Objective: To explore published and unpublished research into consumer understanding and use of nutrition labelling which is culturally applicable in Europe.

Improvements in nutrition labelling could make a small but important contribution towards making the existing point-of-purchase environment more conducive to the selection of healthy choices. In particular, interpretational aids can help consumers assess the nutrient contribution of specific foods to the overall diet.

Objective: Nutrient profiling can be defined as the 'the science of categorising foods according to their nutritional composition'. The purpose of the present paper is to describe a systematic and logical approach to nutrient profiling. Design: A seven-stage decision-making process is proposed and, as an illustration of how the approach might operate in practice, the development of a nutrient profiling model for the purpose of highlighting breakfast cereals that are 'high in fat, sugar or salt' is described. Results: The nutrient profile model developed for this paper calculates scores for foods using a simple equation. It enables breakfast cereals to be compared with each other and with other foods eaten at breakfast. Conclusion: Nutrient profiling is not new, but hitherto most nutrient profiling models have been developed in an unsystematic and illogical fashion. Different nutrient profiling models are needed for different purposes but a key requirement should be that they are developed using a systematic, transparent and logical process. This paper provides an example of such a process; approaches to validating nutrient profiling models are described elsewhere.

Objective: To compare nutrient profile models with a standard ranking of 120 foods. Design: Over 700 nutrition professionals were asked to categorise 120 foods into one of six positions on the basis of their healthiness. These categorisations were used to produce a standard ranking of the 120 foods. The standard ranking was compared with the results of applying eight different nutrient profile models to the 120 foods: Models SSCg3d and WXYfm developed for the UK Food Standards Agency, the Nutritious Food Index, the Ratio of Recommended to Restricted nutrients, the Naturally Nutrient Rich score, the Australian Heart Foundation's Tick scheme, the American Heart Association's heart-check mark and the Netherlands tripartite classification model for foods. Rank correlation was assessed for continuous models, and dependence was assessed for categorical models. Results: The continuous models each showed good correlation with the standard ranking (Spearman's r ¼ 0.6-0.8). The categorical models achieved high x 2 results, indicating a high level of dependence between the nutrition professionals' and the models' categorisations (P , 0.001). Models SSCg3d and WXYfm achieved higher scores than the other models, implying a greater agreement with the standard ranking of foods. Conclusions:The results suggest that Models SSCg3d and WXYfm rank and categorise foods in accordance with the views of nutrition professionals. Keywords Nutrition Nutrition assessment Nutritional requirements Food Food analysis LegislationNutrient profiling can be defined as 'the science of categorising foods according to their nutritional composition' 1 . It can be used in a range of different circumstances including the regulation of food labelling, food advertising and vending of foods. Nutrient profile models can categorise foods in a variety of ways. One way is to divide foods into two or more groups and to categorise groups as healthier than others on the basis of one or more nutritional characteristics of the foods. This 'categorical' approach has been used by food retailers, food manufacturers and others for designating ranges of products as, for example, 'low-fat' or 'healthy'.Another approach is to rank foods from the most healthy to least healthy, again using one or more nutritional characteristics of the food. Each food is given a score based on those characteristics. We have used this approach to develop various nutrient profile models for the UK Food Standards Agency (FSA) 2 -4 . Continuous models can be converted to categorical models by designating foods below a certain score as, for example, 'low-fat' or 'healthy'.Nutrient profiling has, however, been hampered by a lack of validity testing. The method most commonly used is to examine different foods to assess whether the nutrient profile model classifies them appropriately. This assessment is generally done purely subjectively by the team developing the model. Generally the approach taken is to identify 'anomalies' that are generated by the model, and if there are too many of th...

Objective: To provide a basis for making recommendations on the potential to improve use of folic acid supplements in the UK, particularly among low-income and young women. Design: Systematic reviews of relevant research from 1989 to May 2006 in Europe, the USA, Canada, Australia and New Zealand. Results: Twenty-six systematic reviews and/or meta-analyses were identified from the wider public health literature, and eighteen studies on the effectiveness of preconception interventions were included. Ninety studies were identified which were directly relevant to folic acid supplement intake. There were factors that are particularly associated with lower rates of use of folic acid supplements. One of the most important of these is the link with unintended pregnancy, followed by age, socio-economic and ethnic group. Integrated campaigns can increase the use of folic acid supplements to some extent. Research trials indicated that: (i) printed resources and the mass media used in isolation are not effective in the longer term; and (ii) health-care-based initiatives can be effective and are more likely to be successful if they include making supplements easily available. Conclusions: Campaigns and interventions have the potential to exacerbate socioeconomic inequalities in folic acid use. One way of addressing this is to include elements that specifically target vulnerable women. To achieve and maintain an effect, they need to be based on good health promotion practice and to be sustained over a long period. However, even high-quality campaigns that increase use result in under half of women in the target group taking supplements. Keywords Folate Folic acid Supplements Neural tube defects Public health policies/interventionsThe overall aim of the work described in the present paper was to use a systematic approach to carry out literature reviews of research that has been done on influencing low-income groups, particularly girls/young women, to change their behaviour in relation to health. The intention was to provide a basis for making evidencebased recommendations on the potential to improve use of folic acid supplements in the UK.This was achieved by carrying out three complementary reviews. The first two of these provided a basis for the main (third) review. They were intended to assess whether there are findings from the wider public health literature (rather than work focusing specifically on folic acid) that might inform the development of effective interventions to increase use of folic acid supplements. Review 1 identified published systematic reviews or meta-analyses of initiatives that required 'positive precautionary action' by women. Review 2 identified research relevant to the effectiveness of different approaches to preconception interventions on behaviour. Review 3 formed the main part of the work, and focused specifically on quantitative or qualitative research aimed at encouraging women, particularly girls/young women and those from low-income groups, to take folic acid in the periconceptional p...

