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18 Jan 2024
4 min read
Echoes from FENS 2023 Expert interviews

Bioavailability of micronutrients from whole foods, by Dr Alida Melse Boonstra

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Dr. Alida Melse-Boonstra from Wageningen University in the Netherlands delved into the crucial topic of “Bioavailability of Micronutrients from Whole Foods: Zooming In on Dairy, Fruit, and Vegetables.”

Bioavailability of Micronutrients from Whole Foods, briefly

Bioavailability is defined as the fraction of nutrient absorbed from the diet and used for physiological function or storage (retained in body). Bioavailability is an important intermediate between dietary intake and requirements, involving both food-related factors (such as the amount of nutrient, food matrix or food processing…) and host-related factors (gut health, body composition, infectious diseases, genetics…)

How to assess bioavailability?

Various methods exist to assess micronutrient bioavailability:

  • In vitro techniques, designed to simulate the in vivo environment, are based on a simulated digestion process and assess element availability. While fast, inexpensive, and highly controllable, they have limitations as they only provide a proxy for in vivo bioavailability.
  • In vivo techniques (conducted in animals or humans) use various methods (chemical balance, isotopic…) and are quantitative but more complex, expensive, and less controllable.

Milk, dairy, fruits and vegetables

Delving deeper, the focus shifted to the micronutrient bioavailability from milk and dairy, compared to that from vegetables and fruits.

Both milk and dairy as well as vegetables and fruits are nutrient-dense foods that provide nutrients which impact human metabolism and health. They contain a myriad of nutrients, for some of which the bioavailability is now well-understood, whereas others still require further study. They also contain many bioactive components and have a complex matrix, which affect the kinetics of nutrient release, absorption, and bioavailability.

For example, we observe that milk for instance enhances the absorption of zinc from rice, which contains phytate, an anti-nutrient that may inhibit the absorption of zinc or iron. In the same way, guava fruit enhances the absorption of iron, but not of zinc, from a rice-based meal.

Key Messages:

  • Bioavailability is a vital intermediate between dietary intake and nutritional requirements.
  • Milk and dairy products generally contain many enhancers and few inhibitors of nutrient absorption and bioavailability.
  • Vegetables and fruits, with food matrix complex structures, may impede nutrient absorption.
  • Nutrient bioavailability is not a fixed number but a result of the complex interplay between food-related and host-related factors.

Dr. Alida Melse-Boonstra’s insights underscore the intricate dynamics that shape the bioavailability of micronutrients from whole foods.

Source: Melse-Boonstra A. Bioavailability of Micronutrients From Nutrient-Dense Whole Foods: Zooming in on Dairy, Vegetables, and Fruits. Front Nutr. 2020 Jul 24;7:101. doi: 10.3389/fnut.2020.00101. PMID: 32793622; PMCID: PMC7393990.

Learn more with Alida Melse-Boonstra

Hello, can you introduce yourself?

A. Melse-Boonstra: I’m Alida Melse-Boonstra, an associate professor at the Division of Human Nutrition and Health at Wageningen University in The Netherlands.

Can you tell us what would qualify the challenge of studying bioavailability?

A. Melse-Boonstra: Studying bioavailability poses significant challenges, requiring meticulous planning and study design. The complexity, technical demands, and associated costs make these studies inaccessible to everyone. Fortunately, organizations like the International Atomic Energy Agency offer crucial support, both technically and financially, making these studies feasible. Nevertheless, conducting in vivo studies on bioavailability remains inherently challenging.

You presented some data about bioavailability in dairy. How does the bioavailability of different micronutrients vary among dairy products, and which factors contribute to these differences?

A. Melse-Boonstra: Each micronutrient possesses unique and intricate properties, influenced by its chemical characteristics. Divalent metals, for example, exhibit a consistent pattern in their behavior concerning enhancers and inhibitors. However, other nutrients showcase distinct chemical properties.

Variations exist within different dairy products. Factors such as acidic conditions prove advantageous for divalent metals, while fermentation products can stimulate the absorption of certain vitamins, like vitamin K. The matrix of a food, including these differences, plays a defining role in how a specific nutrient is absorbed.

Dr. Alida Melse-Boonstra is currently an Associate Professor at the Division of Human Nutrition, Wageningen University & Research. She focuses her research on new and sustainable solutions for micronutrient malnutrition in low- and middle-income countries. She studies vitamin A, iron, iodine and zinc deficiencies in relation to growth and health in vulnerable population groups such as pregnant women, infants, children and adolescents. She applies various stable isotope dilution technique to assess nutrient status and absorption. Major highlight of her research during the past few years is the research on biofortified cassava in Kenya and in Nigeria

15 Jan 2024
4 min read
Athletes Nutri-dense food

Could yogurt proteins be the key to good muscle health?

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Yogurt is widely known for its health benefits. Being a nutrient dense food, it is packed with vitamins, minerals such as calcium, and proteins.  The physical and biological properties of milk proteins in yogurt differ from those in raw milk,  which could improve their digestibility.

Because consuming proteins that are both digestible and easily absorbed is necessary for muscle mass maintenance, yogurt could be an interesting source of proteins.  As a high-quality protein source, milk has been extensively studied for its benefits on muscle health, but the role of milk proteins in yogurt remains unclear (1).

The digestion & absorption of yogurt proteins may be better than that of milk proteins

Milk mainly contains two kinds of proteins: casein and whey protein.

When making yogurt, milk undergoes heat treatments and lactic acid fermentation, both of which partially break down these proteins, potentially making them easier to absorb and digest.

Some studies reported a slower absorption rate of protein in yogurt than in milk. This could be due to the yogurt’s longer gastric emptying because of its higher viscosity compared with milk. Thus, yogurt processing ensures low viscosity for an optimal absorption.

On the other hand, studies examining blood Total Amino Acids (TAA) after dairy consumption reported higher TAA after yogurt or fermented milk absorption than raw milk (2). Similar results were found for unfermented milk acidified by the addition of lactic acid.

