Salt content of prepacked cereal-based products and their potential contribution to salt intake of the Italian adult population: Results from a simulation study.

BACKGROUND AND AIMS: High sodium intake is one of the main risk factors for noncommunicable diseases, and its consumption should be reduced. This study aimed to simulate changes in the daily salt intake of the Italian adult population based on consumption scenarios of prepacked cereal-based foods sold in Italy. METHODS AND RESULTS: Information on food packages was retrieved from 2893 cereal-based products. Potential changes in salt intake were simulated based on food consumption scenarios that consider the daily consumption of cereal-based products suggested in the Italian Dietary Guidelines and their current daily consumption by Italian adults. The highest salt content was retrieved in bread (median, 25th-75th percentile: 1.3, 1.1-1.4 g/100 g) and bread substitutes (1.8, 1.0-2.2 g/100 g). If the suggested daily amounts were consumed, bread would contribute to 44% of the 5 g salt/day target, whereas bread substitutes, breakfast cereals, biscuits and sweet snacks would marginally contribute (1-2%). Compared to bread with median salt content, a -44% and +10% salt intake would be observed if products within the first and the last quartile of salt content were chosen, respectively. However, considering the actual intake of Italian consumers, bread would cover 25% and bread substitutes 7% of the daily salt target. CONCLUSION: Food labels have a pivotal role and efforts are required to encourage consumers to use them to make healthy choices. Moreover, these results may contribute to setting sodium benchmarks in cereal-based products and encourage the food industry to reduce the salt content in the products.

Adherence to the Mediterranean Diet and its association with sustainable dietary behaviors, sociodemographic factors, and lifestyle: a cross-sectional study in US University students.

BACKGROUND: Promoting healthy and sustainable diets is increasingly important and the Mediterranean Diet (MD) has been recognized as an appropriate example that can be adapted to different countries. Considering that the college years are the time when US young adults are most likely to adopt unhealthy eating habits, the present study assessed adherence to the MD and the sustainability of dietary behaviors in a nationally representative sample of US university students, aiming to identify crucial levers for improving their eating behaviors. METHODS: MD adherence and the adoption of healthy and sustainable dietary patterns were assessed through the KIDMED and the Sustainable-HEalthy-Diet (SHED Index questionnaires, respectively, administered through an online survey that also included sociodemographic and behavioral questions. Non-parametric and logistic regression analyses were performed. RESULTS: A sample of 1485 participants (median (IQR) age 21.0 (19.0-22.0); 59% women) correctly completed the survey. A medium adherence to the MD was the most prevalent (47%). According to multivariate logistic regression analysis, the likelihood of being more compliant with the MD increased when meeting physical activity recommendations, having a high SHED Index score, having the willingness to purchase and eat healthy and sustainable dishes, eating ultra-processed plant-based meat alternatives foods daily, and regularly attending the university canteen. CONCLUSIONS: Encouraging dietary patterns rich in plant-based foods and with a moderate intake of animal products is crucial to increasing the adoption of healthy and sustainable diets, and university dining services represent a suitable setting to build a supportive environment that educates students on human and planetary health.

Nutritional, environmental and economic implications of children plate waste at school: a comparison between two Italian case studies.

OBJECTIVE: This study aims at comparing two Italian case studies in relation to school children's plate waste and its implications, in terms of nutritional loss, economic cost, and carbon footprint. DESIGN: Plate waste was collected through an aggregate selective weighting method for 39 days. SETTING: Children from the first to the fifth grade from four primary schools, two in each case study (Parma and Lucca), were involved. RESULTS: With respect to the served food, in Parma the plate waste percentage was lower than in Lucca (p<0.001). Fruit and side-dishes were highly wasted, mostly in Lucca (>50%). The energy loss of the lunch meals accounted for 26% (Parma) and 36% (Lucca). Among nutrients, dietary fibre, folate and vitamin C, calcium and potassium were lost at most (26-45%). Overall, after adjusting for plate waste data, most of the lunch menus fell below the national recommendations for energy (50%, Parma; 79%, Lucca) and nutrients, particularly for fat (85%, Parma; 89%, Lucca). Plate waste was responsible for 19% (Parma) and 28% (Lucca) of the carbon footprint associated to the food supplied by the catering service, with starchy food being the most important contributor (52%, Parma; 47%, Lucca). Overall, the average cost of plate waste was 1.8 €/kg (Parma) and 2.7 €/kg (Lucca), accounting respectively for 4% and 10% of the meal full price. CONCLUSION: A re-planning of the school meals service organisation and priorities is needed to decrease the inefficiency of the current system and reduce food waste and its negative consequences.

