Postura conjunta de la OPS/OMS, FAO y UNICEF, sobre el etiquetado frontal de advertencia nutricional (efan)

La alta ingesta de sodio, azúcares y grasas saturadas en Panamá está desencadenando un problema de salud pública. Estas dietas poco saludables son la principal causa de obesidad, hipertensión y diabetes, enfermedades que acortan la vida de miles de personas cada año. Según datos oficiales, más del 70% de la población adulta es obesa o tiene sobrepeso, lo que aumenta significativamente el riesgo de enfermedades cardiovasculares. Esta situación no solo afecta la salud individual, sino que también representa una enorme carga para el sistema de salud. Este documento resalta la necesidad de implementación de estrategias y el respaldo multisectoriales para combatir la malnutrición y las ENT que permitan reducir sus impactos sanitarios y económicos. Existe consenso político internacional sobre la necesidad de implementar medidas poblacionales costo-efectivas que reduzcan el impacto de la alimentación no saludable. El Etiquetado Frontal de Advertencia Nutricional (EFAN) es una de las políticas recomendadas por la Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS), el Fondo de las Naciones Unidas para la Infancia (UNICEF) y la Organización de las Naciones Unidas para la Agricultura y la Alimentación (FAO) para proteger la alimentación saludable, la salud pública y los derechos humanos de la población en Panamá.

Market survey of food product indicators and their credibility as a healthy food product in Klang Valley, Malaysia.

INTRODUCTION: The presence of food product indicators may facilitate consumers in making informed healthy choices. However, it may also mislead consumers. This study aims to determine the prevalence of food products carrying food product indicators; the compliance of products bearing Malaysia's Healthier Choice Logo (HCL) and nutrition and health claims (NHC) towards the local regulations; and the credibility of the aforementioned products as healthy food products based on the international regulation in the Malaysian market. METHOD: This is a cross-sectional market survey conducted from February to May 2023 on 3428 products sold in Malaysian supermarkets. Product information including the brand, name, nutrition information panel, food product indicator (front-of-pack nutrition labelling, NHC, other claims), ingredients list and manufacturer or importer were collected. Compliance of products carrying NHC and HCL is evaluated against local guidelines. Credibility as a healthy product is evaluated against the WHO Nutrient Profile Model for the Western Pacific Region on a subsample (products with HCL and/or NHC). RESULTS: 53% of food products surveyed had food product indicators (n=1809). A total of 32% carried at least one NHC (n=1101), of which 47% had excellent overall compliance (n=522). Only 4% carried Malaysia's HCL (n=138), of which 48% had excellent nutrient compliance (n=66). Only 13% of the products carrying Malaysia's HCL and NHC could be identified as absolute healthy food products as defined by the WHO standard (n=147). CONCLUSION: Although half of the products surveyed had food product indicators, merely half of them had excellent compliance towards the standards. Only 13% of the subsample qualified as healthy food products. Voluntary application of the local HCL was low among food industries. Ensuring high standards of compliance and credibility of food products in the Malaysian market is crucial for food companies and government authorities.

Food and beverage manufacturing and retailing company policies and commitments to improve the healthfulness of Canadian food environments.

BACKGROUND: Food and beverage companies play a central role in shaping the healthfulness of food environments. METHODS: The BIA-Obesity tool was used to evaluate and benchmark the specificity, comprehensiveness and transparency of the food environment-related policies and commitments of leading food and beverage manufacturing and retailing companies in Canada. Policies and commitments related to the healthfulness of food environments within 6 action areas were assessed: 1) corporate nutrition strategy; 2) product (re)formulation; 3) nutrition information and labelling; 4) product and brand promotion; 5) product accessibility; and 6) disclosure of relationships with external organizations. Data were collected from publicly available sources, and companies were invited to supplement and validate information collected by the research team. Each company was then assigned a score out of 100 for each action area, and an overall BIA-Obesity score out of 100. RESULTS: Overall BIA-Obesity scores for manufacturers ranged from 18 to 75 out of 100 (median = 49), while scores for retailers ranged from 21 to 25 (median = 22). Scores were highest within the product (re)formulation (median = 60) followed by the corporate nutrition strategy (median = 59) domain for manufacturers, while retailers performed best within the corporate nutrition strategy (median = 53), followed by the disclosure of relationships with external organizations (median = 47) domain. Companies within both sectors performed worst within the product accessibility domain (medians = 8 and 0 for manufacturers and retailers, respectively). CONCLUSIONS: This study highlights important limitations to self-regulatory approaches of the food and beverage industry to improve the healthfulness of food environments. Although some companies had specific, comprehensive, and transparent policies and commitments to address the healthfulness of food environments in Canada, most fell short of recommended best-practice. Additional mandatory government policies and regulations may be warranted to effectively transform Canadian food environments to promote healthier diets and prevent related non-communicable diseases.

