Search

The present study aimed to evaluate the effect of the school-based educational intervention "FOODcamp" on dietary habits among 6th–7th graders (aged 11–13 years), focusing on the food groups: fruits and vegetables, fish, meat, discretionary food, and sugar-sweetened beverages. In this cluster-based quasi-experimental controlled intervention study, 16 intervention classes (322 children) and 16 control classes (267 children) from nine schools were recruited during the school year 2019–2020. The children were asked to record their food intake for four consecutive days (Wednesday to Saturday) before (baseline) and after (follow-up) attending FOODcamp, using a validated self-administered web-based dietary record. Eligible dietary intake registrations from 124 and 118 children from the control and interventions classes, respectively, were included in the final statistical analysis. Hierarchical mixed model analysis was used to evaluate the effect of the intervention. No statistically significant effects of participating in FOODcamp were found on the average food intake of the food groups eaten regularly (vegetables, fruit, vegetables/fruit/juice combined, or meat) (p > 0.05). Among the food groups not eaten regularly (fish, discretionary foods, and sugar-sweetened beverages), a non-significant tendency to lower odds of consuming sugar-sweetened beverages from baseline to follow-up (OR = 0.512; 95% CI: 0.261–1.003; p = 0.0510) was seen among FOODcamp participants compared to control participants. In conclusion, this study found no effect of the educational intervention FOODcamp on the dietary intake of vegetables, fruit, vegetable/fruit/juice combined, meat, fish, or sugar-sweetened beverages. The intake frequency of sugar-sweetened beverages tended to decrease among FOODcamp participants. [ABSTRACT FROM AUTHOR]

Public food procurement has been emphasized as a powerful tool to promote a healthier and more sustainable food system, but there is still a long way to go to reach full potential. This study aimed to investigate practices and opportunities for sustainable and healthy public food procurement. A qualitative cross-sectional study was performed among Danish municipalities and regions stratified and randomly selected to cover standard practice (n = 17). In addition, interviews were performed among selected best-practice municipalities (n = 5) providing examples of ambitious goals and well-defined processes for obtaining sustainable food procurement. Large differences were observed in the cross-sectional analysis in relation to policy support and goals for sustainable food procurement, including organic purchase. Generally, there was a great attentiveness to reduce food waste and many valued the use of local food, especially among rural municipalities, whereas experience with climate impact reduction and shifts towards more plant-based menus was still in an early implementation stage. Results suggest a possible synergy effect between the use of organic food and efforts to reduce food waste and climate impact and emphasize the importance of local government policies to promote healthy and sustainable food procurement. Enabling factors to move sustainable food procurement forward are discussed. [ABSTRACT FROM AUTHOR]

Successful strategies for policy makers and the food industry are required to reduce population salt intake. A 4-month cluster randomized controlled trial was conducted to evaluate whether the provision of salt-reduced bread with or without dietary counselling affected the dietary intake of selected food groups, energy, macronutrients, sodium, and potassium. Eighty-nine families (n = 309) consisting of minimum one parent and one child were assigned to receive bread gradually reduced in salt content alone (Intervention A), combined with dietary counselling (Intervention B), or bread with regular salt content (control). Food intake was recorded for seven consecutive days at baseline and follow-up. Salt intake was reduced in both Intervention A (−1.0 g salt/10 MJ, p = 0.027) and Intervention B (−1.0 g salt/10 MJ, p = 0.026) compared to the control. Consumption of bread and both total and salt-rich bread fillings remained similar between groups, while 'cheese and cheese products' were reduced in Intervention A (−38%, p = 0.011). Energy intake and macronutrient distribution were not affected in Intervention A, but Intervention B resulted in a higher energy intake (512 kJ, p = 0.019) and a lower energy % (E%) from saturated fat (−1.0 E%, p = 0.031) compared to the control. In conclusion, provision of salt-reduced bread both with and without dietary counselling successfully reduced dietary salt intake without adversely affecting the dietary nutritional quality. [ABSTRACT FROM AUTHOR]

