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"Commercial" Ready-To-Use Therapeutic Foods (RUTFs) are used in acute malnutrition management, but they are not always appropriate being expensive and unfamiliar. Much research has tried to develop alternative RUTF formulations and this work systematically reviewed eight articles discussing the approaches used to assess the children's sensory satisfaction, families' acceptance, and the cultural appropriateness of 13 alternative RUTFs. Different approaches were used by the authors and much research to standardise methodologies and findings is urgent to ensure that food products are culturally appropriate, acceptable and appreciated, with the final aim of completing the development process of alternative RUTFs. This work proposed some indications to follow in alternative RUTF acceptability evaluation processing. Moreover, community engagement and education resulted key aspects in alternative RUTF acceptance. An innovative, multi-disciplinary, multi-stakeholder approach could develop alternative "fit-for-the-purpose" RUTFs to help food-insecure communities acquire sufficient, safe, nutritious food in long-term Community Management of Acute Malnutrition. [ABSTRACT FROM AUTHOR]

A cross-sectional study was conducted to assess the possible relationship between chronotype, sleeping, and eating patterns in 74 Italian adults (71.6% women). Based on Morningness-Eveningness Questionnare (MEQ) score, participants were classified as morning (n = 24), intermediate (n = 25), and evening (n = 25) chronotypes. From analysis, no significant differences among chronotypes emerged for sleep habits. As to eating behaviours, the evening subjects showed a significant (p < 0.05) shift towards later hours of the day in the consumption of all meals, except dinner. In addition, the evening subjects had a later midpoint of energy intake (EI) of about 35 min and 1 h (p < 0.001), respectively, than the intermediate and morning subjects. Analysing the diet quality, morning subjects reported significantly (p = 0.030) lower consumption of sweets and sweeteners, and significantly (p = 0.035) lower intake of ultra-processed fats and seasonings. Evening subjects showed a significant delay in EI during the day, while morning subjects reported a better-quality diet. [ABSTRACT FROM AUTHOR]

A cross-sectional study was conducted to assess the possible relationship between chronotype, sleeping, and eating patterns in 74 Italian adults (71.6% women). Based on Morningness-Eveningness Questionnare (MEQ) score, participants were classified as morning (n = 24), intermediate (n = 25), and evening (n = 25) chronotypes. From analysis, no significant differences among chronotypes emerged for sleep habits. As to eating behaviours, the evening subjects showed a significant (p < 0.05) shift towards later hours of the day in the consumption of all meals, except dinner. In addition, the evening subjects had a later midpoint of energy intake (EI) of about 35 min and 1 h (p < 0.001), respectively, than the intermediate and morning subjects. Analysing the diet quality, morning subjects reported significantly (p = 0.030) lower consumption of sweets and sweeteners, and significantly (p = 0.035) lower intake of ultra-processed fats and seasonings. Evening subjects showed a significant delay in EI during the day, while morning subjects reported a better-quality diet. [ABSTRACT FROM AUTHOR]

Perinatal (antenatal and postpartum) depression is increasingly becoming a global public health problem. Studies have shown that the presence of depression during the perinatal period impact on a mother's ability to adequately provide nutritional care for herself and her infants and young children. This may thus negatively influence the nutritional status of these vulnerable children resulting in poor growth, such as stunting which is currently a public health problem in low- and middle-income countries (LMICs). The aim of this systematic review and meta-analysis was to determine the association between maternal postpartum depression and child growth in LMICs. Electronic databases were systematically reviewed by screening abstracts, titles, full text and additional data sources of eligible papers. Articles were eligible for inclusion if based on children aged 0 to 59 months, if reporting maternal postpartum depression as an exposure, if based on observational studies evaluating the relation between maternal postpartum depression and child growth, if reporting at least one physical growth indicator such as stunting as an outcome, and if published after 2000. Article selection was based on the PRISMA guidelines for reporting systematic reviews. Twelve articles were included in the quantitative synthesis (12 for stunting, 8 for underweight and 2 for wasting). Maternal postpartum depression was observed to be associated with an increased risk of child stunting (1.87 (95% CI: 1.52, 2.30; I2 = 41.6%, p = 0.064)) and underweight (1.81 (95% Cl: 1.25, 2.62; I2 = 70.7%, p = 0.001)). These results were confirmed after influence analyses, with publication bias being negligible. Conclusion: Maternal depression is a risk factor for poor child growth in LMICs. This study contributes to the knowledge on this topic and calls on policymakers to improve on its understanding, screening and treatment to alleviate the potential negative impact on child growth. What is Known: • Maternal postpartum depression is currently a public health relevance in low- and middle-income countries (LMICs). • Maternal postpartum depression is a risk factor for poor nutritional status in children from LMICs. What is New: • Maternal postpartum depression is associated with an 80 to 90% increased risk of childhood stunting and underweight in LMICs. • The association between risk of childhood stunting and underweight with maternal postpartum depression is slightly influenced by geographical area, rural or urban location, by factors such as study design, study quality and sample size. [ABSTRACT FROM AUTHOR]