These findings suggest a role of yogurt acidity and texture in improving proteins absorption and digestion.

Yogurt proteins intake may enhance muscle protein synthesis  

Interventional studies using marked amino acid to track Muscle Protein Synthesis (MPS) after meals found more marked amino acid incorporation into muscle proteins after consuming yogurt than with unfermented milk or unfermented acidified milk, suggesting an improved MPS. This was consistent with a higher increase of blood amino acids after yogurt ingestion (3).

After meals, the increase in blood amino acid and insulin stimulates skeletal MPS by triggering two cellular pathways (PI3K/ Akt mediated pathways). Interestingly, studies showed an increased activation of these pathways after consuming yogurt compared to unfermented milk.

While these studies suggest an acute post-meal MPS enhancement, other studies yielded more contrasted results regarding long-term yogurt consumption and its association with skeletal muscle mass maintenance or increase.

Yogurt could be beneficial for muscle health via lactic fermentation

In addition to being a good protein source, yogurt could help muscle via lactic fermentation and the gut-muscle axis – the relationship between intestinal microbiota and skeletal muscle.

Studies investigating the relationship between intestinal microbiota and muscle mass have reported a positive correlation between the presence of lactic acid bacteria in intestinal microbiota and muscle mass (4).

And according to a recent review, the age-related gut microbiota disruption and the increased intestinal permeability might explain the decreased protein absorption and chronic inflammation resulting in sarcopenia (age-related loss of skeletal muscle mass). Additionally, lactic bacteria produce bioactive peptides during fermentation that might exert anti-inflammatory effects and thus improve MPS (5).

However, while probiotics supplementation with lactic acid bacteria and bifidobacteria enhanced both muscle mass and strength, no study was conducted using S. thermophilus and L. delbrueckii subsp. bulgaricus supplementation – the bacteria used for yogurt production.

While these findings are promising, further studies are needed to establish a clear link between yogurt consumption and muscle health benefits.

“Among the dairy foods considered a high-quality protein source, yogurt may be a particularly good source for increasing muscle mass […]. However, since there is little solid evidence for this benefit of yogurt, especially in humans, further efforts are needed. – ”Sumi K, et al – 2023

Source (1) : Sumi K.,Tagawa R., Yamazaki K., Nakayama K., Ichimura T., Sanbongi C., Nakazato K., Nutritional Value of Yogurt as a Protein Source: Digestibility/ Absorbability and Effects on Skeletal Muscle. Nutrients 2023, 15, 4366. https://doi.org/10.3390/ nu15204366

Additional references:

(2) Horstman A.M.H.; Ganzevles R.A.; Kudla U.; Kardinaal A.F.M.; van den Borne J.J.G.C.; Huppertz T. Postprandial bloodamino acid concentrations in older adults after consumption of dairy products: The role of the dairy matrix. Int. Dairy J. 2021, 113, 104890

(3) Ato S.; Fujita S. Regulation of muscle protein metabolism by nutrition and exercise. J. Phys. Fit. Sports Med. 2017, 6, 119–12

(4) Liu C.; Cheung W.H.; Li, J.; Chow S.K.; Yu J.; Wong S.H.; Ip M.; Sung J.J.Y.; Wong R.M.Y. Understanding the gut microbiota and sarcopenia: A systematic review. J. Cachexia Sarcopenia Muscle 2021, 12, 1393–1407.

(5) De Marco Castro E.; Murphy C.H.; Roche H.M. Targeting the Gut Microbiota to Improve Dietary Protein Efficacy to Mitigate Sarcopenia. Front. Nutr. 2021, 8, 656730.

11 Jan 2024
5 min read
Benefits for planet health

Consumer interest in healthy and sustainable diets by Wim Verbeke

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The 14th European Nutrition Conference (FENS) took place in November in Belgrade, and we were there to cover and share with you some insightful topics.

In the session “Plant-based Diets: Transition to a Healthy Plate and Planet,” Professor Wim Verbeke from Ghent University focused specifically on consumer interest in health and sustainable diets.

Consumer Interest in Health and Sustainable Diets, briefly:

The consumer expectations in food production and products are growing, driven by a heightened awareness of the interconnection between dietary habits, environmental impact, and health outcomes. Integrating health and sustainability goals has become a crucial focus, acknowledging the potential for developing diets that are both environmentally sustainable and healthy. The success of such diets, however, hinges on consumers’ willingness and ability to change their behavior.

Investigating the consumer perceptions of the match between healthy and sustainable diets may help build accurate insights into consumers’ motivation to eat healthily and sustainably.

In a study  assessing consumers’ involvement in healthy and sustainable eating, four distinct consumer segment profiles have been identified (1):

  • uninvolved segment,
  • moderately involved,
  • involved in healthy eating
  • the health and sustainability involved segment.

Approximately half of the participants demonstratedhigh involvement in healthy eating, with one-third showing interest in both healthy and sustainable eating.

Consideration of consumers’ levels of involvement in health and sustainability is essential for targeted and effective interventions. Informational food policy actions targeting both healthy and sustainable food consumption behaviors are recommended. Tailoring strategies to address the preferences and concerns of different consumer segments is crucial.

The images of a healthy diet, a sustainable diet, and a plant-based diet are perceived as highly compatible among European consumers and the strong match between perceptions of health and sustainability concepts suggests a convergence in consumer understanding.

Key Messages :

  • Consumers have increasingly high expectations related to various attributes of food, including health, taste, environment, and safety.
  • A multitude of factors, including health and sustainability considerations, shape consumers’ food choice decisions.
  • There is a robust alignment between the concepts of “health” and “sustainability” in consumers’ perceptions.

Professor Wim Verbeke’s insights underscore the nuanced and diverse nature of consumer preferences, emphasizing the importance of understanding and addressing individual motivations and levels of involvement in order to promote healthy and sustainable eating

Source: Van Loo E, Hoefkens C, Verbeke W, Healthy, sustainable and plant-based eating: Perceived (mis)match and involvement-based consumer segments as targets for future policy, Food Policy, 2017, 69:46-57

Learn more with Prof. Wim Verbeke

Hello, can you introduce yourself?

