Where are the low-calorie sweeteners? An analysis of the presence and types of low-calorie sweeteners in packaged foods sold in Brazil from food labelling

AbstractObjectiveStudies have shown that consumption of low-calorie sweeteners (LCS) may be associated with harmful health effects. The current study investigated the presence and types of LCS added to packaged foods.DesignCross-sectional study analysing the presence and types of LCS in the ingredients lists of packaged foods sold at a major Brazilian supermarket. To identify types of LCS allowed for use in foods in Brazil, current legislation was consulted. Data were organised and analysed through descriptive statistics, presenting simple and relative frequencies of LCS presence categorised by food group.SettingSupermarket in Florianópolis, southern Brazil.SubjectsPackaged food products (n4539) from eight food groups.ResultsOne or more LCS were found in 602 (13·3 %) of the packaged foods analysed. There were 1329 citations of LCS among these foods, with a mean of 2·2 sweeteners per food. Groups with the highest frequency of foods containing LCS were: products with energy derived from carbohydrates and fats (25·0 %); milk and dairy products (11·7 %); bakery products, cereals, legumes, roots and tubers (11·2 %); and fruits, juices, nectars and fruit drinks (8·3 %).ConclusionsThere was high prevalence of packaged foods with LCS, especially in food groups that form the basis of the Brazilian diet. The study was the first to extensively analyse the presence and types of LCS in packaged foods available for sale in a Brazilian supermarket and can be useful to monitor the use of LCS in these foods, as well as to support future changes in legislation to label sugars.

Download Full-text

Low-calorie-sweeteners in foods with front-of-package child-directed advertising in Brazil

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.577 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

M F Grilo ◽

C Z Ricardo ◽

L S Taillie ◽

A P B Martins ◽

L A Mais ◽

...

Keyword(s):

Food Supply ◽

Cross Sectional Study ◽

Food Groups ◽

Cross Sectional ◽

Breakfast Cereals ◽

Added Sugars ◽

Low Calorie ◽

Sugary Drinks ◽

Packaged Food ◽

Nutrition Facts Panel

Abstract Background Low-calorie sweeteners (LCS) are currently found in ultra-processed foods, even in those with high content of sugar, without any front-of-package (FOP) information for LCS content. The aim was to assess the presence of LCS and the combination of LCS and added sugars in foods and beverages with FOP child-directed advertising in the Brazilian packaged food supply. Methods In this cross-sectional study, we used data from the nutrition facts panel (NFP) dataset that includes 11,434 unique foods and beverages collected in 2017 in the five largest food retailers in Brazil. We used information on the NFP and the list of ingredients to determine the presence of LCS and added sugars. A subsample of the packages had the available FOP advertising strategies classified using the INFORMAS methodology (n = 3,491). We estimated the prevalence of LCS and the combination of LCS and added sugar presence in the Brazilian food supply, and assessed the prevalence of foods and beverages with FOP child-directed advertising. Results Out of 3,491 products assessed, 8.9% of the products contained LCS, of which 12.9% were advertised towards children. Regarding the presence of LCS and added sugars, 7.3% of products presented that combination, with 14.6% of those having child-directed FOP advertising. The food groups with the highest prevalence of LCS were: sugary drinks (juices, nectars, fruit-flavored drinks, sodas and other beverages) (40.6%), breakfast cereals and granola bars (31.6%), and sweetened dairy products (23.5%). From those, 5.5%, 6.7% and 17.1%, accordingly, were advertised towards children. Conclusions In this sample, 9% of the foods contained LCS or a combination of LCS and added sugars. In products advertised towards children, we found higher rates of products with LCS and greater presence of LCS in beverages, breakfast cereals and granola bars with children-directed advertising. Key messages This study demonstrates that almost 9% of Brazilian packaged foods have LCS, and that 7% have both LCS and added sugars. In products advertised towards children, such rates were higher (13 - 15%). A clearer information on the front-of-package of foods and beverages regarding the presence of LCS in Brazil is necessary, particularly among those products advertised towards children.

