Older adults living in nursing homes (NH) are considered a population group that could be at risk in terms of nutrition, even more so than their community-dwelling peers. Evidence on the nutritional ...status of NH residents is scarce, as they are commonly excluded from population-based dietary studies. This is also the case in Slovenia. In the presented pilot study, we assessed the intake of macronutrients as well as the intake and status of vitamin D and vitamin B12 on a sample of NH and NH daycare center users to explore the need for a larger representative study. The pilot study included 37 participants from three Slovenian NH (20 participants) and their daycare centers (17 participants). Daycare centers offer daytime care services for older adults, where users are also provided with major meals during their stay. Intakes of energy and nutrients were estimated by three 24 h dietary records. Fasting blood samples were collected for the assessment of vitamin D and vitamin B12 status. Over 90% of the participants had daily energy and protein intakes below recommendations (reference values: energy intake: males 2100 kcal and females 1700 kcal; protein intake > 1 g/kg body mass). The males' median daily intakes of vitamin D were 1.7 µg (1.5 µg females), and 2.3 µg for vitamin B12 (2.0 µg females). None of the participants had adequate vitamin D intake (>20 µg), and 92.3% males and 87.5% females had inadequate vitamin B12 intake (<4 µg). The prevalence of vitamin D deficiency (serum 25-OH-D conc. < 30 nmol/L) was 100% among NH residents and 53% among NH daycare center users. The prevalence of vitamin B12 deficiency was found in 20% of NH residents. The study results highlighted that certain nutrients might be critical in this population, especially among NH residents; however, a more thorough investigation with the inclusion of other important markers of nutritional status should be performed on a larger, representative sample to support the development and implementation of appropriate public health interventions.
The nutritional composition of foods marketed to children is important, as it can significantly influence children's preferences. The objective of this research was to evaluate the presence of ...child-oriented food products in the food supply and to investigate their nutritional composition. The sample included 8191 prepacked foods in the Slovenian food supply available in the market in 2015. The nutrient profile (World Health Organisation Regional Office for Europe nutrient profile model) of the products with child-targeted promotions was compared to the nutrient profile of those without child-targeted promotions. Food categories with the highest proportion of products with child-focused promotions were "Breakfast Cereals" (17%), "Chocolate and Sugar Confectionery" (15%) and "Edible Ices" (13%). Altogether, 93% of all products with child-focused promotions and 73% of products without such promotions were classified as "not permitted". The proportion of "not permitted" foods was significantly higher in products with child-targeted promotions, compared with products without child-targeted promotions (
< 0.0001), and this trend was observed in a majority of food categories. To protect children from exposure to the marketing of foods with less favourable nutritional compositions, public health strategies should be focused also towards limiting promotions of unhealthy foods to children on product packaging, not only in media.
This paper focuses on changes in food consumption that occurred during the COVID-19 pandemic. Its objective is to map changes at individual consumer level and identify the influence of different ...factors related to the COVID-19 pandemic on changes in individual food consumption. We conducted a cross-sectional online survey among 2,680 residents of Denmark (DK), Germany (DE), and Slovenia (SI) using quota sampling for gender, age and regional distribution. Data on consumption frequencies before and during the pandemic were collected with a food frequency questionnaire in the spring of 2020 (during the first lockdown period) for important types of fresh food and non-perishable food. Our results showed that, depending on the type of food, 15-42% of study participants changed their consumption frequency during the pandemic, compared to before. In all the study countries, the food categories with the highest rates of change were frozen food, canned food, and cake and biscuits; among the food categories with lower rates of change were bread, alcoholic drinks, and dairy products. People across all three countries shopped less frequently during lockdown and there was an overall reduction in the consumption of fresh foods, but an increase in the consumption of food with a longer shelf life in Denmark and Germany. Interestingly though, we observed diverging trends in all food categories analyzed, with some people decreasing and others increasing their consumption frequencies, demonstrating that the pandemic had different impacts on people's lifestyles and food consumption patterns. Using the method of multinomial regression analysis, we identified factors significantly (
< 0.01,
< 0.05,
< 0.1) related to increases and decrease in individuals' consumption frequencies in different food categories. The factors include restrictions put in place in response to the pandemic (i.e., closure of physical workplaces, canteens, cafés and restaurants, schools, and childcare institutions), changes in households' grocery shopping frequency, individuals' perceived risk of COVID-19, income losses due to the pandemic, and socio-demographic factors. Interesting differences between the countries were detected, allowing insights into the different food cultures. Conclusions include implications for policy-makers and actors in the food supply chain on the issues of healthy diets, food system resilience, and behavior change.
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•In the EU traditional use evidence for botanicals is currently used to substantiate claims on medicines, but not on foodstuffs.•‘On hold’ claims for ten commonly used botanicals in ...the EU were investigated.•For majority of studied botanicals some ‘on hold’ claims were linked with traditional use in herbal monographs.•Possible wordings of health claims were constructed, refereeing to traditional use.•Any regulatory reform would also need to address safety issues of botanicals.
