Functional determinants of dietary intake in community-dwelling older adults: a DEDIPAC (DEterminants of DIet and Physical ACtivity) systematic literature review.

OBJECTIVE: The identification of determinants of dietary intake is an important prerequisite for the development of interventions to improve diet. The present systematic literature review aimed to compile the current knowledge on individual functional determinants of dietary intake in community-dwelling older adults. DESIGN: A systematic search was performed in PubMed, Scopus, Web of Science and the Cochrane Library. Titles, abstracts and full texts were screened according to predefined inclusion and exclusion criteria. Studies were included when focusing on dietary intake as an outcome and on chemosensory, oral, cognitive or physical function as a determinant. SETTING: Community. SUBJECTS: Older adults at least 65 years old without acute or specific chronic diseases. RESULTS: From initially 14 585 potentially relevant papers, thirty-six were included. For chemosensory, cognitive and physical function only a few papers were found, which reported inconsistent results regarding the relationship to dietary intake. In contrast, oral function was extensively studied (n 31). Different surrogates of oral function like dental status, number of teeth, bite force or chewing problems were associated with food as well as nutrient intakes including fibre. As all except six studies had a cross-sectional design, no causal relationships could be derived. CONCLUSIONS: Among functional determinants of dietary intake oral factors are well documented in older adults, whereas the role of other functional determinants remains unclear and needs further systematic research.

Which dietary patterns are more likely to be associated with aspects of eco-sustainable food behaviours in Italy?

Sustainable food consumption (SFC) policies need further investigation into eating habits to improve interventions to encourage shifting to new consumption patterns respectful of human rights, environment and health. Reversing the usual approach focussed on sustainable consumer, the present study investigates how different eating patterns relate to eco-sustainable food. A cluster analysis was carried out on consumption frequencies of food groups recorded in an Italian national survey on 3004 respondents, providing four eating habit segments, further investigated as for sustainable food attitude and behaviour. Openness to eco-sustainable food is found mostly in the more balanced diet segment, accounting for about one third of the adult Italian population. Inaccessibility, non-affordability, unhealthy diet and a lack of information still negatively condition eating habits to the detriment of more sustainable consumption. These findings could support SFC stakeholders in targeting policies and strategies based on diversified approaches to enhance awareness of SFC issues.

Sex hormones and macronutrient metabolism.

The biological differences between males and females are determined by a different set of genes and by a different reactivity to environmental stimuli, including the diet, in general. These differences are further emphasized and driven by the exposure to a different hormone flux throughout the life. These differences have not been taken into appropriate consideration by the scientific community. Nutritional sciences are not immune from this "bias" and when nutritional needs are concerned, females are considered only when pregnant, lactating or when their hormonal profile is returning back to "normal," i.e., to the male-like profile. The authors highlight some of the most evident differences in aspects of biology that are associated with nutrition. This review presents and describes available data addressing differences and similarities of the "reference man" vs. the "reference woman" in term of metabolic activity and nutritional needs. According to this assumption, available evidences of sex-associated differences of specific biochemical pathways involved in substrate metabolism are reported and discussed. The modulation by sexual hormones affecting glucose, amino acid and protein metabolism and the metabolization of nutritional fats and the distribution of fat depots, is considered targeting a tentative starting up background for a gender concerned nutritional science.

Which dimensions of food-related lifestyle are likely to be associated with obesity in Italy?

OBJECTIVE: To compare obese v. non-obese consumers in terms of their general food-related lifestyles and to explore possible food-related factors affecting obesity in Italy. DESIGN: The data were collected using a self-completion questionnaire. Data included sociodemographic information, measures of the Food-Related Lifestyle scale (FRL) and self-reported weight and height. A logistic regression model was fitted for the sample with obesity as the dependent variable and sociodemographic characteristics and FRL dimensions as the independent variables. SETTING: The survey was carried out in Italy between October and November 2010. SUBJECTS: One thousand respondents were recruited with equal quotas for men v. women. The sample was representative of the Italian population in term of age groups and geographic areas. The participants were over 18 years of age and were solely or jointly responsible for the family's food shopping. RESULTS: Our analyses revealed that sociodemographic, economic and cultural variables affect the increasing rate of obesity in Italy. Obese respondents appeared to find more enjoyment from shopping and interest in cooking compared with non-obese ones. Moreover, they were more likely to find self-fulfilment in foods. However, obese respondents appeared to be less interested in the nutritional content of foods, suggesting their weak involvement in nutritional aspects when they eat. In fact, the obese respondents gave preference to snacks over meals. CONCLUSIONS: The outcome of the study would suggest that in targeted interventions for public health purposes in order to address obesity, attention should be placed on the role that food plays in obese consumers' lives.