Animal-source foods as a suitable complementary food for improved physical growth in 6 to 24-month-old children in low- and middle-income countries: a systematic review and meta-analysis of randomised controlled trials.

Although animal-source foods are suitable complementary food for child growth in low- and middle-income countries (LMICs), their efficacy is still under discussion. This systematic review and meta-analysis was done to investigate the suitability of animal-source foods intake on child physical growth in LMICs. A systematic literature search was done using electronic databases and scanning the reference list of included studies, previous meta-analysis and systematic reviews. Paper selection was based on the PICO (ST) criteria. Papers were selected if based on 6 to 24-month-old children, if they were randomised controlled trials evaluating the effect of complementary animal-based food supplementation of any natural origin, if reporting at least a measure of body size and published after 2000. The PRISMA guidelines for reporting systematic review was followed in the paper selection. Fourteen papers were included in the systematic review and eight were considered for the meta-analysis. Animal-based food supplementation resulted in a higher length-for-age LAZ and weight-for-age (WAZ) Z-scores compared with the control group with random effect size of 0·15 (95 % CI 0·02, 0·27) and 0·20 (95 % CI 0·03, 0·36), respectively. Results were confirmed after influence analyses, and publication bias resulted as negligible. An increased effect on LAZ and WAZ was observed when the food supplementation was based on egg with effect size of 0·31 (95 % CI = -0·03, 0·64) and 0·36 (95 % CI = -0·03, 0·75), respectively. Animal-source foods are a suitable complementary food to improve growth in 6 to 24-month-old children in LMICs.

Maternal postpartum depression in relation to child undernutrition in low- and middle-income countries: a systematic review and meta-analysis.

Perinatal (antenatal and postpartum) depression is increasingly becoming a global public health problem. Studies have shown that the presence of depression during the perinatal period impact on a mother's ability to adequately provide nutritional care for herself and her infants and young children. This may thus negatively influence the nutritional status of these vulnerable children resulting in poor growth, such as stunting which is currently a public health problem in low- and middle-income countries (LMICs). The aim of this systematic review and meta-analysis was to determine the association between maternal postpartum depression and child growth in LMICs. Electronic databases were systematically reviewed by screening abstracts, titles, full text and additional data sources of eligible papers. Articles were eligible for inclusion if based on children aged 0 to 59 months, if reporting maternal postpartum depression as an exposure, if based on observational studies evaluating the relation between maternal postpartum depression and child growth, if reporting at least one physical growth indicator such as stunting as an outcome, and if published after 2000. Article selection was based on the PRISMA guidelines for reporting systematic reviews. Twelve articles were included in the quantitative synthesis (12 for stunting, 8 for underweight and 2 for wasting). Maternal postpartum depression was observed to be associated with an increased risk of child stunting (1.87 (95% CI: 1.52, 2.30; I2 = 41.6%, p = 0.064)) and underweight (1.81 (95% Cl: 1.25, 2.62; I2 = 70.7%, p = 0.001)). These results were confirmed after influence analyses, with publication bias being negligible.      Conclusion: Maternal depression is a risk factor for poor child growth in LMICs. This study contributes to the knowledge on this topic and calls on policymakers to improve on its understanding, screening and treatment to alleviate the potential negative impact on child growth. What is Known: • Maternal postpartum depression is currently a public health relevance in low- and middle-income countries (LMICs). • Maternal postpartum depression is a risk factor for poor nutritional status in children from LMICs. What is New: • Maternal postpartum depression is associated with an 80 to 90% increased risk of childhood stunting and underweight in LMICs. • The association between risk of childhood stunting and underweight with maternal postpartum depression is slightly influenced by geographical area, rural or urban location, by factors such as study design, study quality and sample size.

Acceptability of alternative ready-to-use therapeutic foods in acute malnutrition management-a systematic review.

