Product Reformulation Research Articles

Interest of a process approach for the reformulation of products reduced in salt, sugar and fat in pastry and bakery products

Interest of a process approach for the reformulation of products reduced in salt, sugar and fat in pastry and bakery products

Free Sugar Content in Pre-Packaged Products: Does Voluntary Product Reformulation Work in Practice?

Ultra-processed, pre-packaged foods are becoming a growing part of our diet, while displacing whole and minimally processed foods. This results in an increased intake of free sugar, salt, and saturated fats, that have a profoundly negative effect on health. We aimed to assess the trend in free sugar content in pre-packaged foods in Slovenia and evaluate the efficacy of industry self-regulations designed to combat the excess consumption of free sugar. A nation-wide data collection of the Slovenian food supply was performed in 2015 and repeated in 2017. In 2017, 54.5% of all products (n = 21,115) contained free sugars (median: 0.26 g free sugar/100 g). Soft drinks became the main free sugar source among pre-packaged goods (28% of all free sugar sold on the market) in place of chocolates and sweets, of which relative share decreased by 4.4%. In the categories with the highest free sugar share, market-leading brands were often sweeter than the average free sugar value of the category. This indicates that changes in on-shelf availability towards a greater number of healthier, less sweet products are not necessarily reflected in healthier consumers’ choices. Relying solely on voluntary industrial commitments to reduce free sugar consumption will likely not be sufficient to considerably improve public health. While some further improvements might be expected over the longer term, voluntarily commitments are more successful in increasing the availability of healthier alternatives, rather than improving the nutritional composition of the market-leading products. Additional activities are, therefore, needed to stimulate reformulation of the existing market-leading foods and drinks, and to stimulate the consumption of healthier alternatives.

The ineligibility of food products from across the EU for marketing to children according to two EU-level nutrient profile models.

BackgroundA variety of nutrient profiling models have been developed to restrict food marketing to children. Previous assessments have shown substantial differences in terms of model strictness and agreement, but EU-wide data on how leading products in the various national markets perform against these health-minded nutrition criteria are unavailable.ObjectiveTo evaluate the nutritional composition of the pre-packaged food offer in selected categories sold at scale in the EU using criteria of two nutrient profile models intended to restrict food marketing to children.MethodsThe nutrient profile models of the private-sector EU Pledge and of the World Health Organization's Regional Office for Europe were applied to a commercial database with sales and nutritional information of 2691 pre-packaged products from five product categories (breakfast cereals, ready meals, processed meat, processed seafood, and yoghurts) and 20 EU countries. This study describes the criteria not met, the product ineligibility rates, and the distances to the various criteria thresholds.FindingsBetween 48% (EU Pledge) and 68% (WHO Europe) of the 2691 products analysed were found to be ineligible for marketing to children. The criteria thresholds most often not met were those for total sugars (in breakfast cereals, yoghurts), salt (in processed meat, processed seafood, ready meals), and fibre (in breakfast cereals). Total and saturated fat criteria also played a substantial role in rendering yoghurt products ineligible, and the energy criterion did so for ready meals.InterpretationA large number of food products selling at scale in the EU do not meet the criteria of two EU-level nutrient profile models intended to restrict food marketing to children. Given the considerable market share of many such products, they are likely to be consumed widely and in some cases regularly, including by children, even without being marketed to them. Nutrient profile models could serve as benchmarking tools for monitoring and evaluating food product reformulation efforts.

The Salt Swap intervention to reduce salt intake in people with high blood pressure: protocol for a feasibility randomised controlled trial

