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1

Huang, Zeying, Beixun Huang, and Jiazhang Huang. "The Relationship between Nutrition Knowledge and Nutrition Facts Table Use in China: A Structural Equation Model." International Journal of Environmental Research and Public Health 18, no. 12 (June 10, 2021): 6307. http://dx.doi.org/10.3390/ijerph18126307.

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Since 2013, China has implemented a nutrition label regulation that aims to provide essential nutrition information through nutrition facts tables labeled on the back of food packages. Yet, the relationship between people’s nutrition knowledge and their nutrition label use remains less clear. This study adopted the structural equation modeling approach to analyze a nationally representative survey of 1500 Chinese individuals through the cognitive processing model, interrelated nutrition knowledge, attention to nutrition information on the nutrition facts table, comprehension of nutrition information, food choice and dietary intake. It was found that nutrition knowledge positively influenced attention to nutrition information; a better comprehension of nutrition information, which could benefit healthier food choices, did not relate to a higher level of attention to that information; dietary intake was affected significantly by nutrition knowledge, but it had little impact on food choice. The results signify that nutrition knowledge hardly supports nutrition facts table use among the Chinese people, mainly due to incomprehensible labeled information. Therefore, it emphasizes the need to enhance people’s comprehension through front-of-package labels and corresponding smartphone applications.
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Emrich, Teri E., Ying Qi, Julio E. Mendoza, Wendy Lou, Joanna E. Cohen, and Mary R. L’Abbé. "Consumer perceptions of the Nutrition Facts table and front-of-pack nutrition rating systems." Applied Physiology, Nutrition, and Metabolism 39, no. 4 (April 2014): 417–24. http://dx.doi.org/10.1139/apnm-2013-0304.

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Preferences for, and consumer friendliness of, front-of-pack (FOP) nutrition rating systems have not been studied in a Canadian population, and studies comparing systems that are accompanied by mandatory labelling, such as Canada’s Nutrition Facts table (NFt), are lacking. The purpose of this study was to evaluate 4 FOP systems relative to the NFt with respect to consumer friendliness and their influence on perceptions of the healthiness and nutrient content of food. Canadian consumers (n = 3029) participating in an online survey were randomized to score the consumer friendliness of 1 of 5 FOP conditions with or without an NFt and to score the healthiness and nutrient content of 2 foods using the provided label(s). The mean differences in scores were evaluated with analysis of covariance (ANCOVA) controlling for age, gender, and education, with Tukey–Kramer adjustments for multiple comparisons. The NFt received the highest scores of consumer friendliness with respect to liking, helpfulness, credibility, and influence on purchase decisions (p < 0.05); however, consumers still supported the implementation of a single, standardized FOP system, with the nutrient-specific systems (a “Traffic Light” and a Nutrition Facts FOP system) being preferred and scored as more consumer friendly than the summary indicator systems. Without the NFt, consumer ratings of the healthiness and calorie and nutrient content differed by FOP system. With the NFt present, consumers rated the healthiness and calorie and nutrient content similarly, except for those who saw the Traffic Light; their ratings were influenced by the Traffic Light’s colours. The introduction of a single, standard, nutrient-specific FOP system to supplement the mandatory NFt should be considered by Canadian policy makers.
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Updegrove, Natalie A., and Rita M. Johnson. "Using table tents to present sports nutrition facts to collegiate athletes." Journal of Nutrition Education 19, no. 6 (November 1987): 302D. http://dx.doi.org/10.1016/s0022-3182(87)80240-6.

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Dukeshire, Steven, and Emily Nicks. "Benchmarks and Blinders: How Canadian Women Utilize the Nutrition Facts Table." Canadian Journal of Dietetic Practice and Research 78, no. 2 (June 1, 2017): 53–58. http://dx.doi.org/10.3148/cjdpr-2016-032.

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Purpose: To better understand how consumers use the Nutrition Facts Table (NFT) in their everyday shopping decisions and food consumption habits. Methods: Thirteen Canadian females were interviewed about how they use the NFT in their food choices. Results: Different elements of the front of the package served different purposes. Health claims and health checks drew attention to the product, but were not highly trusted. Ingredient lists were used to find “real food.” NFTs were considered important with each participant reporting an individualized strategy for using the NFT characterized by the application of benchmarks and blinders. The term “blinders” reflected only seeing and using one specific nutrient by assessing whether or not it exceeded a certain “benchmark” established by the participant. Therefore, the level of one specific nutrient determined the healthfulness of the product and the subsequent purchase/consumption decision. Conclusions: Findings suggest that NFTs should be redesigned. Some ideas for redesign include only listing “unhealthy” nutrients, having serving sizes more congruent to what is eaten in a typical sitting, making it easier to identify when a food may be high in a nutrient, and providing ways to allow the NFT to be used to meet personal, individualized needs.
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Stastny, Sherri Nordstrom, Alexa Evenson, and Arupendra Mozumdar. "Effect of Nutrition Facts Panel and Ingredient Declaration on Customer Satisfaction and Nutrition Perceptions in a Table-Service Restaurant at Midday Meal." Journal of Foodservice Business Research 14, no. 4 (October 2011): 310–33. http://dx.doi.org/10.1080/15378020.2011.624051.

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6

Franco-Arellano, Beatriz, Lana Vanderlee, Mavra Ahmed, Angela Oh, and Mary R. L’Abbé. "Consumers’ Implicit and Explicit Recall, Understanding and Perceptions of Products with Nutrition-Related Messages: An Online Survey." International Journal of Environmental Research and Public Health 17, no. 21 (November 6, 2020): 8213. http://dx.doi.org/10.3390/ijerph17218213.

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This study aimed to assess consumers’ implicit and explicit recall, understanding and perceptions of products with a nutrition claim and a symbol depicting ‘health,’ and to determine whether these perceptions differed among Nutrition Facts table (NFt) users vs. nonusers. In an online survey, participants (n = 1997) were randomized to one of eight conditions in a 2 × 2 × 2 factorial design, consisting of a label with a claim (present/absent) a heart-shaped symbol depicting ‘health’ (present/absent) for a healthier or less healthy soup. Participants were shown a label for 10 s and asked whether they recalled seeing a claim. If participants answered yes, they were then asked to describe their response using open-ended questions. Participants also rated the product’s perceived nutritional quality and purchase intentions using seven-point Likert scales. In the claim condition, most participants (75%) were able to recall the presence of a claim, while 12% incorrectly mentioned the presence of a claim when there was none. Claims likely attracted consumers’ attention and increased perceived nutritional quality, although with limited influence among NFt users (23%). The symbol depicting ‘health’ did not enhance perceived nutritional quality or purchase intentions. Although most participants (77%) made their decisions implicitly using the front of labels, those who used the NFt had a better understanding of the nutritional quality of products.
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Viswanath B, Manju, and Timsi Jain. "The impact of front of package label design on consumer understanding of nutrient amounts among residents of the urban area in Chennai." International Journal of Research in Pharmaceutical Sciences 11, SPL4 (December 21, 2020): 2141–48. http://dx.doi.org/10.26452/ijrps.v11ispl4.4434.

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The producer, selling and utilisation of packed nourishments have supported a preeminent flood lately in India. Food labelling is one of the vital population-based methods that can help customers make beneficial food selections by offering essential information about the food on the packaging. The present study aims to assess the impact of front of package label design on consumer understanding of nutrient amounts among residents of the urban area in Chennai. A cross-sectional study was conducted in an urban area in Chennai. Four hundred participants were studied by convenient sampling method. Participants were from 18 years age and above. The study duration was about three months. A pretested and semi-structured questionnaire was given, and the desired information was elicited. Data was then analysed with the help of statistical package for the social sciences software (SPSS). Chi-square test was done to test the significance (p<0.05). The mean age was of the participants was found to be 27.52 ± 11SD. About 63% of participants preferred packed foods over unpacked foods. And 68% of participants have nutritional knowledge and looked into nutrition facts on the back of the pack. Association of gender and socioeconomic class with knowledge of participants were found to be insignificant. Association of occupation with the frequency of purchasing packed food products was significant. Many people look into the nutrition facts table and do not understand and fail to interpret. It is important to provide front of pack labels for better understanding of the consumers.
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Hobin, E., J. Sacco, L. Vanderlee, C. M. White, F. Zuo, J. Sheeshka, G. McVey, M. Fodor O’Brien, and D. Hammond. "A randomized trial testing the efficacy of modifications to the nutrition facts table on comprehension and use of nutrition information by adolescents and young adults in Canada." Health Promotion and Chronic Disease Prevention in Canada 35, no. 10 (December 2015): 173–83. http://dx.doi.org/10.24095/hpcdp.35.10.01.

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Introduction Given the proposed changes to nutrition labelling in Canada and the dearth of research examining comprehension and use of nutrition facts tables (NFts) by adolescents and young adults, our objective was to experimentally test the efficacy of modifications to NFts on young Canadians’ ability to interpret, compare and mathematically manipulate nutrition information in NFts on prepackaged food. Methods An online survey was conducted among 2010 Canadians aged 16 to 24 years drawn from a consumer sample. Participants were randomized to view two NFts according to one of six experimental conditions, using a between-groups 2 x 3 factorial design: serving size (current NFt vs. standardized serving-sizes across similar products) x percent daily value (% DV) (current NFt vs. "low/med/high" descriptors vs. colour coding). The survey included seven performance tasks requiring participants to interpret, compare and mathematically manipulate nutrition information on NFts. Separate modified Poisson regression models were conducted for each of the three outcomes. Results The ability to compare two similar products was significantly enhanced in NFt conditions that included standardized serving-sizes (p ≤ .001 for all). Adding descriptors or colour coding of % DV next to calories and nutrients on NFts significantly improved participants’ ability to correctly interpret % DV information (p ≤ .001 for all). Providing both standardized serving-sizes and descriptors of % DV had a modest effect on participants’ ability to mathematically manipulate nutrition information to calculate the nutrient content of multiple servings of a product (relative ratio = 1.19; 95% confidence limit: 1.04–1.37). Conclusion Standardizing serving-sizes and adding interpretive % DV information on NFts improved young Canadians’ comprehension and use of nutrition information. Some caution should be exercised in generalizing these findings to all Canadian youth due to the sampling issues associated with the study population. Further research is needed to replicate this study in a more heterogeneous sample in Canada and across a range of food products and categories.
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Schermel, Alyssa, Teri E. Emrich, JoAnne Arcand, Christina L. Wong, and Mary R. L'Abbé. "Nutrition marketing on processed food packages in Canada: 2010 Food Label Information Program." Applied Physiology, Nutrition, and Metabolism 38, no. 6 (June 2013): 666–72. http://dx.doi.org/10.1139/apnm-2012-0386.

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The current study describes the frequency of use of different forms of nutrition marketing in Canada and the nutrients and conditions that are the focus of nutrition marketing messages. Prepackaged foods with a Nutrition Facts table (N = 10 487) were collected between March 2010 and April 2011 from outlets of the 3 largest grocery chains in Canada and 1 major western Canadian grocery retailer. The nutrition marketing information collected included nutrient content claims, disease risk reduction claims, and front-of-pack nutrition rating systems (FOPS). We found that nutrition marketing was present on 48.1% of Canadian food packages, with nutrient content claims being the most common information (45.5%), followed by FOPS on 18.9% of packages. Disease risk reduction claims were made least frequently (1.7%). The marketing messages used most often related to total fat and trans fat (15.6% and 15.5% of nutrient content claims, respectively). Limiting total and trans fats is a current public health priority, as recommended by Health Canada and the World Health Organization. However, other nutrients that are also recommended to be limited, including saturated fats, sodium, and added sugars, were not nearly as prominent on food labels. Thus, greater emphasis should be placed by the food industry on these other important nutrients. Repeated data collection in the coming years will allow us to track longitudinal changes in nutrition marketing messages over time as food marketing, public health, and consumer priorities evolve.
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Lee, Jennifer J., Mavra Ahmed, Tianyi Zhang, Madyson V. Weippert, Alyssa Schermel, and Mary R. L’Abbé. "The Availability and Quality of Food Labelling Components in the Canadian E-Grocery Retail Environment." Nutrients 13, no. 8 (July 29, 2021): 2611. http://dx.doi.org/10.3390/nu13082611.