Wim Verbeke: I’m Wim Verbeke. I’m a professor of agro-food marketing and consumer behavior at Ghent University in Belgium. I’m a bioscience engineer, so I have a background in natural sciences and also an MBA in marketing management. I combine natural and social sciences backgrounds. Most of my research is on food consumer behaviors, consumer decisions related to food safety, nutrition, health, sustainability.

Regarding the consumers, how can we address them to promote a plant-based sustainable diet?

Wim Verbeke: Effective communication for promoting a plant-based sustainable diet must be tailored to the specific needs and interests of consumer groups. As I discussed in the presentation, there are segments, groups of consumers that are absolutely not interested. In my opinion, it makes little sense to target your communication to those groups, but what matters really is those segments that are still a little bit undecided. There is a group of people who are enthusiastic about protein transition and novelties, who are already convinced. These segments deserve focused attention and communication efforts.

And what are the barriers that these segments encounter and why don’t they go further?

Wim Verbeke: Barriers vary widely based on product type and consumer preferences.

The barrier can be unfamiliarity, so that means if you can make those people familiar with the product, they may be keener on trying it. For some, it will be the fear of trying something new and for others, there is skepticism about health benefits, or an interest in sustainability. In that case, providing knowledge may help.

It’s really depending on the segment, on the product, on the person to some extent as well and making information available is really crucial.

During the FENS congress, we saw another presentation made by Esther Papies, where the key message was that we communicate a lot about sustainability and health and that we should communicate more about the taste and enjoyment of plant-based food. Do you think it could help the very hesitant or target?

Wim Verbeke: In those segmentation studies, some groups prioritize taste and pleasure. Offering a clear promise and convincing them about the delightful aspects of plant-based products, through opportunities to taste, can be effective.

Others may be willing to compromise a bit on taste for the promise of a healthier product. It all depends on the specific consumer segment.

In your presentation, you mentioned that elderly consumers are more interested in plant-based protein. Did you mean raw products like beans, or more processed foods?

Wim Verbeke: In the study, the focus was on alternative proteins, not specifically defined as plant-based proteins. Elderly consumers tended to think more about raw products, possibly associating with pulses and legumes, which they might be more familiar with than younger generations. Their interest leaned towards raw products rather than ingredients like powders found in protein shakes.

Wim Verbeke is professor at Faculty of Bioscience Engineering at the Ghent University, Belgium. His research disciplines are Agricultural and natural resource economics, environmental and ecological economics, consumer behavior, market research and marketing.

09 Jan 2024
4 min read
Benefits for human health Echoes from FENS 2023 Expert interviews

How to talk about plant-based foods by Esther Papies

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The 14th European Nutrition Conference (FENS) took place in November in Belgrade, and we were there to cover and share with you some insightful topics.

In the sessions on “Nutrition and the Environment, Sustainability, and Biodiversity,” Dr. Esther Papies from the University of Glasgow in Scotland addressed the crucial theme of “Sustainable Consumption in Practice,” focusing specifically on effective communication about plant-based foods.

“How to Talk About Plant-Based Food”, briefly

As the global community grapples with the escalating health implications of climate change, it has become an urgent public health concern worldwide. The imperative to limit global warming between 1.5°C and 2°C implicated swift and substantial reductions in greenhouse gas (GHG) emissions. Food systems play a pivotal role in GHG emissions, varying depending on the type of food produced and consumed. Notably, meat tops the list in emissions, while vegetables, fruits, and pulses have a lower environmental impact.

Climate change’s ramifications extend to food systems and security, introducing challenges such as agricultural droughts and heat stresses. Simultaneously, demographic trends indicate a growing global population, placing increased stress on food production.

Addressing these challenges calls for a shift towards more sustainable diets, emphasizing the reduction of meat consumption and an increase in plant-based foods. Dr. Papies highlighted the need for a focus on consumption and reward simulations to enhance the appeal of plant-based foods.

Key messages:

  • Both vegans and omnivores approach plant-based and meat-based foods in terms of consumption and reward.
  • Despite this, food packages and social media posts tend to use less consumption and reward language for plant-based foods, even when created by or for vegans.
  • Plant-based foods are often presented in ways that diminish their appeal.
  • To generate desire, there is merit in describing food in terms of the experience of eating it.

This discussion underscores the critical role of effective communication in promoting sustainable dietary choices, particularly the need for positive framing and emphasis on the positive aspects of plant-based food consumption.

Learn more with Esther Papies

Hello, can you introduce yourself?

Esther Papies: My name is Ester Papies, and I’m an associate professor in the Social and Public Health Sciences Unit at the University of Glasgow.

How does the way of communicating about plant-based foods impact consumption habits?

Esther Papies: The communication around plant-based foods, in supermarkets, on pack or on social media, often revolves around health, nutrition, and dietary groups, For instance, vegan meals are typically presented in terms of ingredients, nutrients, and preparation methods. However, we know that these factors don’t necessarily drive people’s motivation to consume.

When individuals choose a food, they are concerned about the taste experience, the pleasure derived from it, and the overall reward. Emphasizing those components in foods and especially in plant-based foods, which are often novel to consumers, will make it more appealing for people to try out.

This involves focusing on the overall experience, including taste, mouthfeel, temperature of the food, the social context of consumption, and the immediate emotional impact. Instead of highlighting long-term consequences, the focus should be on the immediate reward.

While this approach may not drastically change existing habits, it can entice people to try new foods. Once individuals give them a chance, they often discover a liking for these options, facilitating a shift in dietary habits.

What would be the Do’s and Don’ts when communicating about plant-based food?

Esther Papies: When communicating about plant-based food, it’s advisable not to overly focus on health and sustainability. While educating consumers about the current Western diet’s impact on health and the environment is important, it’s not the primary driver of food choices at the moment.