"Commercial" Ready-To-Use Therapeutic Foods (RUTFs) are used in acute malnutrition management, but they are not always appropriate being expensive and unfamiliar. Much research has tried to develop alternative RUTF formulations and this work systematically reviewed eight articles discussing the approaches used to assess the children's sensory satisfaction, families' acceptance, and the cultural appropriateness of 13 alternative RUTFs. Different approaches were used by the authors and much research to standardise methodologies and findings is urgent to ensure that food products are culturally appropriate, acceptable and appreciated, with the final aim of completing the development process of alternative RUTFs. This work proposed some indications to follow in alternative RUTF acceptability evaluation processing. Moreover, community engagement and education resulted key aspects in alternative RUTF acceptance. An innovative, multi-disciplinary, multi-stakeholder approach could develop alternative "fit-for-the-purpose" RUTFs to help food-insecure communities acquire sufficient, safe, nutritious food in long-term Community Management of Acute Malnutrition.

Association between chronotype, sleep pattern, and eating behaviours in a group of Italian adults.

A cross-sectional study was conducted to assess the possible relationship between chronotype, sleeping, and eating patterns in 74 Italian adults (71.6% women). Based on Morningness-Eveningness Questionnare (MEQ) score, participants were classified as morning (n = 24), intermediate (n = 25), and evening (n = 25) chronotypes. From analysis, no significant differences among chronotypes emerged for sleep habits. As to eating behaviours, the evening subjects showed a significant (p < 0.05) shift towards later hours of the day in the consumption of all meals, except dinner. In addition, the evening subjects had a later midpoint of energy intake (EI) of about 35 min and 1 h (p < 0.001), respectively, than the intermediate and morning subjects. Analysing the diet quality, morning subjects reported significantly (p = 0.030) lower consumption of sweets and sweeteners, and significantly (p = 0.035) lower intake of ultra-processed fats and seasonings. Evening subjects showed a significant delay in EI during the day, while morning subjects reported a better-quality diet.

Effect of coffee and cocoa-based confectionery containing coffee on markers of cardiometabolic health: results from the pocket-4-life project.

PURPOSE: Coffee is an important source of bioactive compounds, including caffeine, trigonelline, and phenolic compounds. Several studies have highlighted the preventive effects of coffee consumption on major cardiometabolic (CM) diseases, but the impact of different coffee dosages on markers of CM risk in a real-life setting has not been fully understood. This study aimed to investigate the effect of coffee and cocoa-based confectionery containing coffee consumption on several CM risk factors in healthy subjects. METHODS: In a three-arm, crossover, randomized trial, 21 volunteers were assigned to consume in a random order for 1 month: 1 cup of espresso coffee/day, 3 cups of espresso coffee/day, and 1 cup of espresso coffee plus 2 cocoa-based products containing coffee, twice per day. At the last day of each treatment, blood samples were collected and used for the analysis of inflammatory markers, trimethylamine N-oxide, nitric oxide, blood lipids, and markers of glucose/insulin metabolism. Moreover, anthropometric parameters and blood pressure were measured. Finally, food consumption during the interventions was monitored. RESULTS: After 1 month, energy intake did not change among treatments, while significant differences were observed in the intake of saturated fatty acids, sugars, and total carbohydrates. No significant effect on CM markers was observed following neither the consumption of different coffee dosages nor after cocoa-based products containing coffee. CONCLUSIONS: The daily consumption of common dosages of coffee and its substitution with cocoa-based products containing coffee showed no effect on CM risk factors in healthy subjects. TRIAL REGISTRATION NUMBER: Registered at clinicaltrials.gov as NCT03166540, May 21, 2017.

Calcium intake from different food sources in Italian women without and with non-previously diagnosed osteoporosis.

An adequate calcium and vitamin D intake may play a role in preventing osteoporosis, but the contribution of the different food sources of calcium with regards to the risk of osteoporosis been barely explored. This observational study evaluated the calcium intake through a food frequency questionnaire in 126 adult women with not previously diagnosed osteoporosis undergoing Dual-energy X-ray Absorptiometry (DXA) to screen for osteoporosis, and to correlate the calcium intake with parameters of bone density, measured by DXA. Total daily calcium intake and daily intake from food were similar among women found to have osteoporosis, osteopenia or normal condition. The main food source was milk and dairy products, while calcium supplementation was consumed by only 14% of subjects, irrespectively from osteoporosis conditions. DXA parameters were not significantly correlated with total daily calcium intake and calcium from food. The present study highlighted no qualitative and quantitative differences in the consumption of food groups contributing to calcium intakes in women with and without osteoporosis.