Prepackaged foods healthiness ranking index: developing front-of-pack labeling to facilitate the assessment and validation of healthiness rankings of prepackaged foods in China.

BACKGROUND: The Medium and Long-Term Plan for the Prevention and Treatment of Chronic Diseases (2017-2025) in China has highlighted the importance of reducing fat, sodium, and sugar in foods. However, front-of-pack labeling, which enables consumers to assess the health levels of prepackaged foods, is lacking in China. In response to the Zhejiang Provincial Health Commission's request, we sought to develop a method for efficiently evaluating the health level of prepackaged foods. METHODS: Through a comprehensive literature review, we established a systematic framework: the Prepackaged Foods Healthiness Ranking Index (PHRI). We determined specific threshold values and grading criteria and conducted two rounds of Delphi survey to refine the index. Using a measurement dataset, we aimed to determine the optimal limit values for assessing the health level of prepackaged foods in real-world settings. RESULTS: After two rounds of Delphi surveys, the PHRI underwent multiple revisions until consensus among experts was reached. The final decision regarding the upper limit values set 30% Nutrient Reference Values as the limit for solid foods and 15% Nutrient Reference Values for liquid foods. The calculation of PHRI values was successfully implemented with the dataset, in accord with current nutrition awareness and real-world conditions. CONCLUSIONS: The PHRI provides a valuable tool for assessing the healthiness of prepackaged foods. This front-of-pack labeling system provides a convenient method for evaluating the nutritional quality of prepackaged foods. Ultimately, the PHRI has the potential to contribute to advancements in health policy, practice, and education in China.

[Labelling and composition of food, basic aspect in the update of the food composition tables]. / Etiquetado y composición de los alimentos, aspecto básico en la actualización de las tablas de composición de alimentos.

Introduction: Food and beverage composition tables are a crucial element for determining nutrient intakes from the dietary records of foods and beverages. Knowing their composition and how they are updated is an essential mechanism for reliably providing real data on these intakes, otherwise it could be the case that current food and beverage consumption would be reflected in nutrient conversion with information on ingredient composition and nutritional value from 5, 10, 15 or 20 years ago, with the resulting deviations in the interpretations, especially in macronutrients, from the existing reality.

Introducción: Las tablas de composición de alimentos y bebidas son un elemento crucial para poder determinar las ingestas de nutrientes a partir de los registros dietéticos de alimentos y bebidas y conocer su composición y sus vías de actualización. Son mecanismos imprescindibles para poder dar con fiabilidad datos reales de dichas ingestas; si no, podría darse el caso de que se reflejaran sobre el consumo de alimentos y bebidas actuales una conversión a nutrientes con información de composición de ingredientes y valor nutricional de hace 5, 10, 15 o 20 años, con las consiguientes desviaciones sobre las interpretaciones, sobre todo en macronutrientes, sobre la realidad existente.

How does a superior quality sign guarantee the quality of lamb meat? The Label Rouge case.