BackgroundHigh salt intake is a risk factor for hypertension and cardiovascular disease. Reducing salt intake has been shown to reduce blood pressure. Despite population-level interventions, including product reformulation and public awareness campaigns, adult salt consumption in the UK still exceeds recommendations; this is primarily due to salt consumed in processed and pre-packaged foods. Moderate or high-intensity dietary advice to encourage individuals to reduce their salt intake has been shown to be effective at reducing blood pressure, but evidence of the effectiveness of interventions that are suitable for delivery at scale in routine primary care is scarce. This feasibility trial investigates a complex behavioural change intervention to reduce dietary salt intake and blood pressure by encouraging individuals to purchase lower-salt foods when grocery shopping.MethodsThis randomised controlled trial will test the feasibility of a novel intervention to reduce salt intake, and the trial procedures to assess its effectiveness. We will recruit participants through UK general practices and randomise 40 participants with high blood pressure, in a 2:1 allocation to receive either the Salt Swap intervention or a control information leaflet. The primary outcomes relate to the criteria for progression to a large-scale trial. These include follow-up rates at 6 weeks, fidelity of intervention delivery and use of the intervention mobile app. Secondary outcomes include the effect of the intervention on the salt content of purchased foods (grams per 100 g), urinary sodium excretion assessed through 24-hour urine samples and blood pressure. Trial process measures will be collected and qualitative assessment will provide insights into participant engagement with the intervention content and perceived barriers to and facilitators of salt reduction dietary behavioural change.DiscussionIf the outcomes indicate the trial is feasible and there is evidence that behavioural change may result in salt reduction, we will proceed to a definitive trial to test the effectiveness of the intervention to lower blood pressure. If successful, this intervention approach could be applied not only to people with high blood pressure, but also to the wider population with normal blood pressure in whom dietary salt intake exceeds recommendations.Trial registrationISRCTN, 20910962. Registered on 5 April 2017.

A novel fat modification strategy in fermented sausages by incorporation of gelled emulsions with fig seed oil

Gelled emulsion (GE) systems are one of the novel proposals for reformulation of meat products with healthier profiles. In this study, the quality of fermented sausages formulated with fig oil seed-in-water GE as partial or total beef fat replacers were studied. Control sausages (C) consisted of 100% beef fat, whereas GE treatments were formulated by replacing 50% (G1) or 100% (G2) of beef fat. Total replacement of beef fat with GE (G2 sausages) did not change 2-Thiobarbituric acid reactive substance (TBARS) levels in the sausages, whilst G1 sausages containing 50% GE had the highest TBARS levels among the sausages. In general, TBARS levels tended to increase at the end of the storage. The highest total carbonyl content was measured in C sausages with 100% beef fat; however, the final carbonyl contents of the sausages were not different. All sensory parameters were within acceptable ranges; color scores were higher in G2 sausages than in C sausages, and the rest of the sensory characteristics were similar to each other. Finally, it was concluded that utilization of gelled emulsion systems consisting of fig seed oil GE as beef fat replacers has good potential to enhance the chemical and sensory quality of fermented sausages.

Sugars and sweeteners: science, innovations, and consumer guidance for Asia.

Rising obesity in Southeast Asia, one consequence of economic growth, has been linked to a rising consumption of energy from added sugars. This symposium, organized by ILSI Southeast Asia, explored regional issues related to dietary sugars and health and identified ways in which these issues could be addressed by regional regulatory agencies, food producers, and the consumer. Papers on the following topics were presented: 1) current scientific evidence on the effects of sugars and non-caloric sweeteners on body weight, health, and eating behaviors; 2) innovations by food producers to reduce sugar consumption in the region; 3) regional dietary surveillance of sugar consumption and suggestions for consumer guidance. A panel discussion explored effective approaches to promote healthy eating in the region. Excessive consumption of energy in the form of added sugars can have adverse consequences on diet quality, lipid profiles, and health. There is a need for better surveillance of total and added sugars intakes in selected Southeast Asian countries. Among feasible alternatives to corn sweeteners (high fructose corn syrup) and cane sugar are indigenous sweeteners with low glycemic index (e.g., coconut sap sugar). Their health benefits should be examined and regional sugar consumption tracked in detail. Product reformulation to develop palatable lower calorie alternatives that are accepted by consumers continues to be a challenge for industry and regulatory agencies. Public-private collaborations to develop healthy products and effective communication strategies can facilitate consumer acceptance and adoption of healthier foods.