Dietary transitions are important for combating many of the environmental challenges humanity is facing today and reducing the global burden of disease. Different dietary patterns are associated with substantially different carbon footprints (CFs). This study aims to estimate the potential CF reduction on a transition from the current Danish diet to a plant-rich diet consistent with the Danish food-based dietary guidelines (FBDG) and to compare results obtained from the use of two different CF databases. Dietary intake data for adults aged 18–64 years from the national dietary survey 2011–2013 were used to calculate the CF of the current diet, and this was compared with the estimated CF of the plant-rich diet modelled for the FBDG. Calculations were carried out using an attributional life cycle assessment (LCA) database (AU-DTU data) and compared to calculations using a top-down hybrid consequential LCA database (BCD data). The transition from the current diet to the plant-rich diet showed a substantial estimated CF reduction of 31% with AU-DTU data, and a greater reduction with BCD data (43%). Ruminant meat reduction was the largest contributor to this CF reduction, especially with the use of BCD data, and other animal-based foods also contribute considerably to the CF reduction, especially with AU-DTU data. These results indicate that the choice of LCA methodology and CF database is important in estimation of dietary CF and for the development of guidelines to promote dietary change. [ABSTRACT FROM AUTHOR]

A high consumption of discretionary foods and drinks has been associated with increased risk of multiple adverse health outcomes, including risk of overweight and dental caries. The family-based cluster randomized intervention study "Are you too sweet?" aimed at reducing the intake of discretionary foods and drinks in a population of children starting pre-school. As part of the intervention a new short web-based sugar-rich food screener (SRFS), was developed to make the parents and the school health nurses aware of the children's intake of discretionary foods and drinks. In addition to the short assessment tool the parents also completed a validated web-based 7-day dietary record for the children. In the present study, estimates for intake of discretionary foods and drinks from the two assessment tools were compared (n = 80). There was significant correlation between estimates from the two assessment tools, but the SRFS provided lower estimates for intake of discretionary foods and drinks compared to the 7-day dietary record. The correlation coefficient between the two assessment tools was 0.49 (p < 0.001) and Kappa coefficient was 0.33. It is concluded that the SRFS can provide a fairly ranking of participants according to their intake of discretionary foods and drinks when compared to a validated 7-day dietary record. The screener may be a useful tool in practical settings, such as school health nurse consultations, in order to gain insight into the child's sweet intake habits. [ABSTRACT FROM AUTHOR]

Reducing the climate impact of food provided for residents in nursing homes is challenging, as the diets for older, frail adults must be high in protein content and energy density while at the same time ensuring that the meals are palatable and recognizable. This study aimed at providing guidance on healthy and more climate-friendly diets for nursing homes in the City of Copenhagen. The goal was to decrease greenhouse gas emissions (GHGE) by at least 25% while at the same time providing nutritionally adequate and recognizable menus. First, food purchase data were compiled with datasets matching each food item to a proxy food item and then to databases containing GHGE and nutrient information. Secondly, two diet scenarios were modelled based on current procurement practices, i.e., an energy- and protein-dense diet and a standard protein-dense diet, and converted into guidelines for menu planning. The diets contained less total meat, especially beef, and significantly more pulses, nuts and seeds in order to increase protein content according to recommendations for older adults. Finally, a combined scenario was calculated to reflect the joint climate impact reduction. This kind of innovation in food procurement is required in order to achieve the necessary transition to a sustainable food system. [ABSTRACT FROM AUTHOR]

