scholarly journals Assessment and Updating of the Fortification Model from 2006

2021 ◽  
pp. 55-57
Author(s):  
Margaretha Haugen ◽  
Jutta Dierkes ◽  
Wenche Frølich ◽  
Livar Frøyland ◽  
Ragnhild Halvorsen ◽  
...  
Keyword(s):  
Food Safety ◽  
Dietary Intake ◽  
Energy Intake ◽  
Maximum Amount ◽  
Food Fortification ◽  
Age Group ◽  
Fortified Foods ◽  
Novel Food ◽  
Dietary Surveys ◽  
The Impact

In 2006 the, the Panel on Nutrition, Dietetic Products, Novel Food and Allergy in the Norwegian Scientific Committee for Food Safety (VKM) adapted a Danish model for assessing applications concerning food fortification into Norwegian conditions. The fortification model is presently used by the Norwegian Food Safety Authorities as a tool in the management of applications on food fortification.   The model from 2006 was based on intake calculations from dietary surveys from 1997-2000. Since then, new national dietary surveys have been published. These are the comprehensive nationwide Norwegian dietary surveys among adults (Norkost 3, 2010-2011), among young children (Småbarnskost, 2007) and infants (Spedkost, 2006-2007). The Norwegian Food Safety Authority has requested VKM to implement the new data into the fortification model from 2006.   In the model from 2006 it is assumed that 25% of the energy in the diet can be derived from fortified foods and drinks. Information from the Norwegian Food Safety Authority, including about a pilot study for Norkost 3 suggested that the overall intake of fortified foods and drinks was marginal. From management of applications for fortified foods, the Norwegian Food Safety Authority also experienced that there are few fortified foods on the market in Norway.  The Norwegian Food Safety Authority has therefore requested VKM to evaluate whether the assumption that 25 energy percent (E%) deriving from fortified foods can be reduced to 15 E%, and if such a reduction will have health implications. In addition, the Norwegian Food Safety Authority has asked VKM to perform an evaluation of the safety factors in the model.   VKM argues that the model for fortification should be based on the dietary intake of vitamins and minerals at the 95th percentile level in various age groups. This is in accordance with risk assessments performed in European Food Safety Authority (EFSA), and will assure that the dietary intake in a majority of the population will be covered, still within a reasonable secure use of dietary exposure calculations. Mean intake of vitamins and minerals from food supplements (among users only) was chosen, in an attempt to reduce the impact of those with a high intake of supplements. The intake at 95th percentile from the diet plus the mean nutrient intake from supplements is deducted from the tolerable upper intake level (UL) for each nutrient in each age group, giving the maximum amount of nutrients that can be “allocated” for food fortification. The maximum amount of a nutrient that can be “allocated” is then distributed over the energy intake at the 95th percentile level. In this manner an estimate is made showing which age group is most likely to have an excessive intake of a certain nutrient.    VKM does not have access to any other information about available fortified foods on the Norwegian market than the information given by the Norwegian Food Safety Authority. However, based on this information, VKM considers that it seems reasonable that the energy intake from fortified foods is reduced to 15 E%. In this revised fortification model the assumption from 2006 that 25 E% of the total energy intake will be derived from fortified foods, have therefore been reduced to 15 E%. This adjustment implies that the addition of e.g. vitamin D, vitamin E, thiamine, riboflavin, niacin, folic acid, vitamin B12, vitamin C and calcium per 100 kcal can be increased without risk of exceeding UL. No changes are made for e.g. vitamin A, beta-carotene, magnesium, iron, zinc or copper. A more summary is presented in Table 1 and Appendix 1.   The Panel on nutrition, dietetic products, novel food and allergy considers that this model for management of fortification will reduce health risk that could be caused by unauthorised food fortification.

