Importance of Food Composition Data to Nutrition and Public Health

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ORIGINAL ARTICLE Importance of food composition data to nutrition and public health

I Elmadfa and AL Meyer

Institute of Nutritional Sciences, University of Vienna, Althanstrasse, Vienna, Austria

Introduction: Adequate nutrition is one of the pillars of public health. Before developing and implementing effective intervention programmes to improve nutrition at the population level, it is important to know the nutritional situation of the target group. Assessment of energy and nutrient intake: The estimation of nutrient intake from food consumption requires reliable data on food composition. These data are also the fundamentals of food-based dietary guidelines for healthy nutrition, containing the necessary information on food sources for different nutrients. Furthermore, food composition tables can provide information on chemical forms of nutrients and the presence and amounts of interacting components, and thus provide information on their bioavailability. For some nutrients such as vitamin A, vitamin E and niacin, the concept of equivalence has been introduced to account for differences in the availability and biological activity of different chemical forms. Non-nutritive food components: Although most food composition tables focus on energy, macro- and micronutrients, interest in non-nutritive components is increasing. Considering the beneficial effects of biologically active secondary plant cell compounds such as polyphenols and carotenoids, more data on these are needed. On the other hand, there are a number of naturally occurring or ‘man-made’ non-nutritive substances with negative effects, and to control exposure, the main dietary sources must be known. Another aspect is contaminants, which could have detrimental effects on consumers’ health. Among these are agrochemicals, industrial pollutants reaching the food chain and substances formed during food preparation. A valid risk assessment requires data on exposure, and thus on the contents of contaminants in foods. However, these data are highly variable and may significantly differ even within narrowly confined regions. Current food composition databases are far from complete: The fact that composition tables generally do not provide information about the origin of substances found in food can also influence their usability. For example, the German Nutrient Data base does not discriminate between naturally occurring and added sucrose impeding the estimation of added sucrose intake that should be limited. Points of focus: Considering the increasing number of persons relying on community nutrition and catering, healthy menu lines can improve the consumers’ diets and contribute to nutrient supply. The development and implementation of appropriate guidelines also need food composition databases (FCBs) to compose meals. The ever-increasing number of new food preparations and manufactured products has resulted in a need for procedures for regularly updated data. Moreover, there is a lack of data particularly for essential trace elements such as copper, chromium or molybdenum and also vitamin K, as well as the already mentioned non-nutritive components. Limited comparability between countries is another issue. Regional differences arise especially from the use of local varieties, different soil quality or meteorological aspects. This variability is further increased with composite meals because of variation in recipes. Conclusion: Information about food composition is necessary for the assessment of diet quality and the development and application of food-based dietary guidelines, providing a useful tool for the field of public health nutrition. In this regard, more attention should be paid to the preparation, extension and maintenance of FCBs. European Journal of Clinical Nutrition (2010) 64, S4–S7; doi:10.1038/ejcn.2010.202

Keywords: food composition; databases; nutrition; public health; non-nutritive compounds