Owing to the social, environmental and health changes in Europe, meat quality is becoming a critical issue for the long-term future of livestock farming. Label Rouge (LR) is a quality label owned by the French government that identifies food products produced inside or outside the European Union. This label guarantees the superior quality of a product compared with a standard product. This superior quality is guaranteed throughout the production process by specifications negotiated between the Institut National de l'Origine et de la Qualité (INAO) and operators in the sector. These specifications comprise two documents: first, common production conditions that apply to all specifications in a sector, and second, a book of specifications (BoSs). These two documents, which form the qualification mechanism, are divided into several parts: product name, product description, traceability, production method, labelling and the main control points. This study aims to understand how the LR defines lamb meat quality in the 11 existing BoSs using the seven dimensions of quality of animal-source foods (nutritional, sensory, commercial, technological, safety, convenience and image). We performed a computerised qualitative transversal analysis of the commitments associated with the production method and description of the product. This analysis was enriched by five semi-structured interviews with INAO members. We show that although LR is committed to all aspects of lamb meat quality, the sensory, image and carcass commercial quality attributes are predominant. However, the image attribute of quality is so ubiquitous that it required refinement to provide a better understanding of the construction of quality in terms of its environmental, ethical and cultural components.

Development and validity testing of the Canadian Food Scoring System (CFSS), a nutrient profile model based on the recommendations of Canada's Food Guide 2019.

Canada's food guide (CFG) 2019 provides dietary guidance for all Canadians; however, there is no tool available to help Canadians easily determine how individual foods align with CFG. Therefore, the objectives of this study were (1) to develop a nutrient profile model, Canadian Food Scoring System (CFSS), to rank the healthfulness of individual foods according to the recommendations of CFG; and (2) to assess its validity. The CFSS was developed based on CFG, leveraging existing Canadian labelling regulations to set quantitative criteria for the CFG recommendations. The CFSS included three main steps: (1) classifying foods into the nutritious food categories and assigning points based on the alignment with the recommendations of CFG; (2) deducting points based on the levels of saturated fat, sugars, and sodium using thresholds from Canadian front-of-pack labelling regulations; and (3) calculating the final score from the first two steps to classify foods into one of five categories: "very poor," "poor," "fair," "good," or "excellent" choice. Convergent validity was assessed by examining the alignment of the CFSS with Health Canada's CFG-Food Classification System using a national food composition database and the Healthy Eating Food Index-2019 using nationally representative dietary intake survey data. The CFSS showed strong correlation with the CFG-Food Classification System (ρ = 0.782, p < 0.001) and moderate correlation with the Healthy Eating Food Index-2019 (r = 0.636, p < 0.001), indicating good convergent validity both at the food and dietary level. The newly developed CFSS can assess the alignment of individual foods with CFG, which can be used to help Canadians more easily make healthy food choices.

An ecological reorientation of the Codex Alimentarius Commission could help transform food systems.

The Codex Alimentarius Commission (Codex) has a substantial influence over the structure and operation of food systems by setting international standards that affect the composition, structure and labelling of food. Despite the dual mandates of Codex to protect public health and ensure fair practices in food trade, food systems are increasingly unhealthy and unsustainable. An ecological reorientation of the decision-making elements that influence how Codex sets food standards-particularly mandates, governance and risk assessment-could help transform food systems towards the UN Sustainable Development Goals.

Current Regulatory Issues for the Use of Probiotics.

The chapter provides an overview of the current regulatory challenges surrounding the use of probiotics. It explores the global regulatory landscape, noting the need for uniform regulations across various regions. It emphasizes that these inconsistencies pose challenges for consumers, healthcare professionals, and industry stakeholders. Furthermore, the chapter highlights the ongoing efforts at the Codex Alimentarius to establish harmonized probiotic guidelines. The chapter also discusses labeling regulations, stressing the need for more accurate and comprehensive information on probiotic products to aid in evidence-based decision-making. Finally, it addresses safety concerns, particularly for vulnerable populations like children, and calls for a multi-layered approach to safety assessments. The chapter concludes by advocating harmonizing regulations and guidelines to facilitate probiotics' safer and more effective use.

A Shotgun Metagenomics Investigation into Labeling Inaccuracies in Widely Sold Probiotic Supplements in the USA.

