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To develop a worked example of product reformulation of a very popular ‘junk food’ to meet nutritional guidelines for public health in a ready meal.
Indicative survey of popular Margherita pizzas, followed by product reformulation, applying dietary guidelines to generate a single-item pizza meal containing 30 % daily amounts of energy and all nutrients. An iterative process was used; first to optimize nutrient balance by adjusting the proportions of bread base, tomato-based sauce and mozzarella topping, then adding ingredients to provide specific nutrients and consumer tasting.
Urban areas of contrasting socio-economic status.
Untrained unselected adults (n 49) and children (n 63), assessing pizza at tasting stations.
Most commercial pizzas provide insufficient information to assess all nutrients and traditional Margherita pizza ingredients provide insufficient Fe, Zn, iodine, and vitamins C and B12. Energy content of the portions currently sold as standard range from 837 to 2351 kJ (200 to 562 kcal), and most exceed 30 % Guideline Daily Amounts for saturated fat and Na when a 2510 kJ (600 kcal) notional meal is considered. The ‘nutritionally balanced pizza’ provides the required energy for a single-item meal (2510 kJ/600 kcal), with all nutrients within recommended ranges: Na (473 mg, ∼45 % below recommended level), saturated fat (<11 % energy) and dietary fibre (13·7 g). Most adults (77 %) and children (81 %) rated it ‘as good as’ or ‘better than’ their usual choice.
Nutritional guidelines to reduce chronic diseases can be applied to reformulate ‘junk food’ ready meals, to improve public health through a health-by-stealth approach without requiring change in eating habits.
To test the appeal of the eatwell week, a nutritionally balanced 7 d menu which satisfies nutritional guidelines of the Food Standards Agency in Scotland; determine the clarity and understanding of the main messages; and gather views on the usability and acceptability of the eatwell week resource format.
Focus group discussions with consumers and health professionals.
Four locations across the UK.
The eatwell week was considered realistic by consumers as it contained foods they recognised and already ate. A preconceived idea had been that there would be more fruit and vegetables and fewer ‘treats’. Consumers found the recipes simple and lack of cooking skills was not an apparent barrier. However, the message of ‘balance’ was poorly understood. Consumers often lacked the knowledge to make informed substitutions in the week. Both the general public and some health professionals felt the menu contained too much carbohydrate. Health professionals felt it was unclear who the eatwell week was intended for and what purpose it served.
Use of familiar foods and the provision of simple, easy-to-follow recipes have the potential to overcome some barriers to healthy eating encountered by the general public and encourage improvements in dietary intakes. The eatwell week shows promise as a resource to facilitate implementation of the principles of the eatwell plate and supports government priorities and policies for health.
To develop a menu and resource to illustrate to consumers and health professionals what a healthy balanced diet looks like over the course of a week.
Development and analysis of an illustrative 7 d ‘eatwell week’ menu to meet current UK recommendations for nutrients with a Dietary Reference Value, with a daily energy base of 8368 kJ (2000 kcal). Foods were selected using market research data on meals and snacks commonly consumed by UK adults. Analysis used the food composition data set from year 1 (2008) of the UK National Diet and Nutrition Survey rolling programme. The eatwell week menu was developed using an iterative process of nutritional analysis with adjustments made to portion sizes and the inclusion/exclusion of foods in order to achieve the target macronutrient composition.
Three main meals and two snacks were presented as interchangeable within the weekdays and two weekend days to achieve adult food and nutrient recommendations. Main meals were based on potatoes, rice or pasta with fish (two meals; one oily), red meat (two meals), poultry or vegetarian accompaniments. The 5-a-day target for fruit and vegetables (range 5–6·7 portions) was achieved daily. Mean salt content was below recommended maximum levels (<6 g/d). All key macro- and micronutrient values were achieved.
Affordable foods, and those widely consumed by British adults, can be incorporated within a 7 d healthy balanced menu. Future research should investigate the effect of using the eatwell week on adults’ dietary habits and health-related outcomes.
A novel system for nutrient analysis has been developed and tested over 5 years. Its key features are a nutrient database of 600 commonly eaten foods (95% of foods eaten in 7-day surveys); a booklet identifying each food with a bar code, bar codes for gram weight and for portion sizes (small, medium, large) and a bar-code reader with dietary analysis software for PCs. In the present study the bar-code system has been evaluated by comparison with a commonly used manual entry nutrient analysis software for dietitians' use.
Glasgow city district.
One hundred and sixty adults aged 18–65 years old.
Comparing mean intakes for macro- and micronutrients, using the Bland and Altman method1, the bias between the two methods was small, ranging from 0.93 to 1.03. The bar-code system took significantly less professional time in data entry and nutrient analysis than the widely used manual system (29 min per 7-day diary vs. 47 min per 7-day diary, P < 0.001).
It is suggested that the bar-code system offers greater speed with a saving of professional time needed for nutrient analysis of dietary surveys. This system is commended for maintaining accuracy while promoting economy.
To assess attitudes, predictors of intention, and identify perceived barriers to increasing fruit and vegetable (F&V) intakes.
UK nationwide postal survey utilizing the theory of planned behaviour.
Stratified (by social class and region) random sample of 2020 UK adults providing a modest response rate of 37% (n = 741).
Belief measures (e.g. health, cost, taste, etc.) were strongly associated with overall attitudes which were reported as being largely favourable towards fruit, vegetables and, to a lesser extent, vegetable dishes, and were strongly associated with reported intention to increase consumption. Subjects reported they could increase their consumption, but this was only weakly associated with intention to do so. Approximately 50% of respondents reported an intention to increase intakes. Social pressure was strongly associated with reported intention to increase; however, scores indicated low perceived social pressure to change. Evidence of unrealistic optimism concerning perceived intakes and the perceived high cost of fruit may also act as barriers.
Results from this study suggest a lack of perceived social pressure to increase F&V intakes and suggests that public health efforts require stronger and broader health messages that incorporate consumer awareness of low present consumption.
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