Personal values, food habits and lifestyles in a sample of adolescents with different adherence to the Mediterranean Diet.

BACKGROUND: The aim of this cross-sectional study was to explore the personal values system of an Italian adolescent sample and examine the interrelations of their values with some variables characterizing their lifestyles. METHODS: A representative sample of 365 adolescents (56.2% females), 15-16 years old from the randomly selected second classes of public/private upper secondary schools of an Italian model region was investigated. The lifestyle of adolescents was explored through a 37-items structured, self-administered questionnaire. Ponderal status was evaluated from measured weight and height. The adherence to the Mediterranean Diet of the sample was determined by the KIDMED Test. The adolescents completed the 21-item Portrait Values Questionnaire, which assesses respondents' endorsement of the ten basic human values. RESULTS: The results suggest that variables related to their eating habits may be associated with their basic values. Some not healthy eating habits, such as eating while "watching TV"/using PC"/ "studying," were negatively related to tradition, conformity, and security values. The adolescents with both moderate and strong alcohol use, and with smoking habits also showed the highest percentage of low adherence to the Mediterranean Diet. CONCLUSIONS: Our findings might provide some useful information to support the development of more effective and targeted health promotion interventions approaches tailored for this age group.

Determinants of Consumers' Acceptance and Adoption of Novel Food in View of More Resilient and Sustainable Food Systems in the EU: A Systematic Literature Review.

This review article aims to provide an up-to-date overview of the main determinants of consumers' acceptance of novel foods (new foods and ingredients) in the EU with emphasis on product's intrinsic properties (sensory characteristics) and individual factors (socio-demographics, perceptive, psychological) by adopting a systematic approach following the PRISMA methodology. Case studies on terrestrial (i.e., insects, cultured meat and other animal origin products, plant-based food including mushrooms, plant-based analogues, pulses, and cereals) and aquatic systems (i.e., algae and jellyfish) are included focusing on age-related and cross-national differences in consumer acceptance of novel foods and ingredients. General trends have emerged that are common to all the novel foods analysed, regardless of their aquatic or terrestrial origin. Aspects such as food neophobia, unfamiliarity, and poor knowledge of the product are important barriers to the consumption of novel foods, while healthiness and environmental sustainability perception are drivers of acceptance. Sensory properties are challenging for more familiar ingredients such as plant-based food (e.g., novel food made by pulses, mushrooms, cereals and pseudocereals). Results are discussed in terms of feasibility of introducing these products in the EU food systems highlighting strategies that can encourage the use of new ingredients or novel foods.

Assessment of evaluations made to healthy eating policies in Europe: a review within the EATWELL Project.

OBJECTIVE: To identify and assess healthy eating policies at national level which have been evaluated in terms of their impact on awareness of healthy eating, food consumption, health outcome or cost/benefit. DESIGN: Review of policy documents and their evaluations when available. SETTING: European Member States. SUBJECTS: One hundred and twenty-one policy documents revised, 107 retained. RESULTS: Of the 107 selected interventions, twenty-two had been evaluated for their impact on awareness or knowledge and twenty-seven for their impact on consumption. Furthermore sixteen interventions provided an evaluation of health impact, while three actions specifically measured any cost/benefit ratio. The indicators used in these evaluations were in most cases not comparable. Evaluation was more often found for public information campaigns, regulation of meals at schools/canteens and nutrition education programmes. CONCLUSIONS: The study highlights the need not only to develop harmonized and verifiable procedures but also indicators for measuring effectiveness and success and for comparing between interventions and countries. EU policies are recommended to provide a set of indicators that may be measured consistently and regularly in all countries. Furthermore, public information campaigns should be accompanied by other interventions, as evaluations may show an impact on awareness and intention, but rarely on consumption patterns and health outcome.

