El etiquetado nutricional: su expresión en el contexto mexicano / Nutritional labeling: its expression in the Mexican context

Introduction: Food is a process that carries implicit socio-cultural elements in a specific historical moment. The changes in the diet caused an increase in problems of obesity and Chronic Non-Communicable Diseases in Mexico. Measures have been taken through public policies that seek to reduce the effects of the consumption of foods with high energy value, one of them is the nutritional labeling of foods. Development: As the first axis, a sociohistorical reconstruction is developed around food labeling in Mexico as an initiative that is part of an international public policy to present nutritional information for the selection and consumption of food. In a second moment, an analysis is carried out from a critical position on the implementation and exercise of decision-making for the consumption of said products, since it is subject to a complex network of sociocultural and individual factors that determine and are determinants of styles. and frequency of consumption of the products. Conclusions: The new labeling with nutritional information is an information tool for the selection in food consumption to face the problem of overweight and obesity in Mexico. However, eating habits and practices respond to sociocultural and economic elements that are above healthy lifestyles and a culture of prevention. It is necessary to build and promote community participation-action that promotes tools such as nutritional labeling to make its objectives effective.

Introducción: la alimentación es un proceso que implica elementos socioculturales en un momento histórico concreto. México se encuentra en un problema de salud generalizado de obesidad y enfermedades crónicas no transmisibles. Ante esto se han tomado medidas mediante políticas públicas que buscan disminuir los efectos del consumo de alimentos de alto valor energético, una de ellas es el etiquetado nutricional de los alimentos. Desarrollo: como primer eje se desarrolla una reconstrucción sociohistórica en torno al etiquetado de alimentos en México como iniciativa que forma parte de una política pública internacional para presentar información nutricional para la selección y consumo de los alimentos. En un segundo momento se realiza un análisis desde un posicionamiento crítico sobre la implementación y el ejercicio de las tomas de decisión del consumo de dichos productos, ya que está sujeta a una compleja red de factores socioculturales e individuales que determinan y son determinantes de los estilos y frecuencia de consumo de los productos. Conclusiones: el nuevo etiquetado con información nutricional es una herramienta de información para la selección en el consumo de alimentos para enfrentar el problema de sobrepeso y obesidad en México. Sin embargo, los hábitos y prácticas de alimentación responden a elementos socioculturales y económicos que están por arriba de los estilos de vida saludable y una cultura de prevención. Es necesario construir y promover una participación-acción comunitaria que potencie las herramientas como el etiquetado nutricional para hacer efectivos sus objetivos.

Alergias alimentarias: revisión de la legislación correspondiente a la gestión y al etiquetado de alérgenos / Food allergies: review of legislation on allergen management and labelling

Introducción: La normativa existente que obliga a los establecimientos alimentarios a reflejar en el etiquetado la información sobre la presencia de alérgenos de declaración obligatoria no consigue evitar que puedan producirse reacciones adversas accidentales en los consumidores susceptibles. Por ello, en este trabajo se revisa la normativa europea existente en materia de alérgenos y se analizan las causas por las que sigue habiendo alertas sanitarias de alérgenos no declarados, proponiéndose posibles soluciones para solventar este problema. Método: Se ha llevado a cabo una investigación documental desarrollada en cinco etapas. Para ello, se recopiló literatura publicada hasta noviembre de 2022. Resultados: El Reglamento 1169/2011 sobre la información alimentaria facilitada al consumidor establece las normas de etiquetado aplicables a los alérgenos contenidos en los productos. En su artículo 36, una de las informaciones alimentarias voluntarias a incluir es la posible presencia no intencionada en el alimento de sustancias o productos que causen alergias o intolerancias, también conocido como etiquetado precautorio de alérgenos (EPA). Tanto la confusión que existe alrededor del uso del EPA, como la compleja estructura de la cadena alimentaria y, en algunos casos, la formación deficiente del personal, pueden aumentar el riesgo poner en el mercado productos inseguros al alcance de personas susceptibles. Conclusiones: Se considera conveniente intensificar la formación de los trabajadores de cualquier establecimiento alimentario y realizar actos de ejecución que regulen el EPA. (AU)