The understanding of consumers' behaviours is crucial for developing strategies and educational interventions necessary to transition towards more sustainable diets at the individual and population level. In this regard, social-psychological models can be effective in identifying and understanding the role of the cognitive constructs behind the consumers' behaviour. The present systematic review is aimed at identifying the main drivers and barriers towards the adoption of sustainable dietary behaviours in adult populations. Sixty-seven papers were analysed by applying at least one of the following three theoretical approaches: the Theory of Reasoned Action, the Theory of Planned Behaviour, and the Social Cognitive Theory. Most of the studies were conducted in industrialised countries and, with one exception, only one among health, environmental, socio-economic and qualitative dietary dimensions was considered in each study. The adoption (or the intention to adopt) a healthy or a low-fat diet was the most analysed. A multitude of significant predictors of intention and behaviour was found. The most recurrent predictors were attitude for intention and intention for behaviour. Social-psychological models can be relevant when applied to dietary behaviour contexts, but present limits in explaining behaviour when prospective and more objective tools to assess food consumption (e.g., food diaries and/or food frequency questionnaires) are used. By identifying the drivers of consumers' behavioural changes, the collected results may support policy makers in providing recommendations and defining primary prevention interventions which enhance consumer awareness and engagement towards more sustainable dietary habits. • A systematic review on determinants of sustainable dietary behaviours is provided. • Attitude and intention are the most recurrent significant behavioural predictors. • Non-cognitive factors help the understanding of sustainable dietary behaviours. • Objective and prospective evaluation of behaviour tends to limit models' efficacy. • Results may help in defining recommendations and primary prevention interventions. [ABSTRACT FROM AUTHOR]

An adequate calcium and vitamin D intake may play a role in preventing osteoporosis, but the contribution of the different food sources of calcium with regards to the risk of osteoporosis been barely explored. This observational study evaluated the calcium intake through a food frequency questionnaire in 126 adult women with not previously diagnosed osteoporosis undergoing Dual-energy X-ray Absorptiometry (DXA) to screen for osteoporosis, and to correlate the calcium intake with parameters of bone density, measured by DXA. Total daily calcium intake and daily intake from food were similar among women found to have osteoporosis, osteopenia or normal condition. The main food source was milk and dairy products, while calcium supplementation was consumed by only 14% of subjects, irrespectively from osteoporosis conditions. DXA parameters were not significantly correlated with total daily calcium intake and calcium from food. The present study highlighted no qualitative and quantitative differences in the consumption of food groups contributing to calcium intakes in women with and without osteoporosis. [ABSTRACT FROM AUTHOR]

Purpose: Coffee is an important source of bioactive compounds, including caffeine, trigonelline, and phenolic compounds. Several studies have highlighted the preventive effects of coffee consumption on major cardiometabolic (CM) diseases, but the impact of different coffee dosages on markers of CM risk in a real-life setting has not been fully understood. This study aimed to investigate the effect of coffee and cocoa-based confectionery containing coffee consumption on several CM risk factors in healthy subjects. Methods: In a three-arm, crossover, randomized trial, 21 volunteers were assigned to consume in a random order for 1 month: 1 cup of espresso coffee/day, 3 cups of espresso coffee/day, and 1 cup of espresso coffee plus 2 cocoa-based products containing coffee, twice per day. At the last day of each treatment, blood samples were collected and used for the analysis of inflammatory markers, trimethylamine N-oxide, nitric oxide, blood lipids, and markers of glucose/insulin metabolism. Moreover, anthropometric parameters and blood pressure were measured. Finally, food consumption during the interventions was monitored. Results: After 1 month, energy intake did not change among treatments, while significant differences were observed in the intake of saturated fatty acids, sugars, and total carbohydrates. No significant effect on CM markers was observed following neither the consumption of different coffee dosages nor after cocoa-based products containing coffee. Conclusions: The daily consumption of common dosages of coffee and its substitution with cocoa-based products containing coffee showed no effect on CM risk factors in healthy subjects. Trial registration number: Registered at clinicaltrials.gov as NCT03166540, May 21, 2017. [ABSTRACT FROM AUTHOR]