Ideally, the emphasis should be on the immediate pleasure derived from consuming plant-based foods. Depicting these foods in consumption settings that inspire enjoyment and positive feelings is crucial. Visuals, such as photographs, should convey the pleasure of eating and be complemented by language emphasizing immediate benefits and enjoyment, rather than solely focusing on health or sustainability benefits.

Esther Papies’ research addresses the cognitive processes underlying the regulation of behavior and behavior change, especially in the domains of health and climate change. Together with her team in Healthycognitionlab.org, she examines the social and psychological processes in the transition to a healthier, more sustainable and more equitable society, with a special focus on food and eating behavior. 

08 Jan 2024
6 min read
Healthy Diets & Lifestyle Publications

Eating yogurt is associated with healthier diet and lifestyle

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Regular yogurt consumers of all ages tend to eat and live healthily. They are less likely to eat unhealthy foods, or smoke or drink alcohol to excess, and are more likely to exercise regularly than people who don’t.

Regular yogurt consumers tend to choose healthy diets

Yogurt consumption is associated with better diet quality, measured using validated indices of healthy eating, among both children and adults in the USA, Canada and Europe.

Regular yogurt consumers are less likely to consume unhealthy food and more likely to stick to dietary guidelines than non-consumers.

In adults

Compared with those who eat little or no yogurt, people who eat yogurt frequently have a better diet quality and tend to follow dietary guidelines more closely.

Yogurt consumers score more highly on the Healthy Eating Index (HEI) than non-consumers, which could be partly explained by a significant increase in fruit, grain and dairy consumption.

Yogurt consumers are more likely to have a diet with more fruits, vegetables, nuts, legumes, fish and seafood, and fewer fast foods such as French fries and fried foods, processed and red meats, pizza, snacks, soft drinks and alcohol.

People who frequently consume yogurt have higher nutrient intakes than those who do not often eat yogurt even when yogurt is not a source of these nutrients.  Hence frequent yogurt consumers (at least one serving per day) have been found to have higher intakes of folic acid, copper, manganese and iron.

Both in children and in adults (in Spain and the USA), swapping high-calorie, nutrient-poor snacks for full fat yogurt with fruit could help boost key nutrients and improve dietary quality without contributing to dietary excess and obesity.

In children

Young children who regularly consume yogurt have a better diet quality and the overall nutrient content of their diets is higher than those who don’t.

The diets of children who eat yogurt regularly are better overall than non-consumers – they consume more fruit, whole grains and total dairy  and fewer fatty foodsDiet quality among children and adults who are yogurt consumers vs non-consumers - YINI

Yogurt consumption is a marker of a healthier lifestyle

Numerous studies suggest yogurt consumption is also a signature of a healthy lifestyle. Compared with people who do not eat yogurt, those who do consume yogurt:

  • are generally healthier and leaner. They also tend to be more highly educated and of higher socioeconomic status.
  • show healthier non-nutritional behaviour: they are less likely to smoke, tend to drink less alcohol and are more likely to be physically active in their leisure time than non-consumers.
  • tend to have a better health-related quality of life and mental health.
Yogurt consumption is linked to a healthier diet and lifestyle

Children who regularly consume milk and yogurt are more likely than those who don’t to engage in healthy lifestyle behaviours with more physical activity and less sitting in front of a screen.

“Yogurt consumption is a signature of healthy living. Compared with non-consumers, people who regularly eat yogurt tend to have better diet quality, have a more active lifestyle, drink less alcohol, and are less likely to smoke. “

Professor Angelo Tremblay

Sources:
02 Jan 2024
5 min read
Benefits for human health Echoes from FENS 2023 Expert interviews

Can everyone afford a healthy and sustainable diet? by Bhavani Shankar

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The 14th European Nutrition Conference (FENS) took place in November in Belgrade, and we were there to cover and share with you some insightful topics.

In the “Nutrition and the Environment, Sustainability, and Biodiversity” sessions, Dr. Bhavani Shankar from the University of Sheffield, UK, addressed the critical question: ‘Can everyone afford a healthy and sustainable diet?’

“Can Everyone Afford a Healthy and Sustainable Diet?”, briefly

Poor diets significantly contribute to the global burden of disease, and current dietary patterns pose negative environmental implications.

The challenge lies in enhancing diets to benefit both human health and the health of the planet.

A healthy diet meeting WHO norms can reduce greenhouse gas emissions by 17%. However, achieving further emission reductions necessitates additional decreases in meat, dairy, and soft drinks consumption, coupled with increases in vegetables, beans, pulses, and nuts.

Historically, the primary focus has been on health aspects, including WHO dietary norms and specific health outcome targets. The recent shift towards reference diets aims to address both health and sustainability through restricted categories of foods (e.g., vegetarian, vegan, flexitarian, pescatarian) and diets like the EAT-Lancet diet.

The affordability of sustainable diets poses a significant question:

  • Ensuring sufficient energy intake at low cost is a priority for lower-income consumers and countries.
  • Many key food groups for healthy and sustainable diets are expensive sources of calories (e.g., fruits and vegetables).
  • Conversely, some less healthy food groups are cheaper sources of calories (oils, fats, sugar).
  • In lower-income countries, nutritious foods are often more expensive than in higher-income countries.

When assessing the affordability of the EAT-Lancet diet, it becomes evident that for 1.58 billion people, mainly in lower-income countries, even the lower bound planetary health diet exceeds total income. Fruits and vegetables account for the highest proportion of diet costs globally (31%), followed by animal source foods (28%), and legumes and nuts (19%). On average, the EAT Lancet diet is 60% more costly than a diet that simply meets essential nutrient requirements.

Key Messages :

  • Environmental co-benefits from healthier diets present a real opportunity for action.
  • The global relative costs of nutrient-dense foods, especially in low-income countries, are high.
  • Integrating sustainability considerations alongside health aspects increases diet costs.
  • Many people, particularly in low-income countries, cannot afford sustainable healthy diets.
  • Challenges also exist in high-income countries, particularly for low-income households.

