High sugar content of European commercial baby foods and proposed updates to existing recommendations.

The aim was to determine whether commercial baby foods marketed within Europe (up to 36 months of age) have inappropriate formulation and high sugar content and to provide suggestions to update European regulations and recommendations as part of a nutrient profile model developed for this age group. The latter was produced following recommended World Health Organization (WHO) steps, including undertaking a rapid literature review. Packaging information from countries across the WHO European region was used to determine mean energy from total sugar by food category. The percentage of products containing added sugar and the percentage of savoury meal-type products containing pureed fruit were also calculated. A total of 2,634 baby foods from 10 countries were summarised: 768 sold in the United Kingdom, over 200 each from Denmark (319), Spain (241), Italy (430) and Malta (243) and between 99-200 from Hungary, Norway, Portugal, Estonia and Slovenia. On average, approximately a third of energy in baby foods in these European countries came from total sugar, and for most food categories, energy from sugar was higher than 10%. Use of added sugars was widespread across product categories, with concentrated fruit juice most commonly used. Savoury meal-type purees did not contain added sugars except in United Kingdom and Malta; however, fruit as an ingredient was found in 7% of savoury meals, most frequently seen in UK products. Clear proposals for reducing the high sugar content seen in commercial baby foods were produced. These suggestions, relating to both content and labelling, should be used to update regulations and promote product reformulation.

The pro children intervention: applying the intervention mapping protocol to develop a school-based fruit and vegetable promotion programme.

BACKGROUND/AIMS: The importance of careful theory-based intervention planning is recognized for fruit and vegetable promotion. This paper describes the application of the Intervention Mapping (IM) protocol to develop the Pro Children intervention to promote consumption of fruit and vegetable among 10- to 13-year-old schoolchildren. METHODS: Based on a needs assessment, promotion of intake of fruit and vegetable was split into performance objectives and related personal, social and environmental determinants. Crossing the performance objectives with related important and changeable determinants resulted in a matrix of learning and change objectives for which appropriate educational strategies were identified. Theoretically similar but culturally relevant interventions were designed, implemented and evaluated in Norway, the Netherlands and Spain during 2 school years. RESULTS: Programme activities included provision of fruits and vegetables in the schools, guided classroom activities, computer-tailored feedback and advice for children, and activities to be completed at home with the family. Additionally, optional intervention components for community reinforcement included incorporation of mass media, school health services or grocery stores. School project committees were supported. CONCLUSION: The Pro Children intervention was carefully developed based on the IM protocol that resulted in a comprehensive school-based fruit and vegetable promotion programme, but culturally sensible and locally relevant.

Estrategias educativas para la promoción del consumo de frutas y verduras en el medio escolar: proyecto pro children / School based education strategies to promote fruit and vegetable consumption: the pro children project

Los datos disponibles sugieren que un porcentaje elevado de niños y jóvenes europeos consumen cantidades insuficientes de frutas y verduras. Las estrategias de promoción de hábitos alimentarios saludables y actividad física en el medio escolar tienen un efecto potencial muy positivo. El proyecto Pro Children tiene como finalidad estimar el consumo de frutas y verduras y sus factores determinantes en niños europeos de 11 años y sus familias. También pretende evaluar la eficacia y viabilidad de un programa de educación nutricional orientado a mejorar el consumo de este grupo alimentario. En la primera fase se realizó un estudio transversal en muestra aleatorias representativas de la población de 11 años de 9 países europeos, contemplando análisis de la ingesta y un cuestionario de evaluación de los determinantes del consumo. Se ha diseñado un programa de intervención nutricional en el medio escolar basado en el modelo "Actitudes, Influencias Sociales y Autonomía: (ASE), con un marco teórico similar pero adaptado al contexto sociocultural de cada uno de los países de intervención. A lo largo de dos cursos escolares se evaluará la eficacia del programa en tres países. Cada punto de intervención aplica el programa en 10 centros docentes y considera otros 10 centros control. La planificación de la intervención se realizó siguiendo un procedimiento de mapeo de intervenciones. Se identificaron las conductas a modificar y sus factores determinantes y se formularon los objetivos educativos. Uno de los componentes destacados de la intervención es el suministro de fruta y verdura en el colegio. El programa consta de fichas de actividades para el aula; actividades con la familia; un programa informático de consejo nutricional para los niños y un componente de refuerzo comunitario a elegir para los tres países participantes entre programa de salud escolar; programa en tiendas de alimentación o implicación de los medios de comunicación de masas. A pesar de la diversidad cultural y social, es posible diseñar estrategias similares de intervención con el fin de fomentar el consumo de frutas y verduras en la población escolar. La adpatación a las situaciones específicas favorecerá un mayor éxito