Cereal polysaccharides as sources of functional ingredient for reformulation of meat products: A review

Abstract Nowadays, consumer perceptions towards meat products are changing and seeking health-related aspects through diet. Owing to the fat and cholesterol content, reformulation of meat products is needed, by incorporating bioactive ingredients or through elimination/ diminution of harmful ingredients to alter their image among health-conscious meat lovers. Thus, numerous bioactive components like antioxidants, dietary fiber, phytochemicals, vegetable proteins, etc. can be used to ameliorate the characteristics of the meat products. Cereal polysaccharides, as a dietary fiber source, are gaining tremendous attention and having documented health implications to eradicate emerging diseases. Their positive role as an antioxidant, antitumor, anti-inflammatory, antimicrobial and antidiabetic agent has been proved by in vitro and in vivo clinical researches. Recent researches emphasized on the exploitation of cereal polysaccharides in various food sectors, this review will open a new horizon towards the incorporation of cereal polysaccharides in meat products and influence on functional characteristics of developed novel meat products.

Drivers of Liking in a Model Retorted Creamy Tomato Soup System with Varying Levels of Sodium, Fat, and Herbs.

Targeting both sodium and fat reduction in processed foods while maintaining consumer acceptance is a challenge in the food industry due to the innate liking by humans toward both ingredients. Canned soup is one of the leading processed food categories containing high quantities of sodium. Efforts to reduce both sodium and fat content in canned soup products have been problematic due to resulting decreased consumer acceptance. The objective of this study was to characterize the changes in the drivers of liking when sodium, fat, and herb levels are varied in a model retorted soup system. A creamy tomato soup system was developed containing four fat levels (free, low, reduced, regular), three sodium levels (low, reduced, regular), and two herb levels (with, without). Ninety-six consumers rated the soups for overall liking on a 9-point hedonic scale. A descriptive analysis panel composed of 10 trained panelists profiled the sensory attributes among the soups. Higher sodium level was found to be a driver of liking when fat content was reduced. Soups were significantly different in saltiness (taste) and tomato (aroma-by-mouth), based on varying fat and sodium levels. Herb content increased overall liking of lower sodium and fat soups and impacted attribute characterization of soups. Future steps would include approaches to increase overall liking of lower fat and sodium soups. Formulation modifications that would decrease intensities of attributes that characterize lower fat and sodium soups, such as sour (taste and aftertaste), grainy (texture), and darkness (appearance), will aid in higher consumer acceptance of these soups. PRACTICAL APPLICATION: With hypertensive individuals requiring reductions of both dietary sodium and fat, food products lower in fat and sodium while maintaining sensory acceptability are needed. Identifying drivers of liking when sodium and fat levels are reduced in processed food systems can assist in product reformulation to increase overall liking. Additionally, understanding the impact of herbs in consumer acceptance of lower sodium and fat food products will also contribute to further advances in product development.

Diet Quality and Water Scarcity: Evidence from a Large Australian Population Health Survey

There is widespread interest in dietary strategies that lower environmental impacts. However, various forms of malnutrition are also widely prevalent. In a first study of its kind, we quantify the water-scarcity footprint and diet quality score of a large (>9000) population of self-selected adult daily diets. Here, we show that excessive consumption of discretionary foods—i.e., energy-dense and nutrient-poor foods high in saturated fat, added sugars and salt, and alcohol—contributes up to 36% of the water-scarcity impacts and is the primary factor differentiating healthier diets with lower water-scarcity footprint from poorer quality diets with higher water-scarcity footprint. For core food groups (fruits, vegetables, etc.), large differences in water-scarcity footprint existed between individual foods, making difficult the amendment of dietary guidelines for water-scarcity impact reduction. Very large reductions in dietary water-scarcity footprint are possible, but likely best achieved though technological change, product reformulation and procurement strategies in the agricultural and food industries.

A Delphi study for exploring nutritional policy priorities to reduce prevalence of non-communicable diseases in Islamic Republic of Iran.