Introduction: a brief history of food composition databases

Correspondence: Professor I Elmadfa, Institute of Nutritional Sciences, University of Vienna, Althanstrasse 14, Vienna 1090, Austria. Food composition databases (FCDBs) are not a recent E-mail: [email protected] attainment. With the emergence of chemistry, interest in Food composition and public health nutrition I Elmadfa and AL Meyer S5 the components of food also arose and the first FCDBs date the distinction between naturally occurring and added mono- back to the second half of the nineteenth century. In those and disaccharides is rather difficult in a mixed diet. However, times, sufficiency and adequacy of the diet, particularly with the content of certain critical nutrients such as added sugars, regard to macronutrients and minerals, were the main foci of saturated fatty acids or salt is often used as an indicator of the food analysis, as most vitamins were only discovered later. healthiness of a diet (Livingstone and Rennie, 2009). Studies on prisoners to determine their nutritional requirements and search for possible alternative food sources are other examples of this pursuit (Carpenter, 2006). Interest- Factors influencing food composition and ingly, natural variation in food composition was already nutrient intake being taken into account by the Dutch scientist Jacob Moleschott (Moleschott, 1859). However, the influence of Food composition can be influenced by a number of factors, food on health was also recognised (Carpenter, 2003) and it many of which can barely be controlled. Indeed, seasonal is noteworthy that the major British FCDB published in 1940 variation can be quite large for the content of micronutrients by McCance and Widdowson (1940), and regularly updated and bioactive substances in plant foods. Regional disparities since then, was preceded by earlier work aimed at providing also occur. An example is the composition of fatty acids in data for the composition of therapeutic diets for diabetics. milk depending on the diet received. Milk from cows kept The first FCDB for the United States of America, compiled on high altitude pastures in the Alps is richer in n-3 by Atwater and Woods (1896), also encompassed data on polyunsaturated fatty acids and conjugated linoleic acid processed foods but not for dairy products. Another two very than milk from those in the lowlands or kept indoors. Season early FCDBs come from Sweden and Denmark, having been also has an effect (Collomb et al., 2008). published in 1879 and 1888, respectively. Systems from When considering a certain food as a source for a given other countries followed later, mostly after World War II. nutrient, bioavailability has an important role but may be Moreover, the problem of the lack of comparability between difficult to estimate if information about factors reducing or the various national reports has been recognised for some enhancing it and the nutrient’s chemical and binding form time. Accordingly, a first attempt to create a FCDB for is not available. In addition, some nutrients can be derived international use was made as long ago as 1949 on the Food in the body from precursors, such as vitamin A from and Agriculture Organization’s initiative (Church, 2006). provitamin A-carotenoids or niacin from tryptophan, so that Today, many countries have their national databases that the total amount provided by a food can be much higher than are regularly updated. However, in light of the increasing that for the mere preformed nutrient. To take this into account, globalisation of the food market, regional and international equivalents are used on the basis of the metabolism of the databases are becoming ever more important. different forms. Vitamin A serves as an example with 6 mg of b-carotene and 12 mg of other vitamin A-active carotenoids, yielding 1 mg retinol (FAO/WHO, 2002). However, more recent Food composition data in nutritional assessment findings suggested higher factors for carotenoids with regard to its lower bioavailability from fruit and vegetables (West et al., Providing the necessary data for the estimation of the intake of 2002). Thus, there is still some discrepancy about the optimal nutrients and other food components is still one of the major conversion factors to use for a mixed diet and they can also be applications of FCDB. Today, the nutrient content of a given altered by physiological conditions. Indeed, the conversion diet is generally calculated with special software programmes of tryptophan to niacin shows individual variations and is that are based on available FCDB. Although it is theoretically much more efficient during pregnancy (Horwitt et al., 1981). possible to analyse directly the nutrient content of the Information about the contents of different metabolites may consumed food, this is rarely carried out and is not applicable thereforeenableamoreaccurateestimation of nutrient intake to large-scale assessments required for representative national and its contribution to an individual’s status. nutrition surveys. For these, calculating the composition of the diet using FCDB is the method of choice. However, different FCDBs may differ strongly from each other with Food composition data as a basis of nutrition regard to the nutrients they include. Thus, their utility counselling depends on the purpose of the analysis. Although energy and total amounts of macronutrients constitute the basic FCDBs are not only needed for the assessment of nutritional components, data on some compounds are less readily status but they also provide the basis for the formulation of available. This is true for some fatty acids and trace elements, food-based dietary guidelines (FBDGs) to improve a population’s folate, as well as for particularly bioactive compounds and diet. FBDGs translate nutrient-based recommendations into contaminants (Greenfield and Southgate, 2003; Palmer a form that is more applicable by consumers. As such, they Zimmerman et al., 2008). Furthermore, it is not always possible have an important role when it comes to behavioural to know about the provenance of a certain nutrient in modifications that are considered a major means for composite foods as in the case of sugar, for instance, wherein the prevention of overweight and lifestyle-associated