Dr. Bhavani Shankar’s insights highlight the intricate balance needed to make healthy and sustainable diets accessible to all, emphasizing the economic challenges.

Learn more with Bhavani Shankar

Hello, can you introduce yourself?

Bhavani Shankar: Hi, I’m Bhavani Shankar, a professor of food systems, nutrition, and sustainability. I work as an applied economist at the University of Sheffield in the UK, engaging in interdisciplinary research that spans food systems, nutrition, and various related fields.

What are the limits to making a sustainable diet accessible and affordable to all?

Bhavani Shankar: There are several barriers, particularly when viewed through an economic lens.

The relative prices of nutrient-dense foods, such as animal source foods or fruits and vegetables, are often prohibitively high in low-income settings.

We have to take them from a situation of being a luxury to being something that’s affordable in a mainstream way to all the people. Nutrition and diet quality cannot be a rich person’s indulgence. It has to be something that’s accessible to all.

And I think that we can elaborate all the possible diets that will meet planetary and health aspects. But until we get people to move towards those diets, it’s very difficult, and there’s an economic aspect to it.

Overcoming this challenge involves addressing economic, behavioral, and knowledge-related difficulties that people face in understanding and adopting sustainable diets.

You talk about working in an interdisciplinary team. Why is it important to work with others and to work together?

Bhavani Shankar: It is crucial because food consumption and food systems inherently involve multiple disciplines. As an economist, I might analyze income and prices, but understanding behavioral change and knowledge barriers requires collaboration with psychologists, food scientists, and food technologists. Different disciplines have distinct languages and methodologies, making interdisciplinary teamwork essential for tackling complex issues like sustainable food systems.

At the end of your presentation, you presented some solutions. What were they?

Bhavani Shankar: To make nutritious diets available to everyone, we need income support for the poorest individuals, as their lack of income is a major hurdle to accessing expensive yet nutritious diets Another aspect is to lower the prices of nutrient-dense foods. We need to make them cheaper somehow, and to do so, we can, for example:

  • invest in agriculture and horticulture related to these nutrient dense foods.
  • develop more R&D in these areas, not only focused on wheat, maize and rice but actually think about nutrient dense foods, like fruits and vegetables or dairy for example
  • develop infrastructure in order to have less food waste, because the most nutritious foods are also the most perishable ones and it spoils very quickly. Unless you have the infrastructure, the block chains and the market capacity to handle these foods, you will lose a lot of food. This keeps the prices high and the availability low.

Bhavani Shankar’s current research interests include sustainable diets, climate and nutrition-sensitive food systems, food and nutrition policy evaluation and inequities in food systems and nutrition. Much of his work is of an interdisciplinary nature, conducted in collaboration with nutritionists, geographers and health, agricultural and environmental scientists. 

26 Dec 2023
4 min read
Benefits for human health Echoes from FENS 2023 Expert interviews

Protein transition by Frans Kok

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The 14th European Nutrition Conference (FENS) took place in November in Belgrade, and we were there to cover and share with you some insightful topics

In the session “Plant-based diets: transition to a healthy plate and planet”, Pr. Frans Kok talked more specifically about: “Protein Transition: Shift to Optimal Diets within Planetary Boundaries”.

“Protein transition”, briefly

The choice of food groups has a significant impact on both our health and the environment. The concept of “sustainable healthy diets,” as outlined by the World Health Organization (WHO) or exemplified by the planetary health plate (EAT-Lancet reference diet), involves considering four key dimensions: health/nutrition, economic factors, environmental sustainability, and socio-cultural aspects.

When focusing on the health and nutrition dimension, modeling studies highlight some alerts on nutritional adequacy for specific diet models:

  • Vegetarian diets should pay attention to protein quality, omega-3 fatty acids, vitamins B12 and D, as well as calcium, iron, and zinc.
  • Vegan diets are associated with lower protein intake/quality, lower omega-3 fatty acids, and deficiencies in vitamins B2, B3, B12, and D, as well as iodine, zinc, calcium, potassium, and selenium.

Regarding the nutritional adequacy of plant protein alternatives, key considerations include:

  • The composition of essential amino acids.
  • The digestibility of indispensable amino acids (DIAAS).
  • The bioavailability and effects of anti-nutritional factors.
  • The impact of processing, especially in the context of ultra-processed foods and their effects on health.

Key Messages :

  • Flexitarian and territorial diets, which involve a reduction in animal products, may offer an optimal balance between human and planetary health.
  • While vegetarian and vegan diets are highly effective for sustainability and health, careful planning is necessary, especially for children, pregnant/lactating women, and the elderly.
  • The evaluation of the nutritional quality of plant-based protein alternatives should consider not only the product level but also the meal level.
  • The ongoing debate on ultra-processed foods (UPFs) is counterproductive to the urgent need for a transition in the food system.

Learn more with Frans Kok

Hello, can you introduce yourself?

Frans Kok: My name is Frans Kok, and I am an emeritus professor in Nutrition & Health at Wageningen University. I am currently retired. I serve on the YINI scientific committee, where I’ve had the pleasure of engaging in enriching discussions and presentations.

If we want to shift to a more plant-based diet, how can we maintain optimal protein intake while taking into account sustainability?

Frans Kok: In Western societies, protein intake is generally sufficient for most people, so shifting towards a more plant-based diet is feasible without compromising on protein needs. When incorporating plant-based protein alternatives, it becomes crucial to consider essential amino acids. Fortunately, achieving a well-balanced amino acid profile is entirely achievable. Additionally, when developing alternative products, attention must be given to the micronutrient content, aligning with specific nutritional goals.

The key is to ensure an adequate supply of essential amino acids and micronutrients.

What would make an ideal plant-based protein?

Frans Kok: Crafting an ideal plant-based protein involves creating blends or mixtures from various plant protein sources. Evaluating the digestibility and the contribution of amino acids is a critical step in this process. There’s a wealth of choices when it comes to plant-based sources, allowing for versatility and adaptability.

