Standard Portion Research Articles

The Effect of Cooking and Cooling Chickpea Pasta on Resistant Starch Content, Glycemic Response, and Glycemic Index in Healthy Adults

Background/Objectives: Legume seeds, such as chickpeas, are a rich source of resistant starch (RS) and have a low glycemic index (GI). The aim of this study was to evaluate the effect of cooking and cooling chickpea pasta on the RS content, glycemic response, and GI in healthy subjects. Methods: Twelve healthy subjects of both sexes, aged 18–65 years, participated in this study. Each person consumed two standardized portions of chickpea pasta: (i) freshly cooked (FCP) and (ii) cooked chickpea pasta which was cooled for 24 h at 4 °C and reheated before consumption (CCP). Glucose solution was provided as a reference food. Participants consumed chickpea pasta in a random order. GI measurements were completed using the standard methodology and calculated according to the ISO 2010 standard. Results: The cooling and reheating process significantly increased the RS content of boiled chickpea pasta (from 1.83 g/100 g to 3.65 g/100 g) and had a beneficial effect on postprandial glycemia in healthy individuals. The CCP pasta had a significantly lower GI value than the FCP pasta (33 vs. 39, p = 0.0022). A significant difference in the glucose, as identified by the incremental area under the curve (IAUC), was observed between the CCP and FCP (1327.9 ± 414.8 mg/dL/min vs. 1556.1 ± 456.9 mg/dL/min, p = 0.0022). The cooling–reheating process did not affect the sensory attributes of the chickpea pasta. In general, the overall acceptability of the CCP pasta was similar to that of the FCP pasta. Conclusions: The results of our study support the hypothesis that a reduced glycemic response after simple changes in technological intervention leads to a decrease in postprandial blood glucose and GI. This can be helpful for people who need to control postprandial glycemia.

Carbohydrate Estimation Accuracy of Two Commercially Available Smartphone Applications vs Estimation by Individuals With Type 1 Diabetes: A Comparative Study.

Despite remarkable progress in diabetes technology, most systems still require estimating meal carbohydrate (CHO) content for meal-time insulin delivery. Emerging smartphone applications may obviate this need, but performance data in relation to patient estimates remain scarce. The objective is to assess the accuracy of two commercial CHO estimation applications, SNAQ and Calorie Mama, and compare their performance with the estimation accuracy of people with type 1 diabetes (T1D). Carbohydrate estimates of 53 individuals with T1D (aged ≥16 years) were compared with those of SNAQ (food recognition + quantification) and Calorie Mama (food recognition + adjustable standard portion size). Twenty-six cooked meals were prepared at the hospital kitchen. Each participant estimated the CHO content of two meals in three different sizes without assistance. Participants then used SNAQ for CHO quantification in one meal and Calorie Mama for the other (all three sizes). Accuracy was the estimate's deviation from ground-truth CHO content (weight multiplied by nutritional facts from recipe database). Furthermore, the applications were rated using the Mars-G questionnaire. Participants' mean ± standard deviation (SD) absolute error was 21 ± 21.5 g (71 ± 72.7%). Calorie Mama had a mean absolute error of 24 ± 36.5 g (81.2 ± 123.4%). With a mean absolute error of 13.1 ± 11.3 g (44.3 ± 38.2%), SNAQ outperformed the estimation accuracy of patients and Calorie Mama (both P > .05). Error consistency (quantified by the within-participant SD) did not significantly differ between the methods. SNAQ may provide effective CHO estimation support for people with T1D, particularly those with large or inconsistent CHO estimation errors. Its impact on glucose control remains to be evaluated.

Feasibility and Acceptability of Standardizing Portions in Restaurants.