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Background: Although packaged foods sold in retail stores must follow food labelling regulations, there are no e-grocery food labelling regulations to mandate and standardize the availability and presentation of product information. Therefore, the objective of the study was to evaluate the availability and quality of food labelling components in the Canadian e-grocery retail environment. Methods: A sample of fresh and pre-packaged products was identified on eight leading grocery retail websites in Canada, to assess the availability and quality of food labelling components. Results: Out of 555 product searches, all products were accompanied by product images with front-of-pack images more readily available (96.0%) than back-of-pack (12.4%) and other side panel images (3.1%). The following mandatory nutrition information was available for 61.1% of the products: nutrition facts table (68.8%), ingredient (73.9%), and allergen (53.8%) information. The majority of the nutrition information was available after scrolling down, clicking additionally on the description page, or viewing only as an image. Date markings were not available; packaging material information was available for 2.0% of the products. Conclusions: There was wide variability and inconsistencies in the presentation of food labelling components in the e-grocery retail environment, which can be barriers in enabling Canadians to make informed purchasing decisions.
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Baxter, Victoria M., Justin W. Andrushko, and Ulrich Teucher. "Size Matters: Package Size Influences Recognition of Serving Size Information." Canadian Journal of Dietetic Practice and Research 79, no. 4 (December 1, 2018): 200–202. http://dx.doi.org/10.3148/cjdpr-2018-020.

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Purpose: To identify the impact of package size on an individual’s use of serving size information. The hypothesis was that participants would make more serving size assumption errors on a nutrition facts table (NFT) interpretation task when assessing packages that appear as a single serving but contain multiple servings, compared with products that appear as a multi-serving and contain multiple servings. Methods: Sixty participants were randomized into 1 of 3 conditions (n = 20 each); products that appeared as a single serving and contain a single serving (SSSS), products that appeared as a single serving and contain multiple servings (SSMS), and products that both appear as a multi-serving and contain multiple servings (MSMS). All 3 conditions were tested on a NFT interpretation task while participants were being presented food items that were appropriate to their given condition. Results: Participants in the SSMS (9.55 ± 7.78) condition made significantly more serving size assumption errors than the SSSS (0.00 ± 0.00; P < 0.001) and MSMS (0.40 ± 0.75; P < 0.001) conditions. Conclusions: Participants did not address serving size information when they perceived a product to be a single serving. This resulted in people misinterpreting nutritional and caloric content of foods that were single unit foods with multiple servings.
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ZUCCHI, Natália Durigon, and Giovanna Medeiros Rataichesck FIATES. "Analysis of the presence of nutrient claims on labels of ultra-processed foods directed at children and of the perception of kids on such claims." Revista de Nutrição 29, no. 6 (December 2016): 821–32. http://dx.doi.org/10.1590/1678-98652016000600007.

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ABSTRACT Objective: To characterize the presence of nutrient claims on the front-of-pack labels of ultra-processed foods directed at children and gain insight on children' views about the presence of marketing strategies and nutrient claims on labels of ultra-processed foods. Methods: Analysis of images (front panel, nutrition facts table, and ingredients list) of labels from 535 packaged foods with marketing strategies directed at children obtained in an audit-type survey conducted at a Brazilian large supermarket store. Food products with ultra-processed characteristics were identified, and the nutrient claims were quantified and described. Focus groups were conducted with children aged 8-10 years. Results: A total of 472 (88.0%) of the 535 packaged foods directed at children were classified as ultra-processed. Of these, 220 (46.6%) had one or more nutrient claims on their front-of-pack label (n=321), most (n=236, 73.5%) claiming the presence/increased quantities of vitamins and minerals. The most common 'free/reduced' content claim regarded trans fat content (n=48). The focus groups allowed the identification of a noticeable influence of nutrition claims on children, who considered the emphasis important but were confused by the meaning and focus of such claims. Conclusion: Highlighted nutrient claims on the packages of ultra-processed foods were common and seemed to influence the children's perception of the products' quality as a whole. The results indicate the need of thoroughly reviewing the legislation on nutrient claims on the packages of ultra-processed foods.
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Jefferson, Katherine, Zhila Semnani-Azad, Christina Wong, Mary R. L’Abbé, and JoAnne Arcand. "Changing Sodium Knowledge, Attitudes and Intended Behaviours Using Web-Based Dietary Assessment Tools: A Proof-Of-Concept Study." Nutrients 11, no. 9 (September 11, 2019): 2186. http://dx.doi.org/10.3390/nu11092186.

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Despite public health efforts to reduce dietary sodium, sodium intakes in most countries remains high. The purpose of this study was to determine if using novel web-based tools that provide tailored feedback, the Sodium Calculator and Sodium Calculator Plus, improves users’ sodium-related knowledge, attitudes, and intended behaviours (KAB). In this single arm pre- and post-test study, 199 healthy adults aged 18–34 years completed a validated questionnaire to assess changes to sodium-related KAB before and after using the calculators. After using the calculators, the proportion of participants who accurately identified the sodium adequate intake and chronic disease risk reduction level increased (19% to 74% and 23% to 74%, respectively, both p = 0.021). The proportion accurately self-assessing their sodium intake as ‘high’ also increased (41% to 66%, p = 0.021). Several intended behavioural changes were reported, i.e., buying foods with sodium-reduced labels, using the Nutrition Facts table, using spices and herbs instead of salt, and limiting eating out. Evidence-based eHealth tools that assess and provide personalized feedback on sodium intake have the potential to aid in facilitating sodium reduction in individuals. This study is an important first step in evaluating and optimizing the implementation of eHealth tools to help reduce Canadians’ sodium intakes.
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Verbanac, Donatella, Željan Maleš, and Karmela Barišić. "Nutrition – facts and myths." Acta Pharmaceutica 69, no. 4 (December 1, 2019): 497–510. http://dx.doi.org/10.2478/acph-2019-0051.

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Abstract Taking responsibility for your life, among other factors, means also considering what to eat and which nutrition pattern to follow. Everyone needs to think about what they put on the plate and which ingredients should be avoided. Food, as such, will never be a drug or medication, like a painkilling tablet relieving pain in a short amount of time, for example. However, proper nutrition is our ally in the prevention of diseases, maintaining balance in our body and our mind. By following the main principles of a healthy diet, the physiological homeostasis can be managed, as well as faster recovery from disease achieved. This review is aimed at summarizing basic principles of nutrition recommendations and at empowering stakeholders (pharmacists, medical biochemists, physicians) to be able to communicate to their patients and customers healthy and sustainable nutrition choices through the personalized advice.
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Vergeer, Laura, Lana Vanderlee, Christine M. White, Vicki L. Rynard, and David Hammond. "Vegetarianism and other eating practices among youth and young adults in major Canadian cities." Public Health Nutrition 23, no. 4 (October 11, 2019): 609–19. http://dx.doi.org/10.1017/s136898001900288x.

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AbstractObjective:To estimate the prevalence and sociodemographic characteristics of youth and young adults in major Canadian cities with self-reported vegetarian dietary practices and examine efforts to alter their diets.Design:Data were collected in autumn 2016 via web-based surveys. Respondents reported vegetarian dietary practices (vegan, vegetarian or pescatarian) and efforts in the preceding year to consume more or less of several nutrients, food groups and/or foods with particular attributes. Logistic regression models examined sociodemographic correlates of each vegetarian dietary practice and differences in other eating practices by diet type.Setting:Participants were recruited from five major Canadian cities.Participants:Youth and young adults, aged 16–30 years (n 2566).Results:Overall, 13·6 % of respondents reported vegetarian dietary practices: 6·6 % vegetarian, 4·5 % pescatarian and 2·5 % vegan. Sex, race/ethnicity, self-reported frequency of using the Nutrition Facts table and health literacy were significantly correlated with self-reported vegetarian dietary practice (P < 0·01 for all). Efforts to consume more fruits and vegetables (66·8 %) and protein (54·8 %), and less sugar (61·3 %) and processed foods (54·7 %), were prevalent overall. Respondents with vegetarian dietary practices were more likely to report efforts to consume fewer carbohydrates and animal products, and more organic, locally produced, ethically sourced/sustainably sourced/fair trade and non-GM foods (P < 0·01 for all), compared with those without these reported dietary practices.Conclusions:Nearly 14 % of the sampled youth and young adults in major Canadian cities reported vegetarian dietary practices and may be especially likely to value and engage in behaviours related to health-conscious diets and sustainable food production.
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Arcand, JoAnne, Katherine Jefferson, Alyssa Schermel, Ferdeela Shah, Susan Trang, Daniela Kutlesa, Wendy Lou, and Mary R. L’Abbe. "Examination of food industry progress in reducing the sodium content of packaged foods in Canada: 2010 to 2013." Applied Physiology, Nutrition, and Metabolism 41, no. 6 (June 2016): 684–90. http://dx.doi.org/10.1139/apnm-2015-0617.

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In 2010, as part of a national sodium reduction strategy, Canada published sodium reduction benchmark targets for packaged foods; however, no evaluation of this policy has occurred. The objective was to evaluate changes in the sodium content of packaged foods, identify categories reduced in sodium, and determine the proportion meeting Health Canada’s sodium reduction benchmarks. This was a cross-sectional analysis of Canadian packaged foods in 2010 and 2013 (n = 10 487 and n = 15 394, respectively). Sodium content was obtained from the Nutrition Facts table. Overall, 16.2% of food categories had significantly reduced sodium levels. The greatest shifts in the distribution of sodium within food categories occurred in imitation seafood (mean ± SD, mg/100 g; 602 ± 50 to 444 ± 81, 26.2%, p = 0.002), condiments (1309 ± 790 to 1048 ± 620, 19.9%, p = 0.005), breakfast cereals (375 ± 26 to 301 ± 242, 19.7%, p = 0.001), canned vegetables/legumes (269 ± 156 to 217 ± 180, 19.3%, p < 0.001), plain chips (462 ± 196 to 376 ± 198, 18.6% p = 0.004), hot cereals (453 ± 141 to 385 ± 155, 15.0%, p = 0.011), meat analogues (612 ± 226 to 524 ± 177, 14.4%, p = 0.003), canned condensed soup (291 ± 62 to 250 ± 57, 14.1%, p = 0.003), and sausages and wieners (912 ± 219 to 814 ± 195, 10.7%, p = 0.012). The proportion of foods meeting at least 1 of the 3 phases of the sodium reduction benchmark targets slightly increased (51.4% to 58.2%) and the proportion exceeding maximum benchmark levels decreased (25.2% to 20.8%). These data provide a critical evaluation of changes in sodium levels in the Canadian food supply. Although progress in reducing sodium in packaged foods is evident, the food industry needs to continue efforts in reducing the sodium in the foods they produce.
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Yang, Yibing, Jinglei Wang, Jixiang Ma, Wenhui Shi, and Jing Wu. "Comparison of Salt-Related Knowledge and Behaviors Status of WeChat Users between 2019 and 2020." Nutrients 13, no. 7 (June 22, 2021): 2141. http://dx.doi.org/10.3390/nu13072141.

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In order to identify the status of salt-related knowledge and behavior of the residents who were active in WeChat software between 2019 and 2020, 10-day salt-related surveys were conducted in 2019 and 2020 based on the WeChat public platform of China Healthy Lifestyle for All Campaign. Distribution and scores of salt-related knowledge, salt reduction behavior and high-salt intake behavior between 2019 and 2020 were compared. Data of 2109 participants in 2019 and 12,732 participants in 2020 were left for analysis. Overall, 88.2% of participants in 2019 had a willingness to reduce the amount of cooking salt in their households, significantly lower than 90.2% in 2020 (p-value < 0.05). In 2019 and 2020, over 80% of the participants knew fine dried noodles contain salt, but less than 30% knew ice cream contains salt. Over 78% of participants chose 5 g or 6 g for the maximum daily salt intake of healthy adults, and about 98% of participants knew that excessive salt intake would increase the risk of hypertension in both years. The percentage of participants who used salt measuring spoons asked restaurants to use less salt, read the sodium content on the nutrition facts table, chose foods with low sodium content and regularly used low-sodium salt, were 36.1%, 45.0%, 44.1%, 40.3% and 35.8% in 2019, and the percentage increased significantly to 46.4%, 49.2%, 50.8%, 47.1% and 43.4% in 2020 (all p-value < 0.05). The percentage of people regularly eating pickled mustard tubers, salted vegetables and sauce foods or using high-salt condiments also increased from 2019 to 2020. The median of salt-related knowledge scores, salt reduction behavior scores and high-salt intake behavior scores were 11, 2, 5 points in 2019, and 10, 3, 5 points in 2020, respectively. Compared to 2019, the salt-related knowledge score was relatively lower, while the salt reduction behavior score and high-salt intake behavior score were relatively higher in 2020. Besides, the score of salt-related knowledge and behaviors differed in different gender, age and hypertension groups. The COVID-19 epidemic may have influenced the salt-related knowledge and behaviors status of WeChat users in China. Promotion and education of salt-related knowledge and online behavior intervention are still needed, particularly for male and hypertension patients in the future.
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Moding, Kameron J., Mackenzie J. Ferrante, Laura L. Bellows, Alyssa J. Bakke, John E. Hayes, and Susan L. Johnson. "Variety and content of commercial infant and toddler vegetable products manufactured and sold in the United States." American Journal of Clinical Nutrition 107, no. 4 (April 1, 2018): 576–83. http://dx.doi.org/10.1093/ajcn/nqx079.