We conducted an overview of systematic reviews to summarize reviews of cohort studies on intake of unprocessed and processed meat and the risk of cardiovascular disease (CVD), coronary heart disease (CHD), and stroke. Systematic reviews of cohort studies published between January 2010 and August 2020 were identified through a systematic literature search in PubMed, Embase, and Web of Science. The quality of how each review was conducted was assessed and the overall confidence in the results of each review was rated using AMSTAR 2. The quality of evidence of each meta-analysis was graded using NutriGrade. Three reviews were included, with meta-analyses of unprocessed red meat and CVD (n = 1) and stroke (n = 2); unprocessed poultry and stroke (n = 1); and processed meat and CVD (n = 1), CHD (n = 1), and stroke (n = 3). The overall confidence in the results of each review was rated as critically low. The meta-evidence was graded moderate for a positive association between unprocessed red meat and stroke and moderate for a positive association between processed meat and CHD and stroke. For other associations the meta-evidence was graded as low or very low. In conclusion, the associations between unprocessed and processed meat with CVD and major subtypes of CVD have not been extensively investigated. [ABSTRACT FROM AUTHOR]

Public procurement has been highlighted as an important strategic tool to drive sustainable development. The present study aimed at providing direction for decreasing greenhouse gas emissions (GHGE) by 25% for the food purchased by child-care centers in the City of Copenhagen while simultaneously providing nutritionally adequate, affordable and tasty menus. Baseline data were provided by compiling food purchase data with datasets matching each food item to a proxy food item and further with databases containing nutrient and GHGE information. For each food item, the edible amount was estimated in order to evaluate nutritional content and GHGE per 10 MJ. Two scenarios were modeled, i.e., a plant-rich diet and a lacto-ovo vegetarian diet directed at children two to five years old based on current purchase practice. Finally, the diets were translated into guidelines for menu planning. Amounts of pulses, nuts and seeds, as well as dark green vegetables and plant-based fats, were increased substantially in the two scenarios, while animal fat was decreased and the amount of meat was either reduced or eliminated in the plant-rich and lacto-ovo vegetarian diets, respectively. These kinds of changes in public food procurement have the power to significantly affect the transition toward a more healthy and sustainable food system. [ABSTRACT FROM AUTHOR]

There is public focus on the environmental impact, and in particular, the emissions of greenhouse gases (GHG), related to our food consumption. The aim of the present study was to estimate the carbon footprint (CF), land use and nutritional impact of the different beef products ready to eat in different real-life dietary patterns. Beef products accounted for 513, 560, 409 and 1023 g CO2eq per day, respectively, in the four dietary patterns (Traditional, Fast-food, Green, and High-beef). The total CFs of these diets were 4.4, 4.2, 4.3 and 5.0 kg CO2eq per day (10 MJ), respectively. The Green diet had almost the same CF as the Traditional and the Fast-food diets despite having the lowest intake of beef as well as the lowest intake of red meat in total. A theoretical substitution of beef with other animal products or legumes in each of these three diets reduced the diets' CF by 4–12% and land use by 5–14%. As regards nutrients, both positive and negative impacts of these substitutions were found but only a few of particular nutritional importance, indicating that replacing beef with a combination of other foods without a significant effect on the nutrient profile of the diet is a potential mitigation option. [ABSTRACT FROM AUTHOR]

Meat replacers could play a role in achieving more plant-based diets, but their current consumption is limited. The present modelling study aimed to explore the nutritional and greenhouse gas emissions impacts of meat replacers. Using dietary surveys from Denmark, Czech Republic, Italy and France (~6500 adults), we composed alternative diets in which all the meat in the observed diet (in grams) was substituted by similar use meat replacers (with and without fortification). Starting from the observed diets and meat-replacement diets, diets with improved adherence to food-based dietary guidelines (FBDGs) were modelled using Data Envelopment Analysis. These improved diets were then further optimised for dietary preferences (MaxP, diet similarity index), nutrient quality (MaxH, Nutrient Rich Diet score, NRD15.3) or diet-related greenhouse gas emissions (GHGE) (MaxS, CO2 equivalents). In all optimised modelled diets, the total amount of meat was lower than in the observed diets, i.e., 30% lower in the MaxP, 50% lower in the MaxH, and 75% lower in the MaxS diets. In the MaxP diet, NRD15.3 was ~6% higher, GHGE was ~9% lower, and ~83% of food intake remained similar. In the MaxH diet, NRD15.3 was ~17% higher, GHGE was ~15% lower, and ~66% of food intake remained similar. In the MaxS diet, NRD15.3 was ~9% higher, GHGE was ~33% lower, and ~65% of food intake remained similar. When using fortified meat replacers, for all modelled diets, the diet similarity was on average 2% lower and the GHGE reduction was on average 3% higher as compared with the same scenarios without fortification. This analysis showed that meat replacers, provided their preference is similar to meat, can provide benefits for GHGE, without necessarily compromising nutrient quality. [ABSTRACT FROM AUTHOR]