It’s essential to conduct thorough testing, not only for digestibility but also for bioavailability. This involves understanding how the product interacts when consumed with a meal—ensuring it still facilitates the absorption of micronutrients and amino acids.

To find out more:

Frans Kok is emeritus professor in Nutrition & Health and former head of the Division of Human Nutrition at Wageningen University, The Netherlands. He was trained in human nutrition in Wageningen and epidemiology at Harvard University, Boston USA.
Kok’s scientific research covers topics such as diet in disease prevention, dietary behaviour, and overweight. In emerging economies in Asia and Africa attention is on diet and deficiency disorders.

18 Dec 2023
7 min read
Benefits for planet health Q&A

Top 3 of the best diets for the environment

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The adoption of healthy, sustainable diets can help reduce the risk of diseases related to malnutrition, while protecting the health of the planet. Four pillars are defining the healthy and sustainable diets: health and nutrition, affordability, cultural acceptability (ethical and religious) and environment (Sustainable healthy diets guiding principles, FAO/WHO). Taking those pilars in account,  which diets can we adopt and what benefits do they provide?

Go for a more plant-based diet

With the increase of the global world population, meat-protein consumption is expected to increase by 14% by 2030. As for global meat production, it is expected to increase by nearly 44 million tons in 2030, reaching 373 million tons (1). One way to promote more sustainable agriculture and food systems is to reduce meat consumption, especially red and processed meat. In addition to reduce the carbon footprint associated with beef production, there are health benefits associated with shifting the balance between animal and plant products. In this dynamic, more fruits, vegetables, legumes and nuts are recommended (2) and several sustainable diets can be considered.

Flexitarian diet or flexitarism

Flexitarianism is a combination of “flexible” and “vegetarianism”. This diet is primarily plant-based and includes the consumption of small amounts of animal-based products (4).

It is defined by:

  • High amount of plant-based foods (fruits, vegetables, unrefined grains, legumes, nuts and seeds),
  • Moderate amounts of poultry, dairy and fish
  • Low amount (1 serving/week) of red meat, highly processed foods and added sugars.

 This diet is ideal to change progressively from a Western-style diet to a more sustainable healthy diet. It is easy to follow for populations without religious, cultural or ethical constraints and who want to follow a healthy, sustainable diet with a moderate amount of animal-based food products in order to meet the recommended nutritional intake.

What is the flexitarian diet? - YINI

The flexitarian diet favors diversity rather than restriction, and is part of a sustainable dynamic.

From a nutritional standpoint, the richness of plant-based foods, combined with the consumption of dairy products and a reduced amount of meat, provides a healthy and complete blend of high-quality proteins, fiber, vitamins, minerals and fatty acids (5).

Planeterranean diet or Territorial diets

Some local or territorial diets (Territorial Diversified Diets – TDDs), such as the Mediterranean diet or the New Nordic diet, have been shown to contribute positively to human and environmental health. These are flexitarian diets that include a high consumption of locally produced seasonal foods, moderate amounts of animal protein, with fish and dairy products and limited processed foods (4).

This diet would contribute to fight against long-term diseases such as type 2 diabetes, certain cancers and cardiovascular diseases, which are responsible for more than 70% of deaths in the world.

What are territorial diversified diets? - YINI

The traditional Mediterranean diet includes a wide range of minimally processed plant foods that are rich in fiber and full of vitamins, minerals and phytochemicals. The low intake of fish, meat, eggs and cheese provides other essential nutrients, such as vitamin B12, that are lacking in an exclusively plant-based diet. Studies suggest that it is associated with a reduced risk of developing multiple chronic diseases and increased life expectancy. The beneficial effects are associated with the prevention of cardiovascular disease, type 2 diabetes, atrial fibrillation and breast cancer(6).

However, the Mediterranean diet is mostly suitable for the inhabitants of the Mediterranean basin, the same cannot be said for the inhabitants of other regions, especially because of the difference in lifestyle, traditions and food products availability. It is therefore preferable for each region to adopt healthier diets and foods that correspond to locally available products.

It is the approach of territorial or planeterranean diet.

Vegetarian diet or vegetarism

Vegetarism is a diet that is increasingly talked about. Different types exist depending on the inclusion/exclusion of certain food categories. It is generally based on an exclusion of meat, fish/shellfish, insects and gelatin. It includes all plant-based food and most of the time dairy products and eggs (4):

  • Lacto-Ovo-Vegetarian diet includes dairy and eggs.
  • Lacto-vegetarian diets include dairy products, but not eggs
  • Ovo-vegetarian diets include eggs, but not dairy.

This diet can be adopted by individuals who wish to move from a Western diet to a healthy, sustainable diet, who may have difficulty maintaining a vegan diet, or who have religious, cultural, or ethical beliefs that exclude flexitarian diets. Nutritional counseling is encouraged to ensure compliance with recommended nutrient intakes.

What is a vegetarian diet? - YINI

Studies focused on the impact of the vegetarian diet in adult (with various methods and criteria) indicate that conventional healthy vegetarian diets allow adequate nutrient (especially protein) intake and beneficial impact on a lower prevalence of cardiovascular diseases (CVD). However, more studies are needed because of inconsistencies in definitions of vegetarianism (8-9).

Environmental impacts of the diet: the challenges of tomorrow

The benefits of the shift towards more plant-based diet like flexitarian, vegetarian or planneterranean diets extend to the environment. A global change in eating habits could be one of the most effective and quickest measures to reduce the anthropogenic pressure on the planet, especially with regard to climate change.

According to the Food and Agriculture Organization (FAO) sustainable diets are defined as “diets with low environmental impact that contribute to food and nutritional security and a healthy life for present and future generations”(10). Plant-based foods (e.g., fruits, vegetables, and legumes) have less impact on GHG emissions and adopting diets that reduce meat consumption and favor vegetables and other plant sources are a good alternative to face environmental challenges. It is the case of the vegetarian or flexitarian diets. Some diets, such as the territorial diversified diet like the local territorial diet, can reduce the freshwater footprint in some countries, as well as energy consumption and land use (11). The impact of these diets is twofold; they allow for a move toward sustainability and improved health.