Background: Identifying and prioritizing the most appropriate policies for enhancing nutritional habits are vital for the prevention and control of non-communicable diseases (NCDs). This study was conducted to prioritize the nutritional policies in Iran. Methods: A cross-sectional survey applying the two-round Delphi technique was used to prioritize policy options in preventing the burden of NCDs. In the first round, the experts in health and nutrition policy were asked to prioritize 21 policy options on a 5-point Likert scale. After analyzing the first-round questionnaire, the highest mean and lowest dispersion index were calculated as an indicator of high-priority options. In the second round, the policy options suggested by the participants were added to the second-round questionnaire. Finally, the questionnaires were sent to all the participants in case they desired to change their opinions. Results: The expert achieved consensus on "principles of healthy eating" courses in the curriculum of students as a high-priority policy option. In this regard, "promoting community education and customizing healthy food choice" was the next high priority policy option. On the other hand, the lowest policy priority option was "sending free/low-price healthy drinks at home". The three high priority policy categories were reformulating the content of food, enhancing the consumers’ knowledge, and food labeling, respectively. Conclusion: Our findings showed that reformulation, food promotion, and food labeling had the highest priorities for preventing NCDs in Iran. Although food provision policies were cost effective in developing countries such as Iran, it is essential to provide sub-structures for the reformulation of food products.

Sugar-based beverage taxes and beverage prices: Evidence from South Africa's Health Promotion Levy

A growing number of jurisdictions are introducing taxes on sugar-sweetened beverages (SSBs) in efforts to reduce sugar intake, obesity, and associated metabolic conditions. A key dimension of the impact of such taxes is how they induce changes in the prices of the taxed beverages and their un-taxed substitutes. At present these taxes have typically been based solely on volume. More recently, however, due to the potential to target the source of SSBs' health harms and to incentivize product reformulation, SSB taxes are being levied based on sugar content. In April of 2018 South Africa implemented such a tax, the Health Promotion Levy (HPL), at a rate of 0.021 ZAR (approximately 0.15 US cents) for each gram of sugar over an initial threshold of 4 g/100 ml. Drawing on a dataset of price observations (N = 71, 677) collected in South Africa between January 2013 and March 2019, we study changes in beverage prices following the introduction of the HPL. We find null price increases among un-taxed beverages and find significant price increases for carbonates, the largest taxed product category. However, within carbonates we find similar increases in price for low- and high-sugar brands, despite the underlying difference in tax liability. In addition, while we find evidence of product reformulation, we find significant price increases among the brands that reduced their sugar content. While the findings are broadly consistent with the price changes of volume-based SSB taxes, future considerations of price effects of sugar-based SSB taxes need to account for the opportunity for intra-firm heterogeneity in price response among large multi-product firms.

Effects of milk fat, casein, and serum protein concentrations on sensory properties of milk-based beverages

Our goal was to determine the effect of systematically controlled variation in milk fat, true protein, casein, and serum protein concentrations on the sensory color, flavor and texture properties, instrumental color and viscosity, and milk fat globule size distribution of milk-based beverages. Beverage formulations were based on a complete balanced 3-factor (fat, true protein, and casein as a percentage of true protein) design with 3 fat levels (0.2, 1.0, and 2.0%), 4 true protein (TP) levels (3.00, 3.67, 4.34, and 5.00%) within each fat level, and 5 casein as a percentage of true protein (CN%TP) levels (5, 25, 50, 75, and 80%) within each protein level (for a total of 60 formulations within each of 2 replicates). Instrumental measures of Hunter L and a values and Commission Internationale de l'Éclairage (CIE) b* values, instrumental viscosity, particle size, flavor, sensory texture and sensory appearance evaluations were done on each pasteurized/homogenized beverage formulation. Within each of the 3 fat levels, higher serum protein concentration drove higher aroma intensity, sweet aromatic, cooked/sulfur, cardboard/doughy flavors, and sensory yellowness scores, whereas higher casein concentration drove higher instrumental viscosity in milk protein beverages. Increasing serum protein concentration increased yellowness, sweet aromatic, aroma intensity, cooked/sulfur, and cardboard/doughy flavors across all fat levels and also had the largest effect on L, a, and b* values, sensory whiteness, and opacity within each fat level. Increases in true protein increased throat cling and astringency intensities. Increases in fat concentration were correlated with higher L, a, and b* values, larger particle size, and increased sensory whiteness, mouth coating, cooked/milky, and milkfat flavors. Multiple linear regression of L, a, and b* values produced better predictions of sensory whiteness and yellowness of pasteurized milk protein beverages than simple linear regression of L or b* values, respectively. Formulating milk protein beverages to a higher true protein level increased astringency regardless of fat level. When formulating milk protein beverages, a product developer has a wide range of milk-based protein ingredient choices that differ in price and change price relationship across time. Understanding the expected relative effect of different milk protein ingredients on the textural and flavor characteristics of milk-based beverages could be used to help guide product reformulation decisions and ingredient choices to achieve a specific sensory profile while controlling total beverage ingredient cost.