While probiotics are generally considered safe, concerns persist regarding the accuracy of labels on these supplements and their potential contribution to the spread of antibiotic resistance genes. Given that probiotics are predominantly ingested with a view towards obtaining particular health benefits. The objective of this study is to assess the composition of 50 widely available probiotic supplements in the USA using shotgun metagenome sequencing. The study also determines the potential resistome profile, and the functional characteristics of these products. This study finds that 67% of products does not contain any labeling inaccuracies. Antimicrobial Resistance Genes (ARGs) are identified in several products, particularly Bacillus-based products carrying between 10 and 56 genes. The risk posed by the presence of these ARGs requires further study. Functional analysis reveals differences in metabolic profiles among probiotic supplements, indicating the importance of strain-level selection for personalized probiotics. This study provides updated and comprehensive analysis to evaluate a snapshot of the USA market. The study demonstrates that label inaccuracies occur on approximately one third of popular dietary supplement products sold in the USA, supporting the need for improved approaches to marketing and quality control. Further, the risk of antibiotic resistance, especially in Bacillus-based formulations, should be assessed.

Theoretical design of blockchain-based traceability for organic egg supply chains according to regulation (EU) 2018/848.

The use of blockchain technology to establish food traceability chains has the potential to provide transparent information of food stuffs along the entire supply chain and also aid in the documentation or even execution of official food control processes. Particularly in instances where analytical methodologies cannot provide definitive data for food control questions under study, the certificate-based approach of a traceability chain may offer a way of regulatory control for state authorities. Given the rising importance of organic produce and the high share of eggs among the organic produce in the European Union as well as the new EU regulation on organic products and labelling that came into force in 2022, we analyze here how the control of egg production type and marketing standards can be represented within a blockchain-based traceability chain such as to maximize the traceability in compliance with the current relevant EU regulations. Intended for the use by the official food control authorities, a traceability chain for organically produced eggs in the EU would need to be implemented as a permissioned blockchain, since only select entities are allowed to participate. By combining a proof of authority consensus mechanism with issuance of soulbound tokens, we effectively suggest a 'proof of soulbound authority' consensus process. The soulbound tokens are issued throughout the administrative chain from the European Commission down to the official food control authorities in individual member states that ultimately certify the control bodies for organic produce. Despite the general limitation of not providing unambiguous proof of the organic status of individual products, the concept discussed here offers advantages with respect to allocation of authority at EU level and therefore might have positive effects beyond the traceability chain.

The Potential Effectiveness of Nutrient Declarations and Nutrition and Health Claims for Improving Population Diets.

Nutrition labeling supports healthier diets by aiding purchase decisions and stimulating reformulation. This systematic literature review applied Cochrane methods to synthesize and appraise evidence on the effectiveness of nutrient declarations and nutrition and health claims on diet-related outcomes. The search spanned 11 academic databases, from inception to July 2022. Evidence was synthesized using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) and vote counting. Data were available from 170 studies. Randomized controlled trials (RCTs) suggest that nutrient declarations likely improved consumer understanding of the nutritional quality/content of foods (moderate certainty) and may have improved the healthfulness of choices (low certainty) versus no label. RCT evidence also suggests that claims likely increased consumer perceptions of food healthfulness and increased choice and purchases of labeled foods (both moderate certainty), irrespective of nutritional quality. To improve label understanding and avoid misinterpretation, nutrient declarations may incorporate interpretive elements and claims can apply disqualifying conditions for their usage, on the basis of overall nutritional quality.

Aligning front-of-pack labelling with dietary guidelines: including whole grains in the health star rating.

