Improving diets by changing the composition of processed foods is considered one of many
means to help reduce the prevalence of dietrelated diseases. Food reformulation initiatives
have so far aimed at reducing salt, transfatty acids, saturated fatty acids, sugars and total
energy. Eventually, any impact of such programmes largely depends on consumers’ food
choices and will only show in the long term.
Challenges of food reformulation
In order for reformulation initiatives to achieve measurable effects on population nutrient and energy
intakes, it is important to assess which food sources contribute most to intake and target these
specifically.
1
For manufacturers, reformulation, e.g. reducing the caloric content or reducing salt,
transfatty acids and saturated fatty acids is far from simply removing or replacing one ingredient in a recipe; it concerns a
whole range of factors.
In order for reformulation initiatives to achieve measurable effects on population nutrient and energy intakes, it is important to
assess which food sources contribute most to intake and target these specifically. For manufacturers, reformulation, e.g. reducing
the caloric content or reducing salt, transfatty acids and saturated fatty acids is far from simply removing or replacing one
ingredient in a recipe; it concerns a whole range of factors.
It is crucial to ensure that replacing one ingredient with another actually improves the nutritional properties of the food product
significantly, bearing in mind consumers do not accept any compromise in taste.
2
This demands knowledge about potential
substitution ingredients, including food additives, as well as reconsideration of the overall composition of a food product. New
ingredients used in reformulation must be allowed for use in all countries where the product is sold. In certain food product
categories reformulation is not applicable for certain ingredients, because the final nutritional properties of the product are not
changed at all.
Notably, reformulation projects also provide opportunities to improve the overall nutrient density of foods by enhancing the
content of desirable ingredients such as minerals, vitamins or fibre.
Quality and consumer acceptance
Different ingredients play their role in the sensory characteristics of a food, and reformulation efforts meeting consumer
expectations for taste, texture, colour etc. must be made. A second challenging alternative is to introduce stepwise changes in
product formulations to let consumers adapt gradually to new sensory properties.
2
A substitution in ingredients can change significantly the list of ingredients as it appears on the label (type of ingredients,
number of ingredients, order of the ingredients, etc.) and this can affect consumer perception of the product. In some cases
the legal denomination of the product will change, which can also affect consumer perception.
Processing
Adapting individual ingredients (e.g. saturated fat) may impact the processing steps required in food production. New recipes
may necessitate adaptation of technologies involved.
3
Alternative ingredients may require specific handling, or changes in the
product technologies, adding to the complexity of reformulation initiatives.
Food safety
In addition to the taste aspects, salt and to a certain extent sugar, traditionally are added to foods for preservation purposes.
1
They bind water and thus lower the water activity of a food, a determining factor for microbial growth and thus food spoilage.
Reducing the levels of these nutrients may compromise food safety and shorten product shelflife. Solutions may be found in
fundamental reformulation, adjusted storage instructions, new packaging approaches and using other preservatives.
Salt reduction
Reformulation to decrease salt content initially often focuses on a stepbystep reduction. To achieve larger reductions in salt
content, salt replacers or taste and flavour enhancing ingredients are needed. Most of these have limitations due to offtastes.
Despite these complexities, the first salt reduction programmes were implemented in the 1970’s. Such initiatives have resulted
in significant decreases in salt intakes, and the estimated economic and public health impact is substantial.
1,4
Fat reduction
The role of fat in food is firstly to give calories, fatsoluble vitamins, taste, texture and volume. Ingredients used for replacing
fat are commonly protein or carbohydratebased from e.g. potato, corn, chicory roots, egg, soy or milk, which may mimic the
properties that fat brings to food.
5
Food innovation and reformulation for a healthier Europe – a challenging
mission
Replacing trans fats – finding the right substitute
Partially hydrogenated vegetable oils, which are a source of trans fats are commonly replaced by other oils because trans fats
have been linked to a higher risk of cardiovascular events.