Associations between risk of malnutrition with dietary intake in people of older age: results from the HELIAD study

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Eirini Mamalaki ◽  
Costas A. Anastasiou ◽  
Meropi D. Kontogianni ◽  
Mary H. Kosmidis ◽  
Georgios M. Hadjigeorgiou ◽  
...  
Keyword(s):  
Older People ◽  
Dietary Intake ◽  
Mediterranean Diet ◽  
Energy Intake ◽  
Nutritional Risk ◽  
Age Group ◽  
Food Groups ◽  
The Mediterranean ◽  
Specific Food

AbstractIntroductionLife expectancy has increased leading to a concomitant increase in the population of older people. Malnutrition, a major problem in this age group, deteriorates their health and quality of life. The association between risk of malnutrition and dietary intake has not been investigated sufficiently. The aim of this study was to examine potential associations between risk of malnutrition and dietary intake in a representative cohort of adults ≥ 65 years old.Materials and methods1,831 older people (mean age 73.1 ± 5.9 years old) from the HELIAD study were included in the analyses. Risk of malnutrition was assessed with the “Determine your Nutritional Health” checklist. Total score of the questionnaire ranges from 1–21, with 0–2 indicating good nutritional status, 3–5 moderate nutritional risk and ≥ 6 high nutritional risk. Dietary intake was evaluated with a semi-quantitative food frequency questionnaire, validated for the Greek population, from which consumption of specific food groups (non-refined cereals, fruits, vegetables, legumes, fish, red meat, poultry, fish, dairy products, alcohol and sweets in servings/day) was estimated, as well as adherence to the Mediterranean diet, using a relevant a priori score.Results35.8% of the participants were well-nourished, 34.8% were at moderate nutritional risk and 29.4% were at high nutritional risk. Total energy intake did not differ between the groups (1,984 ± 500 kcal/day for those well-nourished, 1,995 ± 537 kcal/day for those at moderate nutritional risk and 1,934 ± 566 kcal/day for those at high nutritional risk, p = 0.140). Well-nourished older people consumed per day more portions of vegetables, fruits, legumes, poultry, sweets and fewer portions of alcohol compared to those at moderate and high risk (all p < 0.05). Furthermore, adherence to the Mediterranean diet differed significantly between the groups, i.e. those well-nourished had greater adherence to the Mediterranean Diet compared to the other groups (p < 0.001).DiscussionAlthough energy intake did not differ between the groups, there were significant differences in quality of their diet, as this was depicted in specific food group intake and adherence to a healthy dietary pattern. Thus, health experts should also consider diet quality when screening malnutrition in this vulnerable age group.

scholarly journals The impact of voluntary food fortification on micronutrient intakes and status in European countries: a review

2013 ◽  
Vol 72 (4) ◽  
pp. 433-440 ◽  
Author(s):  
Áine Hennessy ◽  
Janette Walton ◽  
Albert Flynn
Keyword(s):  
European Union ◽  
Adverse Effects ◽  
Population Level ◽  
Food Fortification ◽  
Dietary Energy ◽  
The European Union ◽  
Efficacy And Safety ◽  
Fortified Foods ◽  
National Surveys ◽  
The Impact

This review aims to assess the efficacy and safety of voluntary fortification as an option to address the occurrence of inadequate micronutrient intakes in population subgroups in Europe. Although legislation is harmonised across the European Union, fortification practices and patterns of consumption of fortified foods vary considerably between countries. While the proportion of children consuming fortified foods is greater than adults, the proportion of dietary energy obtained from fortified foods is generally low (<10% in Ireland, where fortified foods are widely consumed). There are a few systematic studies on the overall nutritional impact of voluntary fortification, but there are several studies on the impact of fortified ready-to-eat breakfast cereals. The available evidence indicates that voluntary fortification can reduce the risk of sub-optimal intakes of a range of micronutrients at a population level and can also improve status for selected micronutrients (e.g. folate, vitamin D and riboflavin) in children and adults. Although concerns have been raised regarding the potential of food fortification to lead to unacceptably high micronutrient intakes, particularly for those consuming higher amounts of fortified foods, data from national surveys on total micronutrient intakes (including fortified foods) in Europe show that small proportions of the population, particularly children, may exceed the upper intake level (UL) for some micronutrients. The risk of adverse effects occurring in these individuals exceeding the UL by modest amounts is low. In conclusion, voluntary fortification practices have been shown to improve intake and status of key micronutrients in European Union population groups and do not contribute appreciably to risk of adverse effects.