Information on children's diet including bioactive compounds is quite scarce. This observational study investigated the composition of the diet of children living in Parma (Italy; n = 172, 8–10 years) using 3-day food records completed in winter and spring. Mean daily intakes of food groups, energy and nutrients were obtained using the national food database, while (poly)phenol contents were estimated from Phenol-Explorer or by specific literature searches. Food consumption, energy and nutrient intakes decreased in spring and were partially in line with national data. Adherence to the nutritional recommendations was not satisfied for the majority of nutrients. Main contributors to the phenolic intake were flavonoids (flavan-3-ols) and phenolic acids (hydroxycinnamic acids), while main dietary sources were fruit, chocolate-based products, vegetables, and tea & coffee (decaffeinated). This study provided the first comprehensive analysis of the nutritional composition of children's diet. Future research should look at the health implications of dietary choices in children. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to assess the validity and reliability of a self-administered nutrition knowledge (NK) questionnaire for Italian university students.Design: The NK questionnaire included ninety questions on experts' nutritional recommendations, nutritional content of food, health aspects of food and diets, relationship between diet and diseases, and proper food choices. It was administered to the same population under the same conditions on two different occasions with a time interval of 3 weeks between the two administrations.Setting: The survey was carried out at the University of Parma (Italy) during the 2018-2019 academic year.Participants: Data were collected for 132 bachelor and master degree students attending the University of Parma, either attending or not nutrition classes during their studies (19-30 years, 29·5 % males, 57·6 % with an academic nutrition background).Results: The questionnaire revealed high overall internal consistency reliability (Cronbach's α > 0·8) and a good temporal stability with high correlation of the total score (r = 0·835, P < 0·001). Moreover, it showed a good ability to discriminate between subjects with potentially different NK.Conclusions: This NK questionnaire proved to be a reliable, valid and easy-to-use tool for assessing the NK of Italian university students, either with or without nutrition background. [ABSTRACT FROM AUTHOR]

Purpose: Current evidence accounts for the role of (poly)phenolic compounds in the prevention of non-communicable diseases. Detailed information on population-level intakes is required to translate these findings into recommendations. This work aimed to estimate (poly)phenol intake in the UK population using data from a nationally representative survey. Methods: Data from 9374 participants (4636 children aged 1.5–18 years and 4738 adults aged 19 years and over) from the National Diet and Nutrition Survey Rolling Programme (NDNS RP) 2008–2014 was used. (Poly)phenol content of foods consumed in the NDNS RP was identified using Phenol-Explorer and through literature searches. Data on flavonoids, phenolic acids, and stilbenes were collected. Total (poly)phenol content was also assessed. Results: Mean total (poly)phenol intake ranged from 266.6 ± 166.1 mg/day in children aged 1.5–3 years to 1035.1 ± 544.3 mg/day in adults aged 65 years and over, with flavan-3-ols and hydroxycinnamic acids being the most consumed (poly)phenols across all age groups. (Poly)phenol intake was higher in males in all age groups except for adults aged 19–34 and 50–64 years, where intakes were marginally higher in females. Energy-adjusted intakes accounted for the pattern of increasing (poly)phenol intakes with age and a higher intake was observed in females across all age groups, with the exception of children aged 1.5–3 years. The main food sources were non-alcoholic beverages and fruits, being the main compounds flavan-3-ols and caffeoylquinic acids. Conclusions: This analysis provides estimates of (poly)phenol intake from a representative sample of the UK general population, which can help inform the health implications of (poly)phenol intake. [ABSTRACT FROM AUTHOR]