Dietary assessment training: The Italian IV SCAI study on 10-74 year-old individuals' food consumption.

Dietary surveys are conducted to examine the population's dietary patterns that require a complex system of databases, and rules for constructing the data matrix (precision, coding, deriving new variables, e.g., body mass index from individual's height and weight, classes, e.g., age-class, socio-economic status, physical activity, etc.). Management of the data collection requires specialized fieldworkers to allow for the collection of harmonized and standardized data. In this way, only statistical variability is envisaged and any eventual biases are due to probabilistic distribution but data are not affected by inaccuracy. Training the fieldworkers is a crucial part of each dietary survey. The idea to provide constant training throughout the whole survey period, from the preparatory phase to the data collection phase, relies on the necessity to train fieldworkers and monitor the skills acquired during the study, in addition to helping fieldworkers to gain the necessary experience. This study aims to relate the experience in conducting the course path to high specialized interviewers who carried out the cycle devoted to the 10-74 age class of the fourth nationwide food consumption study in Italy (IV SCAI ADULT) according to the European Food Safety Authority (EFSA) guide. A course path was structured in three steps corresponding to the preparation, pilot, and collection phases. The whole path achieved the goal of collecting data related to 12 individuals by each participant, with an overall success rate (successful trainees/total participants) of 16.8% (84 out of an initial 500). The study aimed to provide good quality data in the short term and a highly specialized community in the long term. Surveillance nutritional systems can count on a highly skilled community, so decision-making in public health nutrition and a sustainable and healthy food system can rely on this infrastructure.

Relationship Between Nutrition Knowledge and Dietary Intake: An Assessment Among a Sample of Italian Adults.

Background: Assessing nutrition knowledge provides useful information especially if coupled with the self-perception of nutrition knowledge that could lead to bias and personal conviction. The objective of this study was to assess nutrition knowledge (NK) and its relationship with eating habits in a group of adults. Methods: A cross-sectional study with the administration of self-reported questionnaires was conducted on a sample of 591 parents (43 ± 5.82 years old) of primary school pupils recruited from the municipality of Rome (urban) and province (rural). The fieldwork was carried out in May 2017. An indicator to evaluate adherence to Italian dietary guidelines was developed. ANOVA (Welch's ANOVA in case of unequal variances) test and chi-squared test were used fixing the significance level at 5% (p < 0.05). Results: The percentage of correct answers to nutrition knowledge was 46%, with the expert recommendation section having the highest percentage (59%). The majority of the respondents (66%) were confident that they had a high level of nutrition knowledge. In 37% of the sample, nutrition knowledge and self-perception nutrition knowledge levels were found to be associated. A total of 40% of the sample showed eating habits congruent with nutrition knowledge level. In the investigated sample, living in rural areas, being young, and having low school education level were factors associated with low nutrition literacy or/and unhealthy eating habits. Conclusions: This study provided a demonstration that an assessment based on a multidimensional and multilevel approach is helpful to identify knowledge gaps and to profile critical segments to put in place targeted policy interventions.

A Dietary Assessment Training Course Path: The Italian IV SCAI Study on Children Food Consumption.

