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Objective:Affordable nutrition refers to the relation between nutrient density of foods and their monetary cost. There are limited data on affordable nutrition in low- and middle-income countries. The present study aimed to develop a nutrient density score and nutrient affordability metrics for 377 most consumed foods in Brazil.Design:The foods were aggregated into seven major food groups and four NOVA food categories. Nutrient composition data were obtained from the Brazilian Institute of Geography and Statistics. Food prices were obtained from retailer websites and were converted to prices per 100 g and 418 kJ. The Nutrient Rich Food (NRF8.2) score was based on protein, fiber, vitamins A, C and E, Ca, Fe and K. Nutrients to limit were sugar and Na. Affordability was measured as kcal/R$ and nutrients/R$.Results:Grains, fats and sweets were more energy dense and had lower NRF8.2 scores than dairy, vegetables and fruits. Grains, fats and sweets were the lowest cost sources of energy. Vegetables and fruits, beans, nuts and seeds and eggs and dairy were the lowest cost sources of multiple nutrients. Ultra-processed foods (48 % of total) had higher energy density and lower NRF8.2 scores than did unprocessed foods. In Brazil, fruits, vegetables and dairy products offered the most nutrients per real.Conclusions:Analysis of the relationship between nutrient density of foods and their cost can help identify locally available foods that are nutrient rich, affordable and culturally acceptable. Achieving high nutrient density at an affordable cost should be the goal of Brazil’s food systems.

Nutrient profiling (NP) models rate the nutritional quality of individual foods, based on their nutrient composition. Their goal is to identify nutrient-rich foods, generally defined as those that contain more nutrients than calories and are low in fat, sugar and salt. NP models have provided the scientific basis for evaluating nutrition and health claims and regulating marketing and advertising to children. The food industry has used NP methods to reformulate product portfolios. To help define what we mean by healthy foods, NP models need to be based on published nutrition standards, mandated serving sizes and open-source nutrient composition databases. Specifically, the development and testing of NP models for public health should follow the seven decision steps outlined by the European Food Safety Authority. Consistent with this scheme, the nutrient-rich food (NRF) family of indices was based on a variable number of qualifying nutrients (from six to fifteen) and on three disqualifying nutrients (saturated fat, added sugar, sodium). The selection of nutrients and daily reference amounts followed nutrient standards for the USA. The base of calculation was 418·4 kJ (100 kcal), in preference to 100 g, or serving sizes. The NRF algorithms, based on unweighted sums of percent daily values, subtracted negative (LIM) from positive (NRn) subscores (NRn – LIM). NRF model performance was tested with respect to energy density and independent measures of a healthy diet. Whereas past uses of NP modelling have been regulatory or educational, voluntary product reformulation by the food industry may have most impact on public health.

Poverty-related food insecurity can be viewed as a form of economic and nutritional uncertainty that can lead, in some situations, to a desire for more filling and satisfying food. Given the current obesogenic food environment and the nature of the food supply, those food choices could engage a combination of sensory, neurophysiological, and genetic factors as potential determinants of obesity.

ObjectiveTo examine the consumption of plain water among children in France and compare total water intakes with guidelines issued by the European Food Safety Authority (EFSA).DesignNationally representative data were used to assess food, beverage and water consumption by sex, age group (4–8 years, 9–13 years), income-to-poverty ratio, eating occasion and location. Beverages were classified into nine groups: water (tap or bottled), milk, 100 % fruit juice, sodas, fruit drinks, hot beverages, sports drinks and flavoured waters. Total water volume in relation to energy intake (litres/kcal) was also examined.SettingINCA 2 study (Étude Individuelle Nationale des Consommations Alimentaires 2006–2007).SubjectsFrench children (n 835) aged 4–13 years.ResultsTotal water intakes were accounted for by plain water (34 %), beverages (26 %) and food moisture (40 %). Plain water could be tap (18 %) or bottled (16 %). Older children drank more plain water than did younger children and boys drank more plain water than did girls. No socio-economic gradient for plain water consumption was observed. About 90 % of children did not meet the EFSA water intake recommendations. The daily water shortfall ranged from 367 to 594 ml/d. Water-to-energy ratio was 0·75–0·77 litres/1000 kcal (4184 kJ). Children drank milk at breakfast and plain water during lunch and dinner. Caloric beverages provided 10 % of dietary energy; consumption patterns varied by eating location.ConclusionsTotal water intakes among young children in France were below EFSA-recommended levels. Analyses of beverage consumption patterns by eating occasion and location can help identify ways to increase water consumption among children.