Background: Regular breakfast consumption is associated with better health status and healthier food intake throughout the day, but this association is a complex interaction of several factors.Objective: This study aimed to investigate the effect of nutritional and cognitive-perceived characteristics of breakfast on metabolic and behavioral variables related to food intake.Methods: The study was a randomized, crossover, controlled trial, with 4 experimental conditions consisting of 3 iso-energetic breakfasts and 1 energy-free control meal. Breakfasts had similar nutritional profiles but differed for glycemic index (GI), glycemic load (GL), and perceived healthiness, satiety, palatability, or energy content. Fifteen healthy normal-weight men [means ± SDs; age: 24 ± 2 y; body mass index (BMI; kg/m2) 23.4 ± 1.6] underwent each experimental condition in random order during 4 different weeks, separated by ≥1-wk washout. On the third day of each intervention week, postprandial blood variables (with insulin as primary outcome), satiety ratings, and food intake during an ad libitum lunch consumed 4 h after breakfast (secondary outcomes) were measured for each experimental condition.Results: A main effect of time, treatment, and time × treatment was found for postprandial insulin, glucose, and nonesterified fatty acids (P < 0.001 for all) after having the 3 iso-energetic breakfasts or the energy-free control one. Postprandial satiety was similar for the 3 energy-containing breakfasts, but higher when compared with the energy-free control (P < 0.001). No difference in energy intake was observed for the ad libitum lunch, whereas prolonged breakfast skipping was compensated by an increase (around +10%) in the average energy intake during the rest of the day, resulting in no differences in the total daily energy intake among the 4 conditions.Conclusions: Although other advantages might exist for breakfasts based on low-GI/low-GL foods, our findings support the hypothesis that minor differences in nutritional and perceived characteristics of breakfast are of limited importance regarding medium-term energy intake in healthy men. This trial was registered at clinicaltrials.gov as BRNN-014 NCT02516956. [ABSTRACT FROM AUTHOR]

Breakfast consumption can entail nutritional advantages positively affecting food choices. This study investigated the effect of minor changes in breakfast composition on the perceived attributes of foods, both at breakfast and at lunchtime. Four breakfasts were defined considering nutritional and perceptual factors. Three breakfasts varied just for a single cereal-based chocolate-containing food item, while a control breakfast mimicked fasting conditions. Breakfast perception was assessed before and after consumption. Subjects rated breakfast energy content on the basis of single items, while judged breakfast healthiness as a whole, suggesting that the combination of different ingredients can modify the perceived health value of foods. Additionally, 4 h after breakfast, a perceptual evaluation of lunch-related food images was performed, without differences among breakfasts. This study extends current knowledge on the relationship between subjective perceptual attributes and objective energy value and food composition, as well as on breakfast impact on food perception at lunchtime. [ABSTRACT FROM AUTHOR]

Vending machines (VMs) have been pointed out as an obesogenic factor contributing to increase the availability of unhealthy foods throughout the day. They usually offer nutrient-poor and energy-dense products, while healthy options are scarce or even absent. This study was carried out between April 2014 and December 2015 at the University of Parma (North Italy) to increase purchases of healthy foods in VMs through the enhancement of healthy product availability and the promotion of healthier food options through nutrition communication. Choices were retrospectively measured by comparing the amount of sales for 24 weeks at baseline and after improving the nutritional quality of products, with or without additional nutrition communication. Purchase of healthy foods increased after improving the nutritional quality of the available products. Product replacement was successful in increasing healthy product sales, while decreasing unhealthy choices. Differently, the addition of a point-of-sales nutrition information service only discouraged choices of less favourable foods without impacting notably on consumer behaviour. Iconographic labels in VMs were able to change only partially consumers’ choices, reducing the purchase of less recommendable products but not substantially enhancing healthier choices. Overall, this study yielded useful information for the implementation of nutrition interventions through VMs, addressing food choices and promoting healthy dietary patterns without limitation of consumers’ freedom. This kind of environmental interventions could lead to improvements in body weight management and consequent health outcomes. [ABSTRACT FROM AUTHOR]

To improve nutritional knowledge of children, single-group educational interventions with pre/post knowledge assessment were performed in primary schools in Parma, Italy, participating to the Giocampus Program. A total of 8165 children (8–11 years old) of 3rd, 4th and 5th grades of primary school were involved in 3 hours per class nutritional lessons, with specifically designed games and activities for each school grade. To evaluate children learning, a questionnaire was administered before and after three months of educational intervention. A total of 16330 questionnaires were analysed. Children nutritional knowledge significantly increased (p< 0.001) in all school grades. The integrated "learning through playing" approach, including the educational figures, tools and games, was successful in improving children's nutritional knowledge. A stable integration of this method in primary school settings could prepare a new generation of citizens, better educated on health-promotion lifestyles. [ABSTRACT FROM PUBLISHER]