6
However, it is essential that the replacement oil actually reduces
such a risk to be of real benefit. Whereas margarines are now virtually free of trans fats in Europe, technical issues prevent
progress for bakery products.
Exchanging saturated with unsaturated fats – a matter of softness
Consistency is a major issue when reducing saturated fatty acid content in food by replacing it with unsaturated fat. The more
unsaturated fatty acids there are, the softer the fat gets, which may create a challenge for manufacturers in that processing
technologies might need to be adapted or replaced.
3
Additionally, more unsaturated fat also means higher tendency towards
fat oxidation and rancidity.
“Sugarfree” and “sugarreduced” products
There are already many sugarfree and sugarreduced products on the market. Their sweetness comes either from intense
sweeteners and/or from bulky sweeteners such as isomalt. As sugar also gives bulk to foods, the bulk needs to be
compensated by other ingredients, which are often other carbohydrates, e.g. starches. As they have the same energy content
as sugar, sugar replacement does not by default lead to changes in the nutritional properties and caloric contents of these
products. It is different with drinks, where sweetness is replaced by intense sweeteners and the bulk with water.
The way forward
The potential recipe for future success of food reformulation comprises e.g. further innovation as part of close collaborations
between authorities and industry, involvement of caterers and retailers, and campaigns that raise awareness about the
importance of dietary changes amongst consumers. However, it also depends on other factors, such as price levels,
acceptance by the consumer, and clear nutrition labelling of these new product offers.
The potential recipe for future success of food reformulation comprises e.g. further innovation as part of close collaborations
between authorities and industry, involvement of caterers and retailers, and campaigns that raise awareness about the
importance of dietary changes amongst consumers. However, it also depends on other factors, such as price levels, acceptance by
the consumer, and clear nutrition labelling of these new product offers.
References
1. van Raaij J et al. (2008). Potential for improvement of population diet through reformulation of commonly eaten foods.
Public Health Nutrition 12(3):325–330.
2. European Commission (2009). Reformulating food products for health: context and key issues for moving forward in
Europe. Brussels, Belgium. Dostupné na:
http://ec.europa.eu/health/nutrition_physical_activity/docs/ev20090714_wp_en.pdf
3. Food Standards Agency (2009). Reduction of Saturated fat in Bakery Products: A Report to the Biscuits, Cakes and
Pastries Stakeholder Group. London, United Kingdom.
4. BibbinsDomingo K et al. (2010). Projected effect of dietary salt reductions on future cardiovascular disease. New
England Journal of Medicine 362(7):590–599.
5. JiménezColmenero F. (2000). Relevant factors in strategies for fat reduction in meat products. Trends in Food Science
& Technology 11:56–66.
6. Mozaffarian D and Clarke R. (2009). Quantitative effects on cardiovascular risk factors and coronary heart disease of
replacing partially hydrogenated vegetable oils with other fats and oils. European Journal of Clinical Nutrition 63:522–
533.
2
Our saliva is ninetynine per cent water. The remaining one per cent, however, contains numerous
substances important for digestion, dental health and control of microbial growth in the mouth.
The salivary glands in our mouth produce about 12 litres of saliva daily. Blood plasma is used as the basis,
from which the salivary glands extract some substances and add various others. The list of ingredients found
so far in saliva is long, and growing. Just as varied are the many functions, of which only a few major ones
will be outlined below.
Food and saliva
Preventing us from choking on food
An important role of saliva during eating is based in its sliminess. During mastication the dry, crumbly or disintegrating food
turns into a soft, cohesive lump, the “bolus”.
1
This bolus is held together by long, threadlike molecules, the mucins, which get
tangled up at their ends. Moreover, mucins bind large quantities of water and thus keep the bolus moist and soft.
2,3
This is
important for us not to choke on the food or let the oesophagus get damaged by rough food particles.
Taste
Saliva is essential for taste sensation. The taste buds lie hidden in deep, narrow vaults across our tongues that cannot be
accessed by dry, lumpy aroma compounds. As an experiment, close your eyes and have a lump of rock sugar or salt placed
on your tongue. Differentiating between the two will be even more difficult the drier your tongue. Only after moisturising the
lump with saliva are the individual sugar or salt molecules released and we taste sweet or salty. This function of saliva is
brought about by its main component, water.
