A vegan dietary pattern is associated with high prevalence of inadequate protein intake in older adults; a simulation study.

Background: A more sustainable diet with fewer animal-based products has a lower ecological impact but might lead to a lower protein quantity and quality. The extent to which shifting to more plant-based diets impacts the adequacy of protein intake in older adults needs to be studied.

Objectives: We simulated how a transition towards a more plant-based diet (flexitarian, pescetarian, vegetarian, or vegan) affects protein availability in the diets of older adults.

Dutch consumers' attitude towards industrial food processing.

Industrial food processing and its possible adverse effects on health are widely debated in scientific literature and media. There is not much known about consumers' attitudes towards the processing of foods. Therefore, a questionnaire (n = 463) was distributed and interviews (n = 11) were conducted with Dutch consumers to evaluate the attitudes and associations towards industrial food processing and to assess opinions about communications on food processing and health.

Nutri-Score of Meat, Fish, and Dairy Alternatives: A Comparison between the Old and New Algorithm.

Nutri-Score is a front-of-pack label that visualizes the nutritional quality of food products from most healthy (A, dark green) to least healthy (E, red). However, concerns have been raised about discrepancies between Nutri-Score labels and dietary recommendations. Therefore, the Nutri-Score algorithm has recently been adapted.

Cross-Sectional Study to Map Nutritional Quality of Meat, Fish, and Dairy Alternatives in Dutch Supermarkets According to the Dutch Food-Based Dietary Guidelines and Nutri-Score.

Due to a growing challenge to feed the world's population and an increased awareness to minimize the impact of our food choices on climate change, a more plant-based diet has gained popularity with a growing number of plant-based products on the market. To stimulate a plant-based diet that also improves long-term health, data are needed to monitor whether these products are healthy alternatives to animal-based foods. Therefore, this study inventoried 916 plant-based meat, fish, and dairy alternatives from eight Dutch supermarkets.

Modelling health and economic impact of nutrition interventions: a systematic review.

Diet related non-communicable diseases (NCDs), as well as micronutrient deficiencies, are of widespread and growing importance to public health. Authorities are developing programs to improve nutrient intakes via foods. To estimate the potential health and economic impact of these programs there is a wide variety of models.

Comparison between the Choices Five-Level Criteria and Nutri-Score: Alignment with the Dutch Food-Based Dietary Guidelines.

The current food environment in The Netherlands is considered obesogenic. Eighty percent of the products in supermarkets are unhealthy. The Wheel of Five is the well-established, science-based Dutch food-based dietary guideline (FBDG) developed to stimulate healthier choices.

The Nutri-Score algorithm: Evaluation of its validation process.

The Nutri-Score front-of-pack label, which classifies the nutritional quality of products in one of 5 classes (A to E), is one of the main candidates for standardized front-of-pack labeling in the EU. The algorithm underpinning the Nutri-Score label is derived from the Food Standard Agency (FSA) nutrient profile model, originally a binary model developed to regulate the marketing of foods to children in the UK. This review describes the development and validation process of the Nutri-Score algorithm.

Low awareness of community-dwelling older adults on the importance of dietary protein: new insights from four qualitative studies.

Meeting the recommended daily protein intake can be a challenge for community-dwelling older adults (CDOA). In order to understand why, we studied attitudes towards protein-rich products and healthy eating in general; identified needs and preferences, barriers and promotors and knowledge regarding dietary behaviour and implementation of high protein products. Attitudes towards protein-rich products and healthy eating were evaluated in focus groups (study 1, 17).

Protein Intake among Community-Dwelling Older Adults: The Influence of (Pre-) Motivational Determinants.

An adequate protein intake is important for healthy ageing, yet nearly 50% of Dutch community-dwelling older adults do not meet protein recommendations. This study explores protein intake in relation to eight behavioral determinants (I-Change model) among Dutch community-dwelling older adults. Data were collected through an online questionnaire from October 2019-October 2020.

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.

What Is on the Menu?-A Quantitative Analysis on Label Format among (Potential) Restaurant Guests and Restaurant Owners.

About 20% of energy intake in the Netherlands is consumed out-of-home. Eating out-of-home is associated with higher energy intake and poorer nutrition. Menu labeling can be considered a promising instrument to improve dietary choices in the out-of-home sector.

The protein gap-increasing protein intake in the diet of community-dwelling older adults: a simulation study.

Objective: Approximately 50 % of Dutch community-dwelling older adults does not meet protein recommendations. This study assesses the effect of replacing low protein foods with protein-rich alternatives on the protein intake of Dutch community-dwelling older adults.

Design: The Dutch National Food Consumption Survey-Older Adults 2010-2012 (DNFCS-OA) was used for scenario modelling.

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.

What do screening tools measure? Lessons learned from SCREEN II and SNAQ.

Background: Over the last decade, different screening tools for malnutrition have been developed. Within these tools, a distinction can be made between tools that assess nutritional risk and tools that assess protein energy malnutrition. Insights in differences in characteristics of participants at risk and in differences in prevalence rates will aid in deciding which tool(s) to use in daily practice.