scholarly journals Impacts of the 2008 Great Recession on dietary intake: a systematic review

2020 ◽  
Author(s):  
Rosemary H. Jenkins ◽  
Eszter P. Vamos ◽  
David Taylor-Robinson ◽  
Christopher Millett ◽  
Anthony A. Laverty
Keyword(s):  
Dietary Intake ◽  
Energy Intake ◽  
Great Recession ◽  
Meta Analysis ◽  
Grey Literature ◽  
Dietary Quality ◽  
Fruit And Vegetable ◽  
The Great Recession ◽  
Study Results ◽  
The Impact

Abstract Background: The 2008 Great Recession significantly impacted economies and individuals globally, with potential impacts on food systems and dietary intake. We systematically reviewed evidence on the impact of the Great Recession on children’s and adults’ dietary intake globally and whether disadvantaged individuals were disproportionately affected.Methods: We searched seven databases and relevant grey literature through June 2020. Longitudinal quantitative studies with the 2008 recession as the exposure and any measure of dietary intake (energy intake, dietary quality and food/macronutrient consumption) as outcomes were eligible for inclusion. Eligibility was independently assessed by two reviewers. The Newcastle Ottawa Scale was used for quality assessment. We undertook a random effects meta-analysis for changes in energy intake. Harvest plots were used to display and summarise study results for other outcomes. The study was registered with PROSPERO (CRD42019135864).Results: Forty-one studies including 2.6 million people met our inclusion criteria and were heterogenous in both methods and results. Ten studies reported energy intake, 11 dietary quality, 34 food intake, and 15 macronutrient consumption. The Great Recession was associated with a mean reduction of 39.9 calories per adult equivalent per day (95% Confidence Interval: -119.9, 40.2) in the meta-analysis of seven studies. We found reductions in dietary quality and small decreases in fruit and vegetable intake. We also found reductions in intake of meat and fish, fast food, sugary products, and soft drinks alongside an increase in the consumption of eggs and legumes. Impacts on macronutrients were inconclusive. Of 17 studies examining inequalities, 14 found that the Great Recession was associated with greater reductions in dietary intake and quality among more disadvantaged individuals. Only 4 studies investigated children’s intakes. Conclusions: The 2008 recession was associated with poorer dietary quality and decreased fruit and vegetable consumption, especially for more disadvantaged individuals. Implementing effective policies to mitigate adverse nutritional changes during the COVID pandemic and other major economic shocks should be prioritised.

scholarly journals The impact of food fortification on stunting in Zimbabwe: Does gender of the household head matter?

2020 ◽  
Author(s):  
Terrence Kairiza ◽  
George Kembo ◽  
Asankha Pallegedara ◽  
Lesley Macheka
Keyword(s):  
Large Scale ◽  
Household Head ◽  
Food Fortification ◽  
Fortified Foods ◽  
Policy Makers ◽  
Major Threat ◽  
High Prevalence ◽  
Gender Based ◽  
Female Headed Households ◽  
The Impact

Abstract High prevalence of stunting in under 5 children poses a major threat to child development in developing countries. It is associated with micronutrient deficiency arising from poor diets fed to under 5 children. Food fortification is amongst the interventions focused at reducing the incidence of stunting in under 5 children. Using a large scale household data from Zimbabwe, we investigated the gender based importance of household adoption of food fortification on the proportion of stunted children in the household. We employed propensity score matching to mitigate self-selection bias associated with household adoption of food fortification. We offer three major findings. Firstly we find little evidence for gender differences in the adoption of fortified foods. Secondly, household adoption food fortification reduces the proportion of stunted children in the household. Finally, vis-à-vis non adopters, female headed households that adopt food fortification reduce a larger proportion of stunted children in their households than their male counterparts who adopt food fortification. These results highlight the need for policy makers to actively promote food fortification programmes to involve men in fortification programmes to improve their knowledge and appreciation of fortified foods and the associated benefits.

