Explore the vast range of titles available.

Historically, much of the discussion surrounding infant feeding focused on promoting breastfeeding the first six months (at least) of an infant's life, and avoiding breastmilk substitutes. In 1981, the World Health Organization (WHO) developed the International Code of Marketing of Breast-Milk Substitutes to restrict the marketing of breastmilk substitutes.1 However, other beverages and toddler foods do not have the same marketing restrictions under the code, and therefore formula companies have broadened into other sections of infant and toddler feeding such as ultra-processed baby foods. The definition of infant formula is milk formula directed at children aged 0-12 months; it excludes growing-up formula as milk formula directed at children aged 12-36 months, and baby food as all packaged foods and/or beverages marketed to infants and toddlers aged 6-36 months.The world is experiencing a continued global transition towards increasing consumption of infant formula, growing-up formula and processed baby foods:2 the global infant and toddler food market is projected to reach 120 billion United States dollars (US$) by 2030.3This increased consumption represents a critical change in infant and toddler food habits as historically, food habits were centred around minimally processed food. The shift towards feeding infants and toddlers ultra-processed foods brings health risks such as increases in abdominal obesity and worse future health outcomes, and may impact future food preferences.4,5A key shift in the infant and toddler food sector is in the amount of sugar added to these foods. Excess sugar consumption is a primary cause of obesity and related diseases, including diabetes, heart disease and some cancers.6 WHO guidelines recommend that less than 10% of total calories come from added sugar, preferably less than 5%,6 to reduce the risk of non-communicable diseases and prevent and control unhealthy weight gain and dental caries. However, these guidelines were developed for children older than 2 years and adults.Here we use data from Euromonitor International7 to assess sales trends of milk formula, growing-up formula and baby foods during the past decade as well as the level of sugar sold in the infant and toddler feeding sector.

The consumption of ultra-processed food (UPF) keeps rising, and at the same time, an increasing number of epidemiological studies are linking high rates of consumption of UPF with serious health outcomes, such as cardiovascular disease, in the general population. Many potential mechanisms, either in isolation or in combination, can explain the negative effects of UPF. In this review, we have addressed the potential role of inorganic phosphate additives, commonly added to a wide variety of foods, as factors contributing to the negative effects of UPF on cardiorenal disease. Inorganic phosphates are rapidly and efficiently absorbed, and elevated serum phosphate can lead to negative cardiorenal effects, either directly through tissue/vessel calcification or indirectly through the release of mineral-regulating hormones, parathyroid hormone, and fibroblast growth factor-23. An association between serum phosphate and cardiovascular and bone disease among patients with chronic kidney disease is well-accepted by nephrologists. Epidemiological studies have demonstrated an association between serum phosphate and dietary phosphate intake and mortality, even in the general American population. The magnitude of the role of inorganic phosphate additives in these associations remains to be determined, and the initial step should be to determine precise estimates of population exposure to inorganic phosphate additives in the food supply.

Objective:American diets are increasingly based on ultra-processed foods (UPF). Current research, particularly on socio-economic differentials, is lacking. This study aimed to provide an updated examination of US household purchases of UPF and how this differs by race–ethnicity, household income and household education.Design:The NielsenIQ Consumer Panel 2020 was utilised for analysis. Each food and beverage product purchased by US households was assigned a level of processing under the Nova level of processing classification system. The volume of UPF purchased overall and by food group was determined for each Nova processing group and examined by race–ethnicity, education and income. Results were stratified by race–ethnicity within each income group. A P value < 0·0001 was considered significant.Setting:This study analysed data from the Nielsen IQ Consumer Panel 2020 which recorded household food purchases in the USA.Participants:The Nielsen IQ Homescan Consumer Panel is a nationally representative longitudinal survey of around 35 000 and 60 000 US households.Results:Of 33 054 687 products purchased by 59 939 US households in 2020, 48 % of foods and 38 % of beverages were considered UPF. Categories with the highest proportion of purchases deriving from UPF included carbonated soft drinks (90 %), mixed dishes and soups (81 %) and sweets and snacks (71 %). Slightly higher but statistically significant proportions of UPF purchases occurred in the lowest income and education groups and among non-Hispanic whites.Conclusions:It is concerning that household purchases of UPF in the USA are high. Policies that reduce consumption of UPF may help reduce diet-related health inequalities.

