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- Determinantes das escolhas alimentares infantis em restaurantes de fast-foodPublication . Rocha, Ada; Viegas, Cláudia; Peixoto, CláudiaNos últimos anos, verificou-se uma alteração no ritmo de vida da população, que se traduziu numa mudança dos hábitos de consumo, com um aumento do consumo de refeições fora de casa, incluindo pelas crianças. Na maioria das vezes, os locais escolhidos para realizar as refeições são os restaurantes de fast-food. Geralmente as refeições preparadas neste tipo de restaurantes, incluindo as refeições infantis, têm uma qualidade nutricional muito baixa. O comportamento das crianças em relação às suas escolhas alimentares, é afetado por vários determinantes de consumo, pelo que o principal objetivo deste estudo foi identificar os determinantes das escolhas alimentares infantis em restaurantes de fast-food. De forma a atingir este objetivo, foi elaborado um questionário, disponibilizado online dirigido a pais de crianças com idades compreendidas entre os 6 e os 12 anos. Observou-se que para as crianças, os fatores determinantes na escolha do restaurante de fast-food e da refeição consumida, foram, por ordem de importância: a oferta de um brinquedo colecionável/promocional, as opções disponíveis e o sabor agradável da refeição. Para os pais, os fatores mais relevantes no momento da escolha do restaurante de fast-food e da refeição infantil consumida, foram a conveniência do local, o preço acessível, o sabor agradável e as preocupações com a saúde, respetivamente. Os resultados deste estudo evidenciam a necessidade de reformular e desenvolver refeições infantis equilibradas sem comprometer a palatabilidade, associando a estas opções equilibradas a oferta de brindes colecionáveis.
- Focus on food instead of nutrients improves consumers’ understanding of meals’ nutrition qualityPublication . Viegas, Cláudia; Lamy, E.; Prada, M.; Rocha, AdaBackground: Nowadays, most of the information directed to consumers focuses on nutrients, ignoring the impact of the interactions between different foods, origin, or degree of processing. The methodologies currently applied have led consumers to confuse foods with nutrients, meat, and fish are often referred to as “proteins”, and grains and potatoes are referred to as “carbohydrates, forgetting that these foods are sources of other nutrients, such as fat, proteins, or fiber. Furthermore, its efficacy is compromised by the difficulties of reading labels among consumers. Objectives: This study aimed to evaluate the understanding of food and nutritional information presented in menus to consumers, comparing the nutrient-focused approach (Nutrition Declaration) and the new food-focused approach (infographic - based on the Portuguese food Guide, from previous research). Methods: 4 different meals were created, 2 balanced and complete in terms of food and nutrient content and 2 unbalanced and incomplete. A questionnaire was applied, evaluating the understanding of the balance and healthiness of the meals, using the two approaches (nutrient-focused and food-focused). The order of presentation of the approaches and the meals was randomized for all participants. The questionnaire was distributed online through snowball sampling. Results: 221 individuals participated, mostly female (67%), aged 25 to 54 years old. Evaluation of meals (“how balanced” and “how to complete” the meal is) using the Nutrition Declaration did not allow to distinguish the quality of meals (Mb ¼ 3,8; Mc¼4,0), in opposite the Infographic returned significant differences between M1/M2 (Mb ¼ 4,3; Mc¼4,4) and M3/M4 (Mb ¼ 2,5; Mc¼2,6) (p < 0.01) allowing consumers to perceive differences between meals. The percentage of consumers that responded “I don’t know” to these questions decreased using the food-focused tool (13% vs 2%). Conclusions: The food-focused approach allows for a better understanding of meals’ nutritional balance.
- KIMEHS – Proposal of an index for qualitative evaluation of children’s menus: a pilot studyPublication . Rocha, Ada; Viegas, CláudiaConsidering the importance of the food environments for health promotion, and the lack of simple, easy-to-use, low-cost measures of the quality of meals, the authors developed a qualitative menu index (KIMEHS-Kids' Menu Healthy Score), tailored to children's menu evaluation. Development of the tool was based on the Mediterranean food pattern. It includes 18 components, divided into seven main groups that reflect key aspects of menu quality, including protein source, side dishes, vegetables, dessert and beverages, and also allergens and nutritional information. The index was analysed for content and construct validity, as well as inter-rater reliability, and was applied to a sample of menus from restaurants in shopping centres in the Lisbon region. Possible index point ranges from -17 to 17, with a higher score indicating greater compliance with the recommendations. A value of 5.5 is obtained if all KIMEHS items are available, considering healthy and non-healthy options. The inter-rater reliability was assessed and values above 0.80 were obtained for Alpha Cronbach, as well as agreement % rate >75%. Agreement percentage is above 75% for all the components. Evaluated restaurants scored from -14 to 7, with an average KIMEHS of -6.15. Only four restaurants scored positive values, ranging from 0.25 to 7. KIMEHS was considered to be an adequate index to evaluate children's menus, from the menu information displayed on restaurant websites and/or on restaurant displays or table menus. It is a simple, low-cost tool that may be used as a reference for health professionals as an objective measure to evaluate the food environment. Stakeholders could also be involved in their own assessment to help educate consumers about healthy food choices, strengthening the efforts to promote an adequate food pattern and health, contributing to the fight against obesity.