For more information:

Sources

(1) OECD-FAO Agricultural Outlook 2021-2030, Meat chapter, OECD-FAO, 2021.
(2) Blanco-Murcia, L.; Ramos-Mejía, M. Sustainable Diets and Meat Consumption Reduction in Emerging Economies: Evidence from Colombia. Sustainability 2019, 11, 6595.
(3) Devine, A.; Lawlis, T. Nutrition and Vulnerable Groups. Nutrients 2019, 11, 1066.    
(4) Moreno L, Meyer R, Donovan SM, Goulet O, Haines J, Kok FJ, van’t Veer P, Perspective: Striking a Balance between Planetary and Human Health—Is There a Path Forward?, Advances in Nutrition, 2022, 13 (2): 355-375
(5) Derbyshire, E. (2017). Flexitarian Diets and Health: A Review of the Evidence-Based Literature. Frontiers in Nutrition, 3.
(6) Tosti V, Bertozzi B, Fontana L. Health Benefits of the Mediterranean Diet: Metabolic and Molecular Mechanisms. J Gerontol A Biol Sci Med Sci. 2018 Mar 2;73(3):318-326.
(7) Hassapidou, M. et al. (2022). European Association for the Study of Obesity Position Statement on Medical Nutrition Therapy for the Management of Overweight and Obesity in Adults Developed in Collaboration with the European Federation of the Associations of Dietitians. Obesity Facts, 16(1), 11‑28.
(8) Mariotti, F. ,Gardner, C. D. (2019). Dietary Protein and Amino Acids in Vegetarian Diets – A Review. Nutrients, 11(11), 2661. 
(9) Pieczyńska, K., & Rzymski, P. (2022). Health Benefits of Vegetarian and Mediterranean Diets: Narrative Review. Polish Journal of Food and Nutrition Sciences, 327‑346.
(10) FAO. WHO. Sustainable Healthy Diets—Guiding Principles. FAO; Rome, Italy: WHO; Geneva, Switzerland: 2019.
(11) Kowalsky, T.O.; Morilla Romero de la Osa, R.; Cerrillo, I. Sustainable Diets as Tools to Harmonize the Health of Individuals, Communities and the Planet: A Systematic Review. Nutrients 2022, 14, 928.
11 Dec 2023
6 min read
by YINI Editorial team
Children Weight management

Skipping breakfast and kids’ weight gain: the impact of exercise

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In the mad dash to get off to school on time, it can be easy for the kids to miss out on breakfast. But if they’re prone to skipping breakfast, they’re at risk of becoming overweight. The good news is that they can stave off the excess weight by taking plenty of exercise, research suggests (1).

Breakfast kick-starts the day and reduces obesity risk

Considered by some experts to be the most important meal of the day, breakfast fuels young people with the energy and nutrients they need for the day ahead. Making breakfast part of your family’s everyday morning routine, combined with an active lifestyle, is a great recipe for getting children and teenagers into healthy habits.

But this can be easier said than done, and growing numbers of young people, especially girls, are going without breakfast.

These children and adolescents who don’t eat breakfast may not be able to make up for the nutrients they’ve missed with the rest of the day’s meals (2). What’s more, they’re more likely to pile on the pounds if they regularly skip breakfast (3). Research has suggested that eating breakfast every day can cut the risk of childhood obesity by a third (4).

For the breakfast-skippers it’s all the more important to avoid a “couch potato lifestyle”. This has been supported by the latest research suggesting that, by stepping up their physical activity, these youngsters can boost their energy balance and help keep their weight in check.

Studying the link between breakfast, diet, exercise and weight

The researchers set out to confirm whether daily exercise can counter-balance the link between skipping breakfast and excess weight among young people (1).

They gathered data from 2 890 Spanish children aged 6-17 years using questionnaires asking about the youngsters’ breakfast habits and how much physical activity they took. Through body mass index (BMI) scores, the researchers assessed whether the children were overweight according to WHO criteria.

Results revealed that 43% of the boys and 35% of the girls were overweight. Girls had a greater tendency to skip breakfast (13%) than boys (9.2%).

Skipping breakfast was associated with higher odds of having excess weight in both boys and girls.

But daily moderate to vigorous physical activity moderated this association between skipping breakfast and excess weight, both in girls and in boys. The more minutes of exercise they did daily, the lower their risk of excess weight.

How might exercise protect against excess weight in breakfast-skippers?

The reasons for the study’s findings are likely to lie in the body’s way of controlling appetite and the feeling of being full.

In the hours after exercising, people don’t tend to eat more to compensate for the calories they’ve burned up during the activity (5). It could be that acute exercise makes us feel less hungry by suppressing levels of a hunger-promoting hormone, ghrelin, previous research has suggested.

Other research has found reduced insulin resistance when aerobic exercise is used to treat obesity in young people, so they’re better at processing blood sugar (6).

Whatever the mechanism, the researchers say their findings help underpin public health efforts to encourage children and teenagers to be physically active, as it’s crucial for maintaining a healthy weight especially among those in the habit of skipping breakfast.

‘… our results indicate that promotion of a healthy eating habit such as having breakfast should be accompanied by increases in daily MVPA [moderate-to-vigorous physical activity], as young participants who have breakfast and with higher daily MVPA seem to be more likely to have no excess weight’ – López-Gil JF, et al. 2022.

Why is skipping breakfast linked to excess weight?

It may be to fall into the trap of thinking you’d lose weight if you go without breakfast. But the chances are you’d be wrong and indeed you could actually gain weight. Scientists don’t yet fully understand why this is, but they suspect several possibilities:

  • Breakfast skipping is linked to an increased appetite, which may lead to over-eating (3)
  • As well as helping to control appetite, having breakfast may improve your insulin sensitivity, steadying blood glucose levels, when it comes to meals later in the day (3)
  • Missing breakfast may lead to increased levels of a hunger-promoting hormone in the body (7)
  • Research in children has suggested that skipping breakfast may be associated with a poor diet overall (2), which could lead to excess weight.