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ABSTRACT Background Exposure to vegetable flavors during infancy and toddlerhood is hypothesized to enhance vegetable acceptance when children transition to table foods. Objective We sought to examine the vegetable types, ingredients, and nutrient contents of vegetable-containing infant and toddler foods (ITFs) manufactured and sold in the United States. Design A database of ITFs that contain vegetables (n = 548) was compiled from websites of companies based in the United States (n = 24). Product information was recorded, including intended age or stage, ingredient lists, and selected nutrients from the Nutrition Facts label. Ingredient lists were used to categorize vegetables using the USDA vegetable categories: dark green (e.g., spinach), red and orange (e.g., carrots), starchy (e.g., green peas, corn), beans and peas (e.g., black beans), and other (e.g., green beans, beets). Furthermore, products were categorized as single-vegetable, multi-vegetable, vegetable and fruit, vegetable and meat, or vegetable and other combinations (e.g., grains and and or dairy). Nutrients were examined, including energy (kilocalories), carbohydrates, fiber, and total sugars [per serving, per 100 g, per reference amount customarily consumed (RACC), and percentage of kilocalories from sugars]. Results Of the 548 vegetable products, only 52 single-vegetable products (9.5%) were identified, none of which contained dark green vegetables or beans and peas. Red and orange vegetables most often appeared as the first ingredient (23.7%) compared to other vegetable types, such as dark green vegetables, which were rarely listed first (1.1%). Fruits were listed as the first ingredient more commonly than all vegetables (37.8%). One-way ANOVA revealed that vegetable and fruit products contained more sugars on average than did vegetable products with other ingredients, such as dairy and/or grains (all P values < 0.001). Conclusions Current available products do not provide caregivers with a sufficient variety of single-vegetable products or products containing dark green vegetables to facilitate children's subsequent acceptance of these vegetables. Guidance should include making caregivers aware of the limitations of commercial ITFs manufactured and sold in the US market.
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Hobin, Erin, Grace Shen-Tu, Jocelyn Sacco, Christine White, Carolyn Bowman, Judy Sheeshka, Gail Mcvey, Mary Fodor O’Brien, Lana Vanderlee, and David Hammond. "Comprehension and Use of Nutrition Facts Tables among Adolescents and Young Adults in Canada." Canadian Journal of Dietetic Practice and Research 77, no. 2 (June 2016): 59–65. http://dx.doi.org/10.3148/cjdpr-2015-042.

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Purpose: Limited evidence exists on the comprehension and use of Nutrition Facts tables (NFt) among adolescents and young adults. This study provides an account of how young people engage with, understand, and apply nutrition information on the current and modified versions of the NFt to compare and choose foods. Methods: Participants aged 16–24 years (n = 26) were asked to “think aloud” while viewing either the current or 1 of 5 modified NFts and completing a behavioural task. The task included a questionnaire with 9 functional items requiring participants to define, compare, interpret, and manipulate serving size and percentage daily value (%DV) information on NFts. Semi-structured interviews were conducted to further probe thought processes and difficulties experienced in completing the task. Results: Equal serving sizes on NFts improved ability to accurately compare nutrition information between products. Most participants could define %DV and believed it can be used to compare foods, yet some confusion persisted when interpreting %DVs and manipulating serving-size information on NFts. Where serving sizes were unequal, mathematical errors were often responsible for incorrect responses. Conclusions: Results reinforce the need for equal serving sizes on NFts of similar products and highlight young Canadians’ confusion when using nutrition information on NFts.
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Cormier, Brittany, Lana Vanderlee, and David Hammond. "Use of Nutrition Information and Understanding of “Percent Daily Value” on Nutrition Facts Tables: Evaluating the Impact of a National Public Education Campaign among Youth and Young Adults in Canada." Canadian Journal of Dietetic Practice and Research 80, no. 4 (December 1, 2019): 200–204. http://dx.doi.org/10.3148/cjdpr-2019-010.

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Purpose: In 2010, Health Canada implemented a national campaign to improve understanding of “percent daily value” (%DV) in Nutrition Facts Tables (NFTs). This study examined sources of nutrition information and knowledge of %DV information communicated in the campaign. Methods: Respondents aged 16–30 years completed the Canada Food Study in 2016 (n = 2665). Measures included sources of nutrition information, NFT use, and %DV knowledge based on the campaign message (“5% DV or less is a little; 15% DV or more is a lot”). A logistic regression examined correlates of providing “correct” responses to %DV questions related to the campaign messaging. Results: Overall, 7.2% (n = 191) respondents correctly indicated that 5% is “a little”, and 4.3% (n = 115) correctly indicated 15% DV was “a lot”. Only 4.0% (n = 107) correctly answered both. Correct recall of %DV amounts was not associated with number of information sources reported, but was greater among those who were female, were younger, and reported greater NFT understanding and serving size information use (P < 0.05 for all). Conclusions: Results show low awareness of messaging from the Nutrition Facts Education Campaign among young Canadians. Such a mass media campaign may be insufficient on its own to enhance population-level understanding of %DV.
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Luisa Machado, Martha, Vanessa Mello Rodrigues, Amanda Bagolin do Nascimento, Moira Dean, and Giovanna Medeiros Rataichesck Fiates. "Nutritional Composition of Brazilian Food Products Marketed to Children." Nutrients 11, no. 6 (May 28, 2019): 1214. http://dx.doi.org/10.3390/nu11061214.

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Most food industry marketing in products targeted at children is found in packages of foods containing either excessive fat, sugar, or salt. This study audited all 5620 packaged foods available in a store of a large Brazilian supermarket chain and retrieved information from the nutrition facts tables on package labels. Products were photographed for further visual analysis to determine the presence of marketing strategies directed at children. Comparison of nutrient content per 100 g between children’s and non-children’s food products employed the Student t-test or the Mann–Whitney U-test (p-value < 0.05), due to the non-normal distribution of the nutritional composition data as verified through the Shapiro–Wilk test. Brazilian children’s food products from groups 4, 5, and 7 presented higher carbohydrate content than similar non-children’s products, while children’s food products from groups 1 and 7 presented lower fiber content. Results indicate that regulation on food labeling needs revising as it has not been effective in stopping the marketing of energy-dense nutrient-poor foods towards children.
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Sari, Lilis Nurlinda, Sitti Sahariah Rowa, and Fatmawaty Suaib. "Biscuit With Substitution Of Red Bean Flour and Taro Flour." Media Gizi Pangan 26, no. 1 (July 10, 2019): 37. http://dx.doi.org/10.32382/mgp.v26i1.473.

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Indonesia faces two nutritional problems, namely malnutrition and over nutrition. Malnutrition is caused by lack of food supply, food distribution, poverty, ignorance, wrong eating habits and health. One of the ways to overcome malnutrition among the community is by using red beans and taro into flour in the form of biscuit snacks by considering the nutrients, their benefits and their acceptability. This study aims to determine the acceptability and analysis of macro nutrient of biscuit content by substituting red bean flour and taro flour. The research design was experimental with a one shot goup design. Acceptance was assessed based on a hedonic test of 30 panelists. The results of the best acceptability were analyzed for their macro nutritional value, protein testing at the laboratory using method micro Kjedal method, fat using the soxhlet and carbohydrate method using method luff schroll method. Then presented in the form of tables and narratives. The results showed that the panelists received the highest power on biscuits with the substitution of red bean flour and taro flour which was Xconcentration1. Panelists were very fond of 100% color aspects, 96.7% aroma, 100% texture and 100% flavor. The nutritional value of biscuits with a concentration of X1 is 5.020% protein, 32.33% fat and 19.81% carbohydrate. It is suggested in making biscuits by substituting red bean flour and taro flour to add more red bean flour in the hope that protein nutritional value can increase. It is better to test other nutrients in biscuits.
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Silveira Jr., Landulfo, Leonardo Marmo Moreira, Viviane G. B. Conceição, Heliodora L. Casalechi, Ingrid S. Muñoz, Fabiano Fernandes Da Silva, Marcos Augusto S. R. Silva, Renato Aparecido De Souza, and Marcos Tadeu T. Pacheco. "Determination of sucrose concentration in lemon-type soft drinks by dispersive Raman spectroscopy." Spectroscopy 23, no. 3-4 (2009): 217–26. http://dx.doi.org/10.1155/2009/313969.

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The objective of this study was to quantify the sucrose amount in commercial lemon-type soft drinks through dispersive Raman spectroscopy, comparing the amount listed in the nutritional table of each product to the predicted by a least-square model, in order to obtain a method for quality assurance applied to soft drinks. A dispersive Raman spectrometer was employed using 830 nm laser and imaging spectrograph coupled to a CCD camera, and a total of 48 samples from four brands of lemon-type soft drinks were analyzed. A calibration curve using sucrose from refined sugar (sugarcane) diluted in spring water was elaborated in the range between 0 and 15.0 g/100 ml, and a quantification model based on Partial Least Squares (PLS) regression was developed to correlate the Raman spectra and the amount of sucrose in each dilution. Then, the sucrose in each soft drink sample was predicted employing the calibration curve. The mean error of calibration for the PLS method was 0.30 g/100 ml (3.0%). Results indicated that soft drinks samples have predicted sugar content ranging from 8.1 to 10.9 g/100 ml, with an error of the predicted value compared to the nutritional table ranged from 1.1% to 5.5%. Therefore, Raman spectroscopy in association with PLS regression was an effective method for quantifying the sucrose, with small prediction error. Thus, the present work allows to infer auspicious possibilities of Raman spectroscopy application in the quantification of relevant nutritional facts in beverages.
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Zweig, Jill, and Julia Pilliar. "Exploring the Understanding of Nutrition Facts Tables Among Adults Attending Group Diabetes Education Classes: A Survey of Knowledge, Understanding and Importance of Reading Nutrition Labels Prior to Receiving Any Diabetes Education." Canadian Journal of Diabetes 36, no. 5 (October 2012): S3. http://dx.doi.org/10.1016/j.jcjd.2012.07.020.

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HORTON, J. "Albendazole: a review of anthelmintic efficacy and safety in humans." Parasitology 121, S1 (October 2000): S113—S132. http://dx.doi.org/10.1017/s0031182000007290.

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This comprehensive review briefly describes the history and pharmacology of albendazole as an anthelminthic drug and presents detailed summaries of the efficacy and safety of albendazole's use as an anthelminthic in humans. Cure rates and % egg reduction rates are presented from studies published through March 1998 both for the recommended single dose of 400mg for hookworm (separately for Necator americanus and Ancylostoma duodenale when possible), Ascaris lumbricoides, Trichuris trichiura, and Enterobius vermicularis and, in separate tables, for doses other than a single dose of 400mg. Overall cure rates are also presented separately for studies involving only children 2–15 years. Similar tables are also provided for the recommended dose of 400mg per day for 3 days in Strongyloides stercoralis, Taenia spp. and Hymenolepis nana infections and separately for other dose regimens. The remarkable safety record involving more than several hundred million patient exposures over a 20 year period is also documented, both with data on adverse experiences occurring in clinical trials and with those in the published literature and/or spontaneously reported to the company. The incidence of side effects reported in the published literature is very low, with only gastrointestinal side effects occurring with an overall frequency of just >1%. Albendazole's unique broad-spectrum activity is exemplified in the overall cure rates calculated from studies employing the recommended doses for hookworm (78% in 68 studies: 92% for A. duodenale in 23 studies and 75% for N. americanus in 30 studies), A. lumbricoides (95% in 64 studies), T. trichiura (48% in 57 studies), E. vermicularis (98% in 27 studies), S. stercoralis (62% in 19 studies), H. nana (68% in 11 studies), and Taenia spp. (85% in 7 studies). The facts that albendazole is safe and easy to administer, both in treatment of individuals and in treatment of whole communities where it has been given by paramedical and nonmedical personnel, have enabled its use to improve general community health, including the improved nutrition and development of children.
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Tomchuk, Irina, and Leonid Tomchuk. "The menu layout is the quintessence of a balanced diet in the daily routine for athletes of different qualifications." Scientific Journal of National Pedagogical Dragomanov University. Series 15. Scientific and pedagogical problems of physical culture (physical culture and sports), no. 8(139) (August 20, 2021): 101–6. http://dx.doi.org/10.31392/npu-nc.series15.2021.8(139).18.