Background: Seafood is an important source of omega-3 fatty acids, which have been associated with improved oocyte quality and embryo morphology in some studies. However, seafood is also a source of persistent organic pollutants and heavy metals, which may adversely affect fecundity. Previous studies of seafood intake and fecundity have generated inconsistent results. Methods: In two prospective cohort studies of 7836 female pregnancy planners from Denmark (Snart Foraeldre, n = 2709) and North America (PRESTO, n = 5127), we evaluated the association of dietary intake of total seafood and marine-sourced long-chain omega-3 fatty acids (eicosapentaenoic acid, docosahexaenoic acid, and docosapentaenoic acid) with fecundability. Participants completed a baseline questionnaire on sociodemographics, behavioral factors, anthropometrics, and medical history, and a food frequency questionnaire. Pregnancy status was updated bimonthly for up to 12 months or until reported conception. We estimated fecundability ratios (FRs) and 95% confidence intervals (CIs) using proportional probabilities regression models, adjusted for energy intake and other potential confounders. We restricted analyses to women with ≤6 menstrual cycles of attempt time at enrollment. Results: Intake of total seafood or marine-sourced long-chain omega-3 fatty acids was not appreciably associated with fecundability in either cohort (≥200 vs. <50 g/week total seafood: FR = 0.94, 95% CI: 0.79–1.10 in Snart Foraeldre; FR = 1.00, 95% CI: 0.90–1.13 in PRESTO; marine fatty acids: ≥90th vs. <25th percentile: FR = 1.00, 95% CI: 0.85–1.18 in Snart Foraeldre; FR = 0.97, 95% CI: 0.86–1.09 in PRESTO). In PRESTO, where we collected additional data on seafood preparation, we observed an inverse association between fecundability and fried shellfish (≥10 g/week vs. none: FR = 0.77, 95% CI: 0.61–0.98), but not unfried shellfish (≥20 g/week vs. none: FR = 0.98, 95% CI: 0.89–1.07); in Snart Foraeldre, there was no association with total shellfish intake. Conclusions: We found little association between seafood intake and fecundability overall, but greater intake of fried shellfish was associated with reduced fecundability among North American participants. [ABSTRACT FROM AUTHOR]

The aim was to examine the effects of two different salt reduction strategies on selected cardiovascular risk factors. The study was a four-month cluster randomised controlled study. Eighty-nine healthy Danish families (309 individuals) were randomly assigned to either (A) gradually salt-reduced bread, (B) gradually salt-reduced bread and dietary counselling to further reduce salt intake and increase potassium intake or (C) standard bread (control). The effect was assessed using linear mixed models. Intention to treat analyses comparing changes in the three groups showed a significant reduction in body fat percent (−1.31% (−2.40; −0.23)) and a borderline significant reduction in total plasma cholesterol (−0.25 mmol/L (−0.51; 0.01) and plasma renin (−0.19 pmol/L (−0.39; 0.00) in group A compared to the control group. Adjusted complete case analyses showed a significant reduction in total plasma cholesterol (−0.29 mmol/L (−0.50; −0.08), plasma LDL cholesterol (−0.08 mmol/L (−0.15; −0.00)), plasma renin (−0.23 pmol/L (−0.41; −0.05)), plasma adrenaline (−0.03 nmol/L (−0.06; −0.01)) and body fat percent (−1.53% (−2.51; −0.54)) in group A compared to the control group. No significant changes were found in group B compared to the control group. In conclusion, receiving sodium reduce bread was associated with beneficial changes in cardiovascular risk factors. No adverse effects were observed. [ABSTRACT FROM AUTHOR]