In response to the need for better guidance and regulation for commercially produced infant and toddler foods and beverages, the WHO Regional Office for Europe published a Nutrient and Promotion Profile Model (hereafter NPPM) in 2022. This study assessed the nutritional and promotional profile of infant and toddler foods (for ages 6–36 months) sold in Australian supermarkets in 2022 using the NPPM. The main types of claims used for product promotion were also examined and results were presented by category and by packaging type. Nutrient and claims data were extracted for commercially produced infant and toddler products from The George Institute's FoodSwitch database. Products were classified according to NPPM food categories and assessed against relevant nutritional and promotional requirements. Of the 309 products examined, 78% failed to meet the nutritional requirements of the NPPM, and 0% met the promotional requirements. Every product had at least one claim on‐pack that was prohibited under the NPPM, with some products displaying up to 21 different claims on‐pack. Pouches had the highest number of prohibited claims of all packaging types. Findings highlight that urgent work is needed to improve the nutritional quality of commercially produced infant and toddler foods in Australia. The high use of prohibited claims also suggests the need to regulate the type and number of claims that can be made on‐pack, as parents and carers could easily be misled by the deceptive labelling that is currently allowed to be displayed. Every commercially produced infant and toddler food product available in Australian supermarkets in 2022 failed to meet World Health Organization recommendations for product promotion. Pouches have experienced rapid growth in the infant and toddler food market in Australia and currently represent more than 50% of all products available on supermarket shelves. Key messages Every commercially produced infant and toddler food product available in Australian supermarkets in 2022 failed to meet World Health Organization recommendations for product promotion. A total of 78% of products did not meet the overall nutritional requirements. This was most commonly due to products failing energy and total sugar content requirements. Up to 21 different claims were found on product packaging, with products on average displaying 6.7 claims. Pouches, which have experienced rapid growth in the infant and toddler food market in Australia, currently represent more than 50% of all products available on supermarket shelves. This is concerning, given these products had the highest use of prohibited claims.

Background: Previous studies have indicated that snacking is contributing to increased calories in the American diet, and that the contribution of snacks to energy intake has increased in recent decades. Objective: The objective was to examine trends in the energy intake deriving from snacks and food sources of snacks for US adults over 35 years from 1977 to 2012, and whether these trends differ across sociodemographic groups. Methods: Participants included 74,291 US adults aged ≥19 years who participated in the 1977–1978 Nationwide Food Consumption Survey (NFCS); the 1989–1991 Continuing Survey of Food Intake by Individuals (CSFII), the 1994–1996 CSFII, the 1997–1998 CSFII, National Health and Nutrition Examination Survey (NHANES) 2003–2004, NHANES 2005–2006, NHANES 2009–2010 and NHANES 2011–2012; all surveys are a stratified random sample of the total civilian, non-institutionalized US population. Overall patterns of snacking, trends in energy intake from snacking, trends in snacking food and beverage sources and energy intake from snacks across racial/ethnic, age, education and income groups were examined. Results: For all US adults there was a significant increase in per capita energy intake from snacks from 1977 to 2012 (p < 0.01). Non-Hispanic blacks had the highest snacking energy intake from sugar-sweetened beverages (SSBs) in each year (p < 0.01 for all), with a peak intake in 2003–2006 of 76 kcal per capita per day. Intake of salty snacks increased in all groups between 1977 and 2012, with non-Hispanic blacks having the highest intake in 2009–2012 (p < 0.01). No significant differences were found between income or education groups. Conclusions: Results show that snacking remains a significant component of the US diet and the foods consumed at these snacks (SSBs, desserts and sweets and salty snacks) are not the types of foods recommended by the US dietary guidelines. Our finding that non-Hispanic blacks are consuming a higher proportion of SSBs and salty snacks than other groups, and showing the largest increase in energy intake deriving from snacks overall over the past 35 years, is indeed concerning.

Increased interest among consumers in the reduction of dietary sugar intake has led to the wider availability of food products containing non-nutritive sweeteners (NNS). However, the extent to which NNS are currently being used by manufacturers to sweeten processed food and beverage products, and how NNS may be displacing added sugars as a sweetener is unknown. The current study utilized branded food composition databases from Australia, Mexico, New Zealand and the US to determine the percentage of processed food and beverage products for which there are nutrition data containing NNS and to compare total sugar density (g per 100 mL for beverages and g per 100 g for foods) between products with and without NNS. Ordinary least squares regression at the country-product level was performed to examine associations between presence of NNS and total sugar. Across all countries, 5% of products contained at least one NNS, with the highest prevalence among beverages (22%). Mexico had the highest percentage of products with NNS (11%), as compared to the United States (US) (4%), New Zealand (1%), and Australia (<1%). The presence of NNS was associated with lower mean total sugar density among beverages (range across countries: 7.5 to 8.7 g per 100 mL) and among foods (23.2 to 25.5 g per 100 g). Products with both added sugar ingredients and NNS had a lower overall mean total sugar density when compared to products containing only added sugar ingredients. Due to paucity of data on sales and market shares across these countries, our results do not reflect the extent to which consumers purchase NNS containing products. Continued monitoring of NNS in the food supply, extension of work from these data, and inclusion of market shares of products will be important as more countries introduce policies to reduce sugar.