Download Full-text

VITAMIN E INTAKE AND FOOD SOURCES IN ADOLESCENT DIET: A CROSS-SECTIONAL POPULATION-BASED STUDY

Revista Paulista de Pediatria ◽

10.1590/1984-0462/2021/39/2019295 ◽

2021 ◽

Vol 39 ◽

Author(s):

Karyne Sumico de Lima Uyeno Jordão ◽

Daniela de Assumpção ◽

Marilisa Berti de Azevedo Barros ◽

Antonio de Azevedo Barros Filho

Keyword(s):

Vitamin E ◽

Nutrient Content ◽

Population Based ◽

Cross Sectional Study ◽

Food Sources ◽

Food Groups ◽

Cross Sectional ◽

Relative Contribution ◽

High Prevalence

ABSTRACT Objective: To assess vitamin E intake and its relationship with sociodemographic variables, and to identify the main dietary sources of the nutrient in the diet of adolescents. Methods: This is a population-based cross-sectional study that used data from 891 adolescents living in Campinas, SP, participating in ISACamp 2014/15 (Health Survey) and ISACamp-Nutri 2015/16 (Food Consumption and Nutritional Status Survey). The nutrient intake averages were estimated using the Generalized Linear Model, adjusted for the total energy of the diet. Dietary sources of vitamin E were identified from the calculation of the relative contribution. Results: The average vitamin E intake was 3.2 mg for adolescents aged 10 to 13 years and 3.5 mg for those aged 14 to 19 years, results far below the recommended values of 9 and 12 mg, respectively. The prevalence of inadequacy was 92.5%. Ten foods/food groups represented 85.7% of vitamin E present in the adolescents’ diet; the vegetable oils group accounted for more than a quarter of the contribution (25.5%), followed by cookies (9.1%) and beans (8.9%). Conclusions: There were a low intake and a high prevalence of inadequate vitamin E intake among adolescents in Campinas, with vegetable oil as the main source. For the total number of adolescents, almost 33% of the nutrient content was derived from foods of poor nutritional quality such as cookies, packaged snacks, and margarine. The results of this study can guide public health actions that aim to improve the quality of adolescents’ diets.

Download Full-text

Dietary patterns, food and macronutrient intakes among adults in three ethnic groups in rural Kenya

Public Health Nutrition ◽

10.1017/s1368980010003782 ◽

2011 ◽

Vol 14 (9) ◽

pp. 1671-1679 ◽

Cited By ~ 25

Author(s):

Andreas W Hansen ◽

Dirk L Christensen ◽

Melanie W Larsson ◽

Jeannette Eis ◽

Tue Christensen ◽

...

Keyword(s):

Food Insecurity ◽

Ethnic Groups ◽

Dietary Patterns ◽

Cross Sectional Study ◽

Food Groups ◽

Sectional Study ◽

Cross Sectional ◽

Present Cross Sectional Study ◽

High Prevalence ◽

Rural Kenya

AbstractObjectiveTo compare dietary patterns and food and macronutrient intakes among adults in three ethnic groups in rural Kenya.DesignIn the present cross-sectional study, dietary intake was estimated in adult volunteers using two non-consecutive interactive 24 h recalls. Dietary patterns were assessed from the number of meals and snacks per day and from the food items and major food groups registered, and their contribution to energy intake (EI) was calculated. Anthropometric values were measured and sociodemographic data obtained using a questionnaire.SettingA cross-sectional study was conducted in the Bondo, Kitui and Transmara districts of rural Kenya. A high prevalence of food insecurity in Kenya underlines the importance of describing the dietary patterns and intakes in different Kenyan ethnic groups.SubjectsA total of 1163 (61 % women) adult Luo, Kamba and Maasai, with a mean age of 38·6 (range: 18–68) years, volunteered to participate.ResultsDietary patterns and food groups contributing to EI differed significantly among the ethnic groups. Mean EI ranged from 5·8 to 8·6 MJ/d among women and from 7·2 to 10·5 MJ/d among men, with carbohydrates contributing between 55·7 % and 74·2 % and fat contributing between 14·5 % and 30·2 % of total EI. Mean protein intake ranged from 0·72 to 1·3 g/kg per d, and EI:BMR ratio ranged between 1·1 and 1·6 in both sexes, and was highest among the Luo. Prevalence of underweight (BMI < 18·5 kg/m2) was 13·7 %, 20·5 % and 24·2 % in the Luo, Kamba and Maasai, respectively.ConclusionsThe degree of food insecurity measured as a degree of undernutrition and as dietary patterns differed considerably among the ethnic groups. The Maasai and Kamba in particular were exposed to food insecurity.