Most restaurants serve customers excess calories which significantly contributes to the obesity epidemic. This pilot study tested the feasibility and acceptability of offering customers standardized portions to reduce caloric consumption when dining out in three restaurants. Portions were developed to limit quantity of food served, with lunches and dinners ≤ 700cal and breakfast ≤ 500cal. Participating restaurants developed an alternative "Balanced Portions Menu." Training and instructions were provided with respect to the volume and weight of food to be plated following the standardized guidelines and providing at least one cup of vegetables per lunch/dinner. We invited local residents to help us evaluate the new menu. We monitored restaurant adherence to guidelines, obtained feedback from customers, and incentivized customers to complete dietary recalls to determine how the new menus might have impacted their daily caloric consumption. Of the three participating restaurants, all had a positive experience after creating the new menus and received more foot traffic. One restaurant that did not want to change portion sizes simply plated the appropriate amount and packed up the rest to-go, marketing the meals as "Dinner today, lunch tomorrow." Two of the restaurants followed the guidelines precisely, while one sometimes plated more rice than the three-fourths cup that was recommended. A significant number of customers ordered from the Balanced Portions menus. Two of the three restaurants have decided to keep offering the Balanced Portions menus indefinitely. Following standardized portions guidelines is both feasible for restaurants and acceptable to customers.

Why do patients refuse hospital meals? Reflections on the nutritionDay Audit at the University Hospital in Krakow.

I n t r o d u c t i o n: Despite increased awareness of malnutrition and improved nutrition-related policies, there are still cases of deterioration of nutritional status during hospitalisation. NutritionDay is an audit organised by the European Society for Clinical Nutrition and Metabolism (ESPEN), the Medical University of Vienna and the Friedrich-Alexander University Erlangen-Nürnberg (FAU) to prevent the onset of malnutrition and to improve hospital policies to deal with this problem. The aim of the study was to analyse the results of the audit with regard to factors that may contribute to the deterioration of a patients' nutritional status in hospital setting. Materials and Methods: This cross-sectional study was performed in a tertiary teaching hospital and was part of an international audit. The questionnaires used were provided by the nutritionDay office, and included information on weight loss, patients' appetite, dietary restrictions, food intake and reasons for food rejection during hospital stay. R e s u l t s: Of the examined patients, 61% reported weight loss prior to the current hospital stay. We identified 25 patients who did not consume a whole portion of their main meal on the day the audit took place. Approximately 17% of the patients' complaints could be resolved within a hospital ward. C o n c l u s i o n s: Hospital patients often eat less than a standard meal portion. Identifying the reasons for meal rejection may be helpful for development of standards for nutritional care in the hospitals.

Validity and Reproducibility of a Semiquantitative Food Frequency Questionnaire and Food Picture Book in Nigeria

BackgroundIncreasing noncommunicable diseases in Nigeria are partly related to dietary factors. However, the lack of validated nutrition assessment tools hinders the conduct of nutritional epidemiology research in this population. ObjectivesTo develop a Food Frequency Questionnaire (FFQ) and Food Picture Book (FPB) for Nigerian adults, and to assess its reproducibility and validity compared with 24-h dietary recalls (24DRs) during different seasons in the year. MethodsWe compiled 202 foods for the FFQ through focus groups and consultations with local dietitians. We created an FPB with standardized food portion images to enhance the accuracy of reports of dietary intakes. We administered the FFQs to 205 purposively selected adults in Ibadan, Nigeria at ∼6 monthly intervals between November 2018 and October 2020. We evaluated the FFQ’s reproducibility and validity compared with 24DR across the dry and rainy seasons by examining the consumption of common food and mixed dishes. We computed the Spearman’s correlation coefficients (SCC), intraclass correlation coefficients (ICC), and Wilcoxon signed-rank tests, and generated Bland and Altman plots. ResultsOverall, we studied 110 women (53.7%) and 95 men (46.3%) with a mean age of 45.0 ± 13.4 y (mean ± SD). The reproducibility tests showed a mean ± SD SCC of 0.39 ± 0.14 and mean ± SD ICC of 0.32 ± 0.12. Higher mean ± SD SCC values were noted for cereal products (0.43 ± 0.09), starchy roots and tubers (0.45 ± 0.17), and soups (0.44 ± 0.20). Conversely, lower mean ± SD SCC values were observed for milk products (0.29 ± 0.02), solid fats (0.29 ± 0.26), and fish (0.22 ± 0.19). Regarding validity tests, the overall mean ± SD SCC was 0.27 ± 0.16 and mean ± SD ICC was 0.26 ± 0.16. We observed seasonal variations in intakes of fruits, cassava flour-based products, and nuts, although most foods did not show significant differences in intakes between seasons. ConclusionsOur FFQ and FPB demonstrated moderate correlations and seasonal variations in intakes of certain foods, emphasizing the need to account for seasonality in dietary intakes in nutritional studies in Nigeria and similar countries.

