Commentary on "Food, the law and public health"

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Evaluating the ≤10:1 wholegrain criterion in identifying nutrient quality and health implications of UK breads and breakfast cereals

This article has been published in a revised form in Public Health Nutrition DOI: https://doi.org/10.1017/S1368980017003718. This version is free to view and download for private research and study only. Not for re-distribution, re-sale or use in derivative works. © 2017 The Authors. Under embargo until 26 June 2018.Objective: To evaluate the nutrient quality of breads and breakfast cereals identified using the wholegrain definition of ≤10:1 carbohydrate:fibre ratio. Design: Following a cross-sectional study design, nutritional information was systematically gathered from food labels of breads and breakfast cereals that met the ≤10:1 carbohydrate:fibre criterion. The median nutrient content was compared with the UK Food Standards Agency nutrient profiling standards and the association between carbohydrate:fibre ratio and other nutrients were analysed. Subgroup analyses were undertaken for products with and without fruit, nuts and/or seeds. Setting: Products from four major supermarket stores in the UK. Subjects: 162 breads and 266 breakfast cereals. Results: Breads which met the ≤10:1 criterion typically contained medium fat, low saturated fat, low sugar and medium sodium. Breakfast cereals typically contained medium fat, low saturated fat, high sugar and low sodium. In both groups, as the carbohydrate:fibre ratio decreased, fat content increased (bread: p=0.029, r=-0.171; breakfast cereal: p=0.033, r=-0.131) and, in breakfast cereals, as the ratio increased, sugar content increased (p<0.0005, r=0.381). Breakfast cereals with fruit, nuts and/or seeds contained, per 100 g, more energy (p=0.002), fat, saturated fat and sugar (all p<0.0005) while seeded breads had more energy, fat and saturated fat (all p<0.0005). Conclusions: Overall, breads and breakfast cereals meeting the ≤10:1 criterion have good nutritional quality, suggesting that the criterion could be useful in public health and/or food labelling. The utility of applying the 10:1 criterion to products containing fruit, nuts and/or seeds is less clear and requires further research.Peer reviewedFinal Accepted Versio

Poor choices: the limits of competitive markets in the provision of essential services to low-income consumers

A major study of the problems faced by the poor in the market for seven essential services in the UK - energy, food, housing, water, telecoms, transport, and financial services. Together these represent 60% of spending by the poorest 30% of households

Monitoring the impacts of trade agreements on food environments

The liberalization of international trade and foreign direct investment through multilateral, regional and bilateral agreements has had profound implications for the structure and nature of food systems, and therefore, for the availability, nutritional quality, accessibility, price and promotion of foods in different locations. Public health attention has only relatively recently turned to the links between trade and investment agreements, diets and health, and there is currently no systematic monitoring of this area. This paper reviews the available evidence on the links between trade agreements, food environments and diets from an obesity and non-communicable disease (NCD) perspective. Based on the key issues identified through the review, the paper outlines an approach for monitoring the potential impact of trade agreements on food environments and obesity/NCD risks. The proposed monitoring approach encompasses a set of guiding principles, recommended procedures for data collection and analysis, and quantifiable ‘minimal’, ‘expanded’ and ‘optimal’ measurement indicators to be tailored to national priorities, capacity and resources. Formal risk assessment processes of existing and evolving trade and investment agreements, which focus on their impacts on food environments will help inform the development of healthy trade policy, strengthen domestic nutrition and health policy space and ultimately protect population nutrition.The following organizations provided funding support for the travel of participants to Italy for this meeting and the preparation of background research papers: The Rockefeller Foundation, International Obesity Taskforce (IOTF), University of Auckland, Deakin University, The George Institute, University of Sydney, Queensland University of Technology, University of Oxford, University of Pennsylvania Perelman School of Medicine, World Cancer Research Fund International, University of Toronto, and The Australian National University. The Faculty of Health at Deakin University kindly supported the costs for open access availability of this paper, and the Australian National Health and Medical Research Council Centre for Research Excellence in Obesity Policy and Food Systems (APP1041020) supported the coordination and finalizing of INFORMAS manuscripts