Download Full-text

Sodium sources in the Japanese diet: difference between generations and sexes

Public Health Nutrition ◽

10.1017/s1368980015003249 ◽

2015 ◽

Vol 19 (11) ◽

pp. 2011-2023 ◽

Cited By ~ 35

Author(s):

Keiko Asakura ◽

Ken Uechi ◽

Shizuko Masayasu ◽

Satoshi Sasaki

Keyword(s):

Dietary Habits ◽

Age Groups ◽

Asian Country ◽

Food Group ◽

Cross Sectional Study ◽

Food Groups ◽

Cross Sectional ◽

Salt Reduction ◽

Fish And Shellfish ◽

Japanese Diet

AbstractObjectiveGlobally, the Na consumption of most people exceeds the WHO recommendation. To be effective, salt reduction programmes require assessment of the dietary sources of Na. Due to methodological difficulties however, comprehensive assessments are rare. Here, we identified Na sources in the Japanese diet using a 4 d diet record that was specifically designed for Na source description.DesignA cross-sectional study.SubjectsApparently healthy men (n 196) and women (n 196) aged 20–69 years.SettingThe subjects were recruited from twenty-three of forty-seven prefectures in Japan.ResultsThe proportion of discretionary Na intake in total Na intake was 52·3 % in men and 57·1 % in women, and was significantly lower in younger subjects. The two major food groups contributing to Na intake were seasonings such as salt or soya sauce (61·7 % of total Na intake in men, 62·9 % in women) and fish and shellfish (6·7 % in men, 6·6 % in women). The third major contributor differed between men and women (noodles in men, 4·9 %; bread in women, 5·0 %). Further, the contribution of each food group to total Na intake differed among age groups.ConclusionsWhile individual efforts to decrease Na intake remain important, population approaches to reducing Na content in processed foods are already equally important and will assume greater importance in the future even in Japan, an Asian country facing a rapid Westernization in dietary habits.

Download Full-text

Association between Consumed Foods and Musculoskeletal Disorder in Office Workers

Journal of Nutrition and Food Security ◽

10.18502/jnfs.v6i1.5299 ◽

2021 ◽

Author(s):

Golnaz Arjmand ◽

Pardis Irandoost ◽

Mojtaba Abbaszadeh ◽

Aliasghar Farshad ◽

Masoud Salehi ◽

...

Keyword(s):

Musculoskeletal Disorder ◽

Food Group ◽

Cross Sectional Study ◽

The Body ◽

Office Workers ◽

Food Groups ◽

Anthropometric Parameters ◽

Cross Sectional ◽

Determining Factors ◽

The Difference

Background: Musculoskeletal disorder (MSD) is one of the important problems concerning the staffs' health and productivity in the workplace. Nutritional status and consumption of some foods are also among the determining factors of MSD. So, this study aimed to evaluate the correlation of diet and consumed food groups with MSD. Methods: This cross-sectional study was conducted on 100 office workers. The participants' anthropometric parameters and their dietary information were collected using a semi-quantitative food frequency questionnaire. The findings were categorized into nine levels. The total scores were calculated for all the items per food group and per person. Nordic musculoskeletal questionnaire was also administered to evaluate the MSD symptoms in nine parts of body. Results: The score of consumed food groups was compared between individuals “with pain” and “without pain” in nine parts of the body. The scores of fruit intake in individuals “with pain” and “without pain” were 2.94 ± 1.27 vs. 3.29 ± 1.16 and 2.81 ± 1.10 vs. 3.49 ± 1.38 in terms of neck and wrists, respectively. The difference between the two groups were significant (P < 0.05). Furthermore, the participants with pain in the neck consumed significantly lower amounts of cereals and nuts (P = 0.03, 0.04). In the case of the shoulder pain, consuming legumes and nuts in the “without pain” group was higher than the group of participants who had pain (P = 0.01, P = 0.03). Fat intake was higher in the patients who had pain in their hips (P = 0.02). Conclusion: Less pain was reported in the musculoskeletal system by higher consumption of fruits, nuts, and legumes. It seems that plant-based dietary pattern is more effective in musculoskeletal health.

Download Full-text

Household food insufficiency is associated with dietary intake in Korean adults

Public Health Nutrition ◽

10.1017/s1368980015002438 ◽

2015 ◽

Vol 19 (6) ◽

pp. 1112-1121 ◽

Cited By ~ 11

Author(s):

Sang Eun Lee ◽

Yoon Ju Song ◽

Young Kim ◽

Jeongsook Choe ◽

Hee-Young Paik

Keyword(s):