In Vitro Assessment of the Bioaccessibility of Zn, Ca, Mg, and Se from Various Types of Nuts.

The bioaccessibility of zinc (Zn), calcium (Ca), magnesium (Mg), and selenium (Se) from various nuts (Brazil nuts, walnuts, peanuts, almonds, cashews, pecans, hazelnuts, macadamia nuts, and pistachios) was assessed using a simulated two-phase model of enzymatic digestion in vitro. The levels of Zn, Mg, and Ca were determined by atomic absorption spectrometry, and Se was measured by inductively coupled plasma-mass spectrometry. All tested nuts were good sources of Mg, and most, except macadamia nuts, were also good sources of Zn (the standard portion covers over 15% of NRV-R (UE) 1924/2006). Brazil nuts had the highest Se content. Almonds and Brazil nuts were rich in Ca. Se demonstrated the highest bioaccessibility from nuts (27.7% to 70.65%), whereas Ca exhibited the lowest bioaccessibility (below 9%). Pistachios had the highest Zn bioavailability, while cashews excelled in Mg bioaccessibility. Macadamia and pistachios were top for Ca bioaccessibility, and Brazil nuts for Se. Bioaccessibility is positively correlated with fat (for Zn: r = 0.23), carbohydrates (for Mg: 0.44; for Ca: 0.35), and sugar content (for Zn: r = 0.36; for Mg: 0.46; for Ca: 0.40).

An exploration of customers’ perceptions, preferences, experiences, and feasibility of offering standardized portions in restaurants

Excess caloric intake increases the risk of weight gain, and diet-related chronic diseases. Restaurants play an integral role in the portions of food people consume. Standardization of portion sizes in restaurants can help customers recognize appropriate portions. Through customer interviews, we aimed to assess and understand the feasibility, perceptions, and acceptability of standardized portions in restaurants. Kaiser Permanente partnered with three restaurants in Southern California to create alternative menu options of meals that would not exceed 700 calories. Kaiser Permanente members who lived within a 5-mile radius of the restaurants were informed through email about the study. Customers (N = 33), who dined at one of the restaurants participated in a one-on-one semi-structured interview. Interviews were recorded, typed, transcribed verbatim, and analyzed using thematic analysis. Four themes emerged from the analysis: 1) Customers perceive standard portions as a better choice and the benefits outweigh regular portions; 2) Individual and restaurant-related factors may influence portion preferences; 3) Restaurant portions are perceived to be in excess of what customers need; and 4) Portion standardization is an evolving area for restaurants. Our findings suggest positive perceptions and acceptance of standardized portions among restaurant customers. Customer awareness and restaurant standardization procedures can improve customers’ dining experience.

Significant inequalities in the cost of food for households with children in Israel in 2018

Abstract Background Dietary guidelines for families with children are designed to reach the Dietary Recommended Intake. However, the cost of a healthy diet and the extent to which families can afford it in Israel is unclear. Methods The distribution of ages and the number of children per household in Israel in 2018 was obtained from the Central Bureau of Statistics. Food prices were purchased from the commercial company Stornext. The cost of the recommended food items in the healthy diet for adults and children was calculated using standard food portions and meal frequency as well as a percentage of the household's net income. The proportion of households for which food expenditures exceed 15% of the net income was calculated by income quintiles, followed by changes in food prices during 2018. Results The average daily cost of a healthy diet was 35.51±7.7 new Israeli shekels (NIS). The older the individual, the more food costs increase. The ratio between the average cost of breakfast, lunch, dinner, and two intermediate meals was 1.5:3.4:1.2:1, respectively. The median monthly dietary cost for households with children as a percentage of net income was 20%. There was an inverse association with socioeconomic status (SES) as the median monthly food expenses for the first (lowest) quintile was 55% of the household's income and only 9.3% of the 5th (highest) income quintile. The food group that composed the highest component of the food budget was the vegetable group, with an average cost of 29% monthly, followed by the meat and meat substitutes group (19%). Discussions Policymakers should consider steps to decrease health inequality in food affordability targeting the three middle-lower income quintiles. The cost of a healthy diet compared with food expenditure in high-income countries was 1.8 higher in Israel. Our findings indicate that expanding the program to provide school lunches five days a week to more students would reduce household food expenditures by 15%. Key messages • Households with children in Israel would need to spend 20% of their net income to meet dietary guidelines. • Significant gaps by income quintile, number of children, and food group were identified.