- Alimentação individual e coletiva: nutrir pessoas, planear refeições e gerir serviçosPublication . Rocha, Ada; Damas, Carlos; Viegas, CláudiaImagine uma manga... Fruta exótica, suculenta e saborosa, rica em carotenos e vitamina C, disponível em qualquer supermercado a preço acessível, mas que viaja milhares de quilómetros, atravessando oceanos e continentes, para chegar à nossa mesa. A distância não torna esta manga mais interessante do ponto de vista alimentar, nem é sinónimo de que a globalização e facilidade nas trocas mundiais sejam fatores que contribuem para uma mesa mais rica. Uma dieta melhor e uma maior literacia alimentar não são determinadas (em regra) por informação em excesso e muitas vezes contraditória, pelo acesso a um leque muito diversificado de alimentos — como se a sua mera soma encerrasse em si vantagem —, ou pela disponibilidade destes alimentos ao longo de todo o ano. O admirável mundo novo e sedutor dos alimentos exóticos, de geografias que desafiam a curiosidade à mesa, ofusca muitas vezes o discernimento dos consumidores face ao produto local. Afasta-nos dele, das suas virtudes, da sua origem próxima, do ciclo de vida por que passa e de como o respeito pelo consumo local também é importante na promoção de uma alimentação equilibrada. Neste contexto, palavras que façam alusão a “saúde” e “bem-estar” ou expressões como “estilo de vida saudável” e “alimentação equilibrada e sustentável” poderão não passar de meros rótulos à boleia da dita globalização alimentar e apropriação insustentável de recursos planetários que sabemos finitos. Saúde e literacia à mesa precisam-se. É necessário recentrar o foco de abordagem: sem desprezo pelos nutrientes consumidos e sem desvalorizar o meio através do qual são veiculados — os alimentos. Há, pois, que procurar inverter o cenário que anteriormente sumariámos: (re)conciliar os consumidores com os alimentos que tecem o seu dia a dia; reativar a relação dos alimentos com o seu teor em nutrientes; e desenvolver uma cultura alimentar que aperfeiçoe as competências culinárias, como forma de tornar a dieta mais rica. Isto sem desmerecer uma realidade transversal à vida moderna, a do consumo de alimentos fora de casa, nos diferentes contextos da alimentação coletiva, como restaurantes, cantinas, refeitórios, entre outros. Uma vez mais, é preciso modelar a oferta alimentar nestes locais, orientando a criação de ementas que contemplem refeições mais saudáveis e sustentáveis. Com a presente obra, pretendemos levar ao leitor uma abordagem da nutrição numa perspetiva enriquecedora e esclarecedora dos alimentos, das suas características e de como deles podemos beneficiar individual e coletivamente. Este é um manual que se quer prático, com aplicação a contextos concretos, e em que são referidas porções de alimentos e valores nutricionais. Na primeira parte do livro, apresentamos os grupos alimentares e as recomendações nutricionais ao longo do ciclo de vida e explicamos como calcular as quantidades de alimentos para atingir essas recomendações. Na segunda parte, abordamos o planeamento de um serviço de refeições, das respetivas ementas e a sua adaptação aos diferentes contextos da restauração. Na terceira e última parte, são incluídos alguns aspetos legais a cumprir, nomeadamente no que diz respeito aos alergénios e à rotulagem da oferta alimentar. Não menos importante, exploramos ainda o tema da sustentabilidade, como garantia da sua autopreservação, mas também como exigência de responsabilidade social.