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The article theoretically substantiates the role of the most important factor in the menu - MENU - LAYOUTS for athletes of different qualifications. The facts about the need for a correct understanding not only of the general principles of nutrition, physiology and food hygiene, but also the role of macronutrients and micronutrients are presented. About their action and interaction. But it is impossible to make a MENU-LAYOUT and choose a diet that would be equally suitable for all athletes and, moreover, would be equally effective for all of them. Metabolism, health and tasks are different for everyone. The fact is that when compiling the MENU-LAYOUT for athletes of different qualifications it is necessary to take into account literally all the knowledge about nutrients. And answer the question - what, where, when and how. Because, the menu will be made, will depend not only on the coverage of daily energy expenditure, but also the mood of the athlete, which more often will depend on the physiological processes taking place in his body. Therefore, the importance of the MENU LAYOUT does not call into question its paramount importance for athletes of different qualifications. Since a well-planned menu in general is in turn a basis for improving their performance. An athlete who follows a balanced diet, including both the number of calories and the composition of macro- and micronutrients is always easier to adapt to physical and mental stress. However, it should be noted that, despite the fact that there are already multiple tables of nutrients, the compilation of a rational MENU-LAYOUT for athletes of different categories remains problematic and needs constant improvement.
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Yang, Yang, Helen Chen, Hammad Qazi, and Plinio P. Morita. "Intervention and Evaluation of Mobile Health Technologies in Management of Patients Undergoing Chronic Dialysis: Scoping Review." JMIR mHealth and uHealth 8, no. 4 (April 3, 2020): e15549. http://dx.doi.org/10.2196/15549.

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Background Studies have shown the effectiveness and user acceptance of mobile health (mHealth) technologies in managing patients with chronic kidney disease (CKD). However, incorporating mHealth technology into the standard care of patients with CKD still faces many challenges. To our knowledge, there are no reviews on mHealth interventions and their assessments concerning the management of patients undergoing dialysis. Objective This study provided a scoping review on existing apps and interventions of mHealth technologies in adult patients undergoing chronic dialysis and identified the gaps in patient outcome assessment of mHealth technologies in the literature. Methods We systematically searched PubMed (MEDLINE), Scopus, and the Cumulative Index to Nursing and Allied Health Literature databases, as well as gray literature sources. Two keywords, “mHealth” and “dialysis,” were combined to address the main concepts of the objectives. Inclusion criteria were as follows: (1) mHealth interventions, which are on a smartphone, tablet, or web-based portals that are accessible through mobile devices; and (2) adult patients (age ≥18 years) on chronic dialysis. Only English papers published from January 2008 to October 2018 were included. Studies with mHealth apps for other chronic conditions, based on e-consultation or videoconferencing, non-English publications, and review papers were excluded. Results Of the 1054 papers identified, 22 met the inclusion and exclusion criteria. Most studies (n=20) were randomized controlled trials and cohort studies. These studies were carried out in 7 countries. The main purposes of these mHealth interventions were as follows: nutrition or dietary self-monitoring (n=7), remote biometric monitoring (n=7), web-based portal (n=4), self-monitoring of in-session dialysis-specific information (n=3), and self-monitoring of lifestyle or behavioral change (n=1). The outcomes of the 22 included studies were organized into five categories: (1) patient satisfaction and acceptance, (2) clinical effectiveness, (3) economic assessment, (4) health-related quality of life, and (5) impact on lifestyle or behavioral change. The mHealth interventions showed neutral to positive results in chronic dialysis patient management, reporting no to significant improvement of dialysis-specific measurements and some components of the overall quality of life assessment. Evaluation of these mHealth interventions consistently demonstrated evidence in patients’ satisfaction, high level of user acceptance, and reduced use of health resources and cost savings to health care services. However, there is a lack of studies evaluating safety, organizational, sociocultural, ethical, and legal aspects of mHealth technologies. Furthermore, a comprehensive cost-effectiveness and cost-benefit analysis of adopting mHealth technologies was not found in the literature. Conclusions The gaps identified in this study will inform the creation of health policies and organizational support for mHealth implementation in patients undergoing dialysis. The findings of this review will inform the development of a comprehensive service model that utilizes mHealth technologies for home monitoring and self-management of patients undergoing chronic dialysis.
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Chan, Jessica Yin Man, Mary J. Scourboutakos, and Mary R. L’Abbé. "Unregulated serving sizes on the Canadian nutrition facts table – an invitation for manufacturer manipulations." BMC Public Health 17, no. 1 (May 8, 2017). http://dx.doi.org/10.1186/s12889-017-4362-0.

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Emrich, Teri E., Julio E. Mendoza, and Mary R. LˈAbbe. "Evaluating the impact of the Nutrition Facts table and front‐of‐pack nutrition rating systems on consumersˈ product healthiness evaluations." FASEB Journal 26, S1 (April 2012). http://dx.doi.org/10.1096/fasebj.26.1_supplement.1032.9.

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Schermel, Alyssa, and Mary R. L'Abbé. "Sodium Claims or Health Focused Messages Help Consumers to Identify Sodium Levels in Foods Better than the Nutrition Facts Table." FASEB Journal 27, S1 (April 2013). http://dx.doi.org/10.1096/fasebj.27.1_supplement.124.1.

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Pölsler, Lukas, Jaroslav Presl, Christian Brandtner, Alexander Gaggl, Jörg Hutter, Oliver Koch, and Klaus Emmanuel. "662 MICROVASCULAR MYOCUTANEOUS AND CUTANEOUS FREE FLAP RECONSTRUCTION FOR PATIENTS WITH TERMINAL ESOPHAGOSTOMY AFTER COMPLICATED ONCOLOGICAL ESOPHAGUS RESECTION." Diseases of the Esophagus 34, Supplement_1 (September 2021). http://dx.doi.org/10.1093/dote/doab052.662.

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Abstract Persisting anastomotic leak after oncological esophagectomy is a severe problem associated with high mortality and morbidity. Unfortunately, treatment options with promising results are scarce especially when conventional operative and endoscopic methods have failed. Due to limitation of oral intake and need for artificial nutrition quality of life is reduced. Microvascular myocutaneous and cutaneous free flap (MFF) reconstruction could be a promising alternative. Methods This retrospective cohort study presents seven patients treated between March 2017 and November 2020 at our surgical department, with terminal esophagostomy after complicated oncological esophagus resection without further feasible treatment options. All Patients received anastomotic MFF reconstruction. We have examined postoperative outcomes, complications according to Clavien-Dindo-Classification and patient contentment with a questionnaire. Additionally, we described important procedure related facts. Results The included seven male patients had median age of 65.15 years (range: 48–75). MFF function was adequate in six out of seven patients, graft rejection appeared in one patient. Five patients initially had good results, surgical revision was performed in one patient to ensure graft function. Postoperative complications appeared in 6/7 patients (Table 1). Mean duration of inpatient care was 63 days (Range: 24–156). At time of evaluation, one patient has died cancer related. No more additional nutrition was needed in 3/6 patients with adequate graft function. The majority of patients reported an improved quality of life compared to preoperatively. Conclusion MFF free flap can be a safe and feasible treatment option for patients with terminal esophagostomy after complicated oncological esophagus resection without further treatment options or in patients with complicated postoperative course with complex combined defects. The renewed ability of oral food intake results in a significant improvement of quality of life for the patients. No procedure related mortality was observed. Number of patients with regained ability of oral intake is encouraging.
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Nieto, Claudia, Alejandra Jáuregui, Alejandra Contreras-Manzano, Edna Arillo-Santillan, Simón Barquera, Christine M. White, David Hammond, and James F. Thrasher. "Understanding and use of food labeling systems among Whites and Latinos in the United States and among Mexicans: Results from the International Food Policy Study, 2017." International Journal of Behavioral Nutrition and Physical Activity 16, no. 1 (October 17, 2019). http://dx.doi.org/10.1186/s12966-019-0842-1.

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Abstract Background Obesity and chronic diseases could be prevented through improved diet. Most governments require at least one type of food labeling system on packaged foods to communicate nutrition information and promote healthy eating. This study evaluated adult consumer understanding and use of nutrition labeling systems in the US and Mexico, the most obese countries in the world. Methods Adults from online consumer panels in the US (Whites n = 2959; Latinos n = 667) and in Mexico (n = 3533) were shown five food labeling systems: 1. Nutrition Facts Table (NFT) that shows nutrients of concern per serving; 2. Guideline Daily Amounts (GDA) that shows levels of nutrients of concern; 3. Multiple Traffic-Light (MTL) that color codes each GDA nutrient (green = healthy; yellow = moderately unhealthy; red = unhealthy); 4. Health Star Rating System (HSR) that rates foods on a single dimension of healthiness; 5. Warning Label (WL) with a stop sign for nutrients present in unhealthy levels. Participants rated each label on understanding (“easy”/“very easy to understand” vs “difficult”/“very difficult to understand”), and, for NFTs and GDAs, frequency of use (“sometimes”/“often” vs “never”). Mixed logistic models regressed understanding and frequency of use on indicators of labeling systems (NFT = ref), testing for interactions by ethnicity (US Latinos, US Whites, Mexicans), while controlling for sociodemographic and obesity-related factors. Results Compared to the NFT, participants reported greater understanding of the WL (OR = 4.8; 95% CI = 4.4–5.3) and lower understanding of the HSR (OR = 0.34, 95% CI = 0.31–0.37) and the MTL (OR = 0.56, 95% CI = 0.52–0.61), with similar patterns across ethnic subgroups. Participants used GDAs less often than NFTs (OR = 0.48; 95%CI = 0.41–0.55), with the greatest difference among US Whites (OR = 0.10; 95%CI = 0.07–0.14). Conclusions Understanding and use of the GDA was similar to that of the NFT. Whites, Latinos, and Mexicans consistently reported the best understanding for WLs, a FOPL that highlights unhealthfulness of a product. Therefore, a FOPL summary indicator, such as WLs, may be more effective in both the US and Mexico for guiding consumers towards informed food choices.
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Roudsari, Arezoo Haghighian, Seyedeh Fatemeh Abdollah Pouri Hosseini, Ali Milani Bonab, Maliheh Zahedi‐rad, Fatemeh Mohammadi Nasrabadi, and Azizollaah Zargaraan. "Consumers' perception of nutritional facts table and nutritional traffic light in food products' labelling: A qualitative study." International Journal of Health Planning and Management, December 29, 2020. http://dx.doi.org/10.1002/hpm.3105.

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Gunjan, Dr Kumar, Dr Vimal Arya, and Dr R. K. Arya. "An Epidemiological Study of Malnutrition and Its Associated Factors in School Going Adolescents of District Ghaziabad, Uttar Pradesh." International Journal of Innovative Research in Medical Science 3, no. 02 (February 25, 2018). http://dx.doi.org/10.23958/ijirms/vol03-i02/16.

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Introduction: Today, the world faces double burden of malnutrition that includes both under nutrition and overweight, especially in developing countries. Malnutrition, especially in adolescent and young women, not only effects the growth and development in this generation but also in the next. This study has been designed with the objectives to assess the nutritional status and various socio-demographic variables in the adolescent population and their association with nutritional status of the adolescents in Ghaziabad, Uttar Pradesh. Material and Methods: The study was carried out during November 2013 to October 2014 in higher secondary schools in urban area of district Ghaziabad by Department of Community Medicine, Santosh Medical College, Ghaziabad. Multistage sampling technique was used. 50 subjects from each school were questioned with self-administered well-designed pre-tested and close-ended questionnaire. Data was coded and transferred to a master chart and simple and association tables were prepared and analysed with appropriate statistical tests like Chi-square test with Yates correction. Results: It was found that out of the total 550 adolescents, the majority of the adolescents (64%) were male while females added up to 36% of the total. The association between age and nutritional status of adolescents was statistically insignificant. The association between socio-economic status and nutritional status of adolescents was statistically insignificant.
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Shen‐Tu, Grace, Erin Hobin, Judy Sheeshka, Mary O'Brien, Gail McVey, and David Hammond. "Using verbal protocol to examine the comprehension and use of nutrition facts tables among young Canadians (390.8)." FASEB Journal 28, S1 (April 2014). http://dx.doi.org/10.1096/fasebj.28.1_supplement.390.8.