The aim of this study was observing and improving children’s eating habits through an edutainment technological platform. A single-group education intervention was carried out in primary schools in Parma and Milano, Italy. A total of 76 children (32 females and 44 males, 8–10 years old) were involved in a 3-month nutritional program including lessons and educational videogames. Intakes of fruits, vegetables, juices and dietary total antioxidant capacity (TAC) were measured using 3-day food diaries before and after the intervention. The daily total consumption of fruit and vegetables increased from 421.8 (320.3) to 484.3 (337.2) g/day (p = 0.016). Consequently, daily dietary TAC increased by 26%, rising from 1.4 (1.3) to 1.6 (1.3) mmol of Trolox equivalents (p = 0.006). The methods and, particularly, the use of technological tools proved to be effective in conducting an educational intervention in children aged 8–10 years old. [ABSTRACT FROM PUBLISHER]

Food production and therefore human diet are identified as important sources of environmental impact. Unhealthy and unsustainable diets with high intake of meat and low intake of plant‐based products are predominant worldwide. On the other hand, a balance between health and sustainability is necessary, since diets that are environmentally sustainable could lack essential macro‐ and micronutrients and result in nutrient deficiencies, non‐communicable diseases and malnutrition. The aim of this project was to investigate the nutritional adequacy and environmental impact of adults' diet by comparing current dietary habits and new alternative dietary scenarios. First, a systematic review was conducted following PRISMA guidelines to assess the environmental impact of current diets and sustainable dietary scenarios such as vegan, vegetarian, pescatarian, omnivorous and optimised dietary patterns worldwide. In the second part of the project, an optimisation study was conducted, based on a multi‐objective optimisation approach, with the purpose of creating the optimal diet based on nutritional and environmental constraints for the adult Italian population. The dietary scenarios of the optimised models were developed in accordance with the Italian food‐based dietary guidelines. Food consumption data was extracted from the INHES study and used as baseline diet. A clear evaluation of the current environmental impact because of diet and potential sustainable dietary scenarios globally is challenging. Finally, national food‐based guidelines should be adjusted by suggesting healthy and sustainable dietary recommendations in line with traditional eating habits and local food availability in order the desirable dietary shifts towards sustainability to be feasible. [ABSTRACT FROM AUTHOR]

Background: Promoting healthy and sustainable diets is increasingly important and the Mediterranean Diet (MD) has been recognized as an appropriate example that can be adapted to different countries. Considering that the college years are the time when US young adults are most likely to adopt unhealthy eating habits, the present study assessed adherence to the MD and the sustainability of dietary behaviors in a nationally representative sample of US university students, aiming to identify crucial levers for improving their eating behaviors. Methods: MD adherence and the adoption of healthy and sustainable dietary patterns were assessed through the KIDMED and the Sustainable-HEalthy-Diet (SHED Index questionnaires, respectively, administered through an online survey that also included sociodemographic and behavioral questions. Non-parametric and logistic regression analyses were performed. Results: A sample of 1485 participants (median (IQR) age 21.0 (19.0–22.0); 59% women) correctly completed the survey. A medium adherence to the MD was the most prevalent (47%). According to multivariate logistic regression analysis, the likelihood of being more compliant with the MD increased when meeting physical activity recommendations, having a high SHED Index score, having the willingness to purchase and eat healthy and sustainable dishes, eating ultra-processed plant-based meat alternatives foods daily, and regularly attending the university canteen. Conclusions: Encouraging dietary patterns rich in plant-based foods and with a moderate intake of animal products is crucial to increasing the adoption of healthy and sustainable diets, and university dining services represent a suitable setting to build a supportive environment that educates students on human and planetary health. [ABSTRACT FROM AUTHOR]