In the European Union, health claims on foods are considered as voluntary food labelling information. While health claims for nutrients and specific bioactive ingredients were subject to strict scientific evaluation, the health claims for botanicals have regulatory status ‘pending evaluation’. They are commonly used on the market, although there is no consensus on the strength of the evidence needed for their support. In the EU the evidence regarding traditional use is sufficient for traditional herbal medicines. Consequently, we investigated the approach of using such evidence to support botanical health claims. The study was conducted on ten commonly used botanicals in Europe. Using data on previously identified relevant health effects and the wording used for authorised health claims, the possible wordings for botanical health claims were constructed. The study results support further discussions and policy options about the use of botanical health claims.
Insights into the use of health-related information on foods are important for planning studies about the effects of such information on the consumer's understanding, purchasing, and consumption of ...foods, and also support further food policy decisions. We tested the use of sales data for weighting consumers' exposure to health-related labeling information in the Slovenian food supply. Food labeling data were collected from 6342 pre-packed foods available in four different food stores in Slovenia. Consumers' exposure was calculated as the percentage of available food products with particular food information in the food category. In addition, 12-month sales data were used to calculate sales weighted exposure as a percentage of sold food products with certain food information in the food category. The consumer's in-store and sales-weighted exposure to nutrition claims was 37% and 45%, respectively. Exposure to health claims was much lower (13%, 11% when sales-weighted). Health claims were mainly found in the form of general non-specific claims or function claims, while children's development and reduction of disease risk claims were present on only 0.1% and 0.2% of the investigated foods, respectively. Sales data were found very useful for establishing a reliable estimation of consumers' exposure to information provided on food labels. The high penetration of health-related information on food labels indicates that careful regulation of this area is appropriate. Further studies should focus on assessing the nutritional quality of foods labeled with nutrition and health claims, and understanding the importance of such labeling techniques for consumers' food preferences and choices.
The implementation of mandatory front-of-pack nutrition labelling is currently being discussed in the European Union (EU). The Nutri-Score (NS) was developed in France to empower consumers to make ...informed and healthier food choices. Based on strong evidence of its efficacy in supporting healthy choices, it has already been implemented for voluntary use in some EU member states, making it relevant to developing a harmonised EU scheme. This study aimed to evaluate the NS’s discriminating ability on products available in the food supply and compare it with Slovenian national nutritional recommendations based on an adapted WHO Europe (WHOE) profile. The innovative approach of the study is that we used sale-weighting to address the public health importance of available foods, with consideration of market share. We profiled 15,822 products available in the Slovenian food supply in 2017. The NS had a high ability to discriminate food products based on nutritional composition. Products that are generally encouraged in dietary recommendations (fruits, vegetables, cereals) had, in most cases, better NS grades than less favourable products (confectionery, snack foods, added fats), which is also in line with the national nutrition policy programme. The discriminating ability of the model was also shown within food (sub)categories (e.g., plain and flavoured yoghurt). Sale-weighting showed that offerings do not always reflect sales. Major differences between offerings and sales were observed for beverages, dairy, fruits/vegetables, and edible oils/emulsions. Additionally, sale-weighted distribution tended towards less favourable nutritional composition, particularly in categories with overall smaller offerings of products with favourable composition. The NS showed moderate agreement with the WHOE profile (κ = 0.57); differences were particularly observed in flavoured yoghurts, juices, cooking oils, and cheeses. Modelling the operation of the NS with representative real-life food samples provided insight valuable for developing and implementing harmonised mandatory front-of-pack nutrition labelling in Europe.
Front‐of‐package nutrition labeling (FOPNL) is an important public health tool, and the introduction of harmonized FOPNL in Europe is one of the most ambitious food labeling changes in decades. ...Nutri‐Score (NS) has been considered for implementation across Europe. However, NS is subject to strong opposition, particularly from the food industry and some agricultural sectors (such as cheese and cured meat), but also from some nutrition scientists and public health professionals, which highlights that the system is not sufficiently aligned with food‐based dietary guidelines and the latest scientific literature. These concerns were recently addressed in a revised version of NS (NS2023), aiming to overcome the limitations of its predecessor (NS2021). Our aim was to assess whether these limitations were addressed and to investigate their alignment with dietary guidelines. A systematic literature review identified 20 limitations of NS, assigned to 3 groups (Food‐based, Component‐based, and Other Dimensions of Food Quality). Subsequent assessment of NS employed a large representative branded food database of 19,510 pre‐packed foods. Alignment with dietary guidelines was assessed based on agreement with the WHO Europe nutrient profile (WHOE). NS2023 was shown as notably stricter compared to NS2021 (7% fewer products received the higher grades A or B) and more aligned with WHOE (κNS2021 = .59, κNS2023 = .65). Overall, most (65%) of the limitations were addressed to some extent; these were mostly Food‐based limitations, followed by Component‐based, whereas the Other Dimension of Food Quality (processing, sustainability, portion sizes) remained mostly unaddressed. We can conclude that the revised NS2023 increased its potential for implementation across Europe. Our review identified all limitations, relevant or not, which were mentioned in the scientific literature. Therefore, some mentioned limitations may never be solvable in the scope of nutrient profiling. Others could be further addressed by adaptation of the visual presentation, but increased complexity of the labeling message would also reduce the potential of the FOPNL to support consumers in healthier food choices. Additional research is also necessary to explore the potential impact of the revised NS2023 on food reformulation and its perception among consumers.
