Toward healthy and sustainable diets for the 21st century: Importance of sociocultural and economic considerations.

Four years after the EAT-Lancet landmark report, worldwide movements call for action to reorient food systems to healthy diets that respect planetary boundaries. Since dietary habits are inherently local and personal, any shift toward healthy and sustainable diets going against this identity will have an uphill road. Therefore, research should address the tension between the local and global nature of the biophysical (health, environment) and social dimensions (culture, economy). Advancing the food system transformation to healthy, sustainable diets transcends the personal control of engaging consumers. The challenge for science is to scale-up, to become more interdisciplinary, and to engage with policymakers and food system actors. This will provide the evidential basis to shift from the current narrative of price, convenience, and taste to one of health, sustainability, and equity. The breaches of planetary boundaries and the environmental and health costs of the food system can no longer be considered externalities. However, conflicting interests and traditions frustrate effective changes in the human-made food system. Public and private stakeholders must embrace social inclusiveness and include the role and accountability of all food system actors from the microlevel to the macrolevel. To achieve this food transformation, a new "social contract," led by governments, is needed to redefine the economic and regulatory power balance between consumers and (inter)national food system actors.

Child-eating behaviour as predictor of anthropometric status of preschool children aged 2-4 years in Umuahia South LGA Abia State, Nigeria.

INTRODUCTION AND OBJECTIVE: Eating behaviour at the childhood level plays a vital role in the outcome of the nutritional status and the overall health of an individual. The study was focused on the association between anthropometric status and child eating behaviour. METHODOLOGY: A community-based cross-sectional survey purposively enrolled consenting participants from 256 households with preschool children aged 2-4 years. The parents/legal guardians were interviewed on the eating behaviour of their children using a validated semi-structured child-eating behaviour scale, and anthropometric measurement of the children were taken. WHO Anthro-software for child growth standards was used to categorize anthropometric status of the preschool children. Paired sample t-test was performed to compare child-eating behaviour by gender, while regression and correlation analysis was performed to determine the extent to which child-eating behaviour predicted anthropometric status at 5% level of significance. RESULTS: Mean comparison of child eating behaviour by gender showed significant difference (P < 0.05) between male and female children in their eating behaviour with respect to enjoyment of food and satiety responsiveness. Some of the children were wasted (26.6%), stunted (20.7%) and underweight (16.4%). A significant association (P < 0.05) was observed between body mass index-for-age and food fussiness behaviour of the children. There was also a significant difference (P < 0.05) between weight-for-age and food fussiness behaviour of the children. CONCLUSION: The study showed that child eating behaviour may have contributed to the anthropometric status of the children, however, differences in their eating behaviours by gender was observed.

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.

Periodic Revisions of the International Choices Criteria: Process and Results.

Unhealthy diets contribute to an increased risk of non-communicable diseases, which are the leading causes of deaths worldwide. Nutrition policies such as front-of-pack labeling have been developed and implemented globally in different countries to stimulate healthier diets. The Choices Programme, including the International Choices criteria, is an established tool to support the implementation of such policies. The Choices criteria were developed to define the healthier choices per product group, taking saturated fatty acids, trans fatty acids, sodium, sugars, energy, and fiber into account. To keep these criteria updated, they are periodically revised by an independent international scientific committee. This paper explains the most important changes resulting from revisions between 2010 and 2016 and describes the process of the latest revision, resulting in the International Choices criteria version 2019. Revisions were based on national and international nutrition and dietary recommendations, large food composition databases, and stakeholders' feedback. Other nutrient profiling systems served as benchmarks. The product group classification was adapted and new criteria were determined in order to enhance global applicability and form a credible, intuitively logical system for users. These newly developed criteria will serve as an international standard for healthier products and provide a guiding framework for food and nutrition policies.

Evaluation of two local cowpea species for nutrient, antinutrient, and phytochemical compositions and organoleptic attributes of their wheat-based cookies.

BACKGROUND: Childhood and adolescent malnutrition is a function of inadequate intake. Cookies are favourite snacks of children and adolescents. OBJECTIVE: This work determined the nutrient, antinutrient, and phytochemical compositions of two local cowpea (oraludi and apama) flours and evaluated the organoleptic properties of their wheat-based cookies. DESIGN: The two local cowpea species were processed into flours separately and blended with wheat on a 56-g protein basis. Chemical compositions of the processed cowpea flours were analysed using standard methods. Organoleptic attributes were evaluated with a nine-point Hedonic scale. Statistical analysis, which involved mean and standard deviations, were computed by analysis of variance, and Duncan's new multiple range tests were used to separate and compare group means of sensory evaluation data, with significance accepted at P<0.05. RESULTS: The results revealed that oraludi had superior percentage values compared to apama in protein (26.22 and 20.88), fat (7.98 and 6.65), and ash (3.81 and 3.13), while apama proved superior in moisture (9.76 and 7.82), crude fibre (5.49 and 4.91), and carbohydrate (54.09 and 49.26). The values were higher for oraludi than apama in iron (8.62 and 6.49 mg), zinc (1.61 and 0.95 mg), and beta-carotene (223.24 and 190.63 mg) but lower in sodium (34.79 and 56.72 mg), potassium (25.73 and 30.65 mg), phosphorus (13.35 and 18.26 mg), thiamine (5.33 and 9.41 mg), vitamin C (16.63 and 21.09 mg), and vitamin E (0.51 and 0.67 mg). Apama had 0.06 mg phytate, 0.09 mg oxalate, 15.22 mg tannins, 3.59 mg flavonoids, and 0.19 mg saponin. Oraludi had 0.03 mg phytate, 0.32 mg oxalate, 15.94 mg tannins, 3.14 mg flavonoid, and 0.13 mg saponin. Mean scores of general acceptability for wheat:apama (80:20) and wheat:oraludi:apama (60:20:20) cookies (7.71 and 7.41) were superior (P<0.05) to others. CONCLUSIONS: Oraludi and apama proved nutrient dense. Their use improved the acceptability of some of the wheat-based cookies. Use of these local cowpeas in cookie production is, therefore, encouraged.

Prevalence and factors associated with anthropometric failure, vitamin A and iron deficiency among adolescents in a Nigerian urban community.

BACKGROUND: Under nutrition is a problem of severe magnitude in low income countries like Nigeria. Adolescent school children might also be vulnerable. The dearth of data hinders planning of school health and nutrition programmes for school children. OBJECTIVE: To determine the prevalence of stunting, thinness; vitamin A and iron deficiencies among adolescent students in Nsukka urban, Nigeria and to determine factors that are associated with these nutritional problems. METHODS: A total of 400 participants were randomly selected from 717 students aged 12 - 18 years in 3 randomly selected secondary schools. Questionnaires, anthropometric measurements, and blood analyses were the data collection methods employed. RESULTS: The prevalence of stunting was 33.3% and thinness 31.0%. Neither overweight nor obesity was observed. While 64.0% were anaemic; 44.0% had vitamin A deficiency (VAD). A total of 48.0% had both anaemia and stunting, 42% had VAD + thinness; while 40% had anaemia + VAD. Household income was a predictor of vitamin A status. Children from medium/high income households had higher odds of having VAD than those from low income households (AOR=0.14; 95% CI=0.031, 0.607; P=0.009). Household income (AOR=0.12; 95% CI=0.021, 0.671; P=0.016), and age (AOR=0.09; 95% CI=0.014, 0.587; P=0.012) were independent determinants of height-for-age status. CONCLUSION: Among urban adolescent students in Nigeria, stunting, thinness, anaemia and VAD were problems of public health significance. Age and household monthly income played major roles.