New Term to Quantify the Effect of Temperature on pH min -Values Used in Cardinal Parameter Growth Models for Listeria monocytogenes.

The aim of this study was to quantify the influence of temperature on pHmin-values of Listeria monocytogenes as used in cardinal parameter growth models and thereby improve the prediction of growth for this pathogen in food with low pH. Experimental data for L. monocytogenes growth in broth at different pH-values and at different constant temperatures were generated and used to determined pHmin-values. Additionally, pHmin-values for L. monocytogenes available from literature were collected. A new pHmin-function was developed to describe the effect of temperatures on pHmin-values obtained experimentally and from literature data. A growth and growth boundary model was developed by substituting the constant pHmin-value present in the Mejlholm and Dalgaard (2009) model (J. Food. Prot. 72, 2132–2143) by the new pHmin-function. To obtain data for low pH food, challenge tests were performed with L. monocytogenes in commercial and laboratory-produced chemically acidified cheese including glucono-delta-lactone (GDL) and in commercial cream cheese. Furthermore, literature data for growth of L. monocytogenes in products with or without GDL were collected. Evaluation of the new and expanded model by comparison of observed and predicted μmax-values resulted in a bias factor of 1.01 and an accuracy factor of 1.48 for a total of 1,129 growth responses from challenge tests and literature data. Growth and no-growth responses of L. monocytogenes in seafood, meat, non-fermented dairy products, and fermented cream cheese were 90.3% correctly predicted with incorrect predictions being 5.3% fail-safe and 4.4% fail-dangerous. The new pHmin-function markedly extended the range of applicability of the Mejlholm and Dalgaard (2009) model from pH 5.4 to pH 4.6 and therefore the model can now support product development, reformulation or risk assessment of food with low pH including chemically acidified cheese and cream cheese.

Growth and growth boundary model with terms for melting salts to predict growth responses of Listeria monocytogenes in spreadable processed cheese

The aim of this study was to develop and validate a growth and growth boundary model with terms for melting salts to predict growth of Listeria monocytogenes in spreadable processed cheese. Cardinal parameter terms for phosphate salts and citric acid were developed in broth studies and used to expand an available growth and growth boundary model. The expanded model includes the effect of nine environmental factors (temperature, pH, aw, lactic acid, acetic acid, citric acid, orthophosphate, di-phosphate and tri-phosphate). To generate growth data for model evaluation challenge tests with inoculated commercial (n = 10) and customized (n = 10) spreadable processed cheeses were performed. Evaluation of the new model by comparison of observed and predicted μmax-values resulted in a bias factor of 1.12 and an accuracy factor of 1.33 (n = 42). Prediction of growth and no-growth responses in processed cheese (n = 60) were 89% correct with 11% fail-safe and 0% fail-dangerous predictions. The developed model can be used to support product development, reformulation or risk assessment for spreadable processed cheese.

Anticipatory effects of the implementation of the Chilean Law of Food Labeling and Advertising on food and beverage product reformulation.

This study evaluated the anticipated food and beverage product reformulation by industry before the Chilean Law of Food Labeling and Advertising (Law 20.606) was implemented in June 2016 requiring a front-of-package (FOP) warning label for products high in sodium, total sugars, saturated fats, and/or total energy. Fieldworkers photographed a purposive sample of packaged food and beverage products in February 2015 (n=5421) and February 2016 (n=5479) from six different supermarkets in Santiago, Chile. The same products collected in both years (n=2086) from 17 food and beverage categories with added critical nutrients (nutrients of concern: sodium, total sugars, and saturated fats) were included in this longitudinal study. The average change in energy and critical nutrient content was estimated by category. The number of warning labels potentially avoided because of reformulation was determined. Between February 2015 and February 2016, no category experienced reductions >5% average change in energy or critical nutrient content; and some increased in critical nutrient content. Few products (<2%) would have avoided at least one warning label with reformulation. In a diverse sample of food and beverage products, there was minimal reformulation by industry in anticipation of the implementation of the 2016 Chilean Law of Food Labeling and Advertising.