Inadequate Ca intakes are a concern for global public health. In France, most dietary Ca is provided by dairy products: milks, fermented milks (mostly yogurts), dairy desserts and cheeses. The present dairy database (n 837) included milks (n 101), fermented milks, yogurts and other fresh dairy products (n 326), desserts (n 162) and a wide variety of cheeses (n 248). Energy and nutrient values were obtained from industry sources and the French national nutrient composition database. Retail prices were from Paris supermarkets. Products in each group were aggregated into twenty-one categories using clustering analyses. The costs in energy (kJ (kcal)), euros (€), and in SFA, added sugar and Na (defined here as nutrients to LIMit) associated with providing 120 mg of Ca (equivalent to 15 % daily value (15 % DV)) were calculated for each product group and category. The milk group supplied Ca at the lowest energy, monetary and LIM cost. Fresh plain and ‘light’ yogurts and fermented milks were next, followed by sweetened yogurts and flavoured milks. Light dairy desserts provided Ca with relatively few energy but were more expensive. Cheeses were a heterogeneous group. Hard cheeses (Comté) provided the most Ca per serving. Semi-hard cheeses (Camembert) and cream and blue cheeses (Roquefort) provided Ca at a cost comparable with sweetened yogurts and flavoured milks. Double cream, soft and goat cheeses were not optimal Ca sources. New value metrics can help identify affordable dairy foods that provide Ca without excessive energy or nutrients to limit. These conditions were satisfied by a wide variety of dairy products in France.

The term ‘nutrient density’ for foods/beverages has been used loosely to promote the Dietary Guidelines for Americans. The 2010 Dietary Guidelines for Americans defined ‘all vegetables, fruits, whole grains, fat-free or low-fat milk and milk products, seafood, lean meats and poultry, eggs, beans and peas (legumes), and nuts and seeds that are prepared without added solid fats, added sugars, and sodium’ as nutrient dense. The 2010 Dietary Guidelines for Americans further states that nutrient-dense foods and beverages provide vitamins, minerals and other substances that may have positive health effects with relatively few (kilo)calories or kilojoules. Finally, the definition states nutrients and other beneficial substances have not been ‘diluted’ by the addition of energy from added solid fats, added sugars or by the solid fats naturally present in the food. However, the Dietary Guidelines Advisory Committee and other scientists have failed to clearly define ‘nutrient density’ or to provide criteria or indices that specify cut-offs for foods that are nutrient dense. Today, ‘nutrient density’ is a ubiquitous term used in the scientific literature, policy documents, marketing strategies and consumer messaging. However, the term remains ambiguous without a definitive or universal definition. Classifying or ranking foods according to their nutritional content is known as nutrient profiling. The goal of the present commentary is to address the research gaps that still exist before there can be a consensus on how best to define nutrient density, highlight the situation in the USA and relate this to wider, international efforts in nutrient profiling.

ObjectiveTo assess a county population's exposure to different types of food sources reported to affect both diet quality and obesity rates.DesignFood permit records obtained from the local health department served to establish the full census of food stores and restaurants. Employing prior categorization schemes which classified the relative healthfulness of food sources based on establishment type (i.e. supermarketsv.convenience stores, or full-servicev.fast-food restaurants), food establishments were assigned to the healthy, unhealthy or undetermined groups.SettingKing County, WA, USA.SubjectsFull census of food sources.ResultsAccording to all categorization schemes, most food establishments in King County fell into the unhealthy and undetermined groups. Use of the food permit data showed that large stores, which included supermarkets as healthy food establishments, contained a sizeable number of bakery/delis, fish/meat, ethnic and standard quick-service restaurants and coffee shops, all food sources that, when housed in a separate venue or owned by a different business establishment, were classified as either unhealthy or of undetermined value to health.ConclusionsTo fully assess the potential health effects of exposure to the extant food environment, future research would need to establish the health value of foods in many such common establishments as individually owned grocery stores and ethnic food stores and restaurants. Within-venue exposure to foods should also be investigated.

