1. Investigación

La política europea de seguridad alimentaria tiene como objetivo garantizar a los ciudadanos una alimentación segura y nutritiva, basada en el análisis del riesgo, compuesto por la determinación del riesgo (asesoramiento científico y análisis de datos), gestión del riesgo (reglamentación y control) y comunicación sobre el riesgo. La sociedad presente y futura plantea retos sociales y sanitarios que pueden comprometer el nivel de seguridad alimentaria, como la globalización, aparición de nuevos alimentos y riesgos emergentes, realización de la compra online, etc., haciendo imprescindible el control por parte de las autoridades sanitarias, así como el autocontrol de los operadores alimentarios, la prevención y el enfoque global, y el compromiso de todos los sectores involucrados (productivo, transformador y comercial). En este capítulo, se abordan fortalezas y debilidades características del grupo poblacional de las personas mayores que, dado el contexto actual y futuro, pueden vulnerar la seguridad alimentaria y la salud de éstos. Asimismo, se muestran posibles amenazas, oportunidades y recomendaciones para evitarlas.

Eating a nutritionally balanced breakfast can be a challenge when following a glutenfree diet (GFD).We assessed the ingredients and nutrient composition of 364 gluten-free breakfast products (GFPs) and 348 gluten-containing counterparts (GCCs), and we analysed the nutritional quality of breakfast in a group of Spanish children and adolescents with celiac disease (CD) (n = 70), as compared to controls (n = 67). Food intakes were estimated using three 24 h dietary records. The composition of GFPs and GCCs was retrieved from the package labels of commercially available products. Most participants (98.5%) ate breakfast daily, and only one person in each group skipped breakfast once. The breakfast contribution of the total daily energy was 19% in participants with CD and 20% in controls. CD patients managed a balanced breakfast in terms of energy (54% from carbohydrates; 12% from proteins; 34% from lipids) and key food groups (cereals, dairy, fruits), but their intake of fruits needs improvement. Compared to controls, breakfast in the CD group provided less protein and saturated fat, a similar amount of carbohydrates and fibre, and more salt. Fibre is frequently added to GFPs, but these contain less protein because of the flours used in formulation. Gluten-free bread contains more fat and is more saturated than is GCC. Sugars, sweets, and confectionery contribute more to energy and nutrient intakes in participants with CD, while grain products do so in controls. Overall, breakfast on a GFD can be adequate, but can be improved by GFPs reformulation and a lower consumption of processed foods.

Ready-to-eat foods have nowadays become a significant portion of the diet. Accordingly, nutritional composition of these food categories should be well-known, in particular its folate content. However, there is a broad lack of folate data in food composition tables and databases. A total of 21 fresh-cut vegetable and fruit packed products were analysed for total folate (TF) content using a validated method that relies on the folate-dependent growth of chloramphenicol-resistant Lactobacillus casei subspecies rhamnosus (NCIMB 10463). Mean TF content ranged from 10.0 to 140.9 lg/100 g for the different matrices on a fresh weight basis. Higher TF quantity, 140.9–70.1 lg/100 g, was found in spinach, rocket, watercress, chard and broccoli. Significant differences were observed between available data for fresh vegetables and fruits from food composition tables or databases and the analysed results for fresh-cut packed products. Supplied data support the potential of folate-rich fresh-cut ready-to-eat vegetables to increase folate intake significantly.

Currently, data concerning the amount of naturally occurring dietary folate in ready-to-eat foods is scarce, in spite of an increasing consumption. Total folate (TF) in 35 chilled ready-to-eat vegetable-based meals, expected to be good natural folate sources, was determined. A validated method that relies on a trienzyme extraction (αamylase, rat plasma conjugase as a substitute to chicken pancreas conjugase, and protease enzymes), and chloramphenicol-resistant Lactobacillus casei subspecies rhamnosus folate dependent growth was developed. No previous reports on folate data in refrigerated ready-to-eat foods from the Spanish market have been published. Vegetable burgers, containing pulses and green leafy vegetables, had the highest folate content (103.8 μg TF/ 100 g fresh weight). Refrigerated recipes including chickpeas, peas, broccoli, or artichokes had an average folate content of 75 μg TF/100 g fresh weight. A typical serving of targeted ready-to-eat meals (175 g) may provide up to 60% of the Dietary Reference Intake for an adult. No differences in TF were found after mild heat treatment, as recommended by the manufacturer before its consumption. Therefore, these products may be used to increase folate intake by choosing naturally rich dietary sources. Data will assist dietary studies in the assessment of population folate dietary intakes.

