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Dietary factors play a major role in the development of non-communicable diseases, however little is known regarding the impact of nutrition on rare diseases like sarcomas. This Rizzoli Orthopedic Institute study aimed to evaluate the relative validity of a Food Frequency Questionnaire (FFQ) to measure the consumption of foods in comparison with a 3-days diary diet in a healthy Italian student population aged between 12 and 17 years. An extended version (including food groups for children) of the semi-quantitative FFQ used in the European Prospective Investigation into Cancer and Nutrition (EPIC) was administered. The validity of the FFQ was assessed by comparing the intakes from the FFQ against the 3-day diary method. 254 Italian subjects were included in the analyses: 128 females, 126 males, 116 from High Secondary School (14–17 years), 138 from Low Secondary School (12–13 years). Mean and median intakes are overall higher in the FFQs than in the food diaries. Spearman correlations adjusted for within-person variability were highest for legumes, vegetables and coffee/tea (&gt, 0.5), followed by potatoes, meat, fruits, breakfast cereals, biscuits and candies, and milk/yoghurts (&gt, 0.4). Moderate correlations were found for alcoholic drinks, soft drinks, juices, and grains (&gt, 0.3). For some food groups, such as fish, potatoes, and bread, correlations tend to become higher when stratifying the analyses for age group. These results demonstrate that the adapted EPIC COS FFQ validated in Italian adults is also appropriate and well understood by Italian children and adolescents.

The eating patterns in a population can be estimated through dietary surveys in which open-ended assessment methods, such as diaries and interviews, or semi-quantitative food frequency questionnaires are administered. A harmonized dietary survey methodology, together with a standardized operational procedure, in conducting the study is crucial to ensure the comparability of the results and the accuracy of information, thus reducing uncertainty and increasing the reliability of the results. Dietary patterns (i) include several target variables (foods, energy and nutrients, other food components), (ii) require several explanatory variables (age, gender, anthropometric measurements, socio-cultural and economic characteristics, lifestyle, preferences, attitudes, beliefs, organization of food-related activities, etc.), and (iii) have impacts in several domains: imbalance diets; acute and chronic exposures affect health, specifically non-communicable diseases; and then sanitary expenditure. On the other hand, food demand has impacts on the food system: production, distribution, and food services system; food wastes and other wastes generated by food-related activities of the households (e.g., packaging disposal) have consequences on the “health of the planet” which in turn can have effects on human health. Harmonization and standardization of measurement methods and procedures in such a complex context require an ad hoc structured information system made by databases (food nomenclatures, portion sizes, food atlas, recipes) and methodological tools (quantification methods, food coding systems, assessment of nutritional status, data processing to extrapolate what we consider validated dietary data). Establishing a community of professionals specialized in dietary data management could lead to build a surveillance system for monitoring eating habits in the short term, thus reducing costs, and to arrange a training re-training system. Creating and maintaining the dietary data managers community is challenging but possible. In this context, the cooperation between the CREA Research Centre for Food and Nutrition and the Italian National Health Institute (ISS) promoted and supported by the Italian Ministry of Health may represent a model of best practice that can ensure a continuous training for the professional community carrying out a nutritional study.

OBJECTIVES: Replacing meat by meat replacers could be an important strategy for achieving a more plant-based diet, however their current consumption is rather limited. The present modelling study therefore aimed to elucidate the role of meat replaces in healthier and more environmentally sustainable diets. METHODS: Using the observed diets from Denmark, Czech Republic, Italy and France (∼6500 adults), we created for each individual a replacement diets by replacing all the meat of the observed diet (in grams) by meat replacers. Starting from the observed diets and meat-replacement diets, diets with improved adherence to food-based dietary guidelines (FBDGs) were modeled using Data Envelopment analysis. These improved diets were then optimized for dietary preferences (Max P, diet similarity index), nutrient quality (Max H, Nutrient Rich Diet (NRD15.3)) or environmental sustainability (Max S, diet-related greenhouse gas emissions (GHGE)). RESULTS: In all modeled diets, for both men and women, the amount of meat was lower than in the observed diets, in particular around 30% lower in the Max P, 50% lower in the Max H, and 75% lower in the Max S diets. Moreover, when using fortified meat replacers, the amount of meat in the scenarios of Max P, Max H and Max S was lower than in the same scenarios without fortification. In the Max P diet, NRD15.3 was ∼6% higher, GHGE was ∼9% lower, and ∼83% of food intake remained similar. In the Max H diet, NRD15.3 was ∼17% higher, GHGE was ∼15% lower, and ∼66% of food intake remained similar. In the Max S diet, NRD15.3 was ∼9% higher, GHGE was ∼33% lower, and ∼65% of food intake remained similar. CONCLUSIONS: Guided by FBDGs to improve diets, adopting meat replacers holds potential to achieve additional benefits on the environment, without necessarily compromising nutrient quality. FUNDING SOURCES: This work was supported by TiFN under Project Agreement number 15SD01 (SHARP-BASIC).