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Bromberg, Michal, Tali Sinai, Lital Keinan-Boker, Ronit Endevelt, and Dvora Frankenthal. "Current use of nutrition facts tables and attitudes towards new red and green front-of-package labels among Israeli consumers." International Journal of Food Sciences and Nutrition, July 26, 2021, 1–8. http://dx.doi.org/10.1080/09637486.2021.1955841.

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Slavin, Joanne L. "Fiber and Nutritional Health." DeckerMed Medicine, September 10, 2018. http://dx.doi.org/10.2310/im.9007.

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Populations that consume more dietary fiber have less chronic disease. According to the 2002 Dietary Reference Intakes (DRIs), dietary fiber includes carbohydrates and lignin that are intrinsic and intact in plants that are not digested and absorbed in the small intestine. Functional fiber consists of isolated or purified carbohydrates that are not digested and absorbed in the small intestine that confer beneficial physiologic effects in humans. Total fiber is the sum of dietary fiber and functional fiber. Fibers alter laxation, attenuate the rise in blood glucose, and normalize blood cholesterol. The solubility of fibers was originally thought to determine physiologic properties, with soluble fiber linked to cholesterol-lowering properties and insoluble fiber linked to laxation effects. The DRI Committee recommended that other descriptors for fiber be developed, suggesting viscosity and fermentability. Manufacturers are allowed to list total dietary fiber, soluble fiber, and insoluble fiber on the Nutrition Facts panel. DRIs recommend consumption of 14 g of dietary fiber per 1,000 kcal based on epidemiologic studies showing protection against cardiovascular disease. Usual intake of dietary fiber is only 15 g/day. Even with a fiber-rich diet, a supplement may be needed to bring fiber intakes into the recommended range. Dietary messages to increase consumption of high-fiber foods such as whole grains, pulses, fruits, and vegetables should be broadly supported by the medical profession. This review contains 3 Tables and 38 references Key words: constipation, diarrhea, dietary fiber, health claims, laxatives, plant foods, stool weight, transit time
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Annamalai, Aniyizhai. "Health of Immigrant and Refugee Women." DeckerMed Obstetrics and Gynecology, August 9, 2018. http://dx.doi.org/10.2310/obg.1601.

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Providers encounter increasingly diverse patient populations, as migration of people continues to increase worldwide. Health of migrant women is influenced by factors before migration as well as those affecting the migratory process and resettlement. Cultural factors influence patient beliefs and attitudes toward all facets of reproductive health including contraception. Providers may also encounter sequelae of traditional practices such as female genital cutting. Migrant women may be at a higher risk of violence both due to intimate partner violence and risks encountered during migration. They are also at risk for psychological sequelae resulting from stressors before and after displacement. Posttraumatic stress disorder prevalence is higher compared to local populations. Whereas migrants still carry a high burden of infectious disease, chronic health conditions are becoming increasingly common in many groups. Healthcare providers with an awareness of health issues faced by migrants can contribute to improving overall health of migrants and ease the process of resettlement for these people. This review contains 53 references, 1 figure, and 10 tables. Key Words: female genital cutting, immigrant, intestinal parasites, intimate partner violence, migration, nutrition, posttraumatic stress disorder, refugee, reproductive health, tuberculosis
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Annamalai, Aniyizhai. "Health of Immigrant and Refugee Women." DeckerMed Medicine, June 30, 2018. http://dx.doi.org/10.2310/im.1601.

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Providers encounter increasingly diverse patient populations, as migration of people continues to increase worldwide. Health of migrant women is influenced by factors before migration as well as those affecting the migratory process and resettlement. Cultural factors influence patient beliefs and attitudes toward all facets of reproductive health including contraception. Providers may also encounter sequelae of traditional practices such as female genital cutting. Migrant women may be at a higher risk of violence both due to intimate partner violence and risks encountered during migration. They are also at risk for psychological sequelae resulting from stressors before and after displacement. Posttraumatic stress disorder prevalence is higher compared to local populations. Whereas migrants still carry a high burden of infectious disease, chronic health conditions are becoming increasingly common in many groups. Healthcare providers with an awareness of health issues faced by migrants can contribute to improving overall health of migrants and ease the process of resettlement for these people. This review contains 53 references, 1 figure, and 10 tables. Key Words: female genital cutting, immigrant, intestinal parasites, intimate partner violence, migration, nutrition, posttraumatic stress disorder, refugee, reproductive health, tuberculosis
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Renzella, J., S. Fernando, B. Kalupahana, P. Scarborough, M. Rayner, and N. Townsend. "Food labour, consumption hierarchies, and diet decision-making in Sri Lankan households: a qualitative study." BMC Nutrition 6, no. 1 (November 20, 2020). http://dx.doi.org/10.1186/s40795-020-00389-w.

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Abstract Background Sri Lanka faces the double burden of over- and undernutrition. To tackle this dual challenge, double duty interventions that improve the quality of the Sri Lankan diet in line with national dietary guidelines have been suggested. The success of these interventions depends upon an understanding of the context-specific factors that impact their uptake within the population. The purpose of this study was threefold: explore household responsibility for food-related labour; understand food decision-making influences; and investigate consumption hierarchies that might impact the distribution of intervention benefits. Methods We conducted face-to-face semi-structured interviews with 93 Sri Lankan adults residing in urban Colombo (n = 56), and urban and rural sectors in Kalutara (n = 29) and Trincomalee (n = 8). Interview data were analysed thematically. Results Findings from this study suggest that women in Sri Lanka continue to shoulder the burden of food-related labour disproportionately to men but that this responsibility is not always a proxy for dietary decision-making power. While men are often absent from the kitchen, their role in food purchasing and payment is prominent in many households. Despite these observed gender differences in food labour and provisioning, “traditional” age- and gender-based consumption hierarchies with negative nutrition consequences for women and children are not common, indicating that Sri Lankan ‘table culture’ may be changing. Conclusion Dietary interventions with the aim of influencing day-to-day practice should be developed with an awareness of who is responsible for, who is able to perform, and who influences targeted behaviours.
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Fahey, Jed W., and Thomas W. Kensler. "The Challenges of Designing and Implementing Clinical Trials With Broccoli Sprouts… and Turning Evidence Into Public Health Action." Frontiers in Nutrition 8 (April 29, 2021). http://dx.doi.org/10.3389/fnut.2021.648788.

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Broccoli sprouts are a convenient and rich source of the glucosinolate glucoraphanin, which can generate the chemopreventive agent sulforaphane through the catalytic actions of plant myrosinase or β-thioglucosidases in the gut microflora. Sulforaphane, in turn, is an inducer of cytoprotective enzymes through activation of Nrf2 signaling, and a potent inhibitor of carcinogenesis in multiple murine models. Sulforaphane is also protective in models of diabetes, neurodegenerative disease, and other inflammatory processes, likely reflecting additional actions of Nrf2 and interactions with other signaling pathways. Translating this efficacy into the design and implementation of clinical chemoprevention trials, especially food-based trials, faces numerous challenges including the selection of the source, placebo, and dose as well as standardization of the formulation of the intervention material. Unlike in animals, purified sulforaphane has had very limited use in clinical studies. We have conducted a series of clinical studies and randomized clinical trials to evaluate the effects of composition (glucoraphanin-rich [± myrosinase] vs. sulforaphane-rich or mixture beverages), formulation (beverage vs. tablet) and dose, on the efficacy of these broccoli sprout-based preparations to evaluate safety, pharmacokinetics, pharmacodynamic action, and clinical benefit. While the challenges for the evaluation of broccoli sprouts in clinical trials are themselves formidable, further hurdles must be overcome to bring this science to public health action.
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Du, Mengxi, Christina Griecci, Frederick Cudhea, David Kim, Heesun Eom, Parke Wilde, John Wong, et al. "Cost-Effectiveness of the FDA Added Sugar Labeling to Reduce Cancer Burden in the United States (OR28-03-19)." Current Developments in Nutrition 3, Supplement_1 (June 1, 2019). http://dx.doi.org/10.1093/cdn/nzz042.or28-03-19.

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Abstract Objectives Meta-analyses have identified obesity as an independent risk factor for 13 cancers and added sugars as a contributor to obesity. In 2016, the new Nutrition Facts label on US packaged foods mandated the inclusion of added sugar content. We assessed the health outcomes, costs, and cost-effectiveness of this policy on obesity-related cancer burdens among 250 million US adults over their lifetime. Methods We populated the Diet Cancer Outcome Model (DiCOM), a probabilistic cohort-state transitional model, to evaluate two effects of the policy on (a) consumer behavior alone; and (b) consumer behavior plus industry reformulation. Policy effect on consumer behavior was derived from a meta-analysis of calorie labeling; and on industry reformulation, from the FDA's regulatory impact analysis and the UK sugar reformulation strategy. Effects of added sugar on obesity and obesity on cancer incidence were derived from meta-analyses and published literature. Cost-effectiveness was evaluated as net costs with 3% annual discounting, under both government affordability and societal perspectives. Results We estimated that, based on consumer responses alone, the added sugar labeling would prevent 35,500 new cancer cases (95% uncertainty interval [UI]: 12,300 to 65,800) and 16,700 cancer deaths (95% UI: 5720 to 31,400) and gain 113,000 quality-adjusted life years (QALYs) (95% UI: 38,800 to 210,000) over a lifetime. Adding potential additional effects on industry reformulation, corresponding values were 79,700 new cancer cases (95% UI: 28,100 to 140,000), 37,500 cancer deaths (95% UI: 13,200 to 66,000), and 253,000 QALYs (95% UI: 89,600 to 444,000). Policy would result in estimated net cost savings of $8600 M (95% UI: $6900 M to $11,000 M) from governmental affordability and $7500 M ($5400 M to $9900 M) from societal perspectives based on consumer responses alone. With industry reformulation, net savings were $19,000 (95% UI: $15,000 M to $23,000 M) and $16,000 M (95% UI: $12,000 M to $20,000 M), respectively. Conclusions Our modeling estimates that implementation of the FDA added sugar labeling will lead to significant numbers of averted cancer cases and deaths, with net cost-savings; and that potential industry responses may contribute to similar or larger benefits than consumer responses alone. Funding Sources NIH/NIMHD. Supporting Tables, Images and/or Graphs
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Karageorgou, Dimitra, Laura Lara-Castor, Catherine Leclercq, Victoria Padula de Quadros, Sofia Ioannidou, Dariush Mozaffarian, and Renata Micha. "Harmonizing Dietary Datasets Around the World for Global Diet Monitoring: Methods from the Global Dietary Database and the Global Individual Food Consumption Data Tool (OR06-06-19)." Current Developments in Nutrition 3, Supplement_1 (June 1, 2019). http://dx.doi.org/10.1093/cdn/nzz039.or06-06-19.

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Abstract Objectives To systematically identify, compile, and harmonize national and sub-national individual-level dietary data around the world using a common food classification and description system (FCDS); promote collaboration with data owners worldwide; and publicly disseminate methods and datasets to the global nutrition community. Methods The Global Dietary Database (GDD) and the FAO/WHO Global Individual Food consumption data Tool (FAO/WHO GIFT) initiative, in collaboration with the European Food Safety Authority (EFSA), developed a framework to standardize the characterization of 24-hour recall and food record survey data at their finest level, using FoodEx2 (Figure). FoodEx2 is a comprehensive FCDS developed by EFSA, adapted for international high-quality food characterization and methodologically superior to prior international FCDS. Single food items are characterized through a classification system (hierarchical nested food groups) and 32 description elements (facets), such as cooking process. Standardized criteria, procedures, and templates were developed to: (1) identify and (2) prioritize eligible surveys for FoodEx2 mapping; (3) efficiently contact data owners and obtain approval for public dissemination; (4) allocate financial assistance as appropriate; (5) obtain survey information and assess survey and diet tool quality; (6) train data owners on dataset preparation and FoodEx2 mapping; (7) collect harmonized microdata, including structure, sociodemographics, diet metrics, units of measure, and food characterization; and (8) publicly disseminate methods and datasets via the GDD and FAO/WHO GIFT platforms. Results A total of 151 surveys have been identified as high priority. Harmonization has been completed for 24 European surveys by EFSA, which will be incorporated in the GDD and FAO/WHO GIFT platforms upon approval of data owners; 8 surveys by FAO/WHO GIFT; and is ongoing for another 4. Thus far, the data owners of 53 surveys from 41 countries, including Brazil, India, and Iran, confirmed interest in joining; all surveys either used none or a local FCDS. Conclusions These new methods developed will provide the most comprehensive and standardized databases of dietary intakes worldwide. Such global dietary data harmonization is imperative for global diet monitoring and informed priority setting. Funding Sources Gates Foundation. Supporting Tables, Images and/or Graphs
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Adams, Craig. "The Taste of Terroir in “The Gastronomic Meal of the French”: France’s Submission to UNESCO’s Intangible Cultural Heritage List." M/C Journal 17, no. 1 (March 18, 2014). http://dx.doi.org/10.5204/mcj.762.