How much exercise is enough?

The World Health Organization recommends that children and adolescents have a daily average of 60 min of moderate-to-vigorous intensity aerobic physical activity in each week (8).

For adults, the WHO advises 150-300 minutes of moderate-intensity, or 75-150 minutes of vigorous-intensity physical activity, or equivalent combination, per week. While some physical activity is better than none, more is better for health.

The guidelines, updated in 2020, recommend regular muscle strengthening activities as well as aerobic exercise for all age groups.

Find out more – read the original article.
Source:
(1) López-Gil JF, Sánchez-Miguel PA, Tapia-Serrano MÁ, García-Hermoso A. Skipping breakfast and excess weight among young people: the moderator role of moderate-to-vigorous physical activity. Eur J Pediatr. 2022 Aug;181(8):3195-3204. Erratum in: Eur J Pediatr. 2022 Jul 11
Additional references:
(2) Ramsay SA, Bloch TD, Marriage B, Shriver LH, Spees CK, Taylor CA. Skipping breakfast is associated with lower diet quality in young US children. Eur J Clin Nutr. 2018;72(4):548–556.
(3) Ma X, Chen Q, Pu Y, et al. Skipping breakfast is associated with overweight and obesity: a systematic review and meta-analysis. Obes Res Clin Pract. 2020;14(1):1–8.
(4) Poorolajal J, Sahraei F, Mohamdadi Y, Doosti-Irani A, Moradi L. Behavioral factors influencing childhood obesity: a systematic review and meta-analysis. Obes Res Clin Pract. 2020;14(2):109–118.
(5) Schubert MM, Desbrow B, Sabapathy S, Leveritt M. Acute exercise and subsequent energy intake. A meta-analysis Appetite. 2013; 63:92–104.
(6) García-Hermoso A, Saavedra JM, Escalante Y, Sánchez-López M, Martínez-Vizcaíno V. Endocrinology and adolescence: aerobic exercise reduces insulin resistance markers in obese youth: a meta-analysis of randomized controlled trials. Eur J Endocrinol. 2014;171(4):R163–R171.
(7) Goldstone AP, Prechtl CG, Scholtz S, et al. Ghrelin mimics fasting to enhance human hedonic, orbitofrontal cortex, and hippocampal responses to food. Am J Clin Nutr. 2014;99(6):1319–1330.
(8) Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451–1462.
04 Dec 2023
4 min read
Echoes from EFAD 2023 Expert interviews Healthy Diets & Lifestyle

Study on label literacy in Hungary by Emese Antal

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In October 2023, the 14th EFAD (European Federation of Association of Dieteticians) Congress was the occasion of exchange and networking around nutrition. We were there to share with you some topics.

Study on label literacy in Hungary

Consumers are paying more and more attention to choose foods they think are healthy. Most of the help they need is on the product packaging. A previous research has shown that although consumers may pay attention, they often do not fully understand the information on foods, making it difficult for them to make a truly informed choice when shopping.

We conducted a survey in Summer 2022 to gain a deeper understanding on how nutrition labels are used and what consumers know. The survey was based on a representative sample of 3 288 people by household size, size of municipality, region and gender, age and education of the head of household.

57% read the food label, mainly when buying a product for the first time or when the packaging changes. When asked about their satisfaction with the information on the labels, 44% said they were satisfied. On average, shoppers look at 9 items on a product. 51% do not know what ingredients are in the product. 40% of the shoppers want more information and would find it useful to have a QR code to get more information.

The ideal label is simple, easy to read according to 88% and easy to understand due to its large font size (71%). However, the majority of households are not in favor of oversimplification: more than six-tenths of the households are expecting full, accurate and detailed information, and not only the data to be provided, but also to be interpreted and comparable (63%).

Dietitians have a key role to play in education, including teaching people how to interpret food labels.

Key messages:

  • Consumers’ knowledge of health and interpretation of food labels is poor and below the required level.
  • Consumers can be educated, welcome useful, credible health information and incorporate it into their daily lives.
  • Health awareness is on the rise, which is also reflected in food choices. At the same time, however, there is also a significant spread of misconceptions

Learn more with Emese Antal

Can you start by introducing yourself?

I am Emese Antal and I am a dietician and sociologist. I am working as a scientific director of a Hungarian Platform Diet, Health and Physical Activity.

During your talk, you present a study. Can you tell us more about it ?

We carried out representative study on the nutrition labelling and not only on the front-of-pack nutrition labelling, but the general nutrition labelling, because we wanted to evaluate the knowledge and attitudes of the population in Hungary.

Our aim was that to obtain basic data to help us to building communication and educational strategy, in order to teach the population about healthy nutrition and how to read the labels.

The consumers are price sensitive, looking for fresh and tasty food, concerned about quality and nutritional characteristics. It’s very important to provide as much information on food as possible and to be transparent. A further challenge for public authorities and professionals as dietitians is to provide as much help as possible, to help understanding the information on packaging.

One of the major concerns is about carbohydrate and sugar content of foods. And it’s important from a public health perspective, as overweight and obesity are a major concern. There is a need for accurate information on the nutritional content of foods and for responsible behavior by our manufacturers. And our conclusion is that food innovations can help to promote healthier behavior. But of course, education is always needed.

Do you know tools or ways to educate the consumer?

We compared three front-of-pack labels and it came out that “Nutriscore” primarily appears to its supporters. It is easy to understand and attention grabbing. We check the GDA as well. It is perceived as detailed, accurate, complete, and encourages people to seek further information.

And what would be the ideal front-of-pack label if it exists ?

The nutrition labelling cannot be effective if there is no possibility of comparison. For now, there is a trend toward a simplification and the application of only one label in all Europe (at least). This is good that it is widely used, both on products and in food chains and catering. However, it should be accompanied by an appropriate consumer education.