The use of Ready-to-Use Therapeutic Foods (RUTFs) is not a sustainable strategy to treat child moderate acute malnutrition due to its high cost and unfamiliarity. An integrated multidisciplinary approach called "Pappa di Parma" was used to develop, characterize and introduce alternative sustainable and energy-dense meals against malnutrition. Six formulations were developed by using basic accessible technologies and locally available ingredients (Tanzania), a daily portion of which meets RUTFs macronutrient requirements and most micronutrients RNI. Quality characterization, rheological properties and shelf-stability of formulae were assessed under different storage conditions disclosing the suitability and stability of no-water formulae in all tested storage conditions for almost under three months. Moreover, the cultural acceptance and the economical sustainability through the implementation in Tanzania were also evaluated. Overall, this study confirmed the "Pappa di Parma" approach as a valid starting point to sustainable alternatives to RUTFs, tailored to specific agricultural and socio-economic contexts. • Sustainable formulae to treat infant moderate acute malnutrition were developed. • Only basic accessible technologies and locally available ingredients were used. • A daily portion meets RUTFs macronutrient requirements and most micronutrients RNI. • Technological traits proved the quality and stability of no-water formulae for 90 days. • Cultural acceptance was also evaluated in the local context. [ABSTRACT FROM AUTHOR]

Background: Synbiotic foods, which combine the action of prebiotics and probiotics along the gastrointestinal tract, can affect inflammatory and glucose-related markers.Objective: The aim of this study was to investigate the effects on inflammatory and glycemia-related markers of a whole-grain pasta containing barley β-glucans and Bacillus coagulans BC30, 6086 in healthy overweight or obese volunteers.Methods: A single-blind, parallel, randomized, placebo-controlled dietary intervention study was carried out. Forty-one healthy sedentary overweight (body mass index [BMI] 25-29.9 kg/m2) and obese (BMI ≥30) volunteers, aged 30-65 y and low consumers of fruit and vegetables, ate 1 serving/d of whole-grain control (CTR) or innovative (INN) pasta for 12 wk and maintained their habitual diets. Biological samples were collected at baseline and every 4 wk for primary (plasma high-sensitivity C-reactive protein [hs-CRP] and fasting plasma lipid profile) and secondary outcomes (glycemia-related markers, blood pressure, fecal microbiota composition, and body weight). Between (CTR compared with INN) and within (among weeks) group differences were tested for the whole population and for subgroups stratified by baseline values of BMI (≥30) and glycemia (≥100 mg/dL).Results: INN or CTR pasta consumption had no effect on primary and secondary outcomes over time, except for a significant increase in plasma γ-glutamyltransferase (GGT) after 12 wk of CTR pasta consumption. Comparisons between intervention groups revealed differences only at 12 wk: plasma GGT was higher in the CTR group; plasma hs-CRP, plasma LDL/HDL cholesterol ratio, and Bifidobacterium spp. were lower in the INN subgroup of obese volunteers; plasma resistin was lower and Faecalibacterium prausnitzii abundance was higher in the INN subgroup of hyperglycemic volunteers.Conclusions: A daily serving of a synbiotic whole-grain pasta had limited effects on primary and secondary outcomes in the entire group of volunteers but affected glycemia- and lipid-related markers and resistin in a subgroup of healthy obese or hyperglycemic volunteers. This trial was registered at clinicaltrials.gov as NCT02236533. [ABSTRACT FROM AUTHOR]

NOVA is a classification that divides foods into four groups according to processing. Since no questionnaires have been validated to assess the consumption of foods with different levels of processing in the general adult population, we tested the reliability and validity of a 94-item Food Frequency Questionnaire (NFFQ) designed to estimate the intake (g/day) and the weight ratio (%) of the NOVA food groups in Italian adults. Time reliability and validity were tested by administrating the NFFQ to 110 subjects on two different occasions and comparing it with a weighed dietary record (WDR). Strong correlations between NFFQs (r > 0.7, p < 0.001) and intraclass correlation coefficients (ICC) of 0.851-0.940 indicated good test-retest reliability. Moderate correlations between the NFFQ and the WDR (0.6