Gluten-free products (GFP) are a good choice for the replacement of cereals when following a gluten-free diet due to celiac disease (CD). However, commercial GFP are made with highly refined flours and may contain more fat, sugar, and salt, and less fiber and micronutrients than glutencontaining analogues, thus challenging the nutritional adequacy of the diet. The aim of this study is to assess the contribution of GFP to the diets of children and adolescents with CD. Food intakes were assessed in a cross-sectional study on 70 children and adolescents with CD (aged four to 18, 50% females), using three 24-h dietary records. GFP consumption reached 165 g a day and comprised mostly bread and fine bakery ware, followed by pasta. GFP contributed with a high percentage (>25%) to total energy, carbohydrates, fiber, and salt daily intakes and, to a lesser extent (<20%), to fat (including saturated fat), sugars and protein. Contribution of homemade products was testimonial. GFP contribution to total energy intake is significant and, consequently, relevant to the nutritional adequacy of the diet. Children and adolescents with CD could benefit from fat, saturated fat, and salt reduction, and fiber enrichment of processed GFP.

Introducción: Los productos ready-to-eat, ya cocinados, envasados y refrigerados, son cada vez más consumidos en nuestro país. Sin embargo, no existen estudios que cuantifiquen su disponibilidad comercial, composición e información detallada para poder estimar su impacto sobre las ingestas, particularmente de folatos, en los diferentes grupos de población. Objetivos: La finalidad de este trabajo de investigación ha consistido en conocer la disponibilidad actual de alimentos ready-to-eat de base vegetal y aportar datos sobre el contenido de folato total de los mismos. Métodos: La concentración de folato total se determinó en 17 productos precocinados refrigerados, con ingredientes vegetales, mediante el método microbiológico basado en el crecimiento del Lactobacillus casei subespecie rhamnosus resistente a cloranfenicol. La precisión del procedimiento analítico se comprobó mediante un material de referencia certificado y por una prueba de recuperación con ácido fólico tritiado. Resultados y discusión: El contenido medio de FT varió desde 13,6 hasta 103,8 µg/100 g de peso fresco, siendo superior en hamburguesas vegetales, recetas con garbanzos, guisantes o alcachofas con jamón. Los alimentos se sometieron al tratamiento térmico indicado por el fabricante previo a su consumo, observándose que no existen pérdidas de folatos durante este último procesado. El coeficiente de variación de los duplicados del mismo producto fue inferior al 15%. Conclusiones: Se presentan datos pioneros relativos al análisis de folatos en alimentos ready-to-eat en el mercado español, que ayudarán a evaluar la adecuación de la ingesta de folatos en la población. El contenido de folatos de estos productos, su facilidad de consumo y atractiva presentación, los convierte en fuentes potenciales de la vitamina.

In the past, food fortifi cation along with nutritional education and the decrease in food costs relative to income have proven successful in eliminating common nutritional defi ciencies. These defi ciencies such as goiter, rickets, beriberi, and pellagra have been replaced with an entirely new set of “emergent defi ciencies” that were not previously considered a problem [e.g., folate and neural tube defects (NTDs)]. In addition, the different nutrition surveys in so-called affl uent countries have identifi ed “shortfalls” of nutrients specifi c to various age groups and/or physiological status. Complex, multiple-etiology diseases, such as atherosclerosis, diabetes, cancer, and obesity have emerged. Food fortifi cation has proven an effective tool for tackling nutritional defi ciencies in populations; but today a more reasonable approach is to use food fortifi cation as a means to support but not replace dietary improvement strategies (i. e. nutritional education campaigns). Folic acid (FA) is a potential relevant factor in the prevention of a number of pathologies. The evidence linking FA to NTD prevention led to the introduction of public health strategies to increase folate intakes: pharmacological supplementation, mandatory or voluntary fortifi cation of staple foods with FA, and the advice to increase the intake of folate-rich foods. It is quite contradictory to observe that, regardless of these fi ndings, there is only limited information on food folate and FA content. Data in Food Composition Tables and Databases are scarce or incomplete. Fortifi cation of staple foods with FA has added diffi culty to this task. Globally, the decision to fortify products is left up to individual food manufacturers. Voluntary fortifi cation is a common practice in many countries. Therefore, the “worldwide map of vitamin fortifi cation” may be analyzed. It is important to examine if fortifi cation today really answers to vitamin requirements at different ages and/or physiological states. The real impact of vitamin fortifi cation on some key biomarkers is also discussed. An important question also to be addressed: how much is too much? It is becoming more evident that chronic excessive intakes may be harmful and a wide margin of safety seems to be a mandatory practice in dietary recommendations. Finally, the “risk/benefi t” dilemma is also considered in the “new” FA-fortifi ed world.