Salt content in pre-packaged foods available in Portuguese market

Salt intake above World Health Organization (WHO) recommendation level (5 g/day) is associated with harmful health effects such as an increased risk to hypertension and cardiovascular diseases, which are the principal cause of death worldwide. Public health strategies to meet WHO targets include monitoring salt content in food, improvement of food labelling and reformulation of products. This study aimed to collect data about labelled salt content of pre-packaged food products available in stores and in the websites of three supermarkets in Porto (Portugal), and also to compare the labelled salt content of products available in store and online. Products were collected in store and website of three main distributing food chains available in Portugal. Median salt content in food categories was: Rice 0.70 g/100 g (n = 27), Potato and potato-products 1.00 g/100 g (n = 196), Pasta 0.88 g/100 g (n = 108), Bread and bread products 1.10 g/100 g (n = 437), Vegetables and legumes 1.10 g/100 g (n = 375), Vegetarian 1.16 g/100 g (n = 182), Eggs 0.30 g/100 g (n = 31), Sauces 1.70 g/100 g (n = 479), Soups 0.70 g/100 g (n = 122), Ready-To-Eat meals 1.10 g/100 g (n = 508), Sausages and charcuterie 2.20 g/100 g (n = 848), Meat and meat products 1.30 g/100 g (n = 273), Fish and fish products 1.00 g/100 g (n = 406), Seafood and shellfish 1.20 g/100 g (n = 92). The prevalence of products with website label equal to store was higher than the prevalence of products that had different information (between 64.8% in Shellfish and seafood and 93.3% in Eggs).The median salt content for every food category analysed was above the recommended range by public health strategies, and there were significant differences between salt content in website and store labels (for Pasta, Vegetables and Fish products). There is a need to reformulate and reduce salt content of available food products/meals as well as a need to assure that clear and accurate label information is provided to consumers about the salt content of the products.

Quantitative Assessment of Trace‐Element Contamination in Parenteral Nutrition Components

Trace-element contamination of contemporary parenteral nutrition (PN) components exists in unknown quantities and, in combination with excessive amounts of certain trace elements provided in commercially available adult, pediatric, and neonatal multitrace-element (MTE) products, could result in eventual accumulation and toxicity. This study aims to quantify trace-element contamination in components used for PN compounding to further inform recommendations for MTE product reformulation and individualized trace-element prescribing in PN. A total of 32 unique components (65 products) available for PN compounding were tested for manganese, chromium, selenium, zinc, and copper contamination, utilizing inductively coupled plasma mass spectrometry. Theoretical adult, pediatric, and neonatal PNs were formulated to assess the impact of macronutrient and micronutrient component doses on PN trace-element contamination. Trace-element contamination was detected in 24 (75%) components tested. Chromium and manganese were common, present in 65.6% and 51.5% of all components, respectively. Eight components did not contain detectable trace-element contamination, most notably sterile water, concentrated dextrose, and lipid emulsion. Manganese contamination in theoretical adult, pediatric, and neonatal PN was 25.18, 9.92, and 1.37 µg, respectively. Chromium contamination was 4.85, 1.5, and 0.28 µg, respectively. Trace-element contamination was prevalent in components used to compound PN. Our findings support reformulation of adult, pediatric, and neonatal manufactured MTE products to eliminate chromium, decrease manganese, and supply full daily physiologic requirements of selenium, zinc, and copper. Future study is needed to assess the additional contamination that could occur through the compounding and storage processes.