scholarly journals Public health aspects of food fortification: a question of balance

2004 ◽  
Vol 63 (4) ◽  
pp. 605-614 ◽  
Author(s):  
Reginald J. Fletcher ◽  
Ian P. Bell ◽  
Janet P. Lambert
Keyword(s):  
Nutrient Intake ◽  
Economic Consequences ◽  
Food Fortification ◽  
Technological Properties ◽  
Fortified Foods ◽  
Eu Legislation ◽  
Dietary Surveys ◽  
Important Health ◽  
The Usa ◽  
Micronutrient Malnutrition

Micronutrient malnutrition is widespread throughout the world, with important health and economic consequences. Tools to address this situation include food fortification, supplementation and dietary diversification, each having different and complementary roles. Fortification (mandatory and voluntary) has been practised over several decades in Western countries as well as in developing countries. Iodised salt was introduced in the USA in 1924 to reduce severe I deficiency. In 1938 voluntary enrichment of flours and breads with niacin and Fe was initiated to reduce the incidence of pellagra and Fe-deficiency anaemia respectively. Micronutrient intakes in European countries appear to be generally adequate for most nutrients. However, a number of population subgroups are at higher risk of suboptimal intakes (below the lower reference nutrient intake) for some micronutrients, e.g. folate, Fe, Zn and Ca in children, adolescents and young women. Dietary surveys indicate that fortified foods play a role in mitigating such risks for several important nutrients. The number of foods suited to fortification are considerably limited by several factors, including technological properties (notably moisture, pH and O2permeability), leading to unacceptable taste and appearance, as well as cost and consumer expectations. In countries in which voluntary fortification is widely practised micronutrient intakes are considerably below tolerable upper intake levels. Concerns about safety are addressed in relation to the potentially increased level or proportion of fortified foods (e.g. following potential EU legislation), for nutrients with relatively low tolerable upper intake levels and where the potential benefit and risks are in different subpopulations (e.g. folic acid). Recent models for assessing these issues are discussed.

scholarly journals Contribution of voluntary fortified foods to micronutrient intake in The Netherlands

2022 ◽  
Author(s):  
Marjolein H. de Jong ◽  
Eline L. Nawijn ◽  
Janneke Verkaik-Kloosterman
Keyword(s):  
The Netherlands ◽  
Food Consumption ◽  
Alcoholic Beverages ◽  
Food Fortification ◽  
Food Groups ◽  
Dutch Population ◽  
Healthy Foods ◽  
Fortified Foods ◽  
Micronutrient Intake ◽  
The Impact

Abstract Purpose In the Netherlands, voluntary fortification of foods with micronutrients is allowed under strict regulations. This study investigates the impact of voluntary food fortification practices in the Netherlands on the frequency and type of fortified food consumption and on the micronutrient intakes of the Dutch population. Methods Data of the Dutch National Food Consumption Survey (2012–2016; N = 4314; 1–79 year) and the Dutch Food Composition Database (NEVO version 2016) was used. To determine if voluntary fortified foods could be classified as healthy foods, criteria of the Dutch Wheel of Five were used. Habitual intakes of users and non-users of voluntary food fortification were calculated using Statistical Program to Assess Dietary Exposure (SPADE) and compared. Results Within the Dutch population, 75% could be classified as user of voluntary fortified foods. Consumed voluntary fortified foods were mostly within food groups ‘Fats and Oils’, ‘Non-alcoholic Beverages’ and ‘Dairy products and Substitutes’ and fell mostly outside the Wheel of Five. Voluntary foods contributed between 9 and 78% to total micronutrient intake of users. Users had up to 64% higher habitual micronutrient intakes, compared to non-users. These higher intakes resulted into lower risks on inadequate intakes, and did not contribute to increased risks of excessive intakes. Conclusion Although voluntary fortified foods increased micronutrient intakes, most of these foods cannot be classified as healthy foods. Future studies should study the association between higher micronutrient intakes and (potential) excessive intakes of e.g. saturated fat and sugar to better understand the role of voluntary fortified foods in a healthy food pattern.