Taxonomic significance of leaf architecture in the genus Basella Linn. in Nigeria

This study seeks to use the leaf architecture as a taxonomic tool for members of the genus Basella Linn. in Nigeria, namely, B. rubra Linn., B. alba Linn., B. cordifolia Lamk. and a form, B. alba round because the taxonomy of the genus Basella Linn. is not clear and there is no information on the leaf architecture of the genus. For studies of the venation pattern of the leaves, sizeable portions were taken from the standard median portion of mature leaves. Cleared leaves were stored in 50% alcohol for anatomical studies. Leaves were stained in Safranin O for 3 minutes and counterstained in Alcian blue and then were rinsed in water to remove excess stain. Stained cleared leaves were treated in serial grades of alcohol for differentiation and dehydration. Stained materials were mounted in dilute glycerol for microscopic examination. Photomicrographs were taken with the aid of 3013 ACCU-SCOPE Trinocular Microscope with Digital Camera. The areolar area was calculated from the length and breadth of the areoles measured using a micrometer inserted into the microscope eyepiece. Basella species have common generic features. Areoles are closed in B. rubra but others have veinlet endings. The area of areole is diagnostic because in B. rubra the area is 305,370±1808.91 μm2; B. alba is 501,796.75±3217.38 μm2, B. cordifolia’s area of areole is 396,394.75±2670.67 μm2 while that of B. alba round is 540,058.75±3702.28 μm2. The arrangement of druses in the areoles is also diagnostic.

The Effect of High Glycemic Modified Breakfast Menu on Increasing Learning Concentration of Junior High School Students Insan Cendekia Mandiri (ICM) Sarirogo – Sidoarjo

The nutritional adequacy of the Insan Cendekia Mandiri (ICM) junior high school students is obtained from the provision of food in the dormitory. One way to increase the acceptance of food intake organized by the boarding institution at the Insan Cendekia Mandiri Junior High School (ICM) is to modify the food menu. The provision of food doesn’t escape the standard portion for each individual so takes a portion of food that is by the RDA, so that it can be seen whether the individual needs of junior high school students have been met or not. This study aims to analyze the effect of modifying the menu of a high-glycemic meal on the acceptability and increase in learning concentration in students of SMP Insan Cendekia Mandiri in Sarirogo, Sidoarjo. This research method uses a pre-experimental design with a one-group pretest-posttest to determine the quality of the modification of the high-glycemic plate menu through the level of preference, acceptance of the increase in learning concentration of junior high school students at Insan Cendekia Mandiri (ICM) Sarirogo, Sidoarjo. The research sample was 37 junior high school students taken by simple random sampling using a formula to meet the inclusion and exclusion criteria. The variables in this study consisted of independent variables, namely modification of high glycemic prescriptions, the dependent variable was acceptance and learning concentration. The research instrument used is a 7-day menu cycle using organoleptic tests by conducting pre and posttest. The result is The breakfast menu from ICM has a lower glycemic index than the modified menu because of the ingredients used. There is a difference in the average energy value in the modified menu, which is 102.5 kcal compared to the breakfast menu from ICM, 2,94 grams of protein average higher than the breakfast menu on ICM, 10,9 grams of fat higher than the breakfast menu on ICM and then 10,76 grams of carbohydrate average lower than breakfast menu on ICM, and student concentration has increased because of the modified menu which has a high glycemic index.