PURPOSE: Front-of-pack labelling systems, such as the Health Star Rating (HSR), aim to aid healthy consumer dietary choices and complement national dietary guidelines. Dietary guidelines aim to be holistic by extending beyond the individual nutrients of food, including other food components that indicate diet quality, including whole grains. We aimed to test the feasibility of including whole grains in the HSR algorithm, to better inform dietary guidance in Australia coherent with existing dietary guidelines. METHODS: We assigned whole-grain points as a favourable component of the HSR based on the whole-grain content of foods. We compared the original, and three modified HSR algorithms (including altered thresholds for star ratings) using independent-samples median tests. Finally, we used Spearman's correlation to measure the strength of association between an item's nutritional composition (all components of the HSR algorithm including all favourable and unfavourable components) and their HSR using each algorithm. RESULTS: Up to 10 points were added for products with ≥ 50% whole-grain content, with no points for products with < 25%. Adjusting the HSR score cut-off by 3 points for grain products created the greatest difference in median HSR between refined and whole-grain items (up to 2 stars difference), compared to the original algorithm (a maximum of 1 star). CONCLUSIONS: The addition of whole grains to the HSR algorithm improved the differentiation of refined and whole-grain items, and therefore better aligned with dietary guidelines. Holistic approaches to food guidance systems are required to provide consistent messaging and inform positive food choices.

Perspectives in precautionary allergen labelling of prepackaged foods after the FAO/WHO consultation.

PURPOSE OF REVIEW: The purpose of this review is to provide an overview of the perspectives regarding precautionary allergen labelling (PAL) of prepackaged foods following the consultation conducted by the Food and Agriculture Organization (FAO) and the WHO. RECENT FINDINGS: The FAO/WHO consultation provided a comprehensive assessment of the current status and practices of PAL implementation worldwide. One of the key findings highlighted by the Expert Committee was the need for improvement in existing PAL systems. It was noted that many countries lacked uniformity in PAL practices, leading to inconsistencies in labelling and potentially misleading information for consumers. Furthermore, the consultation emphasized the importance of PAL being risk-based, taking into account both the amount and frequency of unintended allergen presence (UAP) in food products. SUMMARY: The FAO/WHO consultation shed light on various perspectives and challenges associated with PAL of prepackaged foods. Key findings emphasized the need for improvement in existing PAL systems, including the adoption of a risk-based approach, standardized regulations, and enhanced transparency. Moving forward, collaborative efforts between regulatory agencies, food manufacturers, and consumer advocacy groups will be essential in developing effective PAL strategies that prioritize consumer safety and well being.

Podcast RP Convida: Como o pediatra pode promover o aleitamento materno cumprindo a NBCAL

Episódio especial em alusão ao Agosto Dourado, aborda o tema “Como o pediatra pode promover o aleitamento materno cumprindo a NBCAL”. Programa da série “RP Convida”, da revista Residência Pediátrica, conta com a participação da dra. Katia Brandt, membro do Departamento Científico de Aleitamento Materno da Sociedade Pernambucana de Pediatria (Sopepe).

El etiquetado nutricional: su expresión en el contexto mexicano / Nutritional labeling: its expression in the Mexican context

Introduction: Food is a process that carries implicit socio-cultural elements in a specific historical moment. The changes in the diet caused an increase in problems of obesity and Chronic Non-Communicable Diseases in Mexico. Measures have been taken through public policies that seek to reduce the effects of the consumption of foods with high energy value, one of them is the nutritional labeling of foods. Development: As the first axis, a sociohistorical reconstruction is developed around food labeling in Mexico as an initiative that is part of an international public policy to present nutritional information for the selection and consumption of food. In a second moment, an analysis is carried out from a critical position on the implementation and exercise of decision-making for the consumption of said products, since it is subject to a complex network of sociocultural and individual factors that determine and are determinants of styles. and frequency of consumption of the products. Conclusions: The new labeling with nutritional information is an information tool for the selection in food consumption to face the problem of overweight and obesity in Mexico. However, eating habits and practices respond to sociocultural and economic elements that are above healthy lifestyles and a culture of prevention. It is necessary to build and promote community participation-action that promotes tools such as nutritional labeling to make its objectives effective.