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Introduction What French food is would seem to be an unproblematic idea. Depending on one’s taste and familiarity, a croissant, or snails, might spring to mind. Those who are a little more intimate with French cuisine might suggest the taste of a coq au vin or ratatouille, and fewer still might suggest tarte flambée or cancoillotte. Whatever the relative popularity of the dish or food, the French culinary tradition is arguably so familiar and, indeed, loved around the world that almost everyone could name one or two French culinary objects. Moreover, as the (self-proclaimed) leader of Western cuisine, the style and taste epitomised by French cuisine and the associated dining experience are also arguably some of the most attractive aspects of French gastronomy. From this perspective, where French cuisine appears to be so familiar to the non-French, seeking to define what constitutes a French meal could seem to be an inane exercise. Nonetheless, in 2010, the Mission Française du Patrimoine et des Cultures Alimentaires (not officially translated), under the aegis of the French Ministry of Culture and Communication, put forward the nomination file “The Gastronomic Meal of the French” to UNESCO, defining in clear terms a particular image of French taste, in a bid to have the meal recognised as part of the Representative List of Intangible Cultural Heritage. With the number of specifically culinary elements protected by UNESCO more than doubling with the 2013 session of the Intergovernmental Committee for the Safeguarding of the Intangible Cultural Heritage, and with a further two in line for protection in the 2014 session, it would seem that an examination of these protected culinary traditions is in order. Rather than focusing on the problems associated with creating an intangible heritage list (Kurin; Smith and Akagawa), this article proposes an analysis of one nomination file, “The Gastronomic Meal of the French,” and the ideas which structure it. More specifically, this article will investigate how the idea of taste is deployed in the document from two different yet interconnected points of view. That is, taste as the faculty of discerning what is aesthetically excellent, and taste in its more literal gustative sense. This study will demonstrate how these two ideas of taste are used to create a problematic notion of French culinary identity, which by focusing on the framework of local (terroir) taste seeks to define national taste. By specifically citing local food stuffs (produits du terroir) and practices as well as French Republicanism in the formation of this identity, I argue that the nomination file eschews problems of cultural difference. As a result, “non-French food” and the associated identities it embodies, inherent in contemporary multicultural societies such as France with its large immigrant population, are incorporated into a cohesive, singular, culinary identity. French taste, then, is represented as uniform and embodied by the shared love of the French “art of good eating and drinking”. “Intangible” Versus “Tangible” Cultural Heritage: A Brief Overview The Intangible Cultural Heritage list was created to compliment UNESCO’s Tangible Cultural Heritage, that is, the famous World Heritage, list, which focuses on places of unique heritage. The Intangible Cultural Heritage list, for its part, concentrates on: traditions or living expressions inherited from our ancestors and passed on to our descendants, such as oral traditions, performing arts, social practices, rituals, festive events, knowledge and practices concerning nature and the universe or the knowledge and skills to produce traditional crafts (“What is Intangible Cultural Heritage?”) An examination of the elements which have been admitted to UNESCO’s Representative List of Intangible Cultural Heritage shows that there is a clear preference for traditional dances and songs. The culinary plays a very small role in the almost 300 elements currently protected by UNESCO. With the recent inscription of several additional, specifically culinary elements in December 2013, the number has more doubled but still remains low at ten elements. Out of the ten, only two of them seek to protect a cooking style: the “Mediterranean Diet” and “Traditional Mexican cuisine—ancestral, ongoing community culture, the Michoacán paradigm.” The other elements are specific culinary objects, such as Gingerbread from Northern Croatia, or culinary events, for instance the “Commemoration feast of the finding of the True Holy Cross of Christ in Ethiopia.” “The Gastronomic Meal of the French” belongs to the latter category, however is somewhat different since it is not an annual event and can take place at any time of the year as it is not related to a season or historical event. What really distinguishes the French document from the others on the list, however, is its emphasis on the idea of taste, which connects it to a long history of writing about taste in French cuisine, including of course Brillat-Savarin’s Physiology of Taste. In order to describe exactly what constitutes “The Gastronomic Meal of the French,” the authors refer frequently to two coextensive conceptions of taste, proposing that the taste of the meal is both a question of flavor and the aesthetic qualities of the diner as a whole. Whilst these ideas concerning the place of taste in French gastronomy appear to share numerous similarities to those elaborated in Brillat-Savarin’s work, I will focus on the way the conceptions of taste discussed in the dossier are used to formulate French identity. Taste: An Aesthetic Judgment, An Art When considering “The Gastronomic Meal of the French,” the closeness of the two ideas of aesthetic taste and gustative taste is perhaps clearer in French: the French verb dresser can be used to describe setting the table, an important aspect of the gastronomic meal, and arranging food on a plate. This link to aesthetics is important and in the nomination file the Gastronomic Meal of the French is taken as representative of the height of the French “art of good eating and drinking.” In the terms of the document the authors define the meal as “a festive meal bringing people together for an occasion to enjoy the art of good eating and drinking” (“Nomination file” 3). In evoking art here, they stress the importance that aesthetics play in the design of this meal. For them, the culinary art of the gastronomic meal involves both aesthetic and gustative concerns, since in order for the guests to savour the meal, the hosts must think as much about the delectability of their dishes as the classic French taste they must demonstrate in their table decoration and discussion about the food which they prepare. The participants’ conversation about the food during the meal and their comportment at the table are important elements of this taste, since they reinforce and aestheticize the dining experience. Moreover, both the host and guests must use “codified gestures” and certain expressions to discuss what they are eating and drinking so as to display by means of specific vocabulary that they are enjoying the meal (5). The art of conversation, then, is important in accomplishing one of the goals of the gastronomic meal, that being to share “the pleasure of taste” (8). The nomination file lists the gastronomic meal’s specific rites as involving the “setting [of] a beautiful table, the order of courses, food and wine pairing, [and] conversation about the dishes” (3). By listing these elements in this order, the authors highlight that aesthetic and gustative concerns are interrelated and equally important. What is more, just as the decoration of a table and conversing about the dishes could be seen to be arts in the largest sense of the term, so too should “the order of the courses” and the “food and wine pairing” be understood to be a question of aesthetic judgment. In other words, the role of these rites in the gastronomic meal is as much to reinforce the sophisticated aesthetics of the hosts’ meal as to delight the taste buds of the guests. The prominent role of the aestheticization of taste in the gastronomic meal is made even clearer elsewhere in the document when the authors specify how the table should be laid for a gastronomic meal. They write that this should be done according to the: classic French taste, based on symmetry that fans out from the centre and including a tablecloth, artistically folded napkins, objects whose shapes are appropriate for each course and designed to enhance tastes; and, depending on the circumstance, between two and five glasses, several plates and utensils, and sometimes a written menu. (5) Here the aesthetics of the table are not simply meant to be appreciated visually, but supposed to support and “enhance tastes”. The two forms of taste, then, are clearly complementary ingredients in the successful hosting of a gastronomic meal and hosts should pay equal attention to both. The authors state that the extra care paid to the aesthetics of the meal is meant to honour the guests and differentiate the meal from a standard, everyday meal (5). Since the two ideas of taste intersect, it naturally follows that the choice of the culinary products for the meal also contributes to the goal of creating a special dining experience. Taste as Gustative Experience, The Terroir For the authors, the French palate is not unified by a canon of specific dishes, but a shared “vision of eating well” (3). This collective vision encompasses several different ideas, including the structure of the meal, the recipes used and the choice of products. Just as with the aesthetic concerns above regarding table arrangements, the authors are quite particular about the configuration of the meal. For them, the gastronomic meal must respect the same structure: beginning with the apéritif (drinks before the meal) and ending with liqueurs, containing in between at least four successive courses, namely a starter, fish and/or meat with vegetables, cheese and dessert, the courses possibly numbering five or six depending on the occasion. (5) The structure of the meal is supposed to highlight the quality of the good products that the host has obtained and exhibit how their flavours go well together (5). In terms of the exact recipes used in the meal, the host might call upon a “repertoire of codified recipes” (3) in order to honour the shared “vision of eating well”. So deeply ingrained is this shared vision in the French psyche that the authors do not need to specify what the recipes are, and even go so far as to claim that the unknown list is “constantly growing” (5). This undefined catalogue of recipes and shared “vision of eating well,” then, arguably represent a banal form of national culinary identity, since these culinary practices constitute a “form of life, which is daily lived” (Billig 69) by the nation without being specified. More important than the recipes, however, is the “search for good products” (3). The hunt for good products begins with seeking out “local food products available at markets […] since they have a high cultural value” (6). The authors argue that the importance attached to these products symbolises the French commitment to non-standardised food products and “quality in terms of taste, nutrition and food safety” (6). The height of gustative taste is represented by the use of these local food products (produits du terroir) since they provide evidence of the hosts’ “knowledge of the characteristics of local production areas” (2). Just as above with the aesthetic concerns of the meal, when discussing one idea of taste, the other is never far away. In this case, the hosts’ knowledge of the local products, used in crafting the gustative experience, is meant to contribute the art of conversation which takes place during the meal. The hosts’ gustative and aesthetic tastes are on display and under analysis at every point in the meal. For the authors of the nomination file, then, French gustative taste is ruled by the idea of terroir. Successfully holding a gastronomic meal means that the hosts must be intimately familiar with France’s geography and the local products of France and use this