International audience; Seasonality is a key issue of total diet studies (TDS), as season may impact consumption patterns and concentrations of food chemicals, then exposure levels. This work aimed at analyzing the impact on dietary exposure of different options of seasonality management, to propose guidelines for TDS sampling. Dietary exposure to nine chemicals was assessed for adults and children from the second French Individual and National Food Consumption Survey: arsenic, copper, manganese, dioxins, furans, dioxin-like and non dioxin-like PCBs, deoxinivalenol and ochratoxin A. Seasonality was considered either in both consumption and concentration data, consumption data only, or concentration data only. Results showed significant differences between exposures during different seasons. For most chemicals, the difference between seasonal exposures may not be mainly driven by seasonality of consumption, but partly by seasonality of concentration. Results on risk assessment remained generally the same. If the main objective of the TDS is the risk assessment, considering season for sampling could be costly but with a low added value in terms of results. For exposure refinement, season has to be considered in the sampling design. More particularly, seasonal samples should be kept separately for chemicals with expected seasonal variation in concentrations, such as some metals or mycotoxins.

The present paper was presented as a poster in the 13th European Nutrition Conference in Dublin (Ireland)., [Purpose]: Psychosocial stressors derived from socioeconomic disadvantages in adolescents can result in higher risk of metabolic syndrome (MetS). We aimed to examine whether socioeconomic disadvantages were associated with MetS independent of lifestyle and whether there was a dose-response relationship between the number of cumulated socioeconomic disadvantages and risk of MetS., [Methods]: This study included 1,037 European adolescents (aged 12.5–17.5 years). Sociodemographic variables and lifestyle were assessed by self-reported questionnaires. Disadvantaged groups included adolescents with low-educated parents, low family affluence, migrant origin, unemployed parents, and nontraditional families. MetS risk score was calculated as the sum of sex- and age-specific z-scores of waist circumference, blood pressure, lipids, and insulin resistance. Linear mixed-effects models adjusted for sex, age, pubertal status, and lifestyle were used to study the association between social disadvantages and MetS risk score., [Results]: Adolescents with low-educated mothers showed a higher MetS score (.54 [.09–.98]; β estimate and 99% confidence interval) compared to those with high-educated mothers. Adolescents who accumulated more than three disadvantages (.69 [.08–1.31]) or with missing information on disadvantages (.72 [.04–1.40]) had a higher MetS risk score compared to nonsocioeconomically disadvantaged groups. Stronger associations between socioeconomic disadvantages and MetS were found in male than in female adolescents., [Conclusions]: Adolescents with low-educated mothers or with more than three socioeconomic disadvantages had a higher MetS risk, independent of lifestyle, potentially due to higher psychosocial stress exposure. Policy makers should focus on improving low-educated familiesa and more disadvantaged families' knowledge on nutrition and physical activity to help them cope better with stress., The HELENA Study was conducted with the financial support of the European Community sixth RTD Framework Programme (Contract FOOD-CT-2005-007034).

Meat replacers could play a role in achieving more plant-based diets, but their current consumption is limited. The present modelling study aimed to explore the nutritional and greenhouse gas emissions impacts of meat replacers. Using dietary surveys from Denmark, Czech Republic, Italy and France (~6500 adults), we composed alternative diets in which all the meat in the observed diet (in grams) was substituted by similar use meat replacers (with and without fortification). Starting from the observed diets and meat-replacement diets, diets with improved adherence to food-based dietary guidelines (FBDGs) were modelled using Data Envelopment Analysis. These improved diets were then further optimised for dietary preferences (MaxP, diet similarity index), nutrient quality (MaxH, Nutrient Rich Diet score, NRD15.3) or diet-related greenhouse gas emissions (GHGE) (MaxS, CO2 equivalents). In all optimised modelled diets, the total amount of meat was lower than in the observed diets, i.e., 30% lower in the MaxP, 50% lower in the MaxH, and 75% lower in the MaxS diets. In the MaxP diet, NRD15.3 was ~6% higher, GHGE was ~9% lower, and ~83% of food intake remained similar. In the MaxH diet, NRD15.3 was ~17% higher, GHGE was ~15% lower, and ~66% of food intake remained similar. In the MaxS diet, NRD15.3 was ~9% higher, GHGE was ~33% lower, and ~65% of food intake remained similar. When using fortified meat replacers, for all modelled diets, the diet similarity was on average 2% lower and the GHGE reduction was on average 3% higher as compared with the same scenarios without fortification. This analysis showed that meat replacers, provided their preference is similar to meat, can provide benefits for GHGE, without necessarily compromising nutrient quality.

National food consumption surveys are crucial for monitoring the nutritional status of individuals, defining nutrition policies, estimating dietary exposure, and assessing the environmental impact of the diet. The methods for conducting them are time and resource-consuming, so they are usually carried out after extended periods of time, which does not allow for timely monitoring of any changes in the population’s dietary patterns. This study aims to compare the results of nutrition-related mobile apps that are most popular in Italy, with data obtained with the dietary software Foodsoft 1.0, which was recently used in the Italian national dietary survey IV SCAI. The apps considered in this study were selected according to criteria, such as popularity (downloads &gt, 10,000), Italian language, input characteristics (daily dietary recording ability), output features (calculation of energy and macronutrients associated with consumption), etc. 415 apps in Google Play and 226 in the iTunes Store were examined, then the following five apps were selected: YAZIO, Lifesum, Oreegano, Macro and Fitatu. Twenty 24-hour recalls were extracted from the IV SCAI database and inputted into the apps. Energy and macronutrient intake data were compared with Foodsoft 1.0 output. Good agreement was found between the selected apps and Foodsoft 1.0 (high correlation index), and no significant differences were found in the mean values of energy and macronutrients, except for fat intakes. In conclusion, the selected apps could be a suitable tool for assessing dietary intake