Plant-based diets have been linked to both health benefits and a lower climate impact. However, plant-based diets may represent both healthy and unhealthy dietary practices. The present study aimed to develop a nationally adapted healthy plant-based diet based on the global EAT-Lancet reference diet. Development took place in a series of steps. First, the original EAT-Lancet reference diet was evaluated based on food availability, i.e., using Danish food data (Model 1). Then, the model was further modified to reflect national food based dietary guidelines (FBDG) and characteristics of current consumption pattern, e.g., by including processed food, discretionary foods and beverages in the diet (Model 2). The contents of macronutrients, vitamins and minerals, except for vitamin D and iodine, were found to be sufficient for Model 2, according to the recommended nutrient density to be used for planning diets for groups of individuals aged 6–65 years. In addition, the study gave an insight into the nutrients and foods to be aware of in planning a predominantly plant-based diet, thereby providing directions for future revisions of sustainable FBDGs. These include a stronger emphasis on the intake of legumes, nuts and seeds, fruit and vegetables including dark green vegetables, whole-grain products and vegetable oils as well as lowering meat intake. [ABSTRACT FROM AUTHOR]

"The Nordic diet" is an umbrella term that encompasses any interpretation that combines Food-Based Dietary Guidelines (FBDGs) with local Nordic foods. The five Nordic countries have collaborated on Nordic Nutrition Recommendations for forty years, including FBDGs, so their national guidelines are similar. The countries also share similar public health issues, including widespread nonconformity to the guidelines, although in different ways. The aim of this concept paper is to discuss environmental sustainability aspects of the Nordic diet, describe the status of and make suggestions for the inclusion of sustainability in future work on the Nordic diet. We exploit the sustainability–health synergy. A food intake more in line with the current FBDGs, which emphasises more plant-based and less animal-based foods, is necessary for high environmental sustainability. In turn, sustainability is an important motivator for health-promoting dietary shifts. Policy development requires long-term efforts. Since the Nordic diet can be considered a further development and improvement of old, traditional diets, there is huge potential to formulate a Nordic diet that benefits both human and planetary health. It is time for concerted engagement and actions—a new Nordic nutrition transition. [ABSTRACT FROM AUTHOR]

Monitoring levels of sodium (salt) in meals consumed out-of-home is needed to support effective implementation of salt-reduction strategies. The objective of the study was to examine lunch salt intake at 15 worksite canteens and to compare with results from a comparable study conducted 10 years before. A duplicate-portion-technique with subsequent chemical analysis was used to quantify 240 customers' lunch salt intake. Estimated mean salt intake was 2.6 g/meal (95% Cl: 2.2 to 3.0 g/meal) and 0.78 g/100 g (95% Cl: 0.69 to 0.88 g/100 g). Salt intake measured both as g per meal and per 100 g was found to be significantly higher for male compared with female participants (+0.10 g/100 g, 95% Cl: +0.02 to +0.17 g/100 g, p = 0.011). Compared with the study conducted 10 years before, there was a significantly lower estimated salt intake of 0.5 g/meal (95% CI: −0.8 to −0.2 g/meal, p = 0.001), suggesting a possible reduction in canteen lunch salt intake during a 10-year period. Still, 40% of the meals exceeded the Nordic Keyhole label requirements of maximum 0.8 g salt per 100 g for ready meals. A further reduction of salt intake is warranted to comply with salt reduction targets. [ABSTRACT FROM AUTHOR]