Comprehensive dietary evaluation of Italian primary school children: food consumption and intake of energy, nutrients and phenolic compounds.

Information on children's diet including bioactive compounds is quite scarce. This observational study investigated the composition of the diet of children living in Parma (Italy; n = 172, 8-10 years) using 3-day food records completed in winter and spring. Mean daily intakes of food groups, energy and nutrients were obtained using the national food database, while (poly)phenol contents were estimated from Phenol-Explorer or by specific literature searches. Food consumption, energy and nutrient intakes decreased in spring and were partially in line with national data. Adherence to the nutritional recommendations was not satisfied for the majority of nutrients. Main contributors to the phenolic intake were flavonoids (flavan-3-ols) and phenolic acids (hydroxycinnamic acids), while main dietary sources were fruit, chocolate-based products, vegetables, and tea & coffee (decaffeinated). This study provided the first comprehensive analysis of the nutritional composition of children's diet. Future research should look at the health implications of dietary choices in children.

Reproducibility and validity of a food-frequency questionnaire (NFFQ) to assess food consumption based on the NOVA classification in adults.

NOVA is a classification that divides foods into four groups according to processing. Since no questionnaires have been validated to assess the consumption of foods with different levels of processing in the general adult population, we tested the reliability and validity of a 94-item Food Frequency Questionnaire (NFFQ) designed to estimate the intake (g/day) and the weight ratio (%) of the NOVA food groups in Italian adults. Time reliability and validity were tested by administrating the NFFQ to 110 subjects on two different occasions and comparing it with a weighed dietary record (WDR). Strong correlations between NFFQs (r > 0.7, p < 0.001) and intraclass correlation coefficients (ICC) of 0.851-0.940 indicated good test-retest reliability. Moderate correlations between the NFFQ and the WDR (0.6

Absorption, metabolism, and excretion of orange juice (poly)phenols in humans: The effect of a controlled alcoholic fermentation.

The consumption of orange juice provides high concentrations of health-promoting bioactive compounds, the amount of which may increase upon alcoholic fermentation. Although fermentation may offer new prospects for the industry of orange-related products, there is a lack of studies reporting the influence of controlled alcoholic fermentation on the bioavailability of orange juice (poly)phenols in humans. The aim of this study was to evaluate the absorption profile, pharmacokinetic parameters, and urinary excretion of orange juice (poly)phenols in nine volunteers after acute administration of an orange juice and a beverage prepared after controlled alcoholic fermentation of the juice. Plasma and urine samples were analysed through a UHPLC-ESI-MS/MS targeted approach. A total of 24 (poly)phenol metabolites including both flavanone and phenolic acid derivatives were quantified, most of them being recorded only in urine. Phase II conjugates of hesperetin and naringenin were the main metabolites in plasma, while phenolic acids, in particular hydroxybenzoic acids, were the main compounds in urine. (Poly)phenols in both beverages were highly bioavailable (between 46 and 59%) and a notable inter-individual variability was seen. Significant treatment × time interactions were recorded for the sum of flavanones and phenolic acids in plasma, the (poly)phenols in the fermented juice being absorbed faster than after orange juice intake. Nevertheless, despite the food matrix having an impact on the absorption profile of orange juice (poly)phenols, this did not influence the pharmacokinetic parameters and urinary excretion of the (poly)phenol metabolites.

Body weight of individuals with obesity decreases after a 6-month high pasta or low pasta Mediterranean diet weight-loss intervention.