Introduction: Existing regulations requiring food establishments to label on the presence of mandatory declaration allergen fail to prevent accidental adverse reactions from occurring in susceptible consumers. Therefore, this paper reviews the existing European legislation on allergens and analyses the reasons why health alerts for undeclared allergens continue to occur, proposing possible solutions to solve this problem.Method: Documentary research was carried out in five stages. For this purpose, literature published up to Novem-ber 2022 was collected.Results: Regulation 1169/2011 on the provision of food information to consumers sets out the labelling rules appli-cable to allergens contained in products. In its article 36, one of the voluntary food information to be included is the possible unintended presence in the food of substances or products causing allergies or intolerances, also known as precautionary allergen labelling (PAL). Confusion surrounding the use of PAL, the complex structure of the food chain and, in some cases, poorly trained staff all can increase the risk of placing unsafe products on the market within the reach of susceptible people.Conclusions: It is considered appropriate to intensify the training of workers in all food establishments the PAL. (AU)

Information on food additives on food labels in Brazil: a critical analysis / Informação sobre aditivos alimentares nos rótulos de alimentos no Brasil: análise crítica

ABSTRACT Questions about the safety of food additives and their consumption have been raised in recent years. The increased exposure to these substances, either by intake of ultra-processed foods or by the broad use and combination of various categories of additives, may be related to higher risks to consumer health. This article comments on the results of a study that quantified and characterized food additives found on the labels of 9,856 packaged foods and beverages available in Brazilian supermarkets. The study adopted a field diary method to record and analyze nonconformities in the lists of ingredients. The objective of this article is to discuss the use of additives identified on the labels and the limitations of Brazilian legislation, which should guarantee the right to information and health.

RESUMO Nos últimos tempos, questões vêm sendo levantadas sobre a segurança no uso de aditivos alimentares e em seu consumo. verificou-se que o aumento da exposição a essas substâncias, seja pela ingestão mais frequente de alimentos ultraprocessados ou pela ampla utilização e combinação de várias categorias de aditivos pela indústria, pode estar relacionado ao maior risco à saúde do consumidor. Um estudo quantificou e caracterizou aditivos alimentares encontrados nos rótulos de 9.856 alimentos e bebidas embalados disponíveis nos supermercados brasileiros. nele, foi adotado um diário de campo para registro de falhas e inconformidades nas informações presentes nas listas de ingredientes, sendo, por fim, analisadas qualitativamente e descritas de forma narrativa. Com base nisso, o objetivo deste comentário é apresentar e discutir o uso desses aditivos identificados nos rótulos e as limitações da legislação brasileira, que deveria garantir o direito à informação e a saúde da população.

Food Trade for Specific Health Use FOSHU through Patents in LATAM: Relevant Aspects in International Law / Comercio de Alimentos para Uso Específico de Salud FOSHU a través de Patentes en LATAM: Aspectos Relevantes en el Derecho Internacional

Introduction: This article addresses the legal regulations for Foods for Specified Health Uses (FOSHU) in the main trade associations of Latin America (LATAM), based on the Codex Alimentarius system. Objective: The objective is to determine regulatory progress in the trade of FOSHU products. Material and methods: This study includes a review of the literature emanating from the databases from 2018 to 2022, according to the framework of three general food marketing regulations: food safety claims; inspection regulations, and food manufacturing and labeling. Results: The results reveal the absence of a specific legislation for FOSHU foods, as these are only mentioned in the area of nutrition. Conclusions: The legal framework in the trade of these products is based on jus cogens. Registration of industrial patents in the main member countries of LATAM trade associations can be facilitated through the Patent Prosecution Highway (PPH)(AU)

Introducción: El artículo aborda las regulaciones jurídicas en Alimentos para Uso Específico de Salud "FOSHU" en las principales asociaciones comerciales de América Latina (LATAM), basados en el sistema Codex Alimentarius. Objetivo: Determinar el avance regulatorio en la comercialización de productos FOSHU. Materiales y métodos: Se revisa la literatura emanada de las bases de datos desde el año 2018 al 2022, según el marco de tres regulaciones generales de comercialización de alimentos: las declaraciones de seguridad alimentaria; las regulaciones de inspecciones, las de manufacturas de alimentos y etiquetado. Resultados: Los resultados revelaron la ausencia de una legislación específica para alimentos FOSHU, siendo solo mencionados en el área de la nutrición. Conclusiones: El revestimiento jurídico en la comercialización de estos productos; se cimienta en el ius cogens. Las inscripciones de patentes industriales en los principales países miembros de las asociaciones comerciales en LATAM pueden facilitarse por la vía del Patent Prosecution Highway (PPH)(AU)

Labelling Assessment of Greek "Quality Label" Prepacked Cheeses as the Basis for a Branded Food Composition Database.