Purpose Public health policies and actions increasingly acknowledge the climate burden of food consumption. The aim of this study is to describe dietary intakes across four European countries, as baseline for further research towards healthier and environmentally-friendlier diets for Europe. Methods Individual-level dietary intake data in adults were obtained from nationally-representative surveys from Denmark and France using a 7-day diet record, Italy using a 3-day diet record, and Czech Republic using two replicates of a 24-h recall. Energy-standardised food and nutrient intakes were calculated for each subject from the mean of two randomly selected days. Results There was clear geographical variability, with a between-country range for mean fruit intake from 118 to 199 g/day, for vegetables from 95 to 239 g/day, for fish from 12 to 45 g/day, for dairy from 129 to 302 g/day, for sweet beverages from 48 to 224 ml/day, and for alcohol from 8 to 15 g/day, with higher intakes in Italy for fruit, vegetables and fish, and in Denmark for dairy, sweet beverages and alcohol. In all countries, intakes were low for legumes ( 80 g/day). Within countries, food intakes also varied by socio-economic factors such as age, gender, and educational level, but less pronounced by anthropometric factors such as overweight status. For nutrients, intakes were low for dietary fibre (15.8–19.4 g/day) and vitamin D (2.4–3.0 µg/day) in all countries, for potassium (2288–2938 mg/day) and magnesium (268–285 mg/day) except in Denmark, for vitamin E in Denmark (6.7 mg/day), and for folate in Czech Republic (212 µg/day). Conclusions There is considerable variation in food and nutrient intakes across Europe, not only between, but also within countries. Individual-level dietary data provide insight into the heterogeneity of dietary habits beyond per capita food supply data, and this is crucial to balancing healthy and environmentally-friendly diets for European citizens. Electronic supplementary material The online version of this article (10.1007/s00394-018-1673-6) contains supplementary material, which is available to authorized users.

Effective food policies in Europe require insight into the environmental impact of consumers’ diet to contribute to global nutrition security in an environmentally sustainable way. The present study therefore aimed to assess the environmental impact associated with dietary intake across four European countries, and to explain sources of variations in environmental impact by energy intake, demographics and diet composition. Individual-level dietary intake data were obtained from nationally-representative dietary surveys, by using two non-consecutive days of a 24-h recall or a diet record, from Denmark (DK, n = 1710), Czech Republic (CZ, n = 1666), Italy (IT, n = 2184), and France (FR, n = 2246). Dietary intake data were linked to a newly developed pan-European environmental sustainability indicator database that contains greenhouse gas emissions (GHGE) and land use (LU) values for ∼900 foods. To explain the variation in environmental impact of diets, multilevel regression models with random intercept and random slopes were fitted according to two levels: adults (level 1, n = 7806) and country (level 2, n = 4). In the models, diet-related GHGE or LU was the dependent variable, and the parameter of interest, i.e. either total energy intake or demographics or food groups, the exploratory variables. A 200-kcal higher total energy intake was associated with a 9% and a 10% higher daily GHGE and LU. Expressed per 2000 kcal, mean GHGE ranged from 4.4 (CZ) to 6.3 kgCO2eq/2000 kcal (FR), and LU ranged from 5.7 (CZ) to 8.0 m2*year/2000 kcal (FR). Dietary choices explained most of the variation between countries. A 5 energy percent (50 g/2000 kcal) higher meat intake was associated with a 10% and a 14% higher GHGE and LU density, with ruminant meat being the main contributor to environmental footprints. In conclusion, intake of energy, total meat and the proportion of ruminant meat explained most of the variation in GHGE and LU of European diets. Contributions of food groups to environmental footprints however varied between countries, suggesting that cultural preferences play an important role in environmental footprints of consumers. In particular, Findings from the present study will be relevant for national-specific food policy measures towards a more environmentally-friendly diet.

Aging induces several physiologic and immune changes. The usefulness of probiotics in ameliorating age-related disorders remains largely unexplored. The aim of this study was to evaluate the effectiveness of a Bifidobacterium longum Bar33 and Lactobacillus helveticus Bar13 mixture in improving the physiologic status and immunity of older adults (over 75 years). Furthermore, the possible role of such mixture in ameliorating gut immunity in aged mice was investigated.A randomized, double-blind, placebo-controlled trial was conducted with 98 adults (84.6 ± 7.8 y), supplemented for 30 d with a biscuit containing a probiotic mixture of B. longum Bar33 and L. helveticus Bar13 (1:1), or no probiotics, as placebo. Blood was collected for analysis of biochemical parameters, lymphocyte subpopulations, natural killer activity, and cytokine release. Aged Balb/c mice received the same probiotic mixture or placebo daily for 28 d, then blood and intestinal lymphocyte subpopulations were analyzed.The probiotic mixture ameliorated immune response in older adults by increasing naive, activated memory, regulatory T cells, B cells, and natural killer activity and decreasing memory T cells compared with placebo (P0.05). The biochemical parameters did not change after probiotic supplementation. In the gut of old mice, the two probiotics modulated cells crucial for gut immune homeostasis by increasing regulatory T (Treg and Tr1) and decreasing γδ T cells compared with control mice (P0.05). In addition, B cells increased in the gut and blood of probiotic-treated mice.Results from the present study data indicated that B. longum Bar33 and L. helveticus Bar13 improve immune function at intestinal and peripheral sites in aging.