- Development of a tool to assess the compliance of canteen menus with the Mediterranean dietPublication . Neto, B.; Ferreira, L.; Rocha, Ada; Viegas, CláudiaThe Mediterranean Diet (MD) is one of the healthiest food patterns associated with important health benefits. Acknowledging this, it’s important to understand how the dietary patterns of the consumers align with the MD. Over time, different authors have formulated several indexes for this purpose. However, current indexes lack standardization, and they only evaluate the quality of the diet of individuals to be used by health professionals and political decision-makers. Although there are indexes to assess the food options at the restaurants, none of them assess the menu compliance with the MD. Due to the importance of food services in the food choices and dietary patterns of the consumers, this research developed an index to assess the alignment of food availability with the MD key points. To address this gap, after reviewing the existing indexes in the literature, the authors created a tool that assesses the degree of compliance of menus with the MD - MedCIn. This index is divided into 4 dimensions, the first one assesses the availability (part A) and variety (part B) of the food/food groups. The second dimension assesses the nutritional quality of the menus based on the nutritional declaration, the third dimension assesses the food portions and culinary options, and the fourth dimension allows the verification of the previous information on site. Although the use of all dimensions allows for a more comprehensive menu evaluation, dimension one can be used as a first approach to MD compliance. The index is meant to be applied in a 4-week cycle, though it can be adapted for each food service. Validation of this tool included construct validity, internal consistency, and inter-rater reliability, all of which returned high values (alpha-Cronbach¼0.88; Cohens Kappa¼0.92). The researchers consider this a reliable tool to easily assess compliance of menus with MD key points, allowing for the identification of issues to be addressed and improved.
- Quality of kids’ meals in fast-food restaurants: the nutritional content is not enough for an informed choicePublication . Pinto, Daniela Costa; Viegas, Cláudia; Rocha, AdaObjective: Eating out in restaurants is a common family behavior, but it has been persistently associated with unbalanced nutrient intakes, contributing to create and reinforce unhealthy food habits among children. The purpose of this study was to evaluate the kids’ meals from three common well-known restaurant chains in Portugal. Methods: The nutritional composition (total fat, carbohydrates, protein, and sodium content) of the menus was analyzed bromatologicaly, and food portions were also examined. The assessment was carried out according to the European Food Safety Authority recommendations. Results: Analyses of the menus from the two points of view revealed that the evaluations for macronutrients and food portions may return contradictory results. Protein, carbohydrates, and fats are compliant with the requirements for most meals. The analysis from the food portion perspective exceeds the requirements for the meat, fish, and eggs groups, as well as for fats and oils. Fruits, vegetables, and pulses are not present in the menus. Despite the balance associated with the macronutrients, the salt content exceeds the recommendations for most of the meals. Conclusions: Popular fast-food chain restaurants have already adapted to comply with nutritional recommendations, whilst neglecting important recommended foods such as fruit, pulses, and vegetables. This study points not only to the need of investing in the improvement of the offerings but also to the importance of fighting the tendency to reduce the perception of food quality to its nutritional content, leading consumers to believe that the meals offered are balanced when they are not.
- Menos nutrientes e mais alimentos: proposta de abordagem para escolhas conscientesPublication . Viegas, Cláudia; Rocha, AdaAs preocupações com a alimentação e nutrição fazem parte da realidade dos dias de hoje, existindo uma cada vez maior atenção por parte do público em relação às características nutricionais dos alimentos que escolhem e consomem. A abordagem focada nos nutrientes é reducionista e dificulta a compreensão do consumidor sobre a melhor forma de avaliar a sua ingestão alimentar. No entanto, esta continua a ser a prática que prevalece em todos os contextos, quer na indústria alimentar, na restauração, na publicidade e nos supermercados. O objetivo deste trabalho foi desenvolver uma abordagem disruptiva de aplicação das recomendações alimentares veiculadas pela Roda dos Alimentos. Com base neste guia foi desenvolvida uma infografia a partir dos valores de referência médios para os adultos. A disponibilização desta informação nas ementas, menus, receitas, entre outros, assim como nos produtos alimentares permitiria facilitar a consciencialização da quantidade consumida em relação às porções diárias, assim como melhorar a perceção do que é uma porção para os vários tipos de alimentos, e de como o conjunto das diferentes refeições e produtos alimentares permitem atingir as recomendações alimentares e nutricionais.