A labelling assessment study of Greek prepacked "quality label" cheeses was conducted with a view to provide an overview of the whole category. In total, 158 prepacked products belonging to 19 "quality label" cheeses were identified in the Greek market. Among them, Feta had the highest share followed by Kasseri, Graviera Kritis, Kefalograviera and Ladotyri Mitilinis with 81, 16, 15, 11 and 9 products found in the market, respectively. For the rest of the 14 cheeses, the share was limited, ranging from 1 to 4. All labelling indications, nutritional information, claims and other labelling data were recorded and analysed in relation to their compliance against European food law requirements. The results of the analysis showed that for only 6 of the 19 cheeses, all products fully complied with EU labelling legislation. Among the 14 mandatory labelling requirements, the lowest overall compliance was observed for allergens declaration (65%). The analysis of the nutritional data showed a remarkable variability between cheeses and products. Differences in the nutritional characteristics were more pronounced among soft, semi-hard, hard and whey cheese. The above data were entered into an archival database. Application of global harmonisation and standardisation guidelines and tools lead to the initialisation of a branded food composition database (BFCD), conceptualising a specialised database for "quality label" foods.

Front-of-Pack Labeling in Chile: Effects on Employment, Real Wages, and Firms' Profits after Three Years of Its Implementation.

This study evaluates the impact of Chile's innovative law on Food Labeling and Advertising, enacted in June 2016, on employment and real wages and profit margins for the food and beverage manufacturing sectors in the 2016-2019 period, using unique company-specific monthly data from Chile's tax collection agency (measuring aggregate employment, real wages, average size of firms, and gross profit margins of the food and beverage manufacturing sector). Interrupted-time series analyses (ITSA) on administrative data from tax-paying firms was used and compared to synthetic control groups of sectors not affected by the regulations. ITSA results show no effect on aggregate employment nor on the average size of the firms, while they show negligible effects on real wages and gross margin of profits (as proportion of total sales), after the first two stages of the implementation (36 months), despite significant decreases in consumption in certain categories (sugar-sweetened beverages, breakfast cereals, etc.). Despite the large declines found in purchases of unhealthy foods, employment did not change and impacts on other economic outcomes were small. Though Chile's law, is peculiar there is no reason to believe that if similar regulations were adopted elsewhere, they would have different results.

Projecting the Influence of Sugar-Sweetened Beverage Warning Labels and Restaurant Menu Labeling Regulations on Energy Intake, Weight Status, and Health Care Expenditures in US Adults: A Microsimulation.

BACKGROUND: Accurate, readily accessible, and easy-to-understand nutrition labeling is a promising policy strategy to address poor diet quality and prevent obesity. OBJECTIVE: This study projected the influence of nationwide implementation of sugar-sweetened beverage (SSB) warning labels and restaurant menu labeling regulations. DESIGN: A stochastic microsimulation model was built to estimate the influences of SSB warning labels and menu labeling regulations on daily energy intake, body weight, body mass index, and health care expenditures among US adults. PARTICIPANTS/SETTING: The model used individual-level data from the National Health and Nutrition Examination Survey, Medical Expenditure Panel Survey, and other validated sources. STATISTICAL ANALYSES PERFORMED: The model was simulated using the bootstrapped samples, and the means and associated 95% CIs of the policy effects were estimated. RESULTS: SSB warning labels and restaurant menu labeling regulations were estimated to reduce daily energy intake by 19.13 kcal (95% CI 18.83 to 19.43 kcal) and 33.09 kcal (95% CI 32.39 to 33.80 kcal), body weight by 0.92 kg (95% CI 0.90 to 0.93 kg) and 1.57 kg (95% CI 1.54 to 1.60 kg), body mass index by 0.32 (95% CI 0.31 to 0.33) and 0.55 (95% CI =0.54 to 0.56), and per-capita health care expenditures by $26.97 (95% CI $26.56 to $27.38) and $45.47 (95% CI $44.54 to $46.40) over 10 years, respectively. The reduced per-capita health care expenditures translated into an annual total medical cost saving of $0.69 billion for SSB warning labels and $1.16 billion for menu labeling regulations. No discernable policy effect on all-cause mortality was identified. The policy effects could be heterogeneous across population subgroups, with larger effects in men, non-Hispanic Black adults, and younger adults. CONCLUSIONS: SSB warning labels and menu labeling regulations could be effective policy leverage to prevent weight gains and reduce medical expenses attributable to adiposity.