BackgroundThe prevalence of overweight and obesity in Europe is high. It is a major cause of the overall rates of many of the main chronic (or non communicable) diseases in this region and is characterized by an unequal socio-economic distribution within the population. Obesity is largely determined by modifiable lifestyle behaviours such as low physical activity levels, sedentary behaviour and consumption of energy dense diets. It is increasingly being recognised that effective responses must go beyond interventions that only focus on a specific individual, social or environmental level and instead embrace system-based multi-level intervention approaches that address both the individual and environment. The EU-funded project “sustainable prevention of obesity through integrated strategies” (SPOTLIGHT) aims to increase and combine knowledge on the wide range of determinants of obesity in a systematic way, and to identify multi-level intervention approaches that are strong in terms of Reach, Efficacy, Adoption, Implementation and Maintenance (RE-AIM).Methods/DesignSPOTLIGHT comprises a series of systematic reviews on: individual-level predictors of success in behaviour change obesity interventions; social and physical environmental determinants of obesity; and on the RE-AIM of multi-level interventions. An interactive web-atlas of currently running multi-level interventions will be developed, and enhancing and impeding factors for implementation will be described. At the neighbourhood level, these elements will inform the development of methods to assess obesogenicity of diverse environments, using remote imaging techniques linked to geographic information systems. The validity of these methods will be evaluated using data from surveys of health and lifestyles of adults residing in the neighbourhoods surveyed. At both the micro- and macro-levels (national and international) the different physical, economical, political and socio-cultural elements will be assessed.DiscussionSPOTLIGHT offers the potential to develop approaches that combine an understanding of the obesogenicity of environments in Europe, and thus how they can be improved, with an appreciation of the individual factors that explain why people respond differently to such environments. Its findings will inform governmental authorities and professionals, academics, NGOs and private sector stakeholders engaged in the development and implementation of policies to tackle the obesity epidemic in Europe.

There is substantial scope to use nutrient profiling as part of the policies for the prevention of DRCD. A core nutrient-profiling system underpinning the various applications is likely to reduce discrepancies and minimise the confusion for regulators, manufacturers and consumers. It seems feasible that common elements, such as a standard scoring method, a core set of nutrients and food components, and defined food categories, could be incorporated as part of a core system, with additional application-specific criteria applying. However, in developing and in implementing such a system, several country-specific contextual and technical factors would need to be balanced.

Nutrition, physical activity and health related promotion programmes in schools have developed into a mature field of research over the past decades. A number of success factors have been identified and evidence-based interventions have been performed. However, the school setting as an arena for evidence-based health promotion programmes, is still not used to its full potential. Schools provide an excellent arena for reaching large segments of the population, such as young people, school staff, families and the surrounding community. There is a need for an overview regarding the current status of nutrition, physical activity, related health as well as support structures in the EU member states. Based upon such an analysis, a consensus report should be written, pointing out the major problems at hand. Self-assessment tools for national as well as for school level should be produced, in order to guide changes, but also to include an element of continuous assessment of change, for evaluation purposes. Keywords School Diet Physical activity Dietary guidelines Health promotion Nutrition education InterventionBeginning prevention early by improving lifestyles and focusing on healthful food choices within the context of the total diet has the potential for a major impact on the future of adult chronic diseases 1 . Healthy eating and regular physical exercise help young people to feel good, perform better at school and avoid developing risk factors which may lead to major chronic diseases and premature death. A relevant education in nutrition, physical activity and health, is a key element to promoting lifelong healthy eating and exercise behaviours. In order to successfully promote diet-and physical activity-related health, other factors such as effective policies that facilitate a positive school environment are required 2,3 . The school setting provides a valuable opportunity to influence health through policy measures, education and food provision. Schools provide the most effective and efficient way to reach a large segment of the population, including young people, school staff, families and community members. Evidence baseMajor early literature reviews of nutrition education programmes in school settings 4 highlighted the need for more and better research in this field. Much of the early research in school health education focused on knowledge-based classroom programmes. Many knowledge-based studies did not consider the multiple factors influencing eating behaviours, i.e. interactions between individuals and their social and physical environments 4,5 . Nutrition education in general and school-based education in particular has however developed into a mature field of research over the past decades.A review of the research studies conducted during the 1980s found that there had been a dramatic increase in school-based nutrition education research, with improved research designs and methodologies compared with previous reviews 6 . The importance of making nutrition messages developmentally appropriate and d...