European Journal of Clinical Nutrition Food composition and public health nutrition I Elmadfa and AL Meyer S6 non-communicable diseases. Although recommendations various amino acids, gluten or antigens. The importance of generally refer to food groups as a whole, information on reliable data on food composition for therapeutic diets was the nutritional quality of individual foods is needed in order recognised long ago and, for McCance, it was the main to compose a diet designed to meet specific requirements. reason for compiling his database which, in its updated Accordingly, the concept of nutrient profiling aims to classify form, is still in use in the United Kingdom (Church, 2006). foods according to defined criteria, typically fat content and For diabetics, exchange lists have been commonly used fatty acid pattern, amounts of sugars, fibre, salt and certain classifying foods according to their carbohydrate, energy micronutrients. This approach is especially required to deter- and fat content. Foods can be substituted within groups, mine whether nutrition and health claims should appear facilitating diet composition and adjustment of medication on food (Lobstein and Davies, 2009; for more details on for patients. Newer approaches have focussed on glycaemic nutrition and health claims see Buttriss and Benelam, 2010). index and carbohydrate counting (Gillespie et al., 1998). Besides indicating the nutrient contents by weight unit or portion on food packages, rating systems allowing an easy and rapid appraisal of the product, thus facilitating con- The need for data on other food components sumer choices, have been proposed. Among these, the traffic light system has been intensely debated, being particularly In recent times, new functions beyond mere supply of popular in the United Kingdom (Lobstein and Davies, 2009). energy and nutrients have been assigned to nutrition, as Labelling is increasingly considered as a tool to educate food components with biological activities have been consumers to make healthier food choices. Simple front-of- discovered. They have emerged as substantial contributors package labels appear better suited to this purpose by helping to the health-promoting effects of fruits, vegetables, nuts, consumers in their decision taking (Grunert and Wills, seeds and wholegrain cereals, and encouraging the con- 2007). Indeed, despite some controversies, use of labels can sumption of these foods is therefore an integral part of have a beneficial influence on food choices (Pietinen et al., nutrition campaigns. The knowledge about optimal food 2007; Variyam, 2008). sources requires data about the distribution and amounts of Recently, a number of nutrient profiling tools have been bioactive compounds in foods (Ritchie et al., 2006; for more developed to enable a rapid evaluation of foods. As details on the EuroFir eBasis, providing information on examples, the Nutrimap system (Bio Intelligence Service, bioactive compounds, see Kiely et al., 2010). However, so far, Paris, France; Labouze et al., 2007) and the HANCP tool most FCDBs do not encompass these data or only for some created as part of the European Union-funded project Food- foods (Palmer Zimmerman et al., 2008). In addition, their Profit may be mentioned. The latter particularly targets concentration in foods is subject to a high variability small- and medium-sized enterprises of the food sector to depending on plant variety, cultivation and geographical help producers and caterers improve the nutritional quality conditions (Hecke et al., 2006; Raffo et al., 2006). On the of their products (Colom, 2009). other hand, data on potentially harmful food components With the increasing importance of catering and commu- such as pesticides, contaminants or by-products of food nity nutrition, menus offered in canteens and restaurants processing, such as trans-fatty acids or acrylamide, are also have become a focus of public health nutritionists as a means important when making nutritional recommendations, to improve diet patterns. For example, the German Nutrition providing the basis for the estimation of exposure and risk Society (Deutsche Gesellschaft fu¨r Erna¨hrung, DGE) and the assessment (Jakszyn et al., 2004). They also provide the basis Austrian Nutrition Society (O¨ sterreichische Gesellschaft fu¨r for recipe reformulation and modifications of production Erna¨hrung, O¨ GE) offer a certificate for healthful menu lines methods aimed at reducing the amount present in food prepared according to their guidelines (DGE, 2009) and, (Birlouez-Aragon et al., 2010). In addition, completing again, FCDBs provide the basis for composing the meals and missing values for specific compounds is important to reduce choosing food items. the risk of underestimating exposure that can arise from designating a missing value as null (Merchant and Dehghan, 2006). FCDB in the planning of clinical and therapeutic nutrition Conclusion A special application of FCDB to diet composition is the planning of nutrition as part of a therapy. Well-known Information on food composition is of great importance for examples of diseases that require avoidance or accurate scientists and practitioners working in the fields of nutrition monitoring of certain nutrients include diabetes mellitus and public health. The most apparent role is to provide and dyslipidaemia. Although data on total carbohydrate the basis for dietary assessment and the formulation of and fat contents and major fatty acid classes are widely healthier diets. Ready meals and food served in canteens are available, there is less information on other components increasingly included in this approach considering their with pathological relevance such as fructose, lactose or contribution to daily nutrition. For the general population,

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