- Changes in food behavior during the first lockdown of COVID-19 pandemic: a multi-country study about changes in eating habits, motivations, and food-related behaviorsPublication . Lamy, Elsa; Viegas, Cláudia; Rocha, Ada; Raquel Lucas, Maria; Tavares, Sofia; Capela e Silva, Fernando; Guedes, David; Laureati, Monica; Zian, Zeineb; Machado, Alessandra Salles; Ellssel, Pierre; Freyer, Bernhard; González-Rodrigo, Elena; Calzadilla, Jesús; Majewski, Edward; Prazeres, Ibrahim; Silva, Vlademir; Juračak, Josip; Vorlíčková, Lenka Platilová; Kamutali, Antonino; Tschá, Elizabeth Regina; Villalobos, Keylor; Želvytė, Rasa; Monkeviciene, Ingrida; Elati, Jalila; Pinto, Ana de Souza; Castelo, Paula Midori; Anzman-Frasca, StephanieThe COVID-19 pandemic resulted in severe, unprecedented changes affecting the world population. Restrictions in mobility, social distancing measures, and the persistent social alarm, during the first period of the pandemic, resulted in dramatic lifestyle changes and affected physical and psychological wellbeing on a global scale. An international research team was constituted to develop a study involving different countries about eating motivations, dietary habits, and behaviors related to food intake, acquisition, and preparation. This study presents results of an online survey, carried out during the first lockdown, in 2020, assessing food-related behavior and how people perceived them to change, comparatively to the period preceding the COVID-19 outbreak. A total of 3332 responses, collected from 16 countries, were considered for analysis [72.8% in Europe, 12.8% in Africa, 2.2% in North America (USA), and 12.2% in South America]. Results suggest that the main motivations perceived to drive food intake were familiarity and liking. Two clusters were identified, based on food intake frequency, which was classified as “healthier” and “unhealthier”. The former was constituted by individuals with higher scholarly levels, to whom intake was more motivated by health, natural concerns, and weight control, and less by liking, pleasure or affect regulation. The second cluster was constituted by individuals with a higher proportion of males and intake more influenced by affect-related motivations. During this period, a generalized lower concern with the convenience attributes of foods was noted (namely, choice of processed products and fast-food meals), alongside an increase in time and efforts dedicated to home cooking. Understanding the main changes and their underlying motivations in a time of unprecedented crisis is of major importance, as it provides the scientific support that allows one to anticipate the implications for the future of the global food and nutrition system and, consequently, to take the appropriate action.
- Challenges of food service towards sustainability beyond food wastePublication . Rocha, Ada; Viegas, CláudiaFood service comprises the production of meals consumed outside the home, including consumers from all age groups and in different sectors, such as schools (from kindergarten to university), public and private companies, the health sector (from hospitals to elderly care institutions), military, sports facilities and restaurants (from fine dining to fast-food). Food service units (FSU) achieved importance and responsibility not only for feeding the population but also as an important setting for public health interventions, potentially educating consumers and modulating behaviors through the meals provided. In addition to its socioeconomic impact, the food service industry has a strong environmental impact. More sustainable food service starts with the basics: minimizing environmental impact by reducing carbon footprint. The food service industry is being encouraged to make choices that positively impact the environment. Nevertheless, most of the efforts and research made in the last years have been focused on evaluating and reducing food waste. This article focuses on strategies that could be implemented beyond food waste, and act on changing the food offered towards health and sustainability while promoting consumer behavior change.
- Promoting healthier and sustainable diets: evidence from the interdisciplinary MedDietMenus4CampusPublication . Viegas, Cláudia; Rocha, Ada; Prada, MaríliaFood service comprises the production of meals consumed outside the home, including consumers from all age groups and in different sectors. This service sector has evolved through the years, providing an increasing number of meals, which have been drifting away from the Mediterranean Food Pattern. Food service is an important setting for public health interventions, educating consumers, and modulating behaviors through the meals provided. Prior research on eating habits has mainly focused on a single stakeholder - typically consumers - and on a narrow set of outcome variables. Although these studies provide important clues about the determinants of adherence to food offers, research has yet to address this issue using an integrative approach of multiple stakeholders (e.g., the consumers, food providers, and decisors) across a set of different variables. Also, intervention initiatives, usually act only on the environment without strategies that efficiently engage all the stakeholders involved. In contrast, to promote behavioral change this research will focus on Social Marketing as it has been acknowledged as an effective strategy to enhance the health and well-being of consumers. Establishing and managing long-term partnerships that include different groups of stakeholders - consumers, government, retailers, and other players - are key elements in the application of mid and upstream social marketing to complex issues. The project’s main ambition is to change the food service paradigm, by creating and implementing a new healthy and sustainable food service concept complying with the Mediterranean diet, as well as solutions that comply with consumers’ new needs, and also developing and implementing strategies that engage all the stakeholders with this concept. We expect to create the reference in terms of food offer that will be demanded by consumers of the next generations and the standpoint to inspire the other food service sectors/ settings to achieve an effective and sustainable food offer change and positively influence food service consumers’ food patterns towards Mediterranean recommendations. In this workshop, the findings of the project will be presented focusing on examining the barriers and facilitators of adherence to the Mediterranean Diet in the menus offered in public high education institutes canteens in Portugal, Turkey, and Croatia. To promote the identification of effective intervention pathways, we take on an interdisciplinary approach, integrating the theoretical and methodological frameworks of Nutrition, Psychology, and Marketing.