BACKGROUND & AIMS: The effect of pasta consumption within a low-energy Mediterranean diet on body weight regulation has been scarcely explored. This paper investigates the effect of two Mediterranean diets, which differed for lower or higher pasta intake, on body weight change in individuals with obesity. METHODS & RESULTS: Forty-nine volunteers finished a quasi-experimental 6-month two-parallel group dietary intervention. Participants were assigned to a low-energy high pasta (HP) or to a low-energy low Pasta (LP) group on the basis of their pasta intake (HP ≥ 5 or LP ≤ 3 times/week). Anthropometrics, blood pressure and heart rate were measured every month. Weight maintenance was checked at month 12. Body composition (bioelectrical impedance analysis, BIA), food intake (24-h recall plus a 7-day carbohydrate record) and the perceived quality of life (36-item short-form health survey, SF-36) were assessed at baseline, 3 and 6 months. Blood samples were collected at baseline and month 6 to assess glucose and lipid metabolism. After 6-month intervention, body weight reduction was -10 ± 8% and -7 ± 4% in HP and LP diet, respectively, and it remained similar at month 12. Both dietary interventions improved anthropometric parameters, body composition, glucose and lipid metabolism, but no significant differences were observed between treatment groups. No differences were observed for blood pressure and heart rate between treatments and among times. HP diet significantly improved perception of quality of life for the physical component. CONCLUSIONS: Independent of pasta consumption frequency, low-energy Mediterranean diets were successful in improving anthropometrics, physiological parameters and dietary habits after a 6-month weight-loss intervention. This trial was registered at clinicaltrials.gov as NCT03341650.

Validation of a nutrition knowledge questionnaire in Italian students attending the University of Parma.

OBJECTIVE: The aim of this study was to assess the validity and reliability of a self-administered nutrition knowledge (NK) questionnaire for Italian university students. DESIGN: The NK questionnaire included ninety questions on experts' nutritional recommendations, nutritional content of food, health aspects of food and diets, relationship between diet and diseases, and proper food choices. It was administered to the same population under the same conditions on two different occasions with a time interval of 3 weeks between the two administrations. SETTING: The survey was carried out at the University of Parma (Italy) during the 2018-2019 academic year. PARTICIPANTS: Data were collected for 132 bachelor and master degree students attending the University of Parma, either attending or not nutrition classes during their studies (19-30 years, 29·5 % males, 57·6 % with an academic nutrition background). RESULTS: The questionnaire revealed high overall internal consistency reliability (Cronbach's α > 0·8) and a good temporal stability with high correlation of the total score (r = 0·835, P < 0·001). Moreover, it showed a good ability to discriminate between subjects with potentially different NK. CONCLUSIONS: This NK questionnaire proved to be a reliable, valid and easy-to-use tool for assessing the NK of Italian university students, either with or without nutrition background.

Glucose- and Lipid-Related Biomarkers Are Affected in Healthy Obese or Hyperglycemic Adults Consuming a Whole-Grain Pasta Enriched in Prebiotics and Probiotics: A 12-Week Randomized Controlled Trial.

BACKGROUND: Synbiotic foods, which combine the action of prebiotics and probiotics along the gastrointestinal tract, can affect inflammatory and glucose-related markers. OBJECTIVE: The aim of this study was to investigate the effects on inflammatory and glycemia-related markers of a whole-grain pasta containing barley ß-glucans and Bacillus coagulans BC30, 6086 in healthy overweight or obese volunteers. METHODS: A single-blind, parallel, randomized, placebo-controlled dietary intervention study was carried out. Forty-one healthy sedentary overweight (body mass index [BMI] 25-29.9 kg/m2) and obese (BMI ≥30) volunteers, aged 30-65 y and low consumers of fruit and vegetables, ate 1 serving/d of whole-grain control (CTR) or innovative (INN) pasta for 12 wk and maintained their habitual diets. Biological samples were collected at baseline and every 4 wk for primary (plasma high-sensitivity C-reactive protein [hs-CRP] and fasting plasma lipid profile) and secondary outcomes (glycemia-related markers, blood pressure, fecal microbiota composition, and body weight). Between (CTR compared with INN) and within (among weeks) group differences were tested for the whole population and for subgroups stratified by baseline values of BMI (≥30) and glycemia (≥100 mg/dL). RESULTS: INN or CTR pasta consumption had no effect on primary and secondary outcomes over time, except for a significant increase in plasma γ-glutamyltransferase (GGT) after 12 wk of CTR pasta consumption. Comparisons between intervention groups revealed differences only at 12 wk: plasma GGT was higher in the CTR group; plasma hs-CRP, plasma LDL/HDL cholesterol ratio, and Bifidobacterium spp. were lower in the INN subgroup of obese volunteers; plasma resistin was lower and Faecalibacterium prausnitzii abundance was higher in the INN subgroup of hyperglycemic volunteers. CONCLUSIONS: A daily serving of a synbiotic whole-grain pasta had limited effects on primary and secondary outcomes in the entire group of volunteers but affected glycemia- and lipid-related markers and resistin in a subgroup of healthy obese or hyperglycemic volunteers. This trial was registered at clinicaltrials.gov as NCT02236533.