More complex foods such as starch or protein, require further help from our saliva, before we can identify them as tasty. The
portfolio of receptors on our taste buds can only bind small molecules and ions, but not large chains of molecules (polymers).
This is why a starch molecule although consisting of millions of single sugars (monosaccharides) does not taste sweet. To
reveal the true nature of the food, our saliva contains digestive enzymes.
4
Each enzyme accelerates a specific chemical
reaction that would otherwise proceed too slowly for our purposes. Amylase, for example, helps the water molecules in our
saliva to split the chemical bonds between the monosaccharides in starch. The individual sugar units released then bind to
“sweet” receptors, which relay the message to the brain that this is indeed nutritious food that is safe to swallow. The same
holds for proteins, from which proteases in saliva cut individual amino acids, some of which may stimulate the “umami”
receptor (umami = savoury).
Saliva as a builder
The hard matter of our teeth enamel and dentine consists of a very hard crystal called hydroxyapatite. Hydroxyapatite is
made from calcium, phosphate and hydroxyl ions. Additionally, it contains organic molecules, mainly collagen, and in the case
of dentine also cellular projections from odontoblasts (cells that produce dentine).
Source of building blocks
Because of its specific properties water can dissolve out ions from salt crystals. Table salt for example quickly disintegrates in
water into its constituent sodium and chloride ions. Although in hydroxyapatite the ions are bound very tightly, in water the
crystal would steadily lose ions from the surface and shrink. To reverse this process, our saliva is saturated with calcium and
phosphate ions. These occupy the spaces freed up in the crystal lattice and thus prevent continuous corrosion of the enamel
surface. If our saliva was constantly diluted with water, the concentration of calcium phosphate would be insufficient and the
tooth enamel would start to erode. This happens for example in the socalled nursing bottle syndrome seen in infants. Due to
prolonged sucking on the baby bottle, even if only filled with water, the teeth become porous and typical caries on the upper
front teeth develops.
5
Good oral hygiene including twice daily brushing of teeth with fluoridecontaining toothpaste, and
minimising prolonged exposure of teeth to drinks with fermentable carbohydrates (e.g. juice, milk, formula) are some of the
strategies that may help reduce the risk.
6
Neutralisation of acids
Hydroxyapatite only forms when enough hydroxyl (OH
) and phosphate (PO
4
3
) ions are present. Such conditions prevail at
alkaline pH (pH>7). Under acidic conditions the OH
ions turn to water and the phosphate ions to mono, di, and trihydrogen
phosphates. These do not fit into the crystal lattice and are washed away.
7
Our saliva prevents this through buffering
substances that keep the pH near neutral, i.e. around 7. If the pH is too alkaline over a prolonged period, the hydroxyapatite
grows too quickly, leading to scale (dental calculus). In contrast, continued exposure to acidic fluids (pH<7), e.g. when sucking
juice from a baby bottle, leads to porous, thin enamel.
5
Surface coating
We have seen that the surface of the hydroxyapatite crystal that forms the enamel is sensitive to changes in the composition
of saliva and undergoes constant reconstruction. However, our teeth are supposed to stay healthy and functional for many
decades. Therefore, a stable environment on the enamel surface would be desirable. Here, too, saliva has a role: components
of it, first and foremost the mucins, firmly settle on the crystal surface and create a protective layer.
8
This protective layer of
mucous molecules, called pellicle, binds water and ions and holds them in place.
9
Additionally, it evens out irregularities in the
crystal surface and thus keeps it smooth and lubricated.
Saliva in the biotope of the oral cavity
Our cohabitants
Saliva more than just water in your mouth
3
The many moist and warm surfaces in our mouth serve as an ideal habitat (biotope) for microorganisms, mainly bacteria, but
also yeasts (e.g. Candida) and protozoa (e.g. Entamoeba gingivalis).