knowledge to choose the right products. All of these very specific ideas concerning the aesthetic and gustative tastes illustrated in the document, then, raise interesting questions about inclusion and exclusion in the notion of French culinary identity they embody. Whose Taste Is It? So far I have argued that taste is the central preoccupation of the nomination file, which governs both aesthetic and gustative choices a host makes when organizing and holding a gastronomic meal. This discussion has elided some of the questions raised by the document’s definitions of taste, most notably the problem of whose taste is defined by the document. One possible response to this question is provided in quite clear terms by the document itself, when the authors talk about the antecedent of the current meal. For them, the meal evolved out of the values exemplified by “the high-society meal, transmitted through revolutionary France [and which] inspired working-class practices” (5). This reference to revolutionary French values reveals how the authors’ arguments about taste are informed by the values of the French Republic, a powerful notion in discussions about French national identity. As numerous critics have contended, the status of France as a republic significantly impacts on how national identity is constructed (McCaffrey), since it is conceived of through the idea of citizenship. Put simply, being a French citizen means that, for the state, one’s position as a citizen takes precedence over any cultural particularisms or clan and family solidarities (Jennings). To put it another way, whilst the individual person displays specificities, the citizen demonstrates the universal values held by all citizens of the French state (Schnapper). Citizenship is a political matter and any aspect of one’s private life is irrelevant to the state’s treatment of its citizens. In ignoring any particularisms that a citizen may have, French Republicanism seeks to universalise all values held by its citizens, simultaneously providing a common shared identity and a means to exclude anyone who fails to commit to these ideals. As Jennings has pointed out elsewhere, these Republican ideals have an interesting effect on how one considers French national identity in the contemporary diverse society that is France, since “despite an astonishing level of cultural and ethnic diversity, France has seen itself as and has sought to become a monocultural society” (575). In terms of the French culinary practices discussed here the associated problems with French Republicanism are clear, for such a “mono-culinary” representation of French foodways would potentially lead to significant portions of the population being left out of any such definition. Given the document’s reference to the Republic, the universalizing force displayed in the nomination file cannot simply be considered the result of the structure of UNESCO’s bureaucratic file, but should instead be understood as the expression of French Republican ideas of identity. Here it is the quality of local ingredients (produits du terroir) which characterise the universal pleasure of taste and the appreciation of local farming practices (terroirs) that the authors seek to elevate in the face of any imported tastes concurrently practised in France. The fact that the universal claims made in the French document are specific to it, and not inherent of UNESCO’s form, is evident when examining other nomination files, such as the traditional Mexican cuisine dossier. Whilst the Mexican dossier argues that the cuisine offers a “comprehensive cultural model” (4), its authors talk instead of communities whose identities display “distinct yet shared features, all of them together [making] for a flourishing cuisine throughout the country” (12). The Mexican file, thus, recognises that diversity is an integral part of its culinary model. For the French dossier, on the other hand, the Republican ideas are made patent by the authors’ insistence upon the homogenous nature of these culinary practices and tastes. They assert, for instance, that the meal is a “very popular practice, with which all French people are familiar” (3); that it displays a “homogeneity in the whole community” (3); that it embodies a “social practice […] associated with a shared vision of eating well” (3); and that it is part of a “shared history and that it carries the values on which French culture is based” (5). The authors also reference a small survey to support this supposition in which an incredible 95.7 per cent of respondents consider “the gastronomic meal to be part of their heritage and identity” (10). Furthermore they claim that the gastronomic meal transcends local customs, generations, social class and opinions, and adapts to religious and philosophical beliefs. Its values take in diversity and strengthen feelings of belonging for participants in the gastronomic meal. (5) This quotation demonstrates the Republic’s ability to transform the particular into the general, the individual into citizen. Here this transformative ability is seen in the authors’ assertion that the Gastronomic Meal of the French cuts across “local customs” and “social classes” to bring people together and reinforce the sense of a united nation. With this insistent discourse that the meal is unanimously accepted, understood, and practised by the entire nation, despite one’s particularisms, the authors of the file demonstrate how they seek to universalise the meal. The meal should no longer be considered as an object, for the authors seek to promote it to the status of a national myth which is deeply rooted in the national psyche, echoing the nation’s motto of “One Republic/cuisine united and indivisible for everyone.” The Republican nature of the universal tastes represented in the document is further reinforced when the authors emphasise the role of the State and its education system in ensuring that the right taste prevails. Just as many critics discussing the Republic regard the French education system’s role as one which constructs citizens (Janey), equipping them with the appropriate national values, the authors of nomination file argue that good taste is of national significance and ought to be taught in the education system. For them, this taste should be imparted to students in primary schools by regularly preparing and consuming meals so as to instruct them in “the rites of the gastronomic meal, including the choice of the right products” (8). The idea of the right taste is further impressed upon students through the annual “Taste Week” in which “educational activities on nutrition and the development of taste […] essential to maintaining the rites of the element [take place in schools]” (7). These activities include instruction in “the combining of flavours, pleasure of taste, choice of the right product, conversation and gastronomic discourse” (7). For those not at school, the “choice of the right product” (14) mentioned here is facilitated through yet another state sanctioned source of taste, the Inventory of Traditional Food and Agricultural Know-how. Conclusion The “Gastronomic Meal of the French” defines national culinary identity by combining several different ideas together. On one level, the authors draw together Benedict Anderson’s concept of “imagined communities” and Michael Billig’s notion of “banal nationalism.” They argue that there exists a state approved, written form this identity which is intimately linked to the French Republic and its history (Anderson), whilst also contending that the food practices are so well-known that they are banal facets of everyday lived experience (Billig). On another level, they draw these assertions regarding national identity together through the notion of taste, which the authors stress is integral to French culinary identity. In terms of gustative taste, the preference for terroir in the document points to how the local is used as a “conduit toward national self-understanding” (Gerson 215). Yet this approach leads to a problematic relationship between local and national concerns, which ought to be seen as part of a larger issue concerning the link between Republican values and the disciplining of French culinary identity and space. What it is tempting to ask—and the present paper is just the beginning—is how do state sanctioned bodies, like the Mission Française du Patrimoine et des Cultures Alimentaires combined with brotherhoods (confréries) and local organisations mentioned in the nomination file as well as the system of Appellations d’Origine Contrôlée, come together to discipline French culinary identity and taste? The examination of the present document seems to suggest that Republican Universalism is one key ingredient in this act of discipline. The hesitation between asserting a cohesive, national culinary identity whilst at the same time recognising the “diversity of traditions foods and cuisines” (5), appears to be representative of the hesitation in political discourse apparent in the modern Republic. The tensions exposed in this document are being played out in the policies concerning decentralisation and recognition to a certain extent of regional minorities in France. As Schnapper puts it, the great problem which the Republic currently faces is how can the state reconcile “the absolute of citizenship—the Republic—with the legitimate expression of particularistic allegiances in conformity with democratic values” (quoted, Jennings 152). Ultimately, what “The Gastronomic Meal of the French” shows is how pertinent Republican ideas still are in France, since, despite claims of a crisis in Republican values and the current debates in French parliament, they remain important in any consideration of French identity, not only in the political spectrum, but also in everyday cultural objects like food. References Anderson, Benedict. Imagined Communities: Reflections on the Origins and Spread of Nationalism. London: Verso, 1983. Billig, Michael. Banal Nationalism. London: Sage, 1995. Gerson, Stéphane. “The Local.” The French Republic: History, Values, Debate. Eds. Edward Berensen, Vincent Duclert, and Christophe Prochasson. London: Cornell UP, 2011. 213–20. Janey, Brigitte. “Frenchness in Perspective(s).” Hexagonal Varitations: Diversity, Plurality and Reinvention in Contemporary France. Eds Jo McCormack, Murray Pratt, and Alistair Rolls. Amsterdam: Editions Rodopi, 2011. 57–78. Jennings, Jeremy. “Citizenship, Republicanism and Multiculturalism in Contemporary France.” British Journal of Political Science 30 (2000): 575–98. Jennings, Jeremy. “Universalism.” The French Republic: History, Values, Debate. Eds. Edward Berensen, Vincent Duclert, and Christophe Prochasson. London: Cornell UP, 2011. Kurin, Richard, “Safeguarding Intangible Cultural Heritage in the 2003 UNESCO Convention: A Critical Appraisal.” Museum International 56.1/2 (2004): 66–77. McCaffrey, Edna. The Gay Republic: Sexuality, Citizenship and Subversion in France. Aldershot: Ashgate, 2005. Schnapper, Domonique. La Communauté des Citoyens. Paris: Gallimard, 1994. Smith, Laurajane, and Natsuko Akagawa. Intangible Heritage. New York: Routledge, 2008. UNESCO. “Convention for the Safeguarding of Intangible Cultural Heritage.” UNESCO, Culture Section 17 Oct. 2003. 12 Jun. 2013 ‹http://www.unesco.org/culture/ich/en/convention›. UNESCO. “Dossier de Candidature : Le Repas Gastronomique des Français.” UNESCO, Culture Section. Nov. 2010. 12 Jun 2013 ‹http://www.unesco.org/culture/ich/en/RL/00437›. UNESCO. “Nomination File: The Gastronomic Meal of the French.” UNESCO, Culture Section Nov. 2010. 12 Jun. 2013 ‹http://www.unesco.org/culture/ich/en/RL/00437›. UNESCO. “Nomination File: Traditional Mexican Cuisine—Ancestral, Ongoing Community Culture, the Michoacán Paradigm.” UNESCO, Culture Section Nov. 2010. 12 Jun. 2013 ‹http://www.unesco.org/culture/ich/en/RL/00400›. UNESCO. “What is Intangible Cultural Heritage?” UNESCO, Culture Section n.d. 12 Jun. 2013 ‹http://www.unesco.org/culture/ich/index.php?lg=en&pg=00002›.
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Costello, Moya. "Reading the Senses: Writing about Food and Wine." M/C Journal 16, no. 3 (June 22, 2013). http://dx.doi.org/10.5204/mcj.651.