Symposium proceedings: sugars and sweeteners: science, innovations, and consumer guidance for Asia

Background and Objectives: Rising obesity in Southeast Asia, one consequence of economic growth, has been linked to a rising consumption of energy from added sugars. This symposium, organized by ILSI Southeast Asia, explored regional issues related to dietary sugars and health and identified ways in which these issues could be addressed by regional regulatory agencies, food producers, and the consumer. Methods and Study Design: Papers on the following topics were presented: 1) current scientific evidence on the effects of sugars and non-caloric sweeteners on body weight, health, and eating behaviors; 2) innovations by food producers to reduce sugar consumption in the region; 3) regional dietary surveillance of sugar consumption and suggestions for consumer guidance. A panel discussion explored effective approaches to promote healthy eating in the region. Results: Excessive consumption of energy in the form of added sugars can have adverse consequences on diet quality, lipid profiles, and health. There is a need for better surveillance of total and added sugars intakes in selected Southeast Asian countries. Among feasible alternatives to corn sweeteners (high fructose corn syrup) and cane sugar are indigenous sweeteners with low glycemic index (e.g., coconut sap sugar). Their health benefits should be examined and regional sugar consumption tracked in detail. Product reformulation to develop palatable lower calorie alternatives that are accepted by consumers continues to be a challenge for industry and regulatory agencies. Conclusions: Public-private collaborations to develop healthy products and effective communication strategies can facilitate consumer acceptance and adoption of healthier foods.

Taxing Sugar-sweetened Beverages in Latin America: A Qualitative Comparative Examination of the Mexican and Chilean Experience (P22-009-19)

ObjectivesMexico and Chile implemented sugar-sweetened beverage (SSB) taxes in 2014. This study aimed to trace and compare the SSB tax policy process, and examine the role and perspectives of outside government stakeholders in the process. MethodsQualitative study design using key informant (KI) interviews and document review. We interviewed 24 KIs involved in the SSB tax policy process (16 researchers, 5 civil society organizations (CSOs), and 3 food and beverage industries, F&BI) to examine perceptions on the tax process, effectiveness and future. Two independent coders analyzed the transcripts, using emergent and a priori codes. The results were triangulated with a document review, including research and newspaper articles, and reports covering the pre- and post-tax periods (n = 347). ResultsIn Mexico, the tax on beverages with added sugars (1 peso/liter, or a 10% tax) stemmed from a longer process, compared to Chile, where the tax resulted from a pre-existing one applied to beverages with more than 6.25 g of sugar/100 ml (increased from 13 to 18%). In both countries, CSOs and the F&BI had direct influence on policy makers. CSOs were key in facing F&BI opposition before and after implementation. Researchers’ influence was indirect, providing evidence for or against the tax. There was agreement that the SSB tax alone was insufficient to address noncommunicable diet-related chronic diseases (NDCs). KIs noted needed tax improvements (e.g., increasing the rate, modifying the tax basis, and using revenue for public health initiatives). KIs against the tax argued for nutrition education as a better option to change SSB demand to encourage F&BI product reformulation. The results will examine the taxes within other public health initiatives in the countries and political considerations. ConclusionsWhile often touted as nutrition policy win, SSB taxes are one part of a larger nutrition policy toolbox. The study contributes to past research examining the Chilean and Mexican taxes, individually and mostly through quantitative methods. The comparative perspective shows different potential paths to tackling NDCs through policy, while facing F&BI pushback, and lessons for other countries seeking to implement SSB taxes at a national level. Funding SourcesThe research was funded by PSC-CUNY Research Award 60,806–00 48.

Dietary Sources of Salt in Low- and Middle-Income Countries: A Systematic Literature Review.

Rapid urbanization in low- and middle-income countries (LMICs) is transforming dietary patterns from reliance on traditional staples to increased consumption of energy-dense foods high in saturated fats, trans fats, sugars, and salt. A systematic literature review was conducted to determine major food sources of salt in LMICs that could be targeted in strategies to lower population salt intake. Articles were sourced using Medline, Web of Science, Scopus, and grey literature. Inclusion criteria were: reported dietary intake of Na/salt using dietary assessment methods and food composition tables and/or laboratory analysis of salt content of specific foods in populations in countries defined as low or middle income (LMIC) according to World Bank criteria. Of the 3207 records retrieved, 15 studies conducted in 12 LMICs from diverse geographical regions met the eligibility criteria. The major sources of dietary salt were breads, meat and meat products, bakery products, instant noodles, salted preserved foods, milk and dairy products, and condiments. Identification of foods that contribute to salt intake in LMICs allows for development of multi-faceted approaches to salt reduction that include consumer education, accompanied by product reformulation.