On behalf of the HELENA study group: et al., [Objectives]: To determine dietary patterns (DPs) and explain the highest variance of vitamin B6, folate, and B12 intake and related concentrations among European adolescents., [Methods]: A total of 2173 adolescents who participated in the Healthy Lifestyle in Europe by Nutrition in Adolescence study met the eligibility criteria for the vitamin B intake analysis (46% boys) and 586 adolescents for the biomarkers analysis (47% boys). Two non-consecutive, 24-h, dietary recalls were used to assess the mean intakes. Concentrations were measured by chromatography and immunoassay testing. A reduced rank regression was applied to elucidate the combined effect of food intake of vitamin B and related concentrations., [Results]: The identified DPs (one per vitamin B intake and biomarker and by sex) explained a variability between 34.2% and 23.7% of the vitamin B intake and between 17.2% and 7% of the biomarkers. In the reduced rank regression models, fish, eggs, cheese, whole milk and buttermilk intakes were loaded positively for vitamin B intake in both sexes; however, soft drinks and chocolate were loaded negatively. For the biomarkers, a higher variability was observed in the patterns in terms of food loads such as alcoholic drinks, sugars, and soft drinks. Some food items were loaded differently between intakes and biomarkers such as fish products, which was loaded positively for intakes but negatively for plasma folate in girls., [Conclusions]: The identified DPs explained up to 34.2% and 17.2% of the variability of the vitamin B intake and plasma concentrations, respectively, in European adolescents. Further studies are needed to elucidate the factors that determine such patterns., HELENA study received funding from the European Union’s Sixth RTD Framework Programme (Contract FOODCT-2005-007034). Additional support from the Spanish Ministry of Education (AGL2007-29784-E/ALI), Axis-Shield Diagnostics Ltd (Oslo, Norway), Abbot Científica S.A. (Spain). This analysis was also supported by the Spanish Ministry of Science and Innovation (JCI-2010-07055) with the contribution of the European Regional Development Fund (FEDER). The first author is supported by a grant from the Spanish Carlos III Health Institute: RD08/0072/0025 (Red SAMID: Maternal, Child Health and Development Research Network).

International scientific experts in food, nutrition, dietetics, endocrinology, physical activity, paediatrics, nursing, toxicology and public health met in Lisbon on 2–4 July 2017 to develop a Consensus on the use of low- and no-calorie sweeteners (LNCS) as substitutes for sugars and other caloric sweeteners. LNCS are food additives that are broadly used as sugar substitutes to sweeten foods and beverages with the addition of fewer or no calories. They are also used in medicines, health-care products, such as toothpaste, and food supplements. The goal of this Consensus was to provide a useful, evidence-based, point of reference to assist in efforts to reduce free sugars consumption in line with current international public health recommendations. Participating experts in the Lisbon Consensus analysed and evaluated the evidence in relation to the role of LNCS in food safety, their regulation and the nutritional and dietary aspects of their use in foods and beverages. The conclusions of this Consensus were: (1) LNCS are some of the most extensively evaluated dietary constituents, and their safety has been reviewed and confirmed by regulatory bodies globally including the World Health Organisation, the US Food and Drug Administration and the European Food Safety Authority; (2) Consumer education, which is based on the most robust scientific evidence and regulatory processes, on the use of products containing LNCS should be strengthened in a comprehensive and objective way; (3) The use of LNCS in weight reduction programmes that involve replacing caloric sweeteners with LNCS in the context of structured diet plans may favour sustainable weight reduction. Furthermore, their use in diabetes management programmes may contribute to a better glycaemic control in patients, albeit with modest results. LNCS also provide dental health benefits when used in place of free sugars; (4) It is proposed that foods and beverages with LNCS could be included in dietary guidelines as alternative options to products sweetened with free sugars; (5) Continued education of health professionals is required, since they are a key source of information on issues related to food and health for both the general population and patients. With this in mind, the publication of position statements and consensus documents in the academic literature are extremely desirable., This Consensus is the results of the Ibero–American Consensus Meeting on Low- and No-Calorie Sweeteners held in Lisbon, Portugal, 2–4 July 2017, that was supported with funding from the Nutrition Research Foundation (FIN). The different organizations and institutions that participated and supported this Consensus are greatly acknowledged.

Foods are complex objects with several attributes contributing to defining characteristics interesting for nutritional analyses. Several ways of aggregating foods are possible to describe and evaluate eating behaviors (dietary contents, adequacy, exposure, environmental impacts, etc.). The difficulty of identifying all the inherent aspects and the needs or processing large set of data has led to design of food description and food aggregation systems. These systems facilitate information comparison making feasible the whole range of elaborations using a semi-automated food matching and data linking with further dietary assessment also facilitating the design of dietary survey carried out by exploiting advanced technologies.