Role of Portion Size in the Context of a Healthy, Balanced Diet: A Case Study of European Countries

Over the past decades, a generalised increase in food portion sizes has probably contributed to the growing global obesity epidemic. Increasing awareness of appropriate portion sizes could contribute to reversing this trend through better control of calorie intake. In this study, a comparison of standard portion sizes in European countries for various food categories shows a wide variability of their importance for food, nutrient, and energy consumption according to government and institutional websites. On the other hand, the overall averages appear to be largely in line with the values indicated by the Italian Society of Human Nutrition, which is the most comprehensive and detailed document among those evaluated. The exceptions are milk and yoghurt, for which the reference portions in Europe are generally higher, and vegetables and legumes, for which portions are smaller than those reported in the Italian document. Moreover, the portion sizes of staple foods (e.g., pasta and potatoes) vary according to different food traditions. It is reasonable to consider that the creation of harmonised standard reference portions common to the European countries, based on international guidelines and scientific evidence, would significantly contribute to consumers' nutritional education and ability to make informed choices for a healthy diet.

Foods, nutrients and hip fracture risk: A prospective study of middle-aged women

Hip fracture affects 1.6 million people globally each year, and increases morbidity and mortality. There is potential for risk reduction through diet modification, but prospective evidence for associations between intake of several foods and nutrients and hip fracture risk is limited. This study aimed to investigate associations between food and nutrient intakes and hip fracture risk in the UK Women's Cohort Study, and to determine the role of body mass index (BMI) as a potential effect modifier. Dietary, lifestyle, anthropometric, and socio-economic information of UK women, ages 35-69 years, were collected in a survey at recruitment (1995-1998), and included a validated 217-item food frequency questionnaire. Hip fracture cases were identified by linking participant data at recruitment with their Hospital Episode Statistics (HES) up to March 2019. Cox regression models were used to estimate associations between standard portions of food and nutrient intakes and hip fracture risk over a median follow-up time of 22.3 years. Among 26,318 women linked to HES data (556,331 person-years), 822 hip fracture cases were identified. After adjustment for confounders, every additional cup of tea or coffee per day was associated with a 4% lower risk of hip fracture (HR (95% CI): 0.96 (0.92, 1.00)). A 25g/day increment of dietary protein intake was also associated with a 14% lower risk of hip fracture (0.86 (0.73, 1.00)). In subgroup analyses, BMI modified linear associations between dietary intakes of protein, calcium, total dairy, milk, and tea and hip fracture risk (pinteraction=0.02, 0.002, 0.003, 0.001, and 0.003, respectively); these foods and nutrients were associated with a reduced risk of hip fracture in underweight but not healthy or overweight participants. In particular, risk of hip fracture in underweight participants (28 cases, 545 participants) was 45% lower for every 25g/day protein consumed (0.55 (0.38, 0.78)). This is the first prospective cohort study internationally of multiple food and nutrient intakes in relation to hip fracture risk by BMI using linkage to hospital records. Results suggest that the potential roles of some foods and nutrients in hip fracture prevention, particularly protein, tea and coffee in underweight women, merit confirmation. Clinicaltrials.gov NCT05081466.

Nutritional quality and greenhouse gas emissions of vegetarian and non-vegetarian primary school meals: A case study in Dijon, France.

Since 2018 in France, national regulation mandates that school canteens serve a weekly vegetarian meal to reduce school canteens' environmental impact in addition to previous regulations imposing nutritional composition guidelines. However, a lunch without meat is often perceived as inadequate to cover the nutritional needs of children. The present study aims to assess the nutritional quality and greenhouse gas emissions (GHGE) of vegetarian and non-vegetarian school meals served in primary schools in Dijon, France. The catering department provided the composition of 249 meals served in 2019. Nutritional content and GHGE were retrieved from national food databases. The portion size of each meal component was the standard portion size recommended by the relevant French authority (GEMRCN). Meals were classified into vegetarian meals, i.e., without meat or fish (n = 66), or non-vegetarian meals (n = 183). The nutritional adequacy of the meals for children aged from 6 to 11 years was estimated using the mean adequacy ratio (MAR/2,000 kcal) as the mean percentage of daily recommended intake for 23 nutrients and the mean excess ratio (MER/2,000 kcal) as the mean percentage of excess compared to the maximum daily recommended value for three nutrients. This analysis of actual school meals shows that both vegetarian and non-vegetarian meals had a similar good nutritional quality with MAR/2,000 kcal of 87.5% (SD 5.8) for vegetarian and of 88.5% (SD 4.5) for non-vegetarian meals, and a MER/2,000 kcal of 19.3% (SD 15.0) for vegetarian and of 19.1% (SD 18.6) for non-vegetarian meals. GHGE were more than twofold reduced in vegetarian compared to non-vegetarian meals (0.9 (SD 0.3) vs. 2.1 (SD 1.0) kgC02 eq/meal). Thus, increasing the frequency of vegetarian meals, by serving egg-based, dairy-based or vegan recipes more frequently, would reduce GHGE while maintaining adequate nutritional quality of primary school meals.

