). Conclusion This study provides new evidence for the validity of SFED commonly used in research and emergently used by policymakers. Agreement between the SFED and street audits is sufficiently good to provide local authorities with confidence in using tools and research based on these SFED. Whilst FSA data has statistically significantly higher agreement with street audits than POI, the magnitude of the difference is relatively small. POI also has other advantages (e.g. more detailed outlet classifications and better spatial accuracy). Thus, POI is still a useful and recommended source of food environment data.

Importance Initiatives to reduce sodium in packaged foods have been launched in the United States, yet corresponding changes in the amount of sodium that US households obtain from packaged foods have not been evaluated, to our knowledge. Objective To assess 15-year changes in the amount of sodium that US households acquire from packaged food purchases, the sodium content of purchases, and the proportion of households that have purchases with optimal sodium density. Design, Setting, and Participants Longitudinal study of US households in the 2000 to 2014 Nielsen Homescan Consumer Panel, a population-based sample of households that used barcode scanners to record all packaged foods purchased throughout the year. Time-varying brand- and product-specific nutrition information was used for 1 490 141 products. Main Outcomes and Measures Sociodemographic-adjusted changes in mean sodium per capita (mg/d) and sodium content (mg/100 g), overall and for top food group sources of sodium, and the proportion of households that have total purchases with sodium density of 1.1 mg/kcal or less. Results In a nationwide sample of 172 042 US households (754 608 year-level observations), the amount of sodium that households acquired from packaged food and beverage purchases decreased significantly between 2000 and 2014 by 396 mg/d (95% CI, −407 to −385 mg/d) per capita. The sodium content of households’ packaged food purchases decreased significantly during this 15-year period by 49 mg/100 g (95% CI, −50 to −48 mg/100 g), a 12.0% decline; decreases began in 2005 and continued through 2014. Moreover, the sodium content of households’ purchases decreased significantly for all top food sources of sodium between 2000 and 2014, including declines of more than 100 mg/100 g for condiments, sauces, and dips (−114 mg/100 g; 95% CI, −117 to −111 mg/100 g) and salty snacks (−142 mg/100 g; 95% CI, −144 to −141 mg/100 g). However, in all years, less than 2% of US households had packaged food and beverage purchases with sodium density of 1.1 mg/kcal or less. Conclusions and Relevance In this nationwide study, significant reductions in sodium from packaged food purchases were achieved in the past 15 years. Nonetheless, most US households had food and beverage purchases with excessive sodium density. Findings suggest that more concerted sodium reduction efforts are needed in the United States.