The eating patterns in a population can be estimated through dietary surveys in which open-ended assessment methods, such as diaries and interviews, or semi-quantitative food frequency questionnaires are administered. A harmonized dietary survey methodology, together with a standardized operational procedure, in conducting the study is crucial to ensure the comparability of the results and the accuracy of information, thus reducing uncertainty and increasing the reliability of the results. Dietary patterns (i) include several target variables (foods, energy and nutrients, other food components), (ii) require several explanatory variables (age, gender, anthropometric measurements, socio-cultural and economic characteristics, lifestyle, preferences, attitudes, beliefs, organization of food-related activities, etc.), and (iii) have impacts in several domains: imbalance diets; acute and chronic exposures affect health, specifically non-communicable diseases; and then sanitary expenditure. On the other hand, food demand has impacts on the food system: production, distribution, and food services system; food wastes and other wastes generated by food-related activities of the households (e.g., packaging disposal) have consequences on the "health of the planet" which in turn can have effects on human health. Harmonization and standardization of measurement methods and procedures in such a complex context require an ad hoc structured information system made by databases (food nomenclatures, portion sizes, food atlas, recipes) and methodological tools (quantification methods, food coding systems, assessment of nutritional status, data processing to extrapolate what we consider validated dietary data). Establishing a community of professionals specialized in dietary data management could lead to build a surveillance system for monitoring eating habits in the short term, thus reducing costs, and to arrange a training re-training system. Creating and maintaining the dietary data managers community is challenging but possible. In this context, the cooperation between the CREA Research Centre for Food and Nutrition and the Italian National Health Institute (ISS) promoted and supported by the Italian Ministry of Health may represent a model of best practice that can ensure a continuous training for the professional community carrying out a nutritional study.

Corrigendum: A Dietary Assessment Training Course Path: The Italian IV SCAI Study on Children Food Consumption.

[This corrects the article DOI: 10.3389/fpubh.2021.590315.].

Psychosocial and cultural determinants of dietary intake in community-dwelling older adults: A Determinants of Diet and Physical Activity systematic literature review.

OBJECTIVES: Knowledge of factors determining dietary intake is important to develop targeted strategies to prevent malnutrition and age-related diseases. The aim of the present systematic review was to analyze the state of the art regarding the role of social status, cultural aspects, and psychological distress on dietary intake in community-dwelling older adults. METHODS: A systematic search was performed per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedure. Titles, abstracts, and full texts were screened for predefined inclusion and exclusion criteria. RESULTS: Thirty-nine studies were included. Seven different groups of psychosocial and cultural determinants were associated with dietary intake. Family structure and living situation (e.g., loneliness, marital status), educational level, and income were the most important determinants associated with dietary choices and eating behavior. Less frequently, social assets, demographic parameters, psychosocial status, and awareness of current dietary recommendations were associated with the quality of the eating pattern. CONCLUSIONS: The results of our review indicate heterogeneity of the studies in the field of social and psychological determinants of dietary patterns in older adults, but some important conclusions can be drawn. Further research harmonizing and integrating approaches and methodologies are required to better understand the determinants of dietary intake and the complexity of their interactions.

Willingness to use functional breads. Applying the Health Belief Model across four European countries.

The present study focused on the role of the Health Belief Model (HBM) in predicting willingness to use functional breads, across four European countries: UK (N=552), Italy (N=504), Germany (N=525) and Finland (N=513). The behavioural evaluation components of the HBM (the perceived benefits and barriers conceptualized respectively as perceived healthiness and pleasantness) and the health motivation component were good predictors of willingness to use functional breads whereas threat perception components (perceived susceptibility and perceived anticipated severity) failed as predictors. This result was common in all four countries and across products. The role of 'cue to action' was marginal. On the whole the HBM fit was similar across the countries and products in terms of significant predictors (the perceived benefits, barriers and health motivation) with the exception of self-efficacy which was significant only in Finland. Young consumers seemed more interested in the functional bread with a health claim promoting health rather than in reducing risk of disease, whereas the opposite was true for older people. However, functional staple foods, such as bread in this European study, are still perceived as common foods rather than as a means of avoiding diseases. Consumers seek these foods for their healthiness (the perceived benefits) as they expect them to be healthier than regular foods and for the pleasantness (the perceived barriers) as they do not expect any change in the sensory characteristics due to the addition of the functional ingredients. The importance of health motivation in willingness to use products with health claims implies that there is an opening for developing better models for explaining health-promoting food choices that take into account both food and health-related factors without making a reference to disease-related outcome.

Reprint of "Capturing consumer perception of vegetable freshness in a simulated real-life taste situation".