Dietary intake of (poly)phenols in children and adults: cross-sectional analysis of UK National Diet and Nutrition Survey Rolling Programme (2008-2014).

PURPOSE: Current evidence accounts for the role of (poly)phenolic compounds in the prevention of non-communicable diseases. Detailed information on population-level intakes is required to translate these findings into recommendations. This work aimed to estimate (poly)phenol intake in the UK population using data from a nationally representative survey. METHODS: Data from 9374 participants (4636 children aged 1.5-18 years and 4738 adults aged 19 years and over) from the National Diet and Nutrition Survey Rolling Programme (NDNS RP) 2008-2014 was used. (Poly)phenol content of foods consumed in the NDNS RP was identified using Phenol-Explorer and through literature searches. Data on flavonoids, phenolic acids, and stilbenes were collected. Total (poly)phenol content was also assessed. RESULTS: Mean total (poly)phenol intake ranged from 266.6 ± 166.1 mg/day in children aged 1.5-3 years to 1035.1 ± 544.3 mg/day in adults aged 65 years and over, with flavan-3-ols and hydroxycinnamic acids being the most consumed (poly)phenols across all age groups. (Poly)phenol intake was higher in males in all age groups except for adults aged 19-34 and 50-64 years, where intakes were marginally higher in females. Energy-adjusted intakes accounted for the pattern of increasing (poly)phenol intakes with age and a higher intake was observed in females across all age groups, with the exception of children aged 1.5-3 years. The main food sources were non-alcoholic beverages and fruits, being the main compounds flavan-3-ols and caffeoylquinic acids. CONCLUSIONS: This analysis provides estimates of (poly)phenol intake from a representative sample of the UK general population, which can help inform the health implications of (poly)phenol intake.

Inter-individual variability in the production of flavan-3-ol colonic metabolites: preliminary elucidation of urinary metabotypes.

PURPOSE: There is much information on the bioavailability of (poly)phenolic compounds following acute intake of various foods. However, there are only limited data on the effects of repeated and combined exposure to specific (poly)phenol food sources and the inter-individual variability in their bioavailability. This study evaluated the combined urinary excretion of (poly)phenols from green tea and coffee following daily consumption by healthy subjects in free-living conditions. The inter-individual variability in the production of phenolic metabolites was also investigated. METHODS: Eleven participants consumed both tablets of green tea and green coffee bean extracts daily for 8 weeks and 24-h urine was collected on five different occasions. The urinary profile of phenolic metabolites and a set of multivariate statistical tests were used to investigate the putative existence of characteristic metabotypes in the production of flavan-3-ol microbial metabolites. RESULTS: (Poly)phenolic compounds in the green tea and green coffee bean extracts were absorbed and excreted after simultaneous consumption, with green tea resulting in more inter-individual variability in urinary excretion of phenolic metabolites. Three metabotypes in the production of flavan-3-ol microbial metabolites were tentatively defined, characterized by the excretion of different amounts of trihydroxyphenyl-γ-valerolactones, dihydroxyphenyl-γ-valerolactones, and hydroxyphenylpropionic acids. CONCLUSIONS: The selective production of microbiota-derived metabolites from flavan-3-ols and the putative existence of characteristic metabotypes in their production represent an important development in the study of the bioavailability of plant bioactives. These observations will contribute to better understand the health effects and individual differences associated with consumption of flavan-3-ols, arguably the main class of flavonoids in the human diet.

Nature and Cognitive Perception of 4 Different Breakfast Meals Influence Satiety-Related Sensations and Postprandial Metabolic Responses but Have Little Effect on Food Choices and Intake Later in the Day in a Randomized Crossover Trial in Healthy Men.