The ConsuMEER study: a randomised trial towards the effectiveness of protein-rich ready-made meals and protein-rich dairy products in increasing protein intake of community-dwelling older adults after switching from self-prepared meals towards ready-made meals.

The risk of undernutrition in older community-dwelling adults increases when they are no longer able to shop or cook themselves. Home-delivered products could then possibly prevent them from becoming undernourished. This single-blind randomised trial tested the effectiveness of home-delivered protein-rich ready-made meals and dairy products in reaching the recommended intake of 1·2 g protein/kg body weight (BW) per d and ≥25 g of protein per meal.

Consumer Distrust about E-numbers: A Qualitative Study among Food Experts.

Food additives (E-numbers) are allowed in foods, but many consumers have a negative perception of them. The objective was to study the opinion of food experts about the causes and ways to reduce consumer distrust about E-numbers. Thirteen food experts from universities, research institutes, the government, food industry organisations, media, a nutrition information organisation, a consumer association and two other non-governmental organisations (NGOs) were interviewed with a semi-structured topic list, based on a model of risk perception.

Reformulation as an Integrated Approach of Four Disciplines: A Qualitative Study with Food Companies.

In 2014, the Dutch government agreed with the food sector to lower salt, sugar, saturated fat and energy in foods. To reformulate, an integrated approach of four disciplines (Nutrition & Health, Food Technology, Legislation, and Consumer Perspectives) is important for food companies (Framework for Reformulation). The objective of this study was to determine whether this framework accurately reflects reformulation processes in food companies.

Nutrient profiling for front of pack labelling: how to align logical consumer choice with improvement of products?

The primary goal of front of pack (FOP) labelling is to help consumers make healthier choices through communication. A secondary goal is to encourage producers to improve the nutritional composition of their products. Evidence has shown that (FOP) labelling can help consumers to make healthier food choices and has been an incentive for producers to improve product composition.

Clinical Outcome of Patients With De Novo C1q-Binding Donor-Specific HLA Antibodies After Renal Transplantation.

Background: De novo donor specific anti-HLA antibodies (dnDSA) may cause graft loss in renal transplant recipients. The capability to bind the complement may help to stratify the risk for inferior outcomes associated with dnDSA. We developed a modified C1q-binding assay and hypothesized that C1q-binding dnDSA could differentiate between indolent and harmful dnDSA causing antibody-mediated rejection (AMR) and graft loss.

The use of food composition data in the Choices International Programme.

Food composition data have extensively been used in the Choices International Programme: they formed the basis of both criteria development and nutrient intake modeling. Criteria were developed for key nutrients linked to non communicable diseases by an independent scientific committee. The criteria can be used for the logo assignment on food products, in order to stimulate producers to improve their products and to stimulate consumers to purchase these products.

Modelling of usual nutrient intakes: potential impact of the choices programme on nutrient intakes in young dutch adults.

Introduction: The Choices Programme is an internationally applicable nutrient profiling system with nutrition criteria for trans fatty acids (TFA), saturated fatty acids, sodium, added sugar and for some product groups energy and fibre. These criteria determine whether foods are eligible to carry a "healthier option" stamp. In this paper a nutrient intake modelling method is described to evaluate these nutritional criteria by investigating the potential effect on nutrient intakes.

Methodological quality of front-of-pack labeling studies: a review plus identification of research challenges.

This review evaluates the methodological quality of current front-of-pack labeling research and discusses future research challenges. Peer-reviewed articles were identified using a computerized search of the databases PubMed and Web of Science (ISI) from 1990 to February 2011; reference lists from key published articles were used as well. The quality of the 31 included studies was assessed.

Consuming a diet complying with front-of-pack label criteria may reduce cholesterol levels: a modeling study.

Background/objectives: Front-of-pack nutrition labels can help consumers to make healthier choices and stimulate healthier product development. This is the first modeling study to investigate the potential impact on cholesterol levels of consuming a diet consisting of products that comply with the criteria for a 'healthier choice logo'.

Subjects/methods: National food consumption and food composition data were used to estimate the nutrient intake of the Dutch adult population (18-70 years) before and after replacing foods that did not comply with the choices front-of-pack label criteria.

Development of international criteria for a front of package food labelling system: the International Choices Programme.

Background: A global push to reduce the amount of saturated and trans-fatty acids, added salt and sugar in processed food, and to enhance fruit, vegetable and whole grain intake, while limiting energy intake, exists for most populations.

Objectives: To redesign the International Choices Program (note: this is unrelated to the US Smart Choices Program), initially Netherlands focused, by an international board of scientists to create a generic, global front-of-pack nutrition logo system that helps consumers make healthier food choices and stimulates product reformulation.

Methods: The Programme is a product-group-specific-nutrient-profiling approach with a distinction between basic and discretionary foods.

Potential effects of nutrient profiles on nutrient intakes in the Netherlands, Greece, Spain, USA, Israel, China and South-Africa.

Introduction: Nutrient profiling is defined as the science of categorising foods based on their nutrient composition. The Choices Programme is a nutrient profile system with criteria that determine whether foods are eligible to carry a "healthier option" stamp. The Daily Menu Method which has been developed to evaluate these criteria is described here.