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"verbiage very thinly sliced and plated up real nice" (Barrett 1)IntroductionMany of us share in an obsessive collecting of cookbooks and recipes. Torn or cut from newspapers and magazines, recipes sit swelling scrapbooks with bloated, unfilled desire. They’re non-hybrid seeds, peas under the mattress, an endless cycle of reproduction. Desire and narrative are folded into each other in our drive, as humans, to create meaning. But what holds us to narrative is good writing. And what can also drive desire is image—literal as well as metaphorical—the visceral pleasure of the gaze, or looking and viewing the sensually aesthetic and the work of the imagination. Creative WritingCooking, winemaking, and food and wine writing can all be considered art. For example, James Halliday (31), the eminent Australian wine critic, posed the question “Is winemaking an art?,” answering: “Most would say so” (31). Cookbooks are stories within stories, narratives that are both factual and imagined, everyday and fantastic—created by both writer and reader from where, along with its historical, cultural and publishing context, a text gets its meaning. Creative writing, in broad terms of genre, is either fiction (imagined, made-up) or creative nonfiction (true, factual). Genre comes from the human taxonomic impulse to create order from chaos through cataloguing and classification. In what might seem overwhelming infinite variety, we establish categories and within them formulas and conventions. But genres are not necessarily stable or clear-cut, and variation in a genre can contribute to its de/trans/formation (Curti 33). Creative nonfiction includes life writing (auto/biography) and food writing among other subgenres (although these subgenres can also be part of fiction). Cookbooks sit within the creative nonfiction genre. More clearly, dietary or nutrition manuals are nonfiction, technical rather than creative. Recipe writing specifically is perhaps less an art and more a technical exercise; generally it’s nonfiction, or between that and creative nonfiction. (One guide to writing recipes is Ostmann and Baker.) Creative writing is built upon approximately five, more or less, fundamentals of practice: point of view or focalisation or who narrates, structure (plot or story, and theme), characterisation, heightened or descriptive language, setting, and dialogue (not in any order of importance). (There are many handbooks on creative writing, that will take a writer through these fundamentals.) Style or voice derives from what a writer writes about (their recurring themes), and how they write about it (their vocabulary choice, particular use of imagery, rhythm, syntax etc.). Traditionally, as a reader, and writer, you are either a plot person or character person, but you can also be interested primarily in ideas or language, and in the popular or literary.Cookbooks as Creative NonfictionCookbooks often have a sense of their author’s persona or subjectivity as a character—that is, their proclivities, lives and thus ideology, and historical, social and cultural place and time. Memoir, a slice of the author–chef/cook’s autobiography, is often explicitly part of the cookbook, or implicit in the nature of the recipes, and the para-textual material which includes the book’s presentation and publishing context, and the writer’s biographical note and acknowledgements. And in relation to the latter, here's Australian wine educator Colin Corney telling us, in his biographical note, about his nascent passion for wine: “I returned home […] stony broke. So the next day I took a job as a bottleshop assistant at Moore Park Cellars […] to tide me over—I stayed three years!” (xi). In this context, character and place, in the broadest sense, are inevitably evoked. So in conjunction with this para-textual material, recipe ingredients and instructions, visual images and the book’s production values combine to become the components for authoring a fictive narrative of self, space and time—fictive, because writing inevitably, in a broad or conceptual sense, fictionalises everything, since it can only re-present through language and only from a particular point of view.The CookbooksTo talk about the art of cookbooks, I make a judgmental (from a creative-writer's point of view) case study of four cookbooks: Lyndey Milan and Colin Corney’s Balance: Matching Food and Wine, Sean Moran’s Let It Simmer (this is the first edition; the second is titled Let It Simmer: From Bush to Beach and Onto Your Plate), Kate Lamont’s Wine and Food, and Greg Duncan Powell’s Rump and a Rough Red (this is the second edition; the first was The Pig, the Olive & the Squid: Food & Wine from Humble Beginnings) I discuss reading, writing, imaging, and designing, which, together, form the nexus for interpreting these cookbooks in particular. The choice of these books was only relatively random, influenced by my desire to see how Australia, a major wine-producing country, was faring with discussion of wine and food choices; by the presence of discursive text beyond technical presentation of recipes, and of photographs and purposefully artful design; and by familiarity with names, restaurants and/or publishers. Reading Moran's cookbook is a model of good writing in its use of selective and specific detail directed towards a particular theme. The theme is further created or reinforced in the mix of narrative, language use, images and design. His writing has authenticity: a sense of an original, distinct voice.Moran’s aphoristic title could imply many things, but, in reading the cookbook, you realise it resonates with a mindfulness that ripples throughout his writing. The aphorism, with its laidback casualness (legendary Australian), is affectively in sync with the chef’s approach. Jacques Derrida said of the aphorism that it produces “an echo of really curious, indelible power” (67).Moran’s aim for his recipes is that they be about “honest, home-style cooking” and bringing “out a little bit of the professional chef in the home cook”, and they are “guidelines” available for “sparkle” and seduction from interpretation (4). The book lives out this persona and personal proclivities. Moran’s storytellings are specifically and solely highlighted in the Contents section which structures the book via broad categories (for example, "Grains" featuring "The dance of the paella" and "Heaven" featuring "A trifle coming on" for example). In comparison, Powell uses "The Lemon", for example, as well as "The Sheep". The first level of Contents in Lamont’s book is done by broad wine styles: sparkling, light white, robust white and so on, and the second level is the recipe list in each of these sections. Lamont’s "For me, matching food and wine comes down to flavour" (xiii) is not as dramatic or expressive as Powell’s "Wine: the forgotten condiment." Although food is first in Milan and Corney’s book’s subtitle, their first content is wine, then matching food with colour and specific grape, from Sauvignon Blanc to Barbera and more. Powell claims that the third of his rules (the idea of rules is playful but not comedic) for choosing the best wine per se is to combine region with grape variety. He covers a more detailed and diversified range of grape varieties than Lamont, systematically discussing them first-up. Where Lamont names wine styles, Powell points out where wine styles are best represented in Australian states and regions in a longish list (titled “13 of the best Australian grape and region combos”). Lamont only occasionally does this. Powell discusses the minor alternative white, Arneis, and major alternative reds such as Barbera and Nebbiolo (Allen 81, 85). This engaging detail engenders a committed reader. Pinot Gris, Viognier, Sangiovese, and Tempranillo are as alternative as Lamont gets. In contrast to Moran's laidbackness, Lamont emphasises professionalism: "My greatest pleasure as a chef is knowing that guests have enjoyed the entire food and wine experience […] That means I have done my job" (xiii). Her reminders of the obvious are, nevertheless, noteworthy: "Thankfully we have moved on from white wine/white meat and red wine/red meat" (xiv). She then addresses the alterations in flavour caused by "method of cooking" and "combination of ingredients", with examples. One such is poached chicken and mango crying "out for a vibrant, zesty Riesling" (xiii): but where from, I ask? Roast chicken with herbs and garlic would favour "red wine with silky tannin" and "chocolatey flavours" (xiii): again, I ask, where from? Powell claims "a different evolution" for his book "to the average cookbook" (7). In recipes that have "a wine focus", there are no "pretty […] little salads, or lavish […] cakes" but "brown" albeit tasty food that will not require ingredients from "poncy inner-city providores", be easy to cook, and go with a cheap, budget-based wine (7). While this identity-setting is empathetic for a Powell clone, and I am envious of his skill with verbiage, he doesn’t deliver dreaming or desire. Milan and Corney do their best job in an eye-catching, informative exemplar list of food and wine matches: "Red duck curry and Barossa Valley Shiraz" for example (7), and in wine "At-a-glance" tables, telling us, for example, that the best Australian regions for Chardonnay are Margaret River and the Adelaide Hills (53). WritingThe "Introduction" to Moran’s cookbook is a slice of memoir, a portrait of a chef as a young man: the coming into being of passion, skill, and professionalism. And the introduction to the introduction is most memorable, being a loving description of his frugal Australian childhood dinners: creations of his mother’s use of manufactured, canned, and bottled substitutes-for-the-real, including Gravox and Dessert Whip (1). From his travel-based international culinary education in handmade, agrarian food, he describes "a head of buffalo mozzarella stuffed with ricotta and studded with white truffles" as "sheer beauty", "ambrosial flavour" and "edible white 'terrazzo'." The consonants b, s, t, d, and r are picked up and repeated, as are the vowels e, a, and o. Notice, too, the comparison of classic Italian food to an equally classic Italian artefact. Later, in an interactive text, questions are posed: "Who could now imagine life without this peppery salad green?" (23). Moran uses the expected action verbs of peel, mince, toss, etc.: "A bucket of tiny clams needs a good tumble under the running tap" (92). But he also uses the unexpected hug, nab, snuggle, waltz, "wave of garlic" and "raining rice." Milan and Corney display a metaphoric-language play too: the bubbles of a sparkling wine matching red meat become "the little red broom […] sweep[ing] away the […] cloying richness" (114). In contrast, Lamont’s cookbook can seem flat, lacking distinctiveness. But with a title like Wine and Food, perhaps you are not expecting much more than information, plain directness. Moran delivers recipes as reproducible with ease and care. An image of a restaurant blackboard menu with the word "chook" forestalls intimidation. Good quality, basic ingredients and knowledge of their source and season carry weight. The message is that food and drink are due respect, and that cooking is neither a stressful, grandiose nor competitive activity. While both Moran and Lamont have recipes for Duck Liver Pâté—with the exception that Lamont’s is (disturbingly, for this cook) "Parfait", Moran also has Lentil Patties, a granola, and a number of breads. Lamont has Brioche (but, granted, without the yeast, seeming much easier to make). Powell’s Plateless Pork is "mud pies for grown-ups", and you are asked to cook a "vat" of sauce. This communal meal is "a great way to spread communicable diseases", but "fun." But his passionately delivered historical information mixed with the laconic attitude of a larrikin (legendary Australian again) transform him into a sage, a step up from the monastery (Powell is photographed in dress-up friar’s habit). Again, the obvious is noteworthy in Milan and Corney’s statement that Rosé "possesses qualities of both red and white wines" (116). "On a hot summery afternoon, sitting in the sun overlooking the view … what could be better?" (116). The interactive questioning also feeds in useful information: "there is a huge range of styles" for Rosé so "[g]rape variety is usually a good guide", and "increasingly we are seeing […] even […] Chambourcin" (116). Rosé is set next to a Bouillabaisse recipe, and, empathetically, Milan and Corney acknowledge that the traditional fish soup "can be intimidating" (116). Succinctly incorporated into the recipes are simple greyscale graphs of grape "Flavour Profiles" delineating the strength on the front and back palate and tongue (103).Imaging and DesigningThe cover of Moran’s cookbook in its first edition reproduces the colours of 1930–1940's beach towels, umbrellas or sunshades in matt stripes of blue, yellow, red, and green (Australian beaches traditionally have a grass verge; and, I am told (Costello), these were the colours of his restaurant Panoroma’s original upholstery). A second edition has the same back cover but a generic front cover shifting from the location of his restaurant to the food in a new subtitle: "From Bush to Beach and onto Your Plate". The front endpapers are Sydney’s iconic Bondi Beach where Panoroma restaurant is embedded on the lower wall of an old building of flats, ubiquitous in Bondi, like a halved avocado, or a small shallow elliptic cave in one of the sandstone cliff-faces. The cookbook’s back endpapers are his bush-shack country. Surfaces, cooking equipment, table linen, crockery, cutlery and glassware are not ostentatious, but simple and subdued, in the colours and textures of nature/culture: ivory, bone, ecru, and cream; and linen, wire, wood, and cardboard. The mundane, such as a colander, is highlighted: humbleness elevated, hands at work, cooking as an embodied activity. Moran is photographed throughout engaged in cooking, quietly fetching in his slim, clean-cut, short-haired, altar-boyish good-looks, dressed casually in plain bone apron, t-shirt (most often plain white), and jeans. While some recipes are traditionally constructed, with the headnote, the list of ingredients and the discursive instructions for cooking, on occasion this is done by a double-page spread of continuous prose, inviting you into the story-telling. The typeface of Simmer varies to include a hand-written lookalike. The book also has a varied layout. Notes and small images sit on selected pages, as often as not at an asymmetric angle, with faux tape, as if stuck there as an afterthought—but an excited and enthusiastic afterthought—and to signal that what is informally known is as valuable as professional knowledge/skill and the tried, tested, and formally presented.Lamont’s publishers have laid out recipe instructions on the right-hand side (traditional English-language Western reading is top down, left to right). But when the recipe requires more than one item to be cooked, there is no repeated title; the spacing and line-up are not necessarily clear; and some immediate, albeit temporary, confusion occurs. Her recipes, alongside images of classic fine dining, carry the implication of chefing rather than cooking. She is photographed as a professional, with a chef’s familiar striped apron, and if she is not wearing a chef’s jacket, tunic or shirt, her staff are. The food is beautiful to look at and imagine, but tackling it in the home kitchen becomes a secondary thought. The left-hand section divider pages are meant to signal the wines, with the appropriate colour, and repetitive pattern of circles; but I understood this belatedly, mistaking them for retro wallpaper bemusedly. On the other hand, Powell’s bog-in-don’t-wait everyday heartiness of a communal stewed dinner at a medieval inn (Peasy Lamb looks exactly like this) may be overcooked, and, without sensuousness, uninviting. Images in Lamont’s book tend toward the predictable and anonymous (broad sweep of grape-vined landscape; large groups of people with eating and drinking utensils). The Lamont family run a vineyard, and up-market restaurants, one photographed on Perth’s river dockside. But Sean's Panoroma has a specificity about it; it hasn’t lost its local flavour in the mix with the global. (Admittedly, Moran’s bush "shack", the origin of much Panoroma produce and the destination of Panoroma compost, looks architect-designed.) Powell’s book, given "rump" and "rough" in the title, stridently plays down glitz (large type size, minimum spacing, rustic surface imagery, full-page portraits of a chicken, rump, and cabbage etc). While not over-glam, the photography in Balance may at first appear unsubtle. Images fill whole pages. But their beautifully coloured and intriguing shapes—the yellow lime of a white-wine bottle base or a sparkling wine cork beneath its cage—shift them into hyperreality. White wine in a glass becomes the edge of a desert lake; an open fig, the jaws of an alien; the flesh of a lemon after squeezing, a sea anemone. The minimal number of images is a judicious choice. ConclusionReading can be immersive, but it can also hover critically at a meta level, especially if the writer foregrounds process. A conversation starts in this exchange, the reader imagining for themselves the worlds written about. Writers read as writers, to acquire a sense of what good writing is, who writing colleagues are, where writing is being published, and, comparably, to learn to judge their own writing. Writing is produced from a combination of passion and the discipline of everyday work. To be a writer in the world is to observe and remember/record, to be conscious of aiming to see the narrative potential in an array of experiences, events, and images, or, to put it another way, "to develop the habit of art" (Jolley 20). Photography makes significant whatever is photographed. The image is immobile in a literal sense but, because of its referential nature, evocative. Design, too, is about communication through aesthetics as a sensuous visual code for ideas or concepts. (There is a large amount of scholarship on the workings of image combined with text. Roland Barthes is a place to begin, particularly about photography. There are also textbooks dealing with visual literacy or culture, only one example being Shirato and Webb.) It is reasonable to think about why there is so much interest in food in this moment. Food has become folded into celebrity culture, but, naturally, obviously, food is about our security and survival, physically and emotionally. Given that our planet is under threat from global warming which is also driving climate change, and we are facing peak oil, and alternative forms of energy are still not taken seriously in a widespread manner, then food production is under threat. Food supply and production are also linked to the growing gap between poverty and wealth, and the movement of whole populations: food is about being at home. Creativity is associated with mastery of a discipline, openness to new experiences, and persistence and courage, among other things. We read, write, photograph, and design to argue and critique, to use the imagination, to shape and transform, to transmit ideas, to celebrate living and to live more fully.References Allen, Max. The Future Makers: Australian Wines for the 21st Century. Melbourne: Hardie Grant, 2010. Barratt, Virginia. “verbiage very thinly sliced and plated up real nice.” Assignment, ENG10022 Writing from the Edge. Lismore: Southern Cross U, 2009. [lower case in the title is the author's proclivity, and subsequently published in Carson and Dettori. Eds. Banquet: A Feast of New Writing and Arts by Queer Women]Costello, Patricia. Personal conversation. 31 May 2012. Curti, Lidia. Female Stories, Female Bodies: Narrative, Identity and Representation. UK: Macmillan, 1998.Derrida, Jacques. "Fifty-Two Aphorisms for a Foreword." Deconstruction: Omnibus Volume. Eds. Andreas Apadakis, Catherine Cook, and Andrew Benjamin. New York: Rizzoli, 1989.Halliday, James. “An Artist’s Spirit.” The Weekend Australian: The Weekend Australian Magazine 13-14 Feb. (2010): 31.Jolley, Elizabeth. Central Mischief. Ringwood: Viking/Penguin 1992. Lamont, Kate. Wine and Food. Perth: U of Western Australia P, 2009. Milan, Lyndey, and Corney, Colin. Balance: Matching Food and Wine: What Works and Why. South Melbourne: Lothian, 2005. Moran, Sean. Let It Simmer. Camberwell: Lantern/Penguin, 2006. Ostmann, Barbara Gibbs, and Jane L. Baker. The Recipe Writer's Handbook. Canada: John Wiley, 2001.Powell, Greg Duncan. Rump and a Rough Red. Millers Point: Murdoch, 2010. Shirato, Tony, and Jen Webb. Reading the Visual. Crows Nest: Allen & Unwin, 2004.
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