A Clustering Approach to Meal-Based Analysis of Dietary Intakes Applied to Population and Individual Data

ABSTRACTBackgroundExamination of meal intakes can elucidate the role of individual meals or meal patterns in health not evident by examining nutrient and food intakes. To date, meal-based research has been limited to focus on population rather than individual intakes, without considering portions or nutrient content when characterizing meals.ObjectivesWe aimed to characterize meals commonly consumed, incorporating portions and nutritional content, and to determine the accuracy of nutrient intake estimates using these meals at both population and individual levels.MethodsThe 2008–2010 Irish National Adult Nutrition Survey (NANS) data were used. A total of 1500 participants, with a mean ± SD age of 44.5 ± 17.0 y and BMI of 27.1 ± 5.0 kg/m2, recorded their intake using a 4-d weighed food diary. Food groups were identified using k-means clustering. Partitioning around the medoids clustering was used to categorize similar meals into groups (generic meals) based on their Nutrient Rich Foods Index (NRF9.3) score and the food groups that they contained. The nutrient content for each generic meal was defined as the mean content of the grouped meals. Seven standard portion sizes were defined for each generic meal. Mean daily nutrient intakes were estimated using the original and the generic data.ResultsThe 27,336 meals consumed were aggregated to 63 generic meals. Effect sizes from the comparisons of mean daily nutrient intakes (from the original compared with generic meals) were negligible or small, with P values ranging from <0.001 to 0.941. When participants were classified according to nutrient-based guidelines (high, adequate, or low), the proportion of individuals who were classified into the same category ranged from 55.3% to 91.5%.ConclusionsA generic meal–based method can estimate nutrient intakes based on meal rather than food intake at the sample population and individual levels. Future work will focus on incorporating this concept into a meal-based dietary intake assessment tool.

Comparison of antimicrobial activity of three root canal sealers

Background Endodontic sealers with antimicrobial properties can be advantageous as they would cope better with persisting residual infection and bacteria reentering from the oral cavity. Hence we compare the antimicrobial activity of three endodontic sealers AH Plus, Apexit plus and MTA Fillapex on Enterococcus Faecalis, Staphylococcus Aureus and Candida Albicans. Material and Method : Antimicrobial activity of the materials was evaluated by the method of agar diffusion. A base layer of 10 ml of Mueller Hinton agar was poured in Petri plates (90 x 15 mm). Three wells of 6 mm of diameter (one for each material) were obtained by removing a standardized portion of the agar in equidistant points with the aid of sterilized plastic straw. The wells were immediately filled with the sealers to be evaluated. The endodontic sealers AH Plus, Apexit Plus and MTA Fillapex were prepared according to the manufacturer’s instruction. Inhibition halos formed around the wells were measured with the aid of a millimetric rule with 0.5 mm of accuracy. All the experiments were repeated three times in different moments Results :Antimicrobial action of AH Plus was superior to that of Apexit Plus and MTA Fillapex against all the tested microorganisms p &lt; 0.05).

Trends and amounts of consumption of low-calorie sweeteners: A cross-sectional study.