To quantify progress with the initiation of salt reduction strategies around the world in the context of the global target to reduce population salt intake by 30% by 2025. A systematic review of the published and grey literature was supplemented by questionnaires sent to country program leaders. Core characteristics of strategies were extracted and categorised according to a pre-defined framework. A total of 75 countries now have a national salt reduction strategy, more than double the number reported in a similar review done in 2010. The majority of programs are multifaceted and include industry engagement to reformulate products (n = 61), establishment of sodium content targets for foods (39), consumer education (71), front-of-pack labelling schemes (31), taxation on high-salt foods (3) and interventions in public institutions (54). Legislative action related to salt reduction such as mandatory targets, front of pack labelling, food procurement policies and taxation have been implemented in 33 countries. 12 countries have reported reductions in population salt intake, 19 reduced salt content in foods and 6 improvements in consumer knowledge, attitudes or behaviours relating to salt. The large and increasing number of countries with salt reduction strategies in place is encouraging although activity remains limited in low- and middle-income regions. The absence of a consistent approach to implementation highlights uncertainty about the elements most important to success. Rigorous evaluation of ongoing programs and initiation of salt reduction programs, particularly in low- and middle- income countries, will be vital to achieving the targeted 30% reduction in salt intake.

Reducing population salt intake has been identified as a priority intervention to reduce non-communicable diseases. Member States of the World Health Organization have agreed to a global target of a 30% reduction in salt intake by 2025. In countries where most salt consumed is from processed foods, programs to engage the food industry to reduce salt in products are being developed. This paper provides a comprehensive overview of national initiatives to encourage the food industry to reduce salt. A systematic review of the literature was supplemented by key informant questionnaires to inform categorization of the initiatives. Fifty nine food industry salt reduction programs were identified. Thirty eight countries had targets for salt levels in foods and nine countries had introduced legislation for some products. South Africa and Argentina have both introduced legislation limiting salt levels across a broad range of foods. Seventeen countries reported reductions in salt levels in foods—the majority in bread. While these trends represent progress, many countries have yet to initiate work in this area, others are at early stages of implementation and further monitoring is required to assess progress towards achieving the global target.

Despite growing concerns over the increasing popularity and health impact of commercial foods for infants and toddlers, no nutrition or promotional guidelines currently exist for the United States. In 2022, the WHO Regional Office for Europe published a nutrient and promotion profile model (NPPM) to provide guidance and regulation for commercially produced infant and toddler foods. This study assessed the nutritional and promotional profile of infant and toddler foods (6–36 months of age) collected from the top 10 grocery chains in 2023. Products were assessed against the WHO NPPM nutritional and promotional requirements. The type and number of claims across packaging type were also assessed. Of the 651 products examined, 60% failed to meet the nutritional requirements of the NPPM, and 0% met the promotional requirements. Almost 100% of products had at least 1 claim on-pack that was prohibited under the NPPM, with some products displaying up to 11 prohibited claims. Snack-size packages had the lowest compliance with nutrient requirements. These findings highlight that urgent work is needed to improve the nutritional quality of commercially produced infant and toddler foods in the United States. The high use of prohibited claims also suggests the need to regulate the type and number of claims allowed on-pack.

To investigate changes in mean sugar content of non-alcoholic beverages (overall and sugar-sweetened beverages (SSB)) available for purchase in Australia and to compare signatories . non-signatories of the Australian Beverages Council voluntary pledge from 2018. Retrospective observational study. Australia. About 1500 non-alcoholic beverages per year included in the FoodSwitch Monitoring Datasets for 2015-2019. Overall, mean sugar content fell by 1·3 g/100 ml (17·1 %) from 7·5 g/100 ml in 2015 to 6·2 g/100 ml in 2019. SSB have accounted for about 56 % of all beverages available for purchase since 2015. Between 2015 and 2019, the sugar content of SSB dropped by about 10 % (0·8 g/100 ml). Soft drinks and milk-based drinks were the categories with the largest decrease in sugar content. The greater reduction in sugar observed for beverages overall than SSB suggests at least some of the overall decrease in sugar content is due to the appearance of new products with low or no sugar rather than reformulation. Over the same period, beverages with added non-nutritive sweeteners increased from 41 % to 44 %. The decrease in sugar content for all beverages and SSB was, in general, larger for non-signatories than signatories of the voluntary industry pledge. Between 2015 and 2019, the small reduction in sugar content of non-alcoholic beverages in Australia resulted from the combined effects of introducing low- or no-sugar products and reformulation of some categories of SSB. Further policy and regulatory measures are required to reap the most benefit that sugar reduction among non-alcoholic beverages can bring to population health.