Background: Fluid and water intake have received limited attention in epidemiological studies. The aim of this study was to compare the average daily consumption of foods and beverages in adults of selective samples of the European Union (EU) population in order to understand the contribution of these to the total water intake (TWI), evaluate if the EU adult population consumes adequate amounts of total water (TW) according to the current guidelines, and to illustrate the real water intake in Europe. Methods: Three national European dietary surveys have been selected: Spain used the Anthropometry, Intake, and Energy Balance Study (ANIBES) population database, Italy analyzed data from the Italian National Food Consumption Survey (INRAN-SCAI 2005-06), and French data came from the NutriNet-Sante database. Mean daily consumption was used to compare between individuals. TWI was compared with European Food Safety Authority (EFSA) reference values for adult men and women. Results: On average, in Spain, TWI was 1.7 L (SE 22.9) for men and 1.6 L (SE 19.4) for women; Italy recorded 1.7 L (SE 16.9) for men and 1.7 L (SE 14.1) for women; and France recorded 2.3 L (SE 4.7) for men and 2.1 L (SE 2.4) for women. With the exception of women in France, neither men nor women consumed sufficient amounts of water according to EFSA reference values. Conclusions: This study highlights the need to formulate appropriate health and nutrition policies to increase TWI in the EU population. The future of beverage intake assessment requires the use of new instruments, techniques, and the application of the new available technologies.

Summary What is already known about this subject Although there is no clear evidence of the role of dairy consumption on cardiovascular disease (CVD) risk development in adults, several studies have suggested dairy consumption to have a protective effect. Limited evidence on the relationship between milk and dairy products consumption and CVD risk factors among adolescents. What this study adds Dairy consumption was inversely associated with CVD risk in European adolescent girls. Higher dairy consumption was associated with lower adiposity and higher cardiorespiratory fitness in both genders. Objective To identify those food groups best discriminating individuals at high/low cardiovascular disease (CVD) risk and to investigate the relationship between dairy consumption and CVD risk factors (individual and scores) in adolescents (12.5–17.5 years) from eight European cities participating in the cross-sectional (2006–2007) HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) project. Methods Diet, waist circumference, skin-folds thickness, systolic blood pressure, insulin resistance, triglycerides, total cholesterol/high-density lipoprotein ratio and cardiorespiratory fitness (CRF) were assessed in 511 (49.9% boys) adolescents. Individual z-scores of CVD risk factors were summed to compute sex-specific clustered CVD risk scores. Results Dairy emerged as the food group best discriminating adolescents at low/high CVD risk. In both genders, waist circumference and sum of skin-folds were inversely associated with consumption of milk and yogurt, and milk- and yogurt-based beverages, whereas a positive association was observed with CRF. Moreover, CVD risk score (β = −0.230, P = 0.001) was also inversely associated with overall dairy consumption only in girls. Discussion Dairy consumption is associated with lower adiposity and higher CRF in these adolescents. An inverse association between CVD risk score and dairy consumption is also depicted in girls. The study adds further evidence to the scarce literature on the influence of milk and dairy products on adolescents' cardiovascular health.

Flavouring substances may be naturally present in a food and/or intentionally added. It is essential to have a method to estimate exposure that is rapidly performed and does not underestimate exposure. Recently, a new approach for flavouring, the “Added Portions Exposure Technique” (APET), was proposed by the European Food Safety Authority. This paper explains step by step this technique using furaneol as case study. APET's main advantage is that it allows the assessment of dietary exposure in adults, children and infants, from both added flavourings and from flavourings naturally contained in food, and considering both acute and chronic exposure.

A total diet study (TDS) provides representative and realistic data for assessing the dietary intake of chemicals, such as contaminants and residues, and nutrients, at a population level. Reproducing the diet through collection of customarily consumed foods and their preparation as habitually eaten is crucial to ensure representativeness, i.e., all relevant foods are included and all potential dietary sources of the substances investigated are captured. Having this in mind, a conceptual framework for building a relevant food-shopping list was developed as a research task in the European Union's 7th Framework Program project, 'Total Diet Study Exposure' (TDS-Exposure), aimed at standardising methods for food sampling, analyses, exposure assessment calculations and modelling, priority foods, and selection of chemical contaminants. A stepwise approach following the knowledge translation (KT) model for concept analysis is proposed to set up a general protocol for the collection of food products in a TDS in terms of steps (characterisation of the food list, development of the food-shopping list, food products collection) and pillars (background documentation, procedures, and tools). A simple model for structuring the information in a way to support the implementation of the process, by presenting relevant datasets, forms to store inherent information, and folders to record the results is also proposed. Reproducibility of the process and possibility to exploit the gathered information are two main features of such a system for future applications. EC’s Program (FP7/2012-2016) under grant agreement 289108 info:eu-repo/semantics/publishedVersion

Background: The aim of this study was to investigate total water intake (TWI) from water, beverages and foods among Italian adults and the elderly. Methods: Data of 2607 adults and the elderly, aged 18–75 years from the last national food consumption survey, INRAN-SCAI 2005-06, were used to evaluate the TWI. The INRAN-SCAI 2005-06 survey was conducted on a representative sample of 3323 individuals aged 0.1 to 97.7 years. A 3-day semi-structured diary was used for participants to record the consumption of all foods, beverages and nutritional supplements. Results: On average, TWI was 1.8 L for men and 1.7 L for women. More than 75% of women and 90% of men did not comply with the European Food Safety Authority (EFSA) Adequate Intake. The contribution of beverages to the total energy intake (EI) was 6% for the total sample. Water was the most consumed beverage, followed by alcoholic beverages for men and hot beverages for women. Conclusion: According to the present results, adults and elderly Italians do not reach the adequate intake for water as suggested by the EFSA and by the national reference level of nutrient and energy intake. Data on water consumption should also be analyzed in single socio-demographic groups in order to identify sub-groups of the population that need more attention and to plan more targeted interventions.