Background: Regular breakfast consumption is associated with better health status and healthier food intake throughout the day, but this association is a complex interaction of several factors. Objective: This study aimed to investigate the effect of nutritional and cognitive-perceived characteristics of breakfast on metabolic and behavioral variables related to food intake. Methods: The study was a randomized, crossover, controlled trial, with 4 experimental conditions consisting of 3 iso-energetic breakfasts and 1 energy-free control meal. Breakfasts had similar nutritional profiles but differed for glycemic index (GI), glycemic load (GL), and perceived healthiness, satiety, palatability, or energy content. Fifteen healthy normal-weight men [means ± SDs; age: 24 ± 2 y; body mass index (BMI; kg/m2) 23.4 ± 1.6] underwent each experimental condition in random order during 4 different weeks, separated by ≥1-wk washout. On the third day of each intervention week, postprandial blood variables (with insulin as primary outcome), satiety ratings, and food intake during an ad libitum lunch consumed 4 h after breakfast (secondary outcomes) were measured for each experimental condition. Results: A main effect of time, treatment, and time × treatment was found for postprandial insulin, glucose, and nonesterified fatty acids (P < 0.001 for all) after having the 3 iso-energetic breakfasts or the energy-free control one. Postprandial satiety was similar for the 3 energy-containing breakfasts, but higher when compared with the energy-free control (P < 0.001). No difference in energy intake was observed for the ad libitum lunch, whereas prolonged breakfast skipping was compensated by an increase (around +10%) in the average energy intake during the rest of the day, resulting in no differences in the total daily energy intake among the 4 conditions. Conclusions: Although other advantages might exist for breakfasts based on low-GI/low-GL foods, our findings support the hypothesis that minor differences in nutritional and perceived characteristics of breakfast are of limited importance regarding medium-term energy intake in healthy men. This trial was registered at clinicaltrials.gov as BRNN-014 NCT02516956.

Food perception at lunchtime does not depend on the nutritional and perceived characteristics of breakfast.

Breakfast consumption can entail nutritional advantages positively affecting food choices. This study investigated the effect of minor changes in breakfast composition on the perceived attributes of foods, both at breakfast and at lunchtime. Four breakfasts were defined considering nutritional and perceptual factors. Three breakfasts varied just for a single cereal-based chocolate-containing food item, while a control breakfast mimicked fasting conditions. Breakfast perception was assessed before and after consumption. Subjects rated breakfast energy content on the basis of single items, while judged breakfast healthiness as a whole, suggesting that the combination of different ingredients can modify the perceived health value of foods. Additionally, 4 h after breakfast, a perceptual evaluation of lunch-related food images was performed, without differences among breakfasts. This study extends current knowledge on the relationship between subjective perceptual attributes and objective energy value and food composition, as well as on breakfast impact on food perception at lunchtime.

Towards a sustainable diet combining economic, environmental and nutritional objectives.

Foods consumed and dietary patterns are strong determinants of health status. Diet and nutrition have a key role in health promotion and maintenance during the entire lifetime, but what we choose to eat and drink greatly affects the environmental impact on ecosystems as well as monetary resources. Some studies suggest that a healthy diet with a low environmental impact is not necessarily more expensive. This paper aims to identify a healthy, greener and cheaper diet based on current consumption patterns. Dietary information was collected from 104 young adults in the last year of high school in Parma (Italy). Diet was monitored with 7-day dietary records. Subsequently, food items were decoded to obtain nutritional, economic and environmental impact data. An optimization tool based on mathematical programming (Multi-Objective Linear Programming) was used to identify sustainable diet. Three different 7-day diets were identified, based on nutrition recommendations for the healthy Italian adult population, characterized by different targets and optimizing different impacts: first the diet at the lowest cost (Minimum Cost Diet - MCD), then the Environmentally Sustainable Diet (ESD) obtained by minimizing the three environmental indicators (CO2e emissions, H2O consumption and amount of land to regenerate the resources - m(2)). Finally, the Sustainable Diet (SD) was identified by integrating environmental and economic sustainability objectives. Lastly, suggestions and recommendations for communication campaigns and other interventions to achieve sustainable diet are suggested.