Influence of the San Francisco, CA, Sugar-Sweetened Beverage Health Warning on Consumer Reactions: Implications for Equity from a Randomized Experiment.

BACKGROUND: In 2020, San Francisco, CA, amended an ordinance requiring warning labels on advertisements for sugary drinks to update the warning message. No studies have evaluated consumer responses to the revised message. OBJECTIVES: To evaluate responses to the 2020 San Francisco sugary drink warning label and to assess whether these responses differ by demographic characteristics. DESIGN: Randomized experiment. PARTICIPANTS AND SETTING: During 2020, a convenience sample of US parents of children aged 6 months to 5 years (N = 2,160 included in primary analyses) was recruited via an online panel to complete a survey. Oversampling was used to achieve a diverse sample (49% Hispanic/Latino[a], 34% non-Hispanic Black, and 9% non-Hispanic White). METHODS: Participants were randomly assigned to view a control label ("Always read the Nutrition Facts Panel") or the 2020 San Francisco sugary drink warning label ("SAN FRANCISCO GOVERNMENT WARNING: Drinking beverages with added sugar(s) can cause weight gain, which increases the risk of obesity and type 2 diabetes."). Messages were shown in white text on black rectangular labels. MAIN OUTCOME MEASURES: Participants rated the labels on thinking about health harms of sugary drink consumption (primary outcome) and perceived discouragement from wanting to consume sugary drinks. The survey was available in English and Spanish. STATISTICAL ANALYSES PERFORMED: Ordinary least squares regression. RESULTS: The San Francisco warning label elicited more thinking about health harms (Cohen's d = 0.24; P < 0.001) than the control label. The San Francisco warning label also led to more discouragement from wanting to consume sugary drinks than the control label (d = 0.31; P < 0.001). The warning label's influence on thinking about harms did not differ by any participant characteristics, including age, gender, race/ethnicity, education, income, or language of survey administration (all P values for interactions > 0.12). CONCLUSIONS: San Francisco's 2020 sugary drink warning label may be a promising policy for informing consumers and encouraging healthier beverage choices across groups with diverse demographic characteristics.

The impacts on food purchases and tax revenues of a tax based on Chile's nutrient profiling model.

BACKGROUND: In June 2016, Chile implemented the Law of Food Labelling and Advertising, which included a mandatory front-of-pack warning labels on food and beverages high in added sugar, saturated fat, sodium or energy density, restrictions on child-directed marketing and on the promotion and sales of these products in schools. The regulation does not include taxes although Chile had implemented a tiered tax on SSBs two years before this law was implemented. Therefore, the objective of the study was to simulate the impact of taxing food and beverages based on the cutoff's points for warning labels on purchases and revenues. METHODS: We derived price elasticities using the linear approximation of the almost ideal demand system for six groups of labeled food and beverages (with a warning label based on the regulation) and unlabeled (with no warning label): 1) unlabeled beverages, 2) labeled beverages, 3) unlabeled cereal based products, 4) labeled cereal based products, 5) labeled meat and fish and 6) labeled sweet snacks and desserts. The study used data on household food beverage purchases from the Kantar WorldPanel Chile and Euromonitor sales to adjust the Kantar elasticity results to the national average. We estimated revenues under three tax scenarios for all labeled food and beverages: 10%, 20%, 30% of the final price excluding taxes. RESULTS: Except for labeled fish and meat, all food and beverage groups were price elastic. After accounting for a reduction in consumption after the taxes, economic and population growth, revenues for all groups could reach between 457 million USD to 1.3 billion USD. These results based on the much larger tax base of these labeled "high in added sugar, salt or saturated fat or energy density" foods and beverages is much larger. CONCLUSION: This fiscal package could be implemented in countries with warning labels to enhance health and welfare. The Chilean warning label front-of-the-package system provides an important guide for countries considering policies to reduce diet-related non communicable diseases, including obesity. The fiscal policy impact alone, as shown here for Chile, will be highly impactful in reducing ultra-processed food intake and generating revenues.