Background Few surveys of food and nutrient intakes are conducted at the individual level in low- and middle- income countries, whereas Household Consumption and Expenditures Surveys (HCES) are regularly carried out to monitor economic conditions. Because of the paucity of individual-level data, there is interest in using HCES to aid in the design of food and nutrition policies. Objective Data from the 2001/02 HCES from Cape Verde were used to assess household dietary intakes in the context of the country's nutrition transition. Methods The survey included weighed measure- ments of household food intake and measurements of the weight and height of all household members. Households were classified as “underweight” if they had at least one underweight member, “overweight” if they had at least one overweight member, and “dual burden” if they had at least one underweight and one overweight member. Results The proportion of households classified as underweight, overweight, and dual burden was 18%, 41%, and 14%, respectively. Household food and nutri- ent intakes were higher in the overweight households (particularly protein, vitamin A, and calcium) and lower in the underweight households, while there was no clear pattern of intakes in the dual burden group. Overweight households consumed more animal food groups than other households. Intakes of fruits and vegetables were low in all groups. Conclusions The HCES data for Cape Verde were useful for assessing the extent of the nutrition transition and characterizing dietary intakes by anthropometric classification. Analysis of nutrient and food intakes showed that ensuring sufficient energy availability is no longer the most important issue for Cape Verde, but that ensuring dietary quality is equally crucial, in particular increasing access to fruits and vegetables.

The aim of the present study was to monitor the consumption of foods containing intense sweeteners present on the Italian food market and to investigate whether the Italian general population (aged >3-65+) was at risk for exceeding the Acceptable Daily Intake (ADI) of 10 intense sweeteners. A food label survey was performed in Rome (Italy), using market share data to identify the brands more representative of the market. A sample of 326 foods (table-top sweeteners included), beverages and food supplements containing intense sweeteners was collected and analyzed in order to establish the concentration levels. Intense sweeteners were only found in foods belonging to 8 sugar-free food categories out of 37 regulated. The dietary exposure was estimated using the tiered approach. Food consumption data from the last Italian national survey (INRAN-SCAI 2005-06) were combined with Maximum Levels at Tier 2, and with the actual concentration of sweeteners in the collected food products at Tier 3. The estimated exposure among consumers of sweeteners in Italy was well below the ADIs, in both tiers; non-alcoholic beverages, table-top sweeteners and food supplements were main contributors to exposure.

The diet quality in yogurt consumers and non-consumers was evaluated by applying the probability of adequate nutrient intake (PANDiet) index to a sample of adults and elderly from the Italian food consumption survey INRAN SCAI 2005-06. Overall, yogurt consumers had a significantly higher mean intake of energy, calcium and percentage of energy from total sugars whereas the mean percentage of energy from total fat, saturated fatty acid and total carbohydrate were significantly (p < 0.01) lower than in non-consumers. The PANDiet index was significantly higher in yogurt consumers than in non-consumers, (60.58 ± 0.33 vs. 58.58 ± 0.19, p < 0.001). The adequacy sub-score for 17 nutrients for which usual intake should be above the reference value was significantly higher among yogurt consumers. The items of calcium, potassium and riboflavin showed the major percentage variation between consumers and non-consumers. Yogurt consumers were more likely to have adequate intakes of vitamins and minerals, and a higher quality score of the diet.

International audience; Objective: To assess the relationships among physical activity, measured objectively, and attention capacity in European adolescents.Study design: The study included 273 adolescents, aged 12.5-17.5 years, who participated in the Healthy Lifestyle in Europe by Nutrition in Adolescence Study. Participants wore a uniaxial accelerometer for 7 days to measure physical activity. The d2 Test of Attention was administered to assess attention capacity. Multivariate analyses were used to study the association of attention capacity with each measure of physical activity. Receiver operating characteristic analysis was performed to determine thresholds that best discriminate between low and good attention capacity.Results: After controlling for potential confounding variables (age, sex, body mass index, parental educational level, fat mass, aerobic fitness, and center), adolescents' attention capacity test performances were significantly and positively associated with longer time spent in moderate or moderate-to-vigorous physical activity (MVPA) in free-living conditions (P < .05). Receiver operating characteristic curve analyses revealed that the physical activity thresholds that best discriminated between low/good attention capacities were ≥41 min·day−1 for moderate, ≥12 min·day−1 for vigorous, and ≥58 min·day−1 for MVPA.Conclusion:These findings suggest that promoting MVPA may be have a beneficial effect on attention capacity, an important component of cognition, in adolescents.

Yogurt consumption and associated parameters were analysed on a subsample of 2831 subjects 蠅18 years from the INRAN-SCAI 2005-06 survey. Association of yogurt consumption with socio-demographics, s...

Because socioeconomic factors (SEFs) may influence dietary quality and vitamin intakes, this study aimed to examine associations between socioeconomic factors and folate and vitamin B12 intakes as well as their related biomarkers in the Healthy Lifestyle in Europe by Nutrition in Adolescence study. Vitamin intakes were obtained from two 24-hour recalls in 2253 participants (47% males). Vitamin B biomarkers were assessed in a subsample of 977 participants (46% males). Socioeconomic factors were assessed by questionnaire, and 1-way analysis of covariance and linear regression analysis were applied. For males and females, mean intakes of folate were 211.19 and 177.18μg/d, and for vitamin B12, 5.98 and 4.54μg/d, respectively. Levels of plasma folate, red blood cell folate, serum B12, and holotranscobalamin were 18.74, 807.19, 330.64, and 63.04nmol/L in males, respectively, and 19.13, 770.16, 377.9, and 65.63nmol/L in females, respectively. Lower folate intakes were associated with several SEFs, including maternal and paternal education in both sexes. Regarding folate biomarkers, lower plasma folate intakes were associated with single/shared care in males and with lower paternal occupation in females. Lower vitamin B12 intakes were associated with almost all the studied SEFs, except paternal occupation in both sexes. In females, when considering vitamin B12 biomarkers, lower plasma vitamin B12 was associated with lower maternal education and occupation, and lower holotranscobalamin was associated with lower maternal education and lower paternal occupation. In conclusion, from the set of socioeconomic determinants studied in a sample of European adolescents, maternal education and paternal occupation were more consistently associated with folate and vitamin B12 intakes and biomarkers concentrations. © 2014 Elsevier Inc.

Introduction: To promote healthy food consumption patterns, information is required on the contribution of food groups to total nutrient intake. The objective of this paper is to identify the main dietary sources of nutrients in the diet of the population in Italy. Methods: Data collected through individual food records within the INRAN-SCAI 2005–06 survey were required. The final sample included 3323 subjects aged 0.1–97.7 years. Results: The percentage contributed by each food category to the intake of energy, dietary fibre and of 26 nutrients was calculated. Above 3 years of age, the main contributors to macro- and micro-nutrient intakes were similar among the various age-sex groupings with few exceptions. Conclusion: These data might be used to develop specific strategies for Italy in order to increase the intake of dietary fibre and to decrease that of total fats and of sugars in the population.

This paper provides a model to assess dietary exposure to flavouring substances intentionally added to food. The purpose is to describe the approaches currently available and their scientific basis. The proposed exposure model for flavouring substances envisages three different levels of refinement: basic, intermediate and refined. At the two first levels, the model may be applied to all 2543 substances actually in use in Europe, while the refined level has been applied to 41 target flavouring substances selected within the FACET project. The refined level entails the use of the probability of addition of the flavouring substance added to the food and of correction factors related to losses owing to the processing of a food.

Background/Objectives: To compare the efficacy of a diet rich in natural folate and of two different folic acid supplementation protocols in subjects with “moderate” hyperhomocysteinemia, also taking into account C677T polymorphism of 5,10-methylenetetrahydrofolate reductase (MTHFR) gene. Subjects/Methods: We performed a 13 week open, randomized, double blind clinical trial on 149 free living persons with mild hyperhomocyteinemia, with daily 200 μg from a natural folate-rich diet, 200 μg [6S]5-methyltetrahydrofolate (5-MTHF), 200 μg folic acid or placebo. Participants were stratified according to their MTHFR genotype. Results: Homocysteine (Hcy) levels were reduced after folate enriched diet, 5-MTHF or folic acid supplementation respectively by 20.1% (p < 0.002), 19.4% (p < 0.001) and 21.9% (p < 0.001), as compared to baseline levels and significantly as compared to placebo (p < 0.001, p < 0.002 and p < 0.001, respectively for enriched diet, 5-MTHF and folic acid). After this enriched diet and the folic acid supplementation, Hcy in both genotype groups decreased approximately to the same level, with higher percentage decreases observed for the TT group because of their higher pre-treatment value. Similar results were not seen by genotype for 5-MTHF. A significant increase in RBC folate concentration was observed after folic acid and natural folate-rich food supplementations, as compared to placebo. Conclusions: Supplementation with natural folate-rich foods, folic acid and 5-MTHF reached a similar reduction in Hcy concentrations.

ObjectiveTo examine the association between breakfast consumption and CVD risk factors in European adolescents.DesignCross-sectional. Breakfast consumption was assessed by the statement ‘I often skip breakfast’ and categorized into ‘consumer’, ‘occasional consumer’ and ‘skipper’. Blood pressure, weight, height, waist circumference, skinfold thickness, total cholesterol (TC), HDL cholesterol (HDL-C), LDL cholesterol (LDL-C), TAG, insulin and glucose were measured and BMI, TC:HDL-C, LDL-C:HDL-C and homeostasis model assessment–insulin resistance index (HOMA-IR) were calculated.SettingThe European Union-funded HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study.SubjectsEuropean adolescents, aged 12·50–17·49 years, from ten cities within the HELENA study (n2929,n925 with blood sample, 53 % females).ResultsIn males, significant differences across breakfast consumption category (‘consumer’, ‘occasional consumer’ and ‘skipper’) were seen for age, BMI, skinfold thickness, waist circumference, cardiorespiratory fitness, systolic and diastolic blood pressures, TC:HDL-C, LDL-C:HDL-C, glucose, insulin, HOMA-IR and LDL-C; in females, for cardiorespiratory fitness, skinfold thickness, BMI, insulin and HOMA-IR. In overweight/obese males significant differences were also seen for TC and LDL-C, whereas no differences were observed in non-overweight males or in females regardless of weight status.ConclusionsOur findings among European adolescents confirm previous data indicating that adolescents who regularly consume breakfast have lower body fat content. The results also show that regular breakfast consumption is associated with higher cardiorespiratory fitness in adolescents, and with a healthier cardiovascular profile, especially in males. Eating breakfast regularly may also negate somewhat the effect of excess adiposity on TC and LDL-C, especially in male adolescents.

We evaluated the effects of beta-carotene, a precursor of vitamin A, on the activity of some lysosomal hydrolases and on the levels of their natural substrates in hamster major salivary glands during experimental oral 7,12-dimethylbenzanthracene (DMBA) carcinogenesis. Sixty-four hamsters (Cricetus auratus) were divided into four groups--group 1: untreated control; group 2: DMBA was painted three times a week in the left buccal pouch; group 3: beta-carotene was painted three times a week in the left buccal pouch; group 4: DMBA and beta-carotene were painted alternatively in the left buccal pouch. After 16 weeks, the animals were sacrificed and the activities of some lysosomal hydrolases and their natural substrates in the major salivary glands were measured. beta-Carotene when administered topically in DMBA treated animals (group 4) reduced the levels of the majority of enzymes and substrates closer to those of the untreated control group, thus outlining a mild protective effect of beta-carotene towards the DMBA carcinogenic stress. Nevertheless, the presence of some enzymes which responded negatively to the combined administration of DMBA and beta-carotene suggests the necessity for future studies on the effect of beta-carotene at different concentrations, the systemic administration and the possibility to combine the topical beta-carotene administration with other chemopreventive drugs.

To evaluate the factors affecting the outcome of in-hospital cardiac arrest.A 1400-bed tertiary care teaching hospital with a dedicated cardiac arrest team (CAT). The CAT was immediately available in monitored areas (intensive care unit and emergency room). In the wards the staff had only BLS skills and automated external defibrillation was not available.A 2-year prospective audit according to the Utstein style.A total of 114 cardiac arrests (37 with VF/VT and 77 with non-VF/VT) were included. Fifty-two cardiac arrests (46%) occurred in monitored areas, 62 (54%) occurred in non-monitored areas. The CAT arrival time in non-monitored areas was 3.98+/-1.73 min. Thirty-seven patients (32%) survived to hospital discharge. Cardiac arrests occurring in monitored areas had a significantly better outcome than those occurring in the wards. Patient survival in the wards was significantly higher when the CAT arrival time was less than 3 min. No patient whose CAT arrival time was longer than 6 min survived. CAT arrival time was significantly shorter (1.30+/-1.70) in survivors than in non-survivors (2.51+/-2.37; P0.005). Sex, age and presence of bystanders were not significantly associated with survival.In our setting, where bystander defibrillation was not available, the survival of patients having cardiac arrest in non-monitored areas strongly depends on advanced life support provided by the CAT. A faster CAT response and early defibrillation from the ward staff are the most important improvements necessary to increase cardiac arrest survival in our setting.

Purpose There is wide evidence that regular consumption of whole grain foods may reduce the risk of chronic diseases. The aim of this work was to quantify the intake of whole grains and identify main dietary sources in the Italian population. Methods Whole grain intakes were calculated in a sample of 2830 adults/older adults and of 440 children/adolescents from the last national survey INRAN-SCAI 2005–06. Food consumption was assessed from a 3-day food record. The whole grain content of foods was estimated mainly from quantitative ingredient declarations on labels. Results Mean whole grain intakes were 3.7 g/day in adults/older adults and 2.1 g/day in children/adolescents. Overall, 23 % of the sample reported consumption of whole grain foods during the survey, among which mean whole grain intakes ranged from 6.0 g/day in female children to 19.1 g/day in female older adults. The main sources of whole grains were breakfast cereals in children/adolescents (32 %) and bread in adults/older adults (46 %). Consumption of whole grain among adults was associated with significantly higher daily intakes and adequacy of dietary fibre, several vitamins (thiamine, riboflavin, vitamin B6) and minerals (iron, calcium, potassium, phosphorus, zinc, magnesium) compared to non-consumption. Among children, whole grain intake was associated with significantly higher intakes of iron and magnesium. Conclusions The study reveals very low whole grain intakes across all age groups of the Italian population. Considering the positive association in consumers between whole grain intakes and fibre and micro-nutrient intakes, public health strategies to increase whole grain consumption should be considered. Electronic supplementary material The online version of this article (doi:10.1007/s00394-015-1097-5) contains supplementary material, which is available to authorized users.