Taste preferences, food choices and eating habits all change with age. The transition from childhood to adolescence and adult life is associated with reduced sweet taste preferences, lower sugars consumption and reduced energy density of the diet. Ageing is associated with elevated acceptance of bitter tastes, elevated preferences for vegetables and salad greens, and increased consumption of whole grains, vegetables and fruit. The age-associated drop in energy intakes is achieved through a reduction in the weight and volume of food consumed, as well as a reduction in the overall energy density of the diet. Energy density drops from a peak of 5 kJ (1.2 kcal)/g in adolescence and early adult life to a low of 3.1 kJ (0.75 kcal)/g for adult women aged 45–54 years. Older adults, particularly women, consume less fat and saturated fat and more fibre and vitamin C, suggesting a shift in consumption from snacks, sweets and desserts towards grains, vegetables and fruit. These changes in food preferences and eating habits are associated, on a population level, with a decline in preferences for sweet taste and with increased acceptance of bitter tastes. At present there are no data to show a causal relationship between age-related changes in sensory function and the selection of a more bulky energy-dilute diet. However, it is a plausible hypothesis that sensory factors mediate adjustments in energy density of foods at different life stages.

Objective:To investigate links between taste responses, self-reported food preferences and selected dietary outcomes in young women.Methods:Subjects were 159 women, with a mean age of 27.0 years. Taste responses were measured using aqueous solutions of 6−n-propylthiouracil (PROP) and sucrose. All subjects completed a 171-item food preference checklist, using nine-point category scales. Food preference data were reduced using principal components factor analyses, with the internal consistency of factor-based subscales established using Cronbach's alpha. Dietary intakes, available for a subset of 87 women, were based on 3 days of food records. Estimated intakes of carbohydrate, fibre and β-carotene were the key dietary outcome variables.Results:Genetically-mediated sensitivity to the bitter taste of PROP was associated with reduced preferences for Brussels sprouts, cabbage, spinach and coffee beverages. Higher preferences for sucrose in water were associated with increased preferences for sweet desserts. Food preferences, in turn, were associated with measures of current diet. Reduced acceptability of vegetables and fruits was associated with lower estimated intakes of carbohydrate, fibre and β-carotene.Conclusions:Taste responses to sucrose and PROP were predictive of some food preferences. Food preferences, in turn, were associated with food consumption patterns. Given that taste responsiveness to PROP is an inherited trait, there may be further links between genetic taste markers, eating habits and the selection of healthful diets.

Objective The US Food and Drug Administration (FDA) proposes to establish standardized and mandatory criteria upon which front-of-pack (FOP) nutrition labelling must be based. The present study aimed to estimate the relative contribution of declared amounts of different nutrients to the perception of the overall 'healthfulness' of foods by the consumer. Design Protein, fibre, vitamin A, vitamin C, calcium and iron were nutrients to encourage. Total fat, saturated fat, cholesterol, total and added sugar, and sodium were the nutrients to limit. Two content claims per nutrient used the FDA-approved language. An online consumer panel (n 320) exposed to multiple messages (n 48) rated the healthfulness of each hypothetical food product. Utility functions were constructed using conjoint analysis, based on multiple logistic regression and maximum likelihood estimation. Results Consumer perception of healthfulness was most strongly driven by the declared presence of protein, fibre, calcium and vitamin C and by the declared total absence of saturated fat and sodium. For this adult panel, total and added sugar had lower utilities and contributed less to the perception of healthfulness. There were major differences between women and men. Conclusions Conjoint analysis can lead to a better understanding of how consumers process information about the full nutrition profile of a product, and is a powerful tool for the testing of nutrient content claims. Such studies can help the FDA develop science-based criteria for nutrient profiling that underlies FOP and shelf labelling.