Food Waste on Foodservice: An Overview through the Perspective of Sustainable Dimensions.

Food waste (FW) is a current, complex, and widely debated issue in various spheres of society. Globally, about 2.6 trillion dollars per year is lost because of wasted food. Part of FW is preventable, and it is necessary to identify where it occurs. In most cases, FW occurs at the end of the production chain (meal preparation and distribution). Identifying the main food service failures on FW is important for developing efficient strategies for reducing them. Therefore, this study aimed to perform a narrative review of the impacts caused by FW in food services considering the three dimensions of sustainability (social, economic, or environmental). Multiple reasons were identified in this review that impacts those three dimensions, such as the cost of wasted raw material, use of cleaning material, the energy consumption, salary of food handlers, the water footprint, the amounts of rest-intake, production waste, energy density wasted, use of organic food, and food donation. Identifying these aspects can contribute to reduce FW impacts for better sustainable development, develop tools to measure FW, and assist food service managers in minimizing FW.

Repercussion of COVID-19 Pandemic on Brazilians' Quality of Life: A Nationwide Cross-Sectional Study.

The COVID-19 outbreak, caused by Sars-Cov-2, was officially declared a global pandemic in February 2020, after an unexpected increase in hospitalization and mortality. When faced with this new disease, social and physical distancing and quarantine emerged as solutions to reduce virus transmission. This article examines the quality of life (QoL) of the Brazilian population's during this period of isolation, due to the COVID-19 pandemic by analyzing; physical, psychological, social, and economic aspects. An online survey was distributed from 27 May to 14 August of 2020. A total of 1859 surveys were completed. Our results indicate that Brazilians were more affected by economic and social aspects than psychological and physical. Unemployed participants and individuals who tested positive for COVID-19 presented the lowest QoL. Females showed worst QoL scores than males, but having children did not influence the score. Higher educational level was associated with a better perception of QoL. Not following social distancing guidelines presented better scores in the psychological domain than the ones following restrict or partial social distancing rules. This study is the first to evaluate adults' QoL related to the Sars-Cov-2 pandemic in Brazil at a national level. Our data may help health authorities identify the main factors affecting the QoL of the Brazilian population, thereby orientating them to recover after the pandemic.

Gluten contamination in food services and industry: A systematic review.

Gluten-related disorders (GRD) affects approximately 10% of the general population. The only treatment for GRD is still so far is the lifelong complete exclusion of gluten from the daily diet. The correct information about the presence/absence of gluten in food is very important to this group. The present study aimed to evaluate the prevalence of gluten contamination in gluten-free industrial and non-industrial products. In this systematic review, 24 cross-sectional studies were analyzed. The authors developed specific search strategies for Science Direct, Scopus, Web of Science, Google Scholar and ProQuest Dissertations & Theses Global. The authors evaluated the methodological quality of the included studies using criteria from Meta-analysis of Statistics Assessment and Review Instrument (MASTARI). We performed the statistical meta-analysis by metafor package of R program. 95.83% (n = 23) of the studies presented positive results for contamination (over 20 ppm). In industrial food products, studies showed a contamination prevalence of 13.2% (95% CI: 10.8%-15.7%). In non-industrial food products, studies showed a contamination prevalence of 41.5% (95% CI: 16.6%-66.4%). Despite the non-industrial products presented higher contamination prevalence than the industrial products, the difference was not significant (p = 0.072). The findings indicate cross-contamination in industrialized and non-industrialized products. As expected, industrial products labeled as gluten-free showed a lower percentage of gluten-contamination than non-industrialized. Despite that, any contaminated sample found in this group present greater relevance than non-labeled foods. It indicates that foods labeled as "gluten-free" should not be considered safe for patients with GRD since information on the label regarding the presence/absence of gluten is unreliable. Therefore, any gluten-contamination in products labeled as gluten-free is a serious problem to whom present GRD. Further studies are needed to estimate gluten cross-contamination in food service meals and industry better.

Measuring Quality of Life in Parents or Caregivers of Children and Adolescents with Celiac Disease: Development and Content Validation of the Questionnaire.

Celiac disease (CD) is an autoimmune disorder triggered by the ingestion of gluten and affects approximately 1% of the global population. Currently, the only treatment available is lifelong strict adherence to a gluten-free diet (GFD). Chronic diseases such as CD affect patients and their family members' quality of life (QoL); particularly parents and caregivers who play an essential role in the child's care and treatment. A higher level of psychological distress has been found in the parents of children with chronic ailments due to limited control over the child's daily activities and the child's illness. In this context, the validation of a specific questionnaire of QoL is a valuable tool to evaluate the difficulties faced by parents or caregivers of children with this chronic illness. A specific questionnaire for this population can elucidate the reasons for stress in their daily lives as well as the physical, mental, emotional, and social impact caused by CD. Therefore, this study aimed to develop and validate a specific questionnaire to evaluate the QoL of parents and caregivers of children and adolescents with CD. Overall results showed that a higher family income resulted in a higher score of the worries domain. In addition, having another illness besides CD decreased the QoL (except in the worries domain). The other variables studied did not present a statistically significant impact on the QoL, which was shown to be low in all aspects. Knowledge of the QoL is important to help implement effective strategies to improve celiac patients' quality of life and reduce their physical, emotional, and social burden.

Food Safety Knowledge, Attitudes, and Practices of Brazilian Food Truck Food Handlers.

This study aimed to (i) compare the food safety knowledge, attitudes, and self-reported practices (KAP) and observed food safety practices of food truck (FT) food handlers, (ii) evaluate the microbiological quality of food and water samples collected from these vehicles, and (iii) establish a score classification for the KAP instrument according to the food contamination probability assessment. This study was conducted in three stages with 40 food truck food handlers conveniently sampled in the Federal District, Brazil, through structured interviews, application of an observational checklist for the assessment of handlers' practices and the collection of food and water samples for determination of microbiological quality. FTs that are likely to exhibit food contamination and are at a high risk of foodborne diseases if at least one of the following situations occur: (1) if a food handler scores ≤6 in the knowledge section; (2) if a food handler scores ≤5 in the attitudes section; or (3) if a food handler scores ≤6 in the self-reported practices section. On the other hand, FTs in which handlers score higher than the cutoff points in all the sections are unlikely to exhibit food contamination and are at a low risk of foodborne diseases. The findings of this study are the first step to understand food handlers' point of view and the initial diagnosis to guide educational strategies in the FT sector.

Brazilian Food Truck Consumers' Profile, Choices, Preferences, and Food Safety Importance Perception.

This study aimed to investigate food truck consumers' profile, choices, preferences, and food safety importance perception. We conducted structured interviews with a convenient sample of 133 food truck consumers in the Federal District, Brazil. Most of the participating consumers were married (52%) and female (56%), who had completed at least tertiary school (81%). The interviews revealed that most food truck consumers eat from food trucks once or twice a week (96%), usually near home (74%), and have an average per capita expenditure of approximately US $5 to US $9.99 (70%). Hamburgers and sandwiches are the most popular food among consumers (72%). Consumers indicated that taste (30%) was the most important reason to choose a food truck and that poor vehicle hygiene (30%) was the main point assigned for not opting for a food truck. Food hygiene and vendors' personal hygiene were considered important by consumers when eating from food trucks (78% and 80%, respectively). Considering all food truck consumers interviewed and the questions about food safety importance perception, the minimum score was 1 and the maximum was 2.9, with a mean score of 1.68 (SD = 0.46), indicating a high level of perceived importance. The instrument of food safety importance perception presented a Cronbach's alpha coefficient of 0.73, indicating good internal consistency. No significant differences were observed in the food safety importance perception scores in gender (0.192), marital status (0.418), level of education (0.652) or food safety training (0.166). However, significant differences were found in the food safety importance perception scores for age (0.026) and the presence of children (0.001). The findings of this study indicate that there remains the need for consumers to comprehend their role in the food supply chain. Food safety and food handling practices are of public concern, and strategies are required to prevent foodborne diseases. Future public health interventions aiming to increase consumer knowledge and awareness of food safety should be emphasized.

Self-Reported Non-Celiac Gluten Sensitivity in Brazil: Translation, Cultural Adaptation, and Validation of Italian Questionnaire.

This study aimed to translate, culturally adapt, validate, and apply a questionnaire to the Brazilian non-celiac gluten sensitive (NCGS) population. We also aimed to estimate the prevalence of symptoms which affect Brazilian NCGS. The Brazilian Portuguese version of the NCGS questionnaire was developed according to revised international guidelines. Five-hundred-and-fourty-three participants responded the NCGS questionnaire. We evaluated the reproducibility and validity of the questionnaire which presents valid measures of reproducibility. This is the first specific self-reported validated questionnaire for NCGS patients in Brazilian Portuguese, and the first nationwide characterization of self-reported NCGS in Brazilian adults. Most respondents were female (92.3%), and the main intestinal symptoms reported were bloating and abdominal pain. The most frequent extraintestinal symptoms were lack of wellbeing, tiredness, and depression. We expect that the present study will provide a picture of Brazilian individuals with suspected NCGS, which could help health professionals and governmental institutions in developing effective strategies to improve the treatment and diagnosis of Brazilian NCGS.

Food Trucks: Assessment of an Evaluation Instrument Designed for the Prevention of Foodborne Diseases.

This study aimed to validate an evaluation instrument for food trucks (FTs) regarding its internal consistency and to establish a score classification according to the food contamination probability assessment. The instrument was applied in 44 food trucks (convenience sample), along with microbial analysis, in the Federal District, Brazil. After its application, sample collection and statistical analysis, the evaluation instrument was reduced to a 22-item final version. FTs were divided into three groups according to their ready-to-eat foods. Food trucks from Group A (hot and cold sandwiches) presented the highest percentage of contamination. The lowest percentage of contamination was observed in food trucks from Group C (regional and international cuisine). The application of the validated evaluation instrument to the 44 food trucks revealed that none achieved 100% adequacy. The reproducibility analysis exhibited an Intraclass Correlation Coefficient (ICC) value of 0.780 (CI 95%: 0.597; 0.880), indicating good reproducibility of the instrument. The reliability assessment presented a Kuder⁻Richardson Formula 20 (KR-20) value of 0.627 and a Cronbach's alpha coefficient of 0.634, indicating good internal consistency. The proposed classification score was obtained by assigning 1 point for each item with an inadequate response, and the final score may vary between 0 and 20 points. Food trucks with up to 11 points exhibit low probability of contamination and low risk of foodborne diseases, while food trucks scoring 12 or more points exhibit a high probability of contamination and high risk of foodborne diseases. The evaluation instrument will allow effective assessment of the hygienic⁻sanitary practices and conditions of food trucks and potentially ensure consumers' access to safe food.

Development of a Brazilian Food Truck Risk Assessment Instrument.

This study aimed to develop and validate a checklist instrument as a first step for the risk assessment of the hygienic-sanitary practices and conditions of food trucks. We invited sixteen experienced experts in the food safety field to take part in the process. The checklist was designed based on the Codex Alimentarius, Brazilian resolutions Collegiate Board Resolution 216, Brazilian Collegiate Board Resolution 275, Brazilian Federal District Law no. 5.627 and Brazilian Federal District Normative Instruction 11. The preliminary version of the checklist-composed of 29 items (nine sections)-was evaluated by 13 experts. They evaluated the items regarding their importance (content validation) and clarity (semantic evaluation) by the Delphi technique. The criteria for the approval of the content validation (Likert scale from 1 to 5) and semantic evaluation (Likert scale from 0 to 5) processes were as follows: a minimum of 75% agreement among the experts (W-values ≥ 0.75) and a mean grade ≥ 4. We performed the complete validation process in three rounds. The final version of the assessment instrument comprised 39 items, following suggestions from experts to add or subdivide some questions. The checklist can be used to conduct inspections of food trucks by health surveillance auditors, of food truck vendors' decision-making processes and also as a diagnostic tool. The application of this checklist will allow the effective risk assessment of the hygienic-sanitary practices and conditions in food trucks and potentially ensure consumers' access to safe street food.

Gluten-Free Diet: From Development to Assessment of a Check-List Designed for the Prevention of Gluten Cross-Contamination in Food Services.

Gluten cross-contamination in gluten-free food may jeopardize treatment of celiac patients. Considering the deficit of appropriate instruments to enable the implementation of safe production practices for gluten-free food, this study aimed to evaluate the application of a check-list elaborated for gluten cross-contamination prevention in food services. The instrument was applied in 60 Brazilian food services. Interobserver reproducibility and internal consistency of the check-list were tested. A score classification was created for establishments according to the food contamination risk assessment. Subsequent to the application and statistical analysis, the original instrument was reduced to a 30-item check-list. In the reproducibility analysis, none of the 30 items showed significant divergence among the evaluators (p > 0.05 in the Cochran Q test). The 30-item version of the check-list presented Kuder⁻Richardson Formula 20 (KR-20) = 0.771, indicating good internal consistency. The proposed classification score is obtained by adding 1 point for each item with an "adequate" response; therefore, the final score may vary between 0 and 30 points. Establishments with up to 15 points exhibit risk of gluten contamination, while establishments with a score above 16 points exhibit low risk of contamination. The check-list displayed good reproducibility and internal consistency, suggesting that it could be a useful gluten contamination control instrument in food services.

Consumption of Fruits and Vegetables by Low-Income Brazilian Undergraduate Students: A Cross-Sectional Study.

Objective: This study aimed to evaluate the consumption of fruits and vegetables (FV) by low-income students participating in the Brazilian Student Assistance Program. Methods: For three days, we measured participants' consumption through direct observation of food intake at the University Restaurant (UR) and 24-h recall outside the restaurant. The 174 undergraduates were divided into two groups to obtain data on FV intake at the weekend (Sunday) and two days of the week. Group 1 included low-income undergraduates who received their meals for free, and Group 2 included students who paid for their meals at the UR. Results: Both groups presented a very low consumption of FV. On the weekend, Group 1 consumption was equal to Group 2, but it was higher than Group 2 on weekdays, demonstrating how important the UR is for this population. The lowest contribution of the UR to the daily consumption of FV was 59%, reaching a percentage of 87.27%. Fruit supply in the restaurant menu may have positively influenced this consumption. Conclusions: The consumption of FV varied according to the menu offered at the UR. The UR should be a space to promote healthy eating habits including more FV in its menus.

Content Validation and Semantic Evaluation of a Check-List Elaborated for the Prevention of Gluten Cross-Contamination in Food Services.

Conditions associated to the consumption of gluten have emerged as a major health care concern and the treatment consists on a lifelong gluten-free diet. Providing safe food for these individuals includes adapting to safety procedures within the food chain and preventing gluten cross-contamination in gluten-free food. However, a gluten cross-contamination prevention protocol or check-list has not yet been validated. Therefore, the aim of this study was to perform the content validation and semantic evaluation of a check-list elaborated for the prevention of gluten cross-contamination in food services. The preliminary version of the check-list was elaborated based on the Brazilian resolution for food safety Collegiate Board Resolution 216 (RDC 216) and Collegiate Board Resolution 275 (RDC 275), the standard 22000 from the International Organization for Standardization (ISO 22000) and the Canadian Celiac Association Gluten-Free Certification Program documents. Seven experts with experience in the area participated in the check-list validation and semantic evaluation. The criteria used for the approval of the items, as to their importance for the prevention of gluten cross-contamination and clarity of the wording, was the achievement of a minimal of 80% of agreement between the experts (W-values ≥ 0.8). Moreover, items should have a mean ≥4 in the evaluation of importance (Likert scale from 1 to 5) and clarity (Likert scale from 0 to 5) in order to be maintained in the instrument. The final version of the check-list was composed of 84 items, divided into 12 sections. After being redesigned and re-evaluated, the items were considered important and comprehensive by the experts (both with W-values ≥ 0.89). The check-list developed was validated with respect to content and approved in the semantic evaluation.