Dietary Intake ◽

Health Behaviours ◽

Food Group ◽

Cross Sectional Study ◽

Dietary Quality ◽

Secondary Source ◽

Food Groups ◽

Food Insufficiency ◽

Cross Sectional ◽

Vegetables And Fruits

AbstractObjectiveTo examine the association of food insufficiency with dietary intake and eating and health behaviours.DesignA cross-sectional study.SettingData were obtained from a secondary source, the Fifth Korea National Health and Nutrition Examination Survey (2010–2012).SubjectsThe sample size consisted of 15 603 adults over 19 years of age (8898 households).ResultsSignificant differences in socio-economic factors were observed according to food insufficiency level (P<0·05), but BMI was similar among groups. Regarding macronutrients, lower protein intake and higher carbohydrate intake were found in the severely food-insufficient group, but we found no association with fat intake. Regarding micronutrients, Ca, Fe, vitamin A, thiamin, riboflavin niacin and vitamin C intakes were negatively associated with food insufficiency level (Ptrend<0·05). Consumption of different food groups, such as meat, fish, eggs and beans, vegetables and fruits, was significantly lower as food insufficiency level decreased after controlling for all possible variables; food group consumption also differed by sex. Overall eating and health behaviours were poorer in the mildly and severely food-insufficient groups, who received more food assistance but less nutritional education.ConclusionsOur results showed that dietary intake as well as eating and health behaviours are adversely associated with food insufficiency. These findings suggest that specific strategies to help food-insufficient individuals should be developed in order to improve their dietary quality and health status.

Download Full-text

Diet quality – what is it and does it matter?

Public Health Nutrition ◽

10.1017/s136898000900531x ◽

2009 ◽

Vol 12 (12) ◽

pp. 2473-2492 ◽

Cited By ~ 226

Author(s):

Annika Wirt ◽

Clare E Collins

Keyword(s):

Health Outcomes ◽

Diet Quality ◽

English Language ◽

Food Group ◽

Cross Sectional Study ◽

Dietary Quality ◽

Food Groups ◽

Cross Sectional ◽

The Relationship ◽

Quality Tools

AbstractObjectiveMeasures of diet quality have evolved with a number of scoring indices currently in use. They are increasingly being used to examine epidemiological associations between dietary intake and nutrition-related health outcomes. The present review aims to describe current diet quality tools and their applications, and to examine the relationship between diet quality and morbidity and mortality.DesignA search was conducted of MEDLINE, Cochrane, EMBASE, CINAHL and ProQuest electronic databases. Inclusion criteria were: English language; published from 2004 on; conducted in adult populations; longitudinal/cohort/case–control or cross-sectional study; included a theoretically defined measure of diet quality.ResultsA total of twenty-five indices of overall diet quality and/or variety were found, with components ranging from nutrients only to adherence to recommended food group servings, to variety within healthful food groups. The majority of studies reviewed had methodological weaknesses but demonstrated that higher dietary quality was consistently inversely related to all-cause mortality, with a protective effect of moderate magnitude. The associations were stronger for men and for all-cause and CVD mortality.ConclusionsThe limitations of both the indices and the studies that use them need to be considered when interpreting and comparing results. However, diet quality indices do appear to be able to quantify risk of some health outcomes, including biomarkers of disease and risk of CVD, some cancers and mortality. Further research is needed to improve the validity of these tools and to adapt them for use in clinical dietetic practice.

Download Full-text

Differences in Consumption of NASEM Priority Nutrients and Food Groups by Race/Ethnicity Among Women Living in WIC-Participating Households

American Journal of Health Promotion ◽

10.1177/0890117120920849 ◽

2020 ◽

Vol 34 (7) ◽

pp. 791-795

Author(s):

Meghan C. Zimmer ◽

Veronica Rubio ◽

Kristina W. Kintziger ◽

Cristina Barroso

Keyword(s):

Black Women ◽

Dietary Intake ◽

White Women ◽

Food Group ◽

Cross Sectional Study ◽

Food Groups ◽

Cross Sectional ◽

Race Ethnicity ◽

Nutrition Messages ◽

Hispanic White

Purpose: To examine racial/ethnic differences in dietary intake of women in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Design: Cross-sectional study. Setting: Data from the US National Health and Nutrition Examination Survey. Participants: Women 19 to 50 years of age living in WIC-participating households. Measures: Nutrient/food group intake from one 24-hour dietary recall. Analysis: Multivariable linear regression was used to evaluate the relationship between race/ethnicity and nutrient/food group intake. Results: Compared to non-Hispanic white women, Hispanic women had lower dietary energy density (1.7 ± 0.1 vs 2.2 ± 0.1 kcal/g, P < .001), and better nutrient intake, including more folate (429 ± 20 vs 364 ± 29 µg, P = .024), fiber (20.1 ± 0.9 vs 13.6 ± 0.9 g, P ≤ .001), and potassium (2575 ± 78 vs 2251 ± 66 mg, P = .012). This may be related to greater consumption of total vegetables (1.67 ± 0.16 vs 1.17 ± 0.17 cup equivalents [c-eq], P = .029), including more red and orange vegetables (0.64 ± 0.11 vs 0.32 vs 0.09 c-eq, P = .013) and more legumes (0.17 ± 0.04 vs 0.07 ± 0.02 c-eq, P = .006). Both Hispanic and non-Hispanic black women consumed more sodium (Hispanic: P = .015; non-Hispanic black: P = .008), but less added sugars (Hispanic: P ≤ .001; non-Hispanic black: P = .015), than non-Hispanic white women. Conclusion: These findings highlight differences in dietary intake by race/ethnicity and can inform nutrition messages of WIC nutrition educators and dietitians.