Attenuation of allergic airways inflammation by an extract of Hymenocardia acida

Tracheal hyperresponsiveness, airway mucus production and bronchoalveolar inflammation are the major components of asthma. Here, we aim to investigate the role in the control of asthma of a bioactive plant extracted from Hymenocardia acida in a physiological and pathophysiological model. The effect of H. acida crude extract (HACE) on total cellular components of bronchoalveolar (BAL) fluids was performed on ovalbumin (OVA) and lipopolysaccaride (LPS)-challenged Swiss mice for induction of allergic asthma and airways inflammation, respectively. Mice were pretreated with 0.9% sodium chloride (NaCl), HACE (oral doses at 100 mg/kg/body weight) for a week and then by intranasal instillation with OVA (0.5 mg/ml) + aluminium hydroxyde (20 mg/ml), during three days after intraperitoneally sensitization or with LPS (0.4 mg/ml) for a day (OVA or LPS + HACE). The BAL cells were collected in a mixed solution (0.9% NaCl and 2.6 mm Ethylenediaminetetraacetic acid EDTA) one day after the last challenge and total cells were numbered in a Neubauer chamber. The HACE: (i) significantly inhibited the airways inflammation induced by a single intranasal instillation of LPS or allergic asthma on mice challenged with 3 consecutive days intranasal instillation of OVA in comparison to control mice only instilled with 0.9% sterile. NaCl : (ii) significantly impaired the increased levels of total cells in OVA and LPS-treated mice, without changing the basal cellularity after NaCl or HACE treatment; (iii) and significantly inhibitshydroxyl radicalsandsuperoxideanions production. Taken together, these results suggest that HACE exposure induces a marked reduction of cellular component in the BAL fluid, which is only partially lymphocytes dependent

Progress achieved in restricting the marketing of high-fat, sugary and salty food and beverage products to children

In May 2010, 192 Member States endorsed Resolution WHA63.14 to restrict the marketing of food and non-alcoholic beverage products high in saturated fats, trans fatty acids, free sugars and/or salt to children and adolescents globally. We examined the actions taken between 2010 and early 2016 – by civil society groups, the World Health Organization (WHO) and its regional offices, other United Nations (UN) organizations, philanthropic institutions and transnational industries – to help decrease the prevalence of obesity and diet-related noncommunicable diseases among young people. By providing relevant technical and policy guidance and tools to Member States, WHO and other UN organizations have helped protect young people from the marketing of branded food and beverage products that are high in fat, sugar and/or salt. The progress achieved by the other actors we investigated appears variable and generally less robust. We suggest that the progress being made towards the full implementation of Resolution WHA63.14 would be accelerated by further restrictions on the marketing of unhealthy food and beverage products and by investing in the promotion of nutrient-dense products. This should help young people meet government-recommended dietary targets. Any effective strategies and actions should align with the goal of WHO to reduce premature mortality from noncommunicable diseases by 25% by 2025 and the aim of the UN to ensure healthy lives for all by 2030

Area-level deprivation and adiposity in children: is the relationship linear?

OBJECTIVE: It has been suggested that childhood obesity is inversely associated with deprivation, such that the prevalence is higher in more deprived groups. However, comparatively few studies actually use an area-level measure of deprivation, limiting the scope to assess trends in the association with obesity for this indicator. Furthermore, most assume a linear relationship. Therefore, the aim of this study was to investigate associations between area-level deprivation and three measures of adiposity in children: body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR). DESIGN: This is a cross-sectional study in which data were collected on three occasions a year apart (2005-2007). SUBJECTS: Data were available for 13,333 children, typically aged 11-12 years, from 37 schools and 542 lower super-output areas (LSOAs). MEASURES: Stature, mass and WC. Obesity was defined as a BMI and WC exceeding the 95th centile according to British reference data. WHtR exceeding 0.5 defined obesity. The Index of Multiple Deprivation affecting children (IDACI) was used to determine area-level deprivation. RESULTS: Considerable differences in the prevalence of obesity exist between the three different measures. However, for all measures of adiposity the highest probability of being classified as obese is in the middle of the IDACI range. This relationship is more marked in girls, such that the probability of being obese for girls living in areas at the two extremes of deprivation is around half that at the peak, occurring in the middle. CONCLUSION: These data confirm the high prevalence of obesity in children and suggest that the relationship between obesity and residential area-level deprivation is not linear. This is contrary to the 'deprivation theory' and questions the current understanding and interpretation of the relationship between obesity and deprivation in children. These results could help make informed decisions at the local level

Objectively measured physical activity and fat mass in a large cohort of children

Background Previous studies have been unable to characterise the association between physical activity and obesity, possibly because most relied on inaccurate measures of physical activity and obesity. Methods and Findings We carried out a cross sectional analysis on 5,500 12-year-old children enrolled in the Avon Longitudinal Study of Parents and Children. Total physical activity and minutes of moderate and vigorous physical activity (MVPA) were measured using the Actigraph accelerometer. Fat mass and obesity (defined as the top decile of fat mass) were measured using the Lunar Prodigy dual x-ray emission absorptiometry scanner. We found strong negative associations between MVPA and fat mass that were unaltered after adjustment for total physical activity. We found a strong negative dose-response association between MVPA and obesity. The odds ratio for obesity in adjusted models between top and the bottom quintiles of minutes of MVPA was 0.03 (95% confidence interval [CI] 0.01-0.13, p-value for trend &lt; 0.0001) in boys and 0.36 (95% CI 0.17-0.74, p-value for trend = 0.006) in girls. Conclusions We demonstrated a strong graded inverse association between physical activity and obesity that was stronger in boys. Our data suggest that higher intensity physical activity may be more important than total activity