Revised Nutri‐Score addressed majority of the limitations of its predecessor and became stricter nutrient profiling model. It improved alignment with dietary guidelines and increased its potential for front‐of‐package nutrition labelling harmonization in Europe.
The Mediterranean diet and consumption of olive oil have been connected in several studies with longevity and a reduced risk of morbidity and mortality. Lifestyle, such as regular physical activity, ...a healthy diet, and the existing social cohesion in Southern European countries have been recognised as candidate protective factors that may explain the Mediterranean Paradox. Along with some other characteristics of the Mediterranean diet, the use of olive oil as the main source of fat is common in Southern European countries. The benefits of consuming olive oil have been known since antiquity and were traditionally attributed to its high content in oleic acid. However, it is now well established that these effects must also be attributed to the phenolic fraction of olive oil with its anti‐oxidant, anti‐inflammatory and anti‐microbial activities. The mechanisms of these activities are varied and probably interconnected. For some activities of olive oil phenolic compounds, the evidence is already strong enough to enable the legal use of health claims on foods. This review discusses the health effects of olive oil phenols along with the possibilities of communicating these effects on food labels.
Vitamin D (VitD) has a critical role in phosphorous-calcium metabolism as well as an important role in the immune system. In the human body, VitD is synthesized as cholecalciferol in the skin, but ...this process requires sunlight (UVB) radiation. Numerous reports showed high prevalence of VitD deficiency, particularly during the winter season, indicating the importance of VitD supplementation. Various factors can affect the absorption of VitD, including dosage and formulation. The primary study objective was to examine the efficiency of supplementation with three different formulations containing cholecalciferol in comparison with the control group. The secondary objective was to identify other factors affecting increase in serum 25-OH-VitD. A randomized controlled intervention study was conducted in Slovenia during wintertime (January- March) on 105 apparently healthy subjects (aged 18-65 years) with suboptimal VitD status (25-OH-VitD 30-50 nmol/L). Subjects were randomized into four groups: three treatment groups receiving (A) capsules with starch-adsorbed VitD, (B) oil-based Valens VitD oral spray, or (C) water-based Valens VitD oral spray and a control group (D) which did not receive supplemental VitD. Two months of supplementation with cholecalciferol (1000 IU; 25 µg daily) resulted in significant increase in serum 25-OH-VitD levels in comparison with control group (pooled Δc 32.8 nmol/L; 95% CI: 23.0, 42.5,
< 0.0001). While we did not observe any significant differences between the tested formulations, the efficiency of supplementation was associated with body mass index and baseline serum 25-OH-VitD level. Higher supplementation efficiency was observed in participants with normal body weight (BMI < 25) and in those with more pronounced VitD insufficiency. We also determined that tested dosage was not sufficient to achieve recommended 25-OH-VitD levels in all subjects.
Reducing added sugars in non-alcoholic beverages is an important public health goal, which can result in increased use of low- and no-calorie sweeteners (LNCS). The aim of this study was to ...investigate recent changes in the use of LNCS in non-alcoholic beverages in the Slovenian food supply. The national branded foods dataset was updated with beverages available in 2020, and compared with previous datasets. The data were extracted from food labels. In 2020,
N
= 1,650 unique beverages were found in shops from five different retailers, covering the majority of the national market. The use of LNCS increased from 13.2% in 2017 and 15.5% in 2019 to 20.2% in 2020, with a major growth in soft drinks (16.8, 19.6, and 26.7%, respectively). We observed a significant growth of beverages containing both LNCS and added sugar. Results were also consistent with sales data, which showed that increased offer of beverages with LNCS also resulted in similarly increased sales of such beverages. The average energy and total sugar content in non-alcoholic beverages decreased, which reflects both the higher percentage of beverages with LNCS, and also the reduction of the sugar content in beverages with only added sugar. Analyses of product-specific reformulation practices highlighted reduced sugar content in 16.8% of products, and in 3.6% with the use of LNCS. The most commonly used LNCS are acesulfame K, sucralose, and aspartame. Typically, combinations are used, however steviol glycosides, sucralose and saccharin are also used alone, in most cases combined with added sugar. The results indicated rapid changes in the use of LNCS in non-alcoholic beverages in the Slovenian food supply, making further monitoring of this area highly relevant.
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