Download Full-text

Trans Fat Labeling Information on Brazilian Packaged Foods

Nutrients ◽

10.3390/nu11092130 ◽

2019 ◽

Vol 11 (9) ◽

pp. 2130 ◽

Cited By ~ 2

Author(s):

Camila Zancheta Ricardo ◽

Isabela Mateus Peroseni ◽

Laís Amaral Mais ◽

Ana Paula Bortoletto Martins ◽

Ana Clara Duran

Keyword(s):

Cross Sectional Study ◽

Trans Fat ◽

Cross Sectional ◽

Trans Fats ◽

Food And Beverages ◽

Fat Consumption ◽

Hydrogenated Fats ◽

Packaged Foods ◽

Packaged Food ◽

Nutrition Facts Panel

Although the adverse effects of trans fat consumption are well documented, industrially-produced trans fats are still used in a variety of food products. Our objective was to investigate the presence of trans fat information on the nutrition facts panel, in the list of ingredients, and the use of trans fat claims in packaged food and beverages marketed in Brazil. This was a cross-sectional study that used data from packaged food and beverages available in the five supermarket chains with the largest market share in Brazil. Of the 11,434 products that were analyzed, 81.3% did not present a source of trans fats in the list of ingredients. The percentages of products with specific (hydrogenated fats or oils) and unspecific trans fat terms (margarine, vegetable fat, and vegetable cream) in the list of ingredients were 4.1% and 14.6%, respectively. Bakery products, cookies and crackers, candies and desserts, snacks, and convenience foods had the highest percentages of trans fat claims. We also found claims in products with ingredients that are sources of trans fats. In conclusion, trans fat ingredients were found in almost one-fifth of the Brazilian packaged foods. The current Brazilian legislation is not sufficient to inform consumers about the content of trans fats in packaged foods. Along with measures to restrict the use of industrially-produced trans fats, improvements in nutritional labeling are also needed.

Download Full-text

Comparison of the nutritional content of products, with and without nutrient claims, targeted at children in Brazil

British Journal Of Nutrition ◽

10.1017/s0007114516001021 ◽

2016 ◽

Vol 115 (11) ◽

pp. 2047-2056 ◽

Cited By ~ 19

Author(s):

Vanessa Mello Rodrigues ◽

Mike Rayner ◽

Ana Carolina Fernandes ◽

Renata Carvalho de Oliveira ◽

Rossana Pacheco da Costa Proença ◽

...

Keyword(s):

Food Products ◽

Cross Sectional Study ◽

Food Groups ◽

Nutritional Content ◽

Sectional Study ◽

Cross Sectional ◽

Packaged Foods ◽

Nutrient Profiles

AbstractMany children’s food products highlight positive attributes on their front-of-package labels in the form of nutrient claims. This cross-sectional study investigated all retailed packaged foods (n 5620) in a major Brazilian supermarket, in order to identify the availability of products targeted at children, and to compare the nutritional content of products with and without nutrient claims on labels. Data on energy, carbohydrate, protein, fibre, Na and total and SFA content, along with the presence and type of nutrient claims, were obtained in-store from labels of all products. Products targeted at children were identified, divided into eight food groups and compared for their nutritional content per 100 g/ml and the presence of nutrient claims using the Mann–Whitney U test (P<0·05). Of the 535 food products targeted at children (9·5 % of all products), 270 (50·5 %) displayed nutrient claims on their labels. Children’s products with nutrient claims had either a similar or worse nutritional content than their counterparts without nutrient claims. The major differences among groups were found in Group 8 (e.g. sauces and ready meals), in which children’s products bearing nutrient claims had higher energy, carbohydrate, Na and total and SFA content per 100 g/ml than products without nutrient claims (P<0·05). This suggests that, to prevent misleading parents who are seeking healthier products for their children, the regulation on the use of nutrient claims should be revised, so that only products with appropriate nutrient profiles are allowed to display them.

Download Full-text