Consumer testing in re-created purchase or consumption contexts may produce results with a higher external validity than laboratory testing and be a valid alternative to consumer testing in real-life contexts. Hence, the present study evaluates the utility of a novel immersive approach in sensory consumer testing. An immersive multisensory room was designed to reproduce consumption conditions close to real life, with large wall screen projections, audio and olfactory stimuli and furniture consistent with the video scenario. Overall liking and perceived freshness of two vegetable products (salad tomato and wild rocket) at different storage time were evaluated by a group of volunteers, regular consumers of the products. Evaluations were performed both in a immersive environment setting - the scenario was the dining room of a holiday farm overlooking a patio and the countryside - and in a traditional sensory lab setting, as a control. The magnitude of liking was higher when evaluations were performed in the immersive environment setting than in the traditional lab setting. However, the discrimination efficacy for freshness and liking of stored and un-stored vegetables was reduced in the immersive environment with respect to the control lab. Additional research, aimed at exploring other products and other consumption or purchase immersive scenarios, will further clarify whether these findings are product-dependent or determined by the contingent immersive situation.

Capturing consumer perception of vegetable freshness in a simulated real-life taste situation.

Consumer testing in re-created purchase or consumption contexts may produce results with a higher external validity than laboratory testing and be a valid alternative to consumer testing in real-life contexts. Hence, the present study evaluates the utility of a novel immersive approach in sensory consumer testing. An immersive multisensory room was designed to reproduce consumption conditions close to real life, with large wall screen projections, audio and olfactory stimuli and furniture consistent with the video scenario. Overall liking and perceived freshness of two vegetable products (salad tomato and wild rocket) at different storage time were evaluated by a group of volunteers, regular consumers of the products. Evaluations were performed both in a immersive environment setting - the scenario was the dining room of a holiday farm overlooking a patio and the countryside - and in a traditional sensory lab setting, as a control. The magnitude of liking was higher when evaluations were performed in the immersive environment setting than in the traditional lab setting. However, the discrimination efficacy for freshness and liking of stored and un-stored vegetables was reduced in the immersive environment with respect to the control lab. Additional research, aimed at exploring other products and other consumption or purchase immersive scenarios, will further clarify whether these findings are product-dependent or determined by the contingent immersive situation.

What is the public appetite for healthy eating policies? Evidence from a cross-European survey.

World Health Organization estimates that obesity accounts for 2-8% of health care costs in different parts of Europe, and highlights a key role for national policymaking in curbing the epidemic. A variety of healthy-eating policy instruments are available, ranging from more paternalistic policies to those less intrusive. Our aim is to measure and explain the level of public support for different types of healthy eating policy in Europe, based on data from a probabilistic sample of 3003 respondents in five European countries. We find that the main drivers of policy support are attitudinal factors, especially attribution of obesity to excessive availability of unhealthy foods, while socio-demographic characteristics and political preferences have little explanatory power. A high level of support for healthy eating policy does not translate into acceptance of higher taxes to fund them, however.

Policies to promote healthy eating in Europe: a structured review of policies and their effectiveness.

This review provides a classification of public policies to promote healthier eating as well as a structured mapping of existing measures in Europe. Complete coverage of alternative policy types was ensured by complementing the review with a selection of major interventions from outside Europe. Under the auspices of the Seventh Framework Programme's Eatwell Project, funded by the European Commission, researchers from five countries reviewed a representative selection of policy actions based on scientific papers, policy documents, grey literature, government websites, other policy reviews, and interviews with policy-makers. This work resulted in a list of 129 policy interventions, 121 of which were in Europe. For each type of policy, a critical review of its effectiveness was conducted, based on the evidence currently available. The results of this review indicate a need exists for a more systematic and accurate evaluation of government-level interventions as well as for a stronger focus on actual behavioral change rather than changes in attitude or intentions alone. The currently available evidence is very heterogeneous across policy types and is often incomplete.

A chromone from Seseli praecox (Apiaceae).

Chemical investigation of the stems of Seseli praecox (Gamisans) Gamisans, an endemic Apiaceae from Sardinia, afforded an isopropenylated chromone (5-hydroxy-6-(2-Z-butenyl-3-hydroxymethyl)-7-methoxy-2-methylchromone), along with four known linear furocoumarins and their natural precursor. For biological characterization the new compound was screened against four cancer cell lines in vitro and showed differential microM antiproliferative effects between suspension and adherent cells.