• The position of the dishes on the menu highly impacts choices in the online context. • Placing target dishes at the beginning of the menu could improve students' choices. • For students with little to no sustainable and healthy diet, nudging did not work. • Personal characteristics and eating behaviors influence nudging effects. Finding strategies to motivate consumers to make food choices that could both boost sustainability and improve their health is crucial. Literature suggests that nudging could be effective in increasing the consumption of healthy and sustainable food. This research aims at determining the effects of different nudges on university students' food choices in the context of the online pre-ordering system of the university canteens. An experimental study was conducted in Italy with 1,312 participants using a between-subject design with one control and three treatment groups, i.e., Healthy and Sustainable Logo, Dish Placement (order of which dishes are displayed on the menu), and a combination of both nudges. Our main results show that dish placement leads to a significantly increased selection of healthy and sustainable dishes. Furthermore, both placement and the combination of the two nudges could positively influence students who already have strong sustainable and healthy eating behaviors. Finally, the population's characteristics (i.e., age, gender, being on a low-calorie diet, and living with parents), consumers' intention to consume healthy and sustainable food, and their eating habits should be considered when identifying a successful nudging strategy. [ABSTRACT FROM AUTHOR]

Purpose: There is much information on the bioavailability of (poly)phenolic compounds following acute intake of various foods. However, there are only limited data on the effects of repeated and combined exposure to specific (poly)phenol food sources and the inter-individual variability in their bioavailability. This study evaluated the combined urinary excretion of (poly)phenols from green tea and coffee following daily consumption by healthy subjects in free-living conditions. The inter-individual variability in the production of phenolic metabolites was also investigated. Methods: Eleven participants consumed both tablets of green tea and green coffee bean extracts daily for 8 weeks and 24-h urine was collected on five different occasions. The urinary profile of phenolic metabolites and a set of multivariate statistical tests were used to investigate the putative existence of characteristic metabotypes in the production of flavan-3-ol microbial metabolites. Results: (Poly)phenolic compounds in the green tea and green coffee bean extracts were absorbed and excreted after simultaneous consumption, with green tea resulting in more inter-individual variability in urinary excretion of phenolic metabolites. Three metabotypes in the production of flavan-3-ol microbial metabolites were tentatively defined, characterized by the excretion of different amounts of trihydroxyphenyl-γ-valerolactones, dihydroxyphenyl-γ-valerolactones, and hydroxyphenylpropionic acids. Conclusions: The selective production of microbiota-derived metabolites from flavan-3-ols and the putative existence of characteristic metabotypes in their production represent an important development in the study of the bioavailability of plant bioactives. These observations will contribute to better understand the health effects and individual differences associated with consumption of flavan-3-ols, arguably the main class of flavonoids in the human diet. [ABSTRACT FROM AUTHOR]

Background: Coffee is an important source of bioactive compounds, including caffeine, phenolic compounds (mainly chlorogenic acids), trigonelline, and diterpenes. Several studies have highlighted the preventive effects of coffee consumption on major cardiometabolic diseases, but the impact of coffee dosage on markers of cardiometabolic risk is not well understood. Moreover, the pool of coffee-derived circulating metabolites and the contribution of each metabolite to disease prevention still need to be evaluated in real-life settings. The aim of this study will be to define the bioavailability and beneficial properties of coffee bioactive compounds on the basis of different levels of consumption, by using an innovative experimental design. The contribution of cocoa-based products containing coffee to the pool of circulating metabolites and their putative bioactivity will also be investigated.Methods: A three-arm, crossover, randomized trial will be conducted. Twenty-one volunteers will be randomly assigned to consume three treatments in a random order for 1 month: 1 cup of espresso coffee/day, 3 cups of espresso coffee/day, and 1 cup of espresso coffee plus 2 cocoa-based products containing coffee twice per day. The last day of each treatment, blood and urine samples will be collected at specific time points, up to 24 hours following the consumption of the first product. At the end of each treatment the same protocol will be repeated, switching the allocation group. Besides the bioavailability of the coffee/cocoa bioactive compounds, the effect of the coffee/cocoa consumption on several cardiometabolic risk factors (anthropometric measures, blood pressure, inflammatory markers, trimethylamine N-oxide, nitric oxide, blood lipids, fasting indices of glucose/insulin metabolism, DNA damage, eicosanoids, and nutri-metabolomics) will be investigated.Discussion: Results will provide information on the bioavailability of the main groups of phytochemicals in coffee and on their modulation by the level of consumption. Findings will also show the circulating metabolites and their bioactivity when coffee consumption is substituted with the intake of cocoa-based products containing coffee. Finally, the effect of different levels of 1-month coffee consumption on cardiometabolic risk factors will be elucidated, likely providing additional insights on the role of coffee in the protection against chronic diseases.Trial Registration: ClinicalTrials.gov, NCT03166540 . Registered on May 21, 2017. [ABSTRACT FROM AUTHOR]