Regulatory Framework of Fortified Foods and Dietary Supplements for Athletes: An Interpretive Approach.

A varied and well-planned diet can meet the nutritional needs of an athlete; however, in certain cases, it could be advisable to increase the intake of some vitamins, minerals or other components through the controlled intake of fortified foods or dietary supplements. In the European Union, a high number of sport foods and supplements are marketed; athletes could at times consume them indiscriminately or even choose products that have not been evaluated and approved by scientific evidence. In this sense, it is necessary to know and interpret the specific regulations for these products in order to make adequate use of them. The aim of this manuscript is to describe the current status of the European regulatory framework, focusing on: (1) regulation of the marketing and labelling of both fortified foods and supplements; (2) regulation of the use of substances used as ingredients in fortified foods; and (3) regulation of nutritional claims and/or health properties associated with nutrients, ingredients and other related substances. This review can facilitate knowledgeable decision making by sports nutrition professionals in order to counsel or manage adequate food choices as well as help consumers make better-informed food decisions. Other experts, such as producers who ensure food safety, might also be interested in this review.

Latin American Considerations for Infant and Young Child Formulae.

Infant formula is the only acceptable substitute for breastmilk from 0 to 6 months old when human milk cannot be provided in sufficient amounts. Manufacturers have developed options that intend to meet the changing needs of the child aged from six to twelve months (follow-on formulae) and after the age of one year (young child formulae). The international code for marketing breast milk substitute stipulates standards for marketing practices of these products. In Latin America there are local variations of marketing practices. Novel marketing strategies such as advertising through social media and influencers pose new threats for breastfeeding success in Latin America. This review aims to examine variations in local regulations for marketing of infant formulae and to analyze the emerging phenomenon of influencer advertising. We reviewed the local norms for Latin American countries and examined differences and possible gaps. Emerging evidence of influencer marketing was explored. The results indicate that national regulations differ among Latin American countries, particularly with respect to product labelling and the requirement to use a local native language, highlighting the cost of the product, and different regulations prohibiting certain messages and illustrations. Regarding new marketing strategies, there is limited evidence on advertising infant formula through social media influencers, where different categories of marketing strategies can be described. More transparent reporting of social marketing by formula providers and more independent research on novel marketing strategies are needed.

"Front-of-pack" nutrition labeling.

Excess intake of energy, sugars, salt and saturated fats is an important causal factor of obesity and related non-communicable diseases. In order to help consumers to make healthy food choices, many European countries have developed proposals for "front-of-pack" food labeling, intended as an integration to the nutritional information provided by the mandatory nutritional declaration. Based on the European strategic program "Farm to Fork", the intention is to achieve a harmonized front-of-pack label proposal by Q4 2022. Among the different proposals, the one which received most attention by experts and greater feedback by the EU member countries is the Nutri-Score, a tool based on an algorithm whereby a "quality" category ranging from A to E is assigned to each single food on a background colored from dark green to dark orange. As an alternative to Nutri-Score, the NutrInform Battery has been developed by Italy in association with a few other EU member states: this proposal is objectively alternative to the Nutri-Score proposal due to a different underlying philosophy, in particular for its informative and educational intent rather than purchase orientation. The present document, prepared by the Scientific Board and reviewed by the Scientific Council of the Italian Society of Human Nutrition, represents the scientific-based position of the Society in relation to the general theme of front-of-pack labeling and in particular to the dualism created between the Nutri-Score and NutrInform Battery proposals.

A Fit-for-Purpose Nutrient Profiling Model to Underpin Food and Nutrition Policies in South Africa.

South Africa (SA) is facing a rising prevalence of obesity and diet-related chronic diseases. The government is seeking to develop effective, evidence-based policy measures to address this. A well-designed, fit-for-purpose nutrient profiling model (NPM) can aid policy development. The aim of this study was to develop a fit-for-purpose NPM in SA. Steps included: (1) determining the purpose and target population; (2) selecting appropriate nutrients and other food components to include; (3) selecting a suitable NPM type, criteria and base; and (4) selecting appropriate numbers and thresholds. As part of the evaluation, the nutritional composition of packaged foods containing nutritional information (n = 6747) in the SA food supply chain was analyzed, a literature review was undertaken and various NPMs were evaluated. Our findings indicated that it is most appropriate to adapt an NPM and underpin regulation with a restrictive NPM that limits unhealthy food components. The Chile 2019 NPM was identified as suitable to adapt, and total sugar, saturated fat, sodium and non-sugar sweetener were identified as appropriate to restrict. This NPM has the potential to underpin restrictive policies, such as front-of-package labelling and child-directed marketing regulations in SA. These policies will support the fight against obesity and NCDs in the country.

A Graded Approach for Evaluating Health Claims about Plant-Based Food Supplements: Application of a Case Study Methodology.

The implementation of REGULATION (EC) No 1924/2006 has led to the formation of a list of health claims that can be used in food supplements (EU 432/2012). However, such supplements are often composed of plant preparations with claims omitted from this list. The peculiarity of plants is related to their long history of use, that could allow claims based on traditionally recognized health effects. In addition, the scientific literature has been enriched over the years through clinical studies that have assessed the bioavailability and efficacy of bioactive components, and investigated their mechanisms of action. Based on existing recognized models which aim to classify research according to the level of scientific evidence, Synadiet developed a three-grade model (A, B or C) for assessing plants health claims. In this paper, the applicability of the model is illustrated through an example for which a Grade B health claim attesting the possible contribution of red clover isoflavones to the improvement of blood lipid levels in postmenopausal women has been attributed. The model appears able to be easily extrapolated to claims pertaining to other plants. If adopted by consensus at European level, this model could initiate the implementation of a positive list of health claims on plant preparations.

The WHO South-East Asia Region Nutrient Profile Model Is Quite Appropriate for India: An Exploration of 31,516 Food Products.

The rapid rise in prevalence of overweight/obesity, as well as high prevalence of type 2 diabetes and other nutrition-related noncommunicable diseases, has led the Food Safety and Standards Authority of India (FSSAI) to propose a front-of-package labeling (FOPL) regulation. An effective FOPL system applies a nutrient profile model that identifies foods high in sugar, sodium, and saturated fat that would receive a warning label for consumers to effectively discern between more and less healthy foods. Previous Nutrition Alchemy data collected by the food industry (n = 1306 products) estimated that approximately 96% of foods in India would have at least one warning label based on the FSSAI proposed FOPL. This near universal coverage of warning labels may be inaccurate and misleading. To address this, the current study compared two nutrient profile models, the WHO South-East Asia Region Organization (SEARO) and the Chilean Warning Octagon (CWO) Phase 3, applied to food products available in the Indian market from 2015-2020, collected through Mintel Global New Products Database (n = 10,501 products). Results suggest that 68% of foods and beverages would have at least one ' high-in' level warning label. This study highlights the need to include a more comprehensive sample of food products for assessing the value of warning labels.

Qualitative insights into Australian consumers' views for and against government action on sugary drinks.

OBJECTIVES: Despite significant evidence of harms associated with high levels of sugar-sweetened beverage (SSB) consumption, and international moves towards regulation to curb overconsumption of such drinks, Australia has been slow to take policy action. This study provides in-depth insights into consumers' reactions to different SSB policy options. METHODS: Eight focus groups were undertaken with 59 regular SSB consumers and/or household purchasers, stratified by: young adults aged 21-29 years (no children), parents aged 35-50 (with children at home); gender; and socio-economic status. Consumer responses to potential government intervention and policy options were explored using thematic analysis. RESULTS: Three main themes were identified. Theme 1 describes participants' changing views on regulation of SSBs throughout the focus groups, expressed through shifts in understandings of personal responsibility and the role of government. It was noted that the term 'regulation' should be used judiciously, as it was widely misunderstood to infer bans. Theme 2 articulates the participants' preference for child-focused measures and educative measures such as clearer front-of-pack labelling. Taxation on SSBs was viewed more favourably if paired with investment into education. Theme 3 describes the parallels that participants drew between SSBs and other substances. CONCLUSIONS: A comprehensive approach that includes education, child-focused interventions and regulatory approaches may increase acceptability of policy measures to curb overconsumption of SSBs.

The Contribution of Foods Prepared Outside the Home to the Diets of 18- to 30-Year-Old Australians: The MYMeals Study.

Young adults are the highest consumers of food prepared outside home (FOH) and gain most weight among Australian adults. One strategy to address the obesogenic food environment is menu labelling legislation whereby outlets with >20 stores in one state and >50 Australia-wide must display energy content in kJ. The aim of this study was to assess the contribution of FOH to the energy and macronutrients, saturated fat, total sugars and sodium intakes of young Australians. One thousand and one 18 to 30-year-olds (57% female) residing in Australia's most populous state recorded all foods and beverages consumed and the location of preparation for three consecutive days using a purpose-designed smartphone application. Group means for the daily consumption of energy, percentage energy (%E) for protein, carbohydrate, total sugars, total and saturated fats, and sodium density (mg/1000 kJ) and proportions of nutrients from FOH from menu labelling and independent outlets were compared. Overall, participants consumed 42.4% of their energy intake from FOH with other nutrients ranging from 39.8% (sugars) to 47.3% (sodium). Independent outlets not required to label menus, contributed a greater percentage of energy (23.6%) than menu labelling outlets (18.7%, p < 0.001). Public health policy responses such as public education campaigns, extended menu labelling, more detailed nutrition information and reformulation targets are suggested to facilitate healthier choices.

Fifteen Years of Regulating Nutrition and Health Claims in Europe: The Past, the Present and the Future.

Suggestions that a food contains healthy ingredients or that it can provide beneficial effects upon consumption have been regulated in the EU since 2006. This paper describes the analysis of how this nutrition and health claim regulation has resulted in over 300 authorised claims and how the authorisation requirements and processes have affected the use of claims on foods. Five challenges are identified that negatively affect the current legislation dealing with nutrition and health claims: non-reviewed botanical claims (as well as on hold claims for infants and young children), the lack of nutrient profiles and the focus of claims on single ingredients, consumer understanding, research into health effects of nutrition and finally, enforcement. These challenges are shown to influence the goals of the regulation: protecting consumers from false and misleading claims and stimulating the development of a level playing field in the EU, to foster innovation. Tackling these political and scientific substantiation questions for health claims, together with continuously analysing the understanding and usage of claims by consumers and operators will ensure that the NHCR will stay effective, today and in the future.

Estimated effects of the implementation of the Mexican warning labels regulation on the use of health and nutrition claims on packaged foods.

BACKGROUND: The use of health and nutrition claims on front-of-pack labels may impact consumers' food choices; therefore, many countries have established regulations to avoid misinformation. This study describes the prevalence of health and nutrition claims on the front-of-pack of food products in retail stores in Mexico and estimate the potential effects of the Official Mexican Standards 051 (new regulation that includes specifications for implementing warning labels and other packaging elements such as health and nutrition claims on less healthy foods) on the prevalence of these claims. METHODS: This is a cross-sectional study in which health and nutrition claims, nutrition information panels, and the list of ingredients of all foods and beverages available in the main retail stores in Mexico City were collected. The products were grouped by level of processing according to the NOVA food system classification. Claims were classified using the internationally harmonized INFORMAS taxonomy. According to the criteria of the new Mexican front-of-pack labelling regulation, the effect on the reduction on the prevalence of health and nutrition claims was estimated by type of food and by energy and nutrients of concern thresholds. RESULTS: Of 17,264 products, 33.8% displayed nutrition claims and 3.4% health claims. In total, 80.8% of all products in the Mexican market were classified as "less healthy"; 48.2% of products had excess calories, 44.6% had excess sodium, and 40.7% excess free sugars. The new regulation would prevent 39.4% of products with claims from displaying health and nutrition claims (P < 0.001); the largest reduction is observed for ultra-processed foods (51.1%, P < 0.001). The regulation thresholds that resulted in the largest reduction of claims were calories (OR 0.62, P < 0.001) and non-sugar sweeteners (OR 0.54, P < 0.001). CONCLUSIONS: The new Mexican front-of-pack labelling regulation will prevent most processed and ultra-processed foods from displaying health and nutrition claims and will potentially improve information on packaging for consumers.

[Position statement on the definition of added sugars and their declaration on the labelling of foodstuffs in Spain]. / Posicionamiento sobre la definición de azúcares añadidos y su declaración en el etiquetado de los productos alimenticios en España.

INTRODUCTION: Introduction: there is currently great concern about the sugar content of food and beverages as excessive consumption is associated with a higher prevalence of chronic non-communicable diseases. In addition, there is a great deal of confusion both in published scientific data and in media reports about various concepts such as free sugars, intrinsic or endogenous sugars, and sugars added to food, as well as the type of monosaccharides and disaccharides that are part of them. The term "free sugars" refers to public health aspects whereas the term "added sugars" relates to the nutritional information included in the labelling covered by Regulation 1169/2011 as applicable to food information provided to the consumer. Material and methods: an analysis of the legislation in force in the European Union and Spain, as well as in the United States and Mexico, together with the position statements of the World Health Organization (WHO), the European Food Safety Authority (EFSA), and the Spanish Agency for Food Safety and Nutrition (AESAN), as well as their Scientific Committees on the definition and declaration of total sugars, free sugars, and added sugars. Results: added sugars are declared on the label in countries such as the United States and Mexico. In the case of the United States, there is a proposal to modify the percentage they should contribute to the diet from 10 % to 6 %. In the case of the European Union, only the reference intake for carbohydrates is established: 45-65 %, as has already been done by the Scientific Committee of AESAN. Only in the case of the ANIBES study is there an approximate figure for the consumption of added sugars by the Spanish population: 7.3 %. Conclusions: reference intakes for added sugars should be established and declared in the information provided on food product labels in order to work with reliable data in the food composition tables, and to assess their real intake by the Spanish population, and thus implement public health measures to reduce their intake in all food products containing them.

INTRODUCCIÓN: Introducción: actualmente existe una gran preocupación relacionada con el contenido de azúcares de los alimentos y bebidas ya que un consumo excesivo se asocia con una mayor prevalencia de enfermedades crónicas no transmisibles. Además, hay una gran confusión tanto en los datos científicos publicados como en las informaciones que aparecen en los medios de comunicación sobre diversos conceptos tales como azúcares libres, azúcares intrínsecos o endógenos y azúcares añadidos a los alimentos, así como sobre el tipo de monosacáridos y disacáridos que forman parte de ellos. El término azúcares libres se refiere a aspectos de salud pública mientras que el de azúcares añadidos se relaciona con la información nutricional incluida en el etiquetado regulado en el Reglamento 1169/2011, aplicable a la información alimentaria facilitada al consumidor. Material y métodos: análisis de la legislación vigente en la Unión Europea y en España, así como en Estados Unidos y México, junto con los posicionamientos de la Organización Mundial de la Salud (OMS), la European Food Safety Authority (EFSA) y la Agencia Española de Seguridad Alimentaria y Nutrición (AESAN), así como de sus comités científicos sobre la definición y declaración de azúcares totales, azúcares libres y azúcares añadidos. Resultados: los azúcares añadidos se declaran en el etiquetado en países como en Estados Unidos y México. En el caso de Estados Unidos hay una propuesta de modificación del porcentaje que deben contribuir a la dieta, pasando del 10 % al 6 %. En el caso de la Unión Europea solo está establecida la ingesta de referencia para los hidratos de carbono: 45-65 %, al igual que ya lo ha hecho el Comité Científico de la AESAN. Solo en el caso del estudio ANIBES hay un dato aproximado del consumo de azúcares añadidos para la población española: un 7,3 %. Conclusiones: se deben establecer ingestas de referencia para los azúcares añadidos y hacer que se declaren en la información del etiquetado de los productos alimenticios, para poder trabajar con datos fidedignos en las tablas de composición de alimentos y poder conocer la ingesta real por parte de la población española, y así implementar medidas de salud pública que permitan reducir la ingesta de los mismos en todos los productos alimenticios que los contengan.