Introducción: la alimentación es un proceso que implica elementos socioculturales en un momento histórico concreto. México se encuentra en un problema de salud generalizado de obesidad y enfermedades crónicas no transmisibles. Ante esto se han tomado medidas mediante políticas públicas que buscan disminuir los efectos del consumo de alimentos de alto valor energético, una de ellas es el etiquetado nutricional de los alimentos. Desarrollo: como primer eje se desarrolla una reconstrucción sociohistórica en torno al etiquetado de alimentos en México como iniciativa que forma parte de una política pública internacional para presentar información nutricional para la selección y consumo de los alimentos. En un segundo momento se realiza un análisis desde un posicionamiento crítico sobre la implementación y el ejercicio de las tomas de decisión del consumo de dichos productos, ya que está sujeta a una compleja red de factores socioculturales e individuales que determinan y son determinantes de los estilos y frecuencia de consumo de los productos. Conclusiones: el nuevo etiquetado con información nutricional es una herramienta de información para la selección en el consumo de alimentos para enfrentar el problema de sobrepeso y obesidad en México. Sin embargo, los hábitos y prácticas de alimentación responden a elementos socioculturales y económicos que están por arriba de los estilos de vida saludable y una cultura de prevención. Es necesario construir y promover una participación-acción comunitaria que potencie las herramientas como el etiquetado nutricional para hacer efectivos sus objetivos.

Development of the Choices 5-Level Criteria to Support Multiple Food System Actions.

In 2008, the Choices International Foundation developed its logo criteria, identifying best-in-class food products. More advanced, global and graded nutrient profiling systems (NPSs) are needed to substantiate different national nutrition policies. The objective of this work was to extend Choices NPS to identify five levels of the healthiness of food products, so that the Choices NPS can also be used to support other nutrition policies, next to front-of-pack labelling. Based on the same principles as the previous logo criteria, four sets of threshold criteria were determined using a combination of compliance levels, calculated from a large international food group-specific database, the Choices logo criteria, and WHO-NPSs developed to restrict marketing to children. Validation consisted of a comparison with indicator foods from food-based dietary guidelines from various countries. Some thresholds were adjusted after the validation, e.g., because intermediate thresholds were too lenient. This resulted in a new international NPS that can be applied to different contexts and to support a variety of health policies, to prevent both undernutrition and obesity. It can efficiently evaluate mixed food products and represents a flexible tool, applicable in various settings and populations.

"Front-of-pack" nutrition labeling.

Excess intake of energy, sugars, salt and saturated fats is an important causal factor of obesity and related non-communicable diseases. In order to help consumers to make healthy food choices, many European countries have developed proposals for "front-of-pack" food labeling, intended as an integration to the nutritional information provided by the mandatory nutritional declaration. Based on the European strategic program "Farm to Fork", the intention is to achieve a harmonized front-of-pack label proposal by Q4 2022. Among the different proposals, the one which received most attention by experts and greater feedback by the EU member countries is the Nutri-Score, a tool based on an algorithm whereby a "quality" category ranging from A to E is assigned to each single food on a background colored from dark green to dark orange. As an alternative to Nutri-Score, the NutrInform Battery has been developed by Italy in association with a few other EU member states: this proposal is objectively alternative to the Nutri-Score proposal due to a different underlying philosophy, in particular for its informative and educational intent rather than purchase orientation. The present document, prepared by the Scientific Board and reviewed by the Scientific Council of the Italian Society of Human Nutrition, represents the scientific-based position of the Society in relation to the general theme of front-of-pack labeling and in particular to the dualism created between the Nutri-Score and NutrInform Battery proposals.

Rotulagem do leite humano ordenhado pasteurizado / Etiquetado de la leche humana extraída pasteurizada / Labeling of pasteurized expressed human milk

Esta Norma Técnica tem por objetivo estabelecer o processo de rotulagem de recipientes ou frascos que acondicionem o leite humano ordenhado pasteurizado, visando a garantia da qualidade em Bancos de Leite Humano e sua certificação.

El objetivo de esta Norma Técnica es establecer el proceso de etiquetado de los recipientes o frascos que acondicionen leche humana extraída pasteurizada, con el fin de asegurar la calidad de los Bancos de Leche Humana y su certificación.