White sugar has been blamed to cause health consequences including diabetes and obesity. With the increased need to decrease sugar intake, attention was shifted towards sugar alternatives also known as low-calorie sweeteners. Low-calorie sweeteners are ubiquitous within food products, but their consumption among Lebanese adults isn't well elucidated. Our study aims to investigate the trends and amounts of low-calorie sweeteners' consumption in addition to their main sources among a sample of Lebanese adults. A cross-sectional study was conducted over 384 adult Lebanese individuals from both genders residing in Beirut and Mount-Lebanon from February to August 2020. After excluding eight individuals, 376 completed the survey. To assess the trends, frequency and quantity of low-calorie sweeteners' consumption, a questionnaire was filled by trained and licensed dietitians in addition to a previously validated food frequency questionnaire adapted to the most widely known products in the Lebanese market. Food products were divided into categories, amount of sweeteners in each item was obtained from the label, and analysis was performed according to the type of sweetener they are made of. Frequencies were converted into numbers of servings per day and multiplied by the standard portion size. Daily individual consumption of each sweetener apart was obtained by multiplying the amount of sweetener in each item consumed by total daily consumption. The amount in mg/kg was obtained by dividing total consumption of each sweetener apart by the mean weight of our population. The Statistical Package for Social Sciences (SPSS) was used for data entry and analysis. Results showed that 94.4% were consuming an artificially-sweetened item at least once in the last six months. While weight loss and healthy lifestyle constituted the main reasons for past and current consumption respectively, safety and unpleasant taste affected consumption trends. Pills and powders' consumption was significantly associated with gender (p=0.032) and dieting (p=0.000) but not with age (p=0.831), educational level (p=0.294), living district (p=0.421) or income (p=0.828) where women and dieters used significantly more pills and powders than their counterparts. "Food and beverages" consumption was independent of all factors except age (p=0.001); it peaked at 26-40 and declined thereafter. Consumption of low-calorie sweeteners came mainly from beverages and was as follows while remaining within the acceptable daily intake limits: aspartame: 98.9mg/d (1.38mg/kg/d); sucralose: 22.19mg/d (0.31mg/kg/d); acesulfame-K: 39.12mg/d (0.55mg/kg/d); stevia 3.28mg/d (0.05mg/kg/d). Food and beverages were consumed more than pills and powders due to unintentional consumption. Despite that safety and unpleasant taste affected consumption of low-calorie sweetened products, intake of such products was found to be highly prevalent in the studied population. While remaining within the acceptable daily intake limits, consumption of food and beverages exceeded that of pills and powders due to unintentional consumption making awareness a necessity to help consumers make an informed decision. Moreover, a nation-level study is needed to generalize the results.

The Instrumentation of Standard Diet Food Portions for Diabetes Mellitus

The right diet is needed in the treatment of Diabetes Mellitus. The dietary standards used must be by their nutritional adequacy. This study aims to determine the effectiveness of the use of aluminum cup serving tools for standard measuring devices in the Diabetes mellitus diet. The portion measurement instrument is designed by 1P, 1 1 / 2P, and 2P standards. The study was conducted at a laboratory scale in 2018 with a quasi-experimental approach. Data analysis uses Analysis of Variance (ANOVA) with α = 5%. The results show that the average effectiveness of 1P portion accuracy is 99%, 1½ P for 101%, and 2P about 99.6%. There was no difference in effectiveness compared to using a scale and there were differences in measurements using bowls and spoons. Standard portion of 1P measuring instruments 114% effectiveness bowl and 113% spoon, standard 1½ P portion for 107% bowl and 105% spoon, and 2P standard portion for measuring the effectiveness of the portion of the bowl is 104% and 103% spoon. Using a measuring device Aluminum cup portions, both 1P, 1.5P, and 2P parts can determine the value of food and nutritional adequacy standards of patients with Diabetes Mellitus.

“This snack is too small - I'll take a different one”: Quantifying ‘norm’ and ‘choice’ boundaries to inform effective portion-reduction strategies

Previous research suggests that portion sizes can be categorised as ‘normal’ or ‘abnormal’ and that reduced portions which are still categorised as normal do not promote compensatory responses in intake. However, a critical question remains – will consumers choose a reduced portion product from among standard portion competitors? For the first time, we explore the effects of portion reduction on food choice. Participants (N = 45) categorised 20 different portions (range 40–420 kcal) of five snacks as normal or abnormal (to quantify individual ‘norm boundaries’ for each food) and rated their desire to eat each snack. Using a 2-alternative forced choice hypothetical task, we then calculated a ‘choice boundary’ by offering smaller portions of their most-desired snack (range 40–240 kcal) alongside standardised portions (240 kcal) of the less-desired foods. Boundaries were derived using probit analysis (choice boundary mean = 185.8 kcal, SD = 54, norm boundary mean = 127.3 kcal, SD = 49.5) and these deviated significantly (p < .01, d = 0.98, mean difference = 58.0 kcal, SD = 59.1). Critically, this shows that only a small reduction – where the product is still considered normal - can nudge a consumer to select an alternative. Choice boundaries were also affected by differences in desire to eat; when two foods were desired to a similar degree, only minor reductions in the size of the favourite food elicited a switch in choice. Together, these findings indicate that portion reduction can also influence food choice, highlighting the importance of measuring choice boundaries before reformulating commercial products.

Proposal of 0.5mg of protein/100g of processed food as threshold for voluntary declaration of food allergen traces in processed food-A first step in an initiative to better inform patients and avoid fatal allergic reactions: A GA²LEN position paper.

Food anaphylaxis is commonly elicited by unintentional ingestion of foods containing the allergen above the tolerance threshold level of the individual. While labeling the 14main allergens used as ingredients in food products is mandatory in the EU, there is no legal definition of declaring potential contaminants. Precautionary allergen labeling such as "may contain traces of" is often used. However, this is unsatisfactory for consumers as they get no information if the contamination is below their personal threshold. In discussions with the food industry and technologists, it was suggested to use a voluntary declaration indicating that all declared contaminants are below a threshold of 0.5mg protein per 100g of food. This concentration is known to be below the threshold of most patients, and it can be technically guaranteed in most food production. However, it was also important to assess that in case of accidental ingestion of contaminants below this threshold by highly allergic patients, no fatal anaphylactic reaction could occur. Therefore, we performed a systematic review to assess whether a fatal reaction to 5mg of protein or less has been reported, assuming that a maximum portion size of 1kg of a processed food exceeds any meal and thus gives a sufficient safety margin. MEDLINE and EMBASE were searched until 24January 2021 for provocation studies and case reports in which one of the 14major food allergens was reported to elicit fatal or life-threatening anaphylactic reactions and assessed if these occurred below the ingestion of 5mg of protein. A Delphi process was performed to obtain an expert consensus on the results. In the 210studies included, in our search, no reports of fatal anaphylactic reactions reported below 5mg protein ingested were identified. However, in provocation studies and case reports, severe reactions below 5mg were reported for the following allergens: eggs, fish, lupin, milk, nuts, peanuts, soy, and sesame seeds. Based on the literature studied for this review, it can be stated that cross-contamination of the 14major food allergens below 0.5mg/100g is likely not to endanger most food allergic patients when a standard portion of food is consumed. We propose to use the statement "this product contains the named allergens in the list of ingredients, it may contain traces of other contaminations (to be named, e.g. nut) at concentrations less than 0.5mg per 100g of this product" for a voluntary declaration on processed food packages. This level of avoidance of cross-contaminations can be achieved technically for most processed foods, and the statement would be a clear and helpful message to the consumers. However, it is clearly acknowledged that a voluntary declaration is only a first step to a legally binding solution. For this, further research on threshold levels is encouraged.

The Estimation of Standard Portion Sizes Using Food Photographic Booklet Among University Students in Turkey

Objective: To examine estimation of standard portion size and, the influence of different food plates on the estimation of food portion size, using photograph booklet in students.&#x0D; Methods: The sample consisted of 300 students, aged 18-35 years old from different academic departments. The student’s general characteristics were asked by using a questionnaire, and anthropometric measurements were taken. Students were asked to select the standard portion sizes of each food from a photographic booklet, which was developed by the researchers. Dietary guidelines for Turkey were used for assessing the quantity of standard portion size of foods of a photographic booklet (1).&#x0D; Results: The findings of the present study indicate that the food group which the most students provided the accurate estimation was protein foods (36.0%), pursued by grains (35.1%), dairy (29.2%), fruits and vegetables group (28.9%). The most and the least accurate estimated foods were found boiled potato (64%) and cheese (3.7%), respectively. The percentages of the accurate estimation of standard portion size for five foods (meatball, meat cubes, shredded chicken, egg, yogurt) in 24 foods were higher in females than men (p