Nutrition Transition in the Post-Economic Crisis of Greece: Assessing the Nutritional Gap of Food-Insecure Individuals. A Cross-Sectional Study.

Food insecurity has risen by 40% in Europe's post-economic crisis, linked to the economic turmoil and austerity. Despite the intensification of efforts to fight all forms of poverty, including the implementation of programs targeted to the most deprived, the study of individuals at risk of food insecurity has been largely neglected. This study aimed to map the nutritional habits and needs of the most deprived in Greece, one of the countries most affected by the economic crisis. Individuals classified as most deprived under the Fund for the European Aid to the Most Deprived (FEAD) criteria (n = 499) from across Greece and an age matched control from the general population (n = 500) were interviewed between December 2017 and December 2019. Participants provided information about demographic characteristics, and self-reported anthropometric measures and nutritional intake of the past month via a food frequency questionnaire (FFQ). Protein and energy malnutrition were defined as daily intake <1.950 kcal and ≤0.75 g/kg body-weight accordingly. Protein and energy malnutrition were high among FEAD recipients (52.3% and 18.6% respectively, p < 0.001), alongside a high prevalence of overweight and obesity (BMI > 25: 68.4% versus 55.1%; p < 0.001). The diet of FEAD recipients included higher amounts of carbohydrates, lower amounts of monounsaturated fat (MUFA) and polyunsaturated fat (PUFA; p < 0.001 compared to control), larger amounts of plant-based proteins (5.81 ± 1.7 versus 4.94 ± 1.3% E respectively, p < 0.001) and very limited intake of fish (0.07 portions/day). Despite being enrolled in a food assistance program, protein and energy malnutrition is prevalent among Greece's most deprived who experience not only lower diet quality but also the double burden of malnutrition.

Nutrient profiling for product reformulation: public health impact and benefits for the consumer.

The food industry holds great potential for driving consumers to adopt healthy food choices as (re)formulation of foods can improve the nutritional quality of these foods. Reformulation has been identified as a cost-effective intervention in addressing non-communicable diseases as it does not require significant alterations of consumer behaviour and dietary habits. Nutrient profiling (NP), the science of categorizing foods based on their nutrient composition, has emerged as an essential tool and is implemented through many different profiling systems to guide reformulation and other nutrition policies. NP systems should be adapted to their specific purposes as it is not possible to design one system that can equally address all policies and purposes, e.g. reformulation and labelling. The present paper discusses some of the key principles and specificities that underlie a NP system designed for reformulation with the example of the Nestlé nutritional profiling system. Furthermore, the impact of reformulation at the level of the food product, dietary intakes and public health are reviewed. Several studies showed that food and beverage reformulation, guided by a NP system, may be effective in improving population nutritional intakes and thereby its health status. In order to achieve its maximum potential and modify the food environment in a beneficial manner, reformulation should be implemented by the entire food sector. Multi-stakeholder partnerships including governments, food industry, retailers and consumer associations that will state concrete time-bound objectives accompanied by an independent monitoring system are the potential solution.

Industry Approach to Nutrition-Based Product Development and Reformulation in Asia.

In the recent years there has been a proliferation of initiatives to classify food products according to their nutritional composition (e.g., high in fat/sugar) to better guide consumer choices and regulate the food environment. This global trend, lately introduced in Asia as well, utilizes nutrient profiling (NP) to set compositional criteria for food products. Even though the use of NP to set targets for product reformulation has been proposed for years, to date only two NP systems have been specifically developed for that purpose. The majority of the NP applications, especially in Asia, focus on marketing and/or health claim regulation, as well as front-of-pack labeling. Product reformulation has been identified, by the World Health Organization and other official bodies, as a key tool for the food industry to help address public health nutrition priorities and provide support towards the reduction of excessive dietary sugar, salt and fats. In the United Kingdom, the Responsibility Deal is an excellent example of a public-private collaborative initiative that successfully reduced the salt content of products available in the supermarkets by 20-30%, resulting in an estimated 10% reduction in salt intake at the population level. Validation of NP systems targeted towards reformulation supports the hypothesis that, by adopting them, the industry can actively support existing policies in the direction of lowering consumptions in public health-sensitive nutrients. The symposium presented a discussion on the current NP landscape in Asia, the importance of reformulation for public health and the Nestlé approach to improve the food environment in Asia through NP.