scholarly journals 1372Food-network Analysis: The impact of change in food intake on other foods and energy intake

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Khalid Iqbal ◽  
Antonia Walter ◽  
Lukas Schwingshackl ◽  
Carolina Schwedhelm ◽  
Sven Knüppel ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Energy Intake ◽  
Simultaneous Increase ◽  
Processed Meat ◽  
White Bread ◽  
Food Groups ◽  
Whole Grain ◽  
Partial Correlations ◽  
The Impact ◽  
Prospective Investigation

Abstract Background Intake of most foods show correlations with other foods implying that change in the intake of one food affects the intake of other foods. However, it is unclear whether such relationships are quantitatively meaningful and should be considered when a change in dietary intake is suggested. Methods We used data from European Prospective Investigation into Cancer and Nutrition-Potsdam and the previously published pairwise partial correlations between 49 food groups and calculated the impact of modifications in three correlated food groups that are relevant for public health, i.e. whole grain bread, white bread and processed meat, on intakes of other foods and total energy. Results Increase in the quantities of whole grain bread by 25% resulted in lowered white bread quantities both in men (7%) and women (8%). A 25% decrease in quantity of white bread resulted in increased quantities of whole grain bread (10-11%) and decreased (6%) in processed meat. Lowering intake of processed meat by 25% resulted in lower intakes of refined bread in both sexes. A simultaneous increase of whole grain bread and decrease in white bread and processed meat amplified the desirable benefit by increasing intake of whole grain bread by 12 g in men and 16 g in women. Simultaneous modification of all three food groups resulted in an overall decrease of 212 Kcal in men and 121 Kcal in women. Conclusions In conclusion, this study could show that the interdependencies between the intakes of foods affect not only the implicated food of an intended change but the whole diet including energy intake. Key messages Food networks has the potential to identify optimum changes required to achieve desired modification in dietary intake.

scholarly journals Dietary intake and development of a quantitative FFQ for a nutritional intervention to reduce the risk of chronic disease in the Navajo Nation

2009 ◽  
Vol 13 (3) ◽  
pp. 350-359 ◽  
Author(s):  
Sangita Sharma ◽  
Mihokom Yacavone ◽  
Xia Cao ◽  
Marla Pardilla ◽  
Muge Qi ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Total Energy ◽  
Energy Intake ◽  
Nutritional Intervention ◽  
Culturally Appropriate ◽  
Intervention Programme ◽  
Navajo Nation ◽  
Cross Sectional ◽  
The Mean ◽  
The Impact

AbstractObjectivesTo characterize dietary intake for Navajo adults, to identify foods for a nutritional intervention programme and to develop a culturally appropriate quantitative FFQ (QFFQ) for evaluating the impact of the intervention programme.DesignA cross-sectional study was conducted using 24 h dietary recalls.SettingNavajo Nation, USA.SubjectsSeventy-nine (forty men, thirty-nine women) aged 18–71 years completed 24 h dietary recalls.ResultsThe median daily energy intake was 11 585 kJ (2769 kcal) for men and 8519 kJ (2036 kcal) for women. The greatest contributors to energy were fried potato dishes, sweetened juices/drinks, regular pop, bread, tortillas and burritos (contributing approximately 30 % of total energy intake). The mean number of meat servings was over twice that recommended (2–3 servings recommendedv. 7·4 consumed by men and 5·3 by women). The mean servings of vegetables were well below the recommendation of 3–5 servings (1·0 serving for men and 1·2 servings for women). The final QFFQ contains 177 food and drink items.ConclusionsOur study found that major contributors to total energy, fat and sugar intakes in the Navajo Nation included mostly processed meats and sweetened drinks. A nutritional intervention will target these foods and promote acceptable and healthier alternatives. In addition, we were able to identify foods and beverages for inclusion on a culturally appropriate QFFQ to assess dietary intake. This QFFQ will be used to evaluate the effectiveness of our intervention on food and food group consumption and nutrient intake.