Promoting folate intake from natural food sources is a healthy worldwide strategy for attaining safe levels of folate in overall nutritional status and avoiding potential harm from chronic excessive intakes of folic acid from fortified food products or supplements in certain population groups. Over recent years the consumption of ready-to-eat foods, such as packed vegetables or precooked meals, has become a significant part of the diet. Accordingly, the folate composition of these food categories must be investigated. There is a broad lack of folate data in food composition tables and databases, especially for ready-to-eat products. This context warrants the need for providing new data on total folate and individual forms of folate in ready-to-eat commercial products, either to complete food composition tables or databases and/or to achieve regulatory objectives, or to assess population dietary intakes. Currently, intake recommendations for folate in some European countries range from 400 to 500 mg/day for folate for women of childbearing age, 600 mg/day for the second half of pregnancy and 500 mg/day for women who are breastfeeding. For other population groups, the recommended daily intakes (RDI) for folate are established depending on the age and sex of the individuals (children around 150–200 mg/day, and adults and elderly, 300–400 mg/day), but vary considerably among European countries. Moreover, contradictory data exist concerning both recommended and real dietary intake of folate throughout Europe. Despite a wide variety of analytical methods available for food folate measurement (microbiological assay or high performance liquid chromatography (HPLC), with a previous enzyme extraction based on the use of amylase, protease and/or folate conjugase; HPLC coupled with mass spectrometry; alternative protein-binding and immunoassay methods), many procedural complexities continue to result in poor agreement among methods and laboratories. Given the uncertainty involved in accurately measuring folate, the available certified reference materials should be used by laboratories to check the accuracy of folate data. The challenge to improve quantity and quality of folate data in food composition databases exists in most developed countries, and particularly in Europe, in the absence of mandatory food fortification policies for folate.

Los datos epidemiológicos sugieren que el consumo de productos de soja está correlacionado con la mejora de los problemas asociados con la menopausia y la incidencia de enfermedades crónicas, como la osteoporosis y ciertos tipos de cáncer. Aunque la evidencia actual no es concluyente, sugiere que la soja podría constituir una opción alternativa a la terapia de sustitución hormonal (TSH) para aliviar la sintomatología menopáusica, considerando la posibilidad de emplearla únicamente en períodos de corta duración en mujeres sin antecedentes de cáncer. Son necesarios estudios bien diseñados para establecer, entre otros aspectos, la dosis óptima de consumo para conseguir los efectos beneficioso. La soja no es la única fuente de fitoestrógenos y su efecto podría deberse a la calidad de la dieta. Una dieta completa, variada y equilibrada es un pilar fundamental como prevención de la salud.

We developed a comprehensive composition database of 629 cereal-based gluten free (GF) products available in Spain. Information on ingredients and nutritional composition was retrieved from food package labels. GF products were primarily composed of rice and/or corn flour, and 90% of them included added rice starch. The most common added fat was sunflower oil (present in one third of the products), followed by palm fat, olive oil, and cocoa. Only 24.5% of the products had the nutrition claim “no added sugar”. Fifty-six percent of the GF products had sucrose in their formulation. Xanthan gum was the most frequently employed fiber, appearing in 34.2% of the GF products, followed by other commonly used such as hydroxypropyl methylcellulose (23.1%), guar gum (19.7%), and vegetable gums (19.6%). Macronutrient analysis revealed that 25.4% of the products could be labeled as a source of fiber. Many of the considered GF food products showed very high contents of energy (33.5%), fats (28.5%), saturated fatty acids (30.0%), sugars (21.6%), and salt (28.3%). There is a timid reformulation in fat composition and salt reduction, but a lesser usage of alternative flours and pseudocereals.