10
In addition to the ideal climate, these organisms also
benefit from the generous “feeding” that they receive through our regular food intake.
Surviving in the biotope of the oral cavity
Bacteria only stand a chance to survive in our mouth if they manage to hold on and not get swallowed. A few bacterial species,
especially streptococci, can bind directly to the pellicle. On the one hand this happens via positively charged calcium ions that
mediate between the negatively charged surfaces of the pellicle and the bacteria. On the other hand, there is also direct,
specific binding of bacterial proteins (lectins) to the pellicle structure.
Already five minutes after the tooth surface has been cleaned, the first bacteria start attaching to the newly formed pellicle.
They then proliferate by cell division to form a biofilm. This first layer of “pioneers” in turn allows other bacteria to attach. After
two to three hours, a plaque visible to the naked eye is established. In protected areas of the mouth, bacterial colonies over
the next days grow into thick, complex threedimensional structures known as mature plaque. If the plaque is undisturbed by
tooth brush or floss, it can grow as thick as one millimetre or 300 bacteria.
11
In such large colonies, especially the lower layers
facing the tooth experience a lack of oxygen. To be able to continue extracting energy from food, these bacteria need to switch
to fermentation, a process that yields organic acids instead of carbon dioxide and water. The resulting acidic microclimate
dissolves the hydroxyapatite crystal and caries ensues. After about a week, the plaque begins to mineralise: calcium and
phosphate from saliva are deposited in the bacterial colony and harden it, leading to dental calculus.
Plaque as thick and firm as this can only form in places in the mouth where bacteria can proliferate undisturbed over many
days. The constant flow of saliva prevents this on most dental surfaces simply by washing away loosely attached bacterial
layers. Even in people who neglect brushing their teeth over a prolonged period of time, dental plaque and calculus do not
form on exposed surfaces. However, niches such as the interdental space and gum pockets provide sufficient protection
against the mechanical rinsing function of saliva.
But saliva can do even more: the proteins that form the pellicle on the tooth surface and to which bacteria can hold on, are
also still present in a soluble form in saliva. Bacteria cannot actively discern whether the mucin they bound to is fixed to the
tooth surface or free floating in saliva and washed into the stomach with the next swallowing process. Many bacteria are thus
entrapped and swallowed. In addition, saliva contains the enzyme lysozyme that attacks and perforates the cell walls of certain
bacteria, eventually making them burst. Then there are antibodies (immunoglobulin A) secreted into saliva that prevent
pathogens from settling in the oral cavity.
12
Our saliva promotes bacteria that do not produce acids, and it helps kill undesirable and excess bacteria with the use of nitrate.
Nitrate is an important nitrogen source for plants and is therefore used as fertiliser. Many plants, especially salads and
vegetables, store nitrate as a reserve in times of need. Our cells do not have much use for nitrate, which is why dietary nitrate
floats unused in our blood until we excrete it via urine. Some bacteria, however, can use nitrate (NO
3
) instead of oxygen for
respiration, turning it into nitrite (NO
2
). When nitrite gets in contact with acid it becomes a strong poison that can kill bacteria
in close vicinity. Our salivary glands actively accumulate nitrate from the blood and secrete it with the saliva into the mouth.
There it has several functions: it helps those bacteria that can breathe nitrate instead of oxygen (denitrifying bacteria). When
oxygen is scarce they produce nitrite, but not acids, so they do not cause caries. If a denitrifying bacterium lives next to an
acidproducing bacterium, the latter will be killed through the reaction of its own acid with nitrite, resulting in reduced acid
production. Less acid means better tooth protection.
13
Furthermore, the nitrite we swallow with the saliva reacts with gastric
acid and can kill potential pathogens in the stomach that may have been taken in orally.
14
Conclusions
So what if it was really only water accumulating in our mouth when salivating? We would choke much more often on food,
because the cohesive bolus would not form. Macromolecular nutrients such as protein and starch, