Healthy Snacks: Using Nutrient Profiling to Evaluate the Nutrient‐Density of Common Snacks in the United States

Objective: To quantify and compare the nutrient‐density of commonly consumed snacks using two nutrient‐density measures, Nutrient Rich Foods Indices 9.3 (NRF 9.3) and 15.3 (NRF 15.3). Design: Identify commonly consumed categories of snacks and individual snack foods, calculate NRF 9.3 and 15.3 scores, rank snacks by category and by individual food based on nutrient density, compare and contrast scores generated by the two NRF Indices. Main Outcome Measures: NRF 9.3 and 15.3 scores. Analysis: Averages and standard deviations of nutrient‐density scores for each snack category. Results: Vegetables and coffee/tea received the highest category scores on both indices. Cakes/cookies/pastries and sweets had the lowest category scores. NRF 9.3 scores for individual snacks ranged from –46 (soda) to 524 (coffee). NRF 15.3 scores ranged from –45 (soda) to 736 (coffee). Conclusions and Implications: If added to food labels, NRF scores could help consumers identify more nutritious choices. The differences between NRF 9.3 and 15.3 scores generated for the same foods and the limitations of these indices highlight the need for careful consideration of which nutrient‐density measure to include on food labels as well as consumer education.     

营养素度量法在营养和健康声称中的应用现状

随着膳食与健康关系研究的深入,食品的健康效应越来越受到重视,营养和健康声称作为向消费者提供食品健康效应的说明部分,成为政府、非政府组织、企业和消费者关注的热点。营养素度量法作为一个评价食品营养特性的方法,对食品给予了综合评价,有助于规范食品的营养和健康声称。本文就营养素度量模型在营养和健康声称中的应用情况作一综述。     

Opportunities for product innovation using authorised European Union health claims

For authorisation of a health claim in Europe, applicants must follow the procedures in the legislation and in the guidelines for submission of a dossier, as well as the guidance in the European Food Safety Authority's opinions on the scientific requirements for health claims. In addition to the authorised functional benefits of the vitamins and minerals, certain foods and food constituents offer beneficial physiological effects that extend beyond traditionally accepted nutritional effects. The elucidation of these effects is becoming more important, as reflected by the increasing amount of nutrition research and number of product innovations. Provided that they are scientifically substantiated, health claims linked to food and food supplement products can help consumers make well‐informed food choices. The present review focuses on scientific substantiation and consumer understanding of health claims, and it aims to help those involved in academic research, food product development and consumer education about food and health.     

Why Sugar Is Added to Food: Food Science 101

Avoiding too much sugar is an accepted dietary guidance throughout the world. The U.S. Nutrition Facts panel includes information on total sugars in foods. A focus on added sugars is linked to the concept of discretionary calories and decreasing consumption of added sugars or free sugars as a means to assist a consumer to identify foods that are nutrient‐dense. On March 14, 2014, the U.S. Food and Drug Administration proposed that including “added sugars” declaration on the Nutrition Facts panel would be another tool to help consumers reduce excessive discretionary calorie intake from added sugars. Through deductive reasoning, labeling added sugars is one tactic to potentially curb the obesity epidemic in the United States. This review discusses the functions of sugar in food and shows that the methods used to replace added sugars in foods can result in no reduction in calorie content or improvement in nutrient density. Without clear benefit to the consumer for added sugars labeling, this review highlights the complex business obstacles, costs, and consumer confusion resulting from the proposed rule.     

Food Technological Applications for Optimal Nutrition: An Overview of Opportunities for the Food Industry

Abstract: An increasingly important determinant in food choice is the growing consumer concern about nutrition and health. This focusing of consumer interest on the food supply, and also extensive research and technological developments in food science will provide further opportunities for new product development. The Food‐Based Dietary Guidelines of the World Health Organization (WHO) and European Union (EU) legislation on health claims play an important role in regulating information to the public about a wholesome diet and for improving the availability and affordability of nutritious food choices to consumers. More specifically, the food industry can contribute by reducing the number of energy‐dense products; by improving the nutrient profile of processed food through the reduction of salt, added sugar, trans‐fatty acid, and saturated fat content. As a result, food science and technology are prompted to create a new framework for these food‐based dietary guidelines, principally in the areas of food physics, methods of food storage and preservation, nutrient restoration and fortification of foods, and the development of health‐focused designer foods and functional foods. The aim of this review is to provide an overview of some further opportunities for new product development and nutrition research. Some topics related to the energy reduction of foods include: dilution and structure design, carbohydrate and/or fat substitutes, and inhibition of enzymes in carbohydrate and/or fat digestion; additionally, regulation of some metabolic functions with food‐derived bioactive peptides and probiotics, and enrichment of foods with bioactive compounds are reviewed in this overview as the most promising issues.     

Nutri-Score,multiple traffic light and incomplete nutrition labelling on food packages: Effects on consumers’ accuracy in identifying healthier snack options

Front-of-package (FOP) nutrition labels are designed to help consumers evaluate the healthiness of foods and to promote healthier food choices. In this study, an online experiment with Swiss consumers (N = 1313) was conducted to compare the effects of different nutrition label formats on consumers’ evaluations of snack food healthiness. Participants were asked to select the healthier option in 105 pairwise comparisons of 15 salty snacks. The participants were randomly assigned to one of five conditions: the FOP presented with (1) the nutrition facts table, (2) the multiple traffic light (MTL), (3) the Nutri-Score, (4) the Nutri-Score on half of the products, or (5) no nutrition information (control). The consumers’ evaluations of the snacks’ healthiness were fairly accurate, even without being given nutrition information on the packaging. The Nutri-Score led to the greatest accuracy in identifying the healthier of two snacks (when using the British FSA/Ofcom nutrient profiling score to determine product healthiness); however, this had only a minimal effect on the evaluation when only some of the products were labelled. Both FOP labels were superior to the FOP with and without the nutrition facts. This indicates that for maximum effectiveness, the labelling of all available products is needed. The perceived usefulness and public support of mandatory implementation were higher for the MTL than for the Nutri-Score label; however, for the latter, perceived usefulness and public acceptance were higher among the participants who became familiar with the label during the experiment than among those who did not.     

Food and agriculture policy: issues related to prevention of noncommunicable diseases

Good nutrition depends on access to a healthful food supply. Although a great deal of attention has been paid to food intake as a determinant of nutrition and overall health, little attention has been paid to the food supply system, health risks embedded in it, and its effect on people's choices. Most national governments intervene in their agricultural sectors in order to provide benefits to producers and consumers; however, these interventions are not designed with public health in mind. Governments should consider population nutrition and chronic disease risk when devising and implementing agricultural and food policies. They should seek opportunities to adjust agricultural and trade policies to be consistent with national health and nutritional priorities and guidelines. Although the paper gives several examples, country-specific policy changes can be determined only through analysis of individual country policies and nutrition conditions.     

The influence of health claims and nutritional composition on consumers’ yoghurt preferences

The use of health claims on foods with a poor nutritional composition could pose a risk of misleading some groups of consumers in their food choices. This study aimed to explore the influence of the use of claims on consumers’ preferences for yoghurts with a different nutritional composition and the influence of more and less familiar claims on food choices. The study was conducted on 371 consumers using conjoint methodology and further cluster analysis. Fruit yoghurt was used as a base product. We investigated the impact of the following product attributes on consumers’ preferences: presence/absence of a probiotic and fat metabolism claim; sugar content; and fat content. The results suggest that, while consumers generally consider the nutritional composition of yoghurt to be more important than the tested claims, some groups of consumers are more sensitive to the use of health-related statements. We observed the consumers’ generally positive preference for a familiar probiotic claim, and their negative preference for a non-familiar fat metabolism claim. Overall, these results indicate that some groups of consumers are more sensitive to the use of health-related communications and are therefore more exposed to the risk of being misled if the composition of the yoghurt they buy is in fact less favourable. It would be beneficial if nutrient profiles were introduced to limit the use of claims on foods.     

营养标签——食品的“健康身份证”

<正> 世界经济一体化的今天,食品营养标签的发展已趋向于国际化,世界各国纷纷制定食品营养标签标准或法规,在法律上对其认可,规范其作为公布食品营养信息重要媒体的行为,引导消费者合理选择食品以促进身体健康。     

The independent and combined impact of front-of-pack labelling and sensory quality on calorie estimations and portion selection of commercial food products

Front-of-Pack (FOP) health and nutrition labels are intended to help consumers make better food choices, but labels that infer a product is ‘healthier’ than it is have been linked to increased consumption. Three studies were set up to assess whether a product’s sensory characteristics counteract label-generated biases in calorie estimation and portion selection across two product categories: soymilk and instant noodles. Participants in Study 1 (n = 116, 21–50 years) evaluated a range of popular FOP labels. Relative to a control, participants were willing to pay more for products with added labels, and estimated “healthier choice” and “reduced sugar/MSG” versions to have fewer calories per portion. Participants also selected larger portions of the “healthier choice” products. Participants in Study 2 (n = 48, 21–50 years) evaluated 10 different soymilks and 10 instant noodles in the absence of any labelling information. Increased taste intensity was linked to higher estimated calorie content, increased liking and larger portion selection. Study 3 (n = 94, 21–50 years) combined these factors to test the impact of “healthier choice” and “reduced” sugar/MSG labeling applied to products varying in sensory intensity. Label-generated beliefs that a product was healthier and contained fewer calories persisted regardless of how the product tasted, while portion decisions were primarily guided by sensory intensity. Although FOP health and nutrient labels can bias consumer judgements, portion selection may be based more on the sensory experience of eating. Findings suggest modifying a product’s sensory intensity could be more influential at shaping portion decisions than labelled health messages.     

Are Front of Pack Claims Indicators of Nutrition Quality? Evidence from 2 Product Categories

American grocery shoppers face an array of front of pack (FOP) nutrition and health claims when making food selections. Such systems have been categorized as summary or nutrient specific. Either type should help consumers make judgments about the nutrition quality of a product. This research tests if the type or quantity of FOP claims are indeed good indicators of objective nutrition quality. Claim and nutrition information from more than 2200 breakfast cereals and prepared meals launched between 2006 and 2010 were analyzed using binary and multinomial logistic regression models. Results suggest that no type or number of front of pack claims could distinguish “healthy” foods. However, some types and frequencies of FOP claims were significant predictors of higher or lower levels of certain key nutrients. Given the complex and crowded label environment in which these FOP claims reside, one may be concerned that such cues are not closely related to objective measures of nutrition quality.     

Consumer awareness of salt and sodium reduction and sodium labeling

Reduction of dietary sodium by reduction of sodium in foods is a current industry target. Quantitative information on consumer knowledge of sodium and reduction of dietary sodium is limited. The objectives of this study were to characterize consumer knowledge and awareness of sodium and salt reduction in foods. Consumers (n= 489) participated in a quantitative internet survey designed to gather knowledge and attitudes towards dietary sodium, sodium in foods, and health. Eating habits and food consumption characteristics, knowledge of salt and sodium, and interest in health and wellness were probed. Saltiness believe and sodium knowledge indices were calculated based on correct responses to salt levels in food products. Kano analysis was conducted to determine the role of nutrition labels and satisfaction/dissatisfaction of foods. Consumers were aware of the presence of sodium in "salty" foods, and that sodium was part of salt. People who had a family history of certain diseases associated with a higher intake of dietary sodium did not necessarily have more knowledge of the relationship between sodium intake and a specific disease compared to consumers with no family history. Sodium content on the food label panel did not influence consumer dissatisfaction; however, sodium content did not necessarily increase consumer product satisfaction either. The addition of a healthy nutrient (that is, whole grain, fiber) into a current food product was appealing to consumers. For nutrient labeling, a "reduced" claim was more appealing to consumers than a "free" claim for "unhealthy" nutrients such as fat, sodium, and sugar. Practical Application: This study demonstrated the current state of consumer knowledge on sodium and salt reduction, and consumer perception of the relationship between diets high in sodium and many chronic diseases. Information that may contribute to consumer satisfaction on nutrition panel labeling was also determined.     

The brave new world of FDA nutrition regulation — some thoughts about current trends and long‐term effects∗

This article reviews long‐term trends at the U.S. Food and Drug Administration (FDA) concerning regulation of nutrition, and considers how these trends may affect products of the food industry in the decades ahead. Among the topics discussed are the FDA's rules concerning the provision of basic, standard format nutrition information (“nutrition labeling”) on food products. These rules have changed dramatically over the past 50 years from a period when no information was required to a period when information was required only if a nutrient claim was made or if a nutrient was added to the product to the new FDA regulations that become effective in 1994, which require standardized nutrition labeling on most food products in interstate commerce.

There have also been important shifts in the procedures concerning government regulation of nutrition‐related labeling. In general, previously a food company was free to provide truthful and nonmisleading labeling claims about the nutrition content of a food product, leaving it to FDA to police the market and to take regulatory action against any labeling that the agency deemed either to be false or misleading or to constitute an unauthorized drug claim. In contrast, under new FDA regulations, it will become automatically illegal to use any “health claim” or “nutrient content claim” in food labeling unless the claim has been approved in advance by an FDA regulation.

The author notes that these and other developments reveal, on the one hand, a trend toward requiring more nutrition information on food labels, but, on the other hand, a countervailing trend toward requiring government approval for the making of new nutrition‐related statements and placing greater burdens on industry to justify new types of nutrition‐related statements. Additional trends include the increased pressures on companies to formulate foods to be more healthful and a trend toward giving the FDA more power over the industry.

The article concludes with comments about additional regulatory requirements to which the long‐term trends might lead in future decades.     

European consumers’ perceived importance of qualifying and disqualifying nutrients in food choices

Providing nutrition information through food labels is increasingly important in helping consumers making better informed food choices. Major questions are whether consumers perceive specific nutrients as valuable in food choices, and whether their perception differs for qualifying and disqualifying nutrients. Consumers placing high importance on nutrition are expected to use nutritional labels more. This paper reports on the perceived importance of qualifying nutrients (fibre, vitamins/minerals) and disqualifying nutrients (energy, fat, saturated fat, salt, sugars), and possible differences between consumer groups. A pan-European consumer survey (n = 4828) was conducted with samples representative for age, gender and region in Belgium, France, Italy, Norway, Poland and Spain. Overall, consumers perceive the nutritional value of foods as important when selecting foods, and even more important for qualifying than for disqualifying nutrients. Statistically significant but small differences are observed between countries. A higher perceived importance is reported by women, older respondents, dieters and more health conscious respondents. The effects of children in the household, education and BMI are very small. For age and gender compared to health consciousness, group differences are more significant regarding disqualifying nutrients than qualifying nutrients. Small effect sizes are found for dieting on the perceived importance of qualifying nutrients. Implications for nutrition policy makers and food industries are discussed.     

Achieving dietary recommendations: Whole‐grain foods in the food guide pyramid

The Food Guide Pyramid illustrates USDA's food guide developed to help people follow the Dietary Guidelines for Americans. Unlike earlier food guides, the new food guide specifies foods for a total diet; that is, it addresses both concerns about adequacy and moderation. The food guide recommends increased intakes of the vegetable, fruit, and grain groups with special emphasis on dark‐green leafy vegetables, legumes, and whole‐grain products. These foods are important sources of several vitamins and minerals, complex carbohydrates, and dietary fiber, and they are generally low in fat. Analyses of expected nutrient levels provided by the food guide diet patterns indicate that the nutrient contribution of whole‐grain products is particularly important for diets at lower calorie levels. In these diets, it is recommended that at least half the number of servings in the grain group be whole‐grain products. In all diets, it is recommended that several servings of whole‐grain products be included each day. Average intakes of vegetables, fruits, and grain products are less than recommended. The pyramid graphic has been especially helpful in emphasizing to the public the importance of increased consumption of vegetables, fruits, and grain products for a healthful diet.     

Nutrition and Health Claims as Marketing Tools

European regulations mandate that only substantiated and approved statements can be used as nutrition- and health-related claims in food marketing. A thorough understanding of consumer perceptions of these approved claims is needed to assess their impact on both the purchase intention of functional foods and the development of innovative functional food concepts. In this paper, a conceptual framework on the European consumers’ perception of nutrition and health claims on these functional foods is proposed. Through a literature review, common independent variables are structured, and an analysis of these variables shows that nutrition and health claims are mostly only perceived positive by specific target consumers (who need the product, accept the ingredient, understand the benefit, and trust the brand). These consumers indicate that the products with substantiated and approved claims help them in reaching overall health goals. This increased expectation in functional efficacy may mediate an increase in repurchase intent, overall liking, and the amount consumers are willing to spend. Other consumers, however, may have adverse reactions towards nutrition and health claims on functional foods. Implications for the consumer and the industry are discussed.     

Agricultural biodiversity, nutrition, and health: making a difference to hunger and nutrition in the developing world

BACKGROUND: In spite of the strides made globally in reducing hunger, the problems of micronutrient deficiencies and coexisting obesity and related cardiovascular and degenerative diseases constitute a formidable challenge for the future. Attempts to reverse this trend with single-nutrient intervention strategies have met with limited success, resulting in renewed calls for food-based approaches. The deployment of agricultural biodiversity is an approach that entails greater use of local biodiversity to ensure dietary diversity. OBJECTIVE: To outline a new strategy proposed by the International Plant Genetic Resources Institute (IPGRI) that employs agricultural biodiversity as the primary resource for food security and health. METHODS: The authors carried out a meta-analysis to review and assemble existing information on the nutritional and healthful properties of traditional foods based on a diverse set of case studies and food composition and nutritional analysis studies. The methods highlight particular examples of foods where analysis of nutrient and non-nutrient composition reveals important traits to address the growing problems of malnutrition associated with the rise of chronic diseases. Finally, the authors analyze social, economic, and cultural changes that undermine the healthful components of traditional diets. RESULTS: Based on this multidisciplinary and comparative approach, the authors suggest a holistic food-based approach that combines research to assess and document nutritional and healthful properties of traditional foods, investigating options in which nutritionally valuable traditional foods can contribute to better livelihoods, and ways that awareness and promotional campaigns can identify healthful components of traditional diets that fit the needs of urban and market-oriented consumers. CONCLUSIONS: There is an urgent need for agricultural research centers, national agricultural research systems, universities, and community-based organizations to work together under a shared policy framework with the aim of developing a strong evidence base linking biodiversity, nutrition, and health. Although these initiatives are still ongoing, the gains realized in small-scale and local pilot efforts have encouraged IPGRI to work with local partners toward the implementation of scale-up efforts in various regions.     

A comparison of nutrient density scores for 100% fruit juices

ABSTRACT:  The 2005 Dietary Guidelines for Americans recommend that consumers choose a variety of nutrient-dense foods. Nutrient density is usually defined as the quantity of nutrients per calorie. Food and nutrition professionals should be aware of the concept of nutrient density, how it might be quantified, and its potential application in food labeling and dietary guidance. This article presents the concept of a nutrient density score and compares nutrient density scores for various 100% fruit juices. One hundred percent fruit juices are popular beverages in the United States, and although they can provide concentrated sources of a variety of nutrients, they can differ considerably in their nutrient profiles. Six methodologies were used to quantify nutrient density and 7 100% fruit juices were included in the analysis: apple, grape, pink grapefruit, white grapefruit, orange, pineapple, and prune. Food composition data were obtained from the USDA National Nutrient Database for Standard Reference, Release 18. Application of the methods resulted in nutrient density scores with a range of values and magnitudes. The relative scores indicated that citrus juices, particularly pink grapefruit and orange juice, were more nutrient dense compared to the other nonfortified 100% juices included in the analysis. Although the methods differed, the relative ranking of the juices based on nutrient density score was similar for each method. Issues to be addressed regarding the development and application of a nutrient density score include those related to food fortification, nutrient bioavailability, and consumer education and behavior.     

Decision-making in the dairy aisle: maximizing taste, health, cost and family considerations.

PURPOSE: To gain insight into the decision-making processes used by women when selecting dairy and dairy alternative foods, including examination of the role of bone health concerns. METHODS: Semi-structured, point-of-purchase interviews were conducted with a convenience sample of 30 female grocery shoppers. Constant comparative data analysis was used to generate themes on shoppers' decision-making processes. RESULTS: Women considered multiple issues in their dairy and dairy alternative food choice strategies: taste was most often associated with the fat and sugar content of foods; health concerns were centred on achieving an acceptable body weight and preventing osteoporosis and cardiovascular disease, and women chose foods to satisfy other family members' needs and preferences and to obtain "good food value." Women prioritized their food choices by weighing the value of each issue, which led to a strategic process for "maximizing the value" of their food choices. The availability of a wide range of dairy and dairy alternative foods meant that in most instances, it was unnecessary for women to "trade off" one area of concern for another. CONCLUSIONS: Dietitians and nutrition educators can help women make dietary changes by helping them identify foods that they perceive as meeting a variety of needs.