Foods consumed and dietary patterns are strong determinants of health status. Diet and nutrition have a key role in health promotion and maintenance during the entire lifetime, but what we choose to eat and drink greatly affects the environmental impact on ecosystems as well as monetary resources. Some studies suggest that a healthy diet with a low environmental impact is not necessarily more expensive. This paper aims to identify a healthy, greener and cheaper diet based on current consumption patterns. Dietary information was collected from 104 young adults in the last year of high school in Parma (Italy). Diet was monitored with 7-day dietary records. Subsequently, food items were decoded to obtain nutritional, economic and environmental impact data. An optimization tool based on mathematical programming (Multi-Objective Linear Programming) was used to identify sustainable diet. Three different 7-day diets were identified, based on nutrition recommendations for the healthy Italian adult population, characterized by different targets and optimizing different impacts: first the diet at the lowest cost (Minimum Cost Diet - MCD), then the Environmentally Sustainable Diet (ESD) obtained by minimizing the three environmental indicators (CO2e emissions, H2O consumption and amount of land to regenerate the resources - m(2)). Finally, the Sustainable Diet (SD) was identified by integrating environmental and economic sustainability objectives. Lastly, suggestions and recommendations for communication campaigns and other interventions to achieve sustainable diet are suggested. [ABSTRACT FROM AUTHOR]

Increasingly, policymakers are setting ambitious goals for sustainability in public procurement, integrated across different pillars. Such ambitions are apparent in public catering services, where procurement models have been shifting towards greater localisation of supply chains and purchasing of more organically grown food. To date however, few studies have examined empirically what the impacts of different procurement models are across these multiple pillars of sustainability. This research aimed to fill the gap, by measuring and comparing the environmental, economic and nutritional outcomes of different models of school meals procurement. Case studies were undertaken of ten primary school meals services in five European countries, capturing different procurement model types. Results showed carbon emissions ranged from 0.95 kgs CO 2 e per meal in the lowest case to 2.41 kgs CO 2 e in the highest case, with adoption of low carbon food waste disposal methods and reduction of the amount of ruminant meat in the menus being the most important actions for lowering emissions. In terms of economic impact, local economic multiplier ratios ranged from 1.59 to 2.46, and although the level of local food sourcing contributed to these ratios, the effect was eclipsed, in some cases, by investment in local catering staff. Meanwhile, implementation of a robust standards regime and improving canteen environment and supervision were the most important actions for nutritional quality and intake. The paper discusses the implications of the findings for integrated, sustainable models of food procurement. [ABSTRACT FROM AUTHOR]

The consumption of orange juice provides high concentrations of health-promoting bioactive compounds, the amount of which may increase upon alcoholic fermentation. Although fermentation may offer new prospects for the industry of orange-related products, there is a lack of studies reporting the influence of controlled alcoholic fermentation on the bioavailability of orange juice (poly)phenols in humans. The aim of this study was to evaluate the absorption profile, pharmacokinetic parameters, and urinary excretion of orange juice (poly)phenols in nine volunteers after acute administration of an orange juice and a beverage prepared after controlled alcoholic fermentation of the juice. Plasma and urine samples were analysed through a UHPLC-ESI-MS/MS targeted approach. A total of 24 (poly)phenol metabolites including both flavanone and phenolic acid derivatives were quantified, most of them being recorded only in urine. Phase II conjugates of hesperetin and naringenin were the main metabolites in plasma, while phenolic acids, in particular hydroxybenzoic acids, were the main compounds in urine. (Poly)phenols in both beverages were highly bioavailable (between 46 and 59%) and a notable inter-individual variability was seen. Significant treatment × time interactions were recorded for the sum of flavanones and phenolic acids in plasma, the (poly)phenols in the fermented juice being absorbed faster than after orange juice intake. Nevertheless, despite the food matrix having an impact on the absorption profile of orange juice (poly)phenols, this did not influence the pharmacokinetic parameters and urinary excretion of the (poly)phenol metabolites. Image 1 • The absorption, metabolism, and excretion of orange juice phenolics were assessed. • Orange juice or its fermented counterpart were compared. • (Poly)phenols in both beverages were highly bioavailable. • The food matrix did not influence the excretion of metabolites. • (Poly)phenols in the fermented juice were absorbed faster than in orange juice. [ABSTRACT FROM AUTHOR]