Food Safety Security: A new Concept for Enhancing Food Safety Measures

2012 ◽  
Vol 82 (3) ◽  
pp. 216-222 ◽  
Author(s):  
Venkatesh Iyengar ◽  
Ibrahim Elmadfa
Keyword(s):  
Food Safety ◽  
Hazard Analysis ◽  
Warning System ◽  
Shared Responsibility ◽  
Fine Tuning ◽  
Strategic Action ◽  
Surveillance Network ◽  
Measurement Systems ◽  
Critical Control Points ◽  
The Impact

The food safety security (FSS) concept is perceived as an early warning system for minimizing food safety (FS) breaches, and it functions in conjunction with existing FS measures. Essentially, the function of FS and FSS measures can be visualized in two parts: (i) the FS preventive measures as actions taken at the stem level, and (ii) the FSS interventions as actions taken at the root level, to enhance the impact of the implemented safety steps. In practice, along with FS, FSS also draws its support from (i) legislative directives and regulatory measures for enforcing verifiable, timely, and effective compliance; (ii) measurement systems in place for sustained quality assurance; and (iii) shared responsibility to ensure cohesion among all the stakeholders namely, policy makers, regulators, food producers, processors and distributors, and consumers. However, the functional framework of FSS differs from that of FS by way of: (i) retooling the vulnerable segments of the preventive features of existing FS measures; (ii) fine-tuning response systems to efficiently preempt the FS breaches; (iii) building a long-term nutrient and toxicant surveillance network based on validated measurement systems functioning in real time; (iv) focusing on crisp, clear, and correct communication that resonates among all the stakeholders; and (v) developing inter-disciplinary human resources to meet ever-increasing FS challenges. Important determinants of FSS include: (i) strengthening international dialogue for refining regulatory reforms and addressing emerging risks; (ii) developing innovative and strategic action points for intervention {in addition to Hazard Analysis and Critical Control Points (HACCP) procedures]; and (iii) introducing additional science-based tools such as metrology-based measurement systems.

Dietary Vitamin and Stability of Oral Anticoagulation: Proposal of a Diet with Constant Vitamin K1 Content

1997 ◽  
Vol 77 (03) ◽  
pp. 504-509 ◽  
Author(s):  
Sarah L Booth ◽  
Jacqueline M Charnley ◽  
James A Sadowski ◽  
Edward Saltzman ◽  
Edwin G Bovill ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Vitamin K ◽  
High Performance ◽  
Case Reports ◽  
Food Composition ◽  
Dietary Guidelines ◽  
Dietary Vitamin ◽  
Vitamin K1 ◽  
The Stability ◽  
The Impact

SummaryCase reports cited in Medline or Biological Abstracts (1966-1996) were reviewed to evaluate the impact of vitamin K1 dietary intake on the stability of anticoagulant control in patients using coumarin derivatives. Reported nutrient-drug interactions cannot always be explained by the vitamin K1 content of the food items. However, metabolic data indicate that a consistent dietary intake of vitamin K is important to attain a daily equilibrium in vitamin K status. We report a diet that provides a stable intake of vitamin K1, equivalent to the current U.S. Recommended Dietary Allowance, using food composition data derived from high-performance liquid chromatography. Inconsistencies in the published literature indicate that prospective clinical studies should be undertaken to clarify the putative dietary vitamin K1-coumarin interaction. The dietary guidelines reported here may be used in such studies.

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