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.

Study Protocol of a Multicenter Randomized Controlled Trial to Tackle Obesity through a Mediterranean Diet vs. a Traditional Low-Fat Diet in Adolescents: The MED4Youth Study.

Youth obesity is a strong predictor of adult obesity, which has well-known negative health consequences. Thus, addressing adult obesity requires tackling youth obesity. MED4Youth's main objective is to strengthen the link between the Mediterranean Diet (MD) and the health benefits against youth obesity and associated cardiovascular disease (CVD) risk factors, identifying positive effects exerted by an MD including sourdough bread and healthy products from the Mediterranean basis (chickpeas/hummus, nuts, and pomegranate juice). For this purpose, a multicenter randomized controlled trial in which an MD-based intervention will be compared to a traditional low-fat diet intervention will be carried out with 240 overweight and obese adolescents (13-17 years) from Spain, Portugal, and Italy. Both interventions will be combined with an educational web-application addressed to engage the adolescents through a learning-through-playing approach, using both educational materials and games. To assess the interventions, adherence to the MD, dietary records, physical activity, food frequency, sociodemographic, and quality of life questionnaires as well as classical anthropometric and biochemical parameters will be evaluated. Furthermore, an omics approach will be performed to elucidate whether the interventions can shape the gut microbiota and gut-derived metabolites to gain knowledge on the mechanisms through which the MD can exert its beneficial effects.

The Role of Individual Knowledge in Functional Olive Oil Preferences: Does Self-Coherence Lead to Different Health Attributes Perception?

This study examined whether health cues influence the choices of olive oil consumers with different degrees of knowledge about the nutritional properties of olive oil. To this end, a direct survey on the consumption of healthy extra-virgin olive oil was implemented by examining the stated preferences of a sample of consumers. Two econometric analyses were carried out to identify the drivers of the consumption of olive oil with high polyphenol content. The logistic model was chosen as the most suitable method to answer the research questions. The results revealed a general consensus among consumers regarding the beneficial properties of olive oil consumption. Moreover, the findings show that different degrees of individual knowledge act as distinctive drivers in influencing the health perception of olive oil consumers. Finally, this study verified that, even for healthy foods, consumers' choices are strongly dependent on their own self-coherence. As a consequence, consumers' knowledge or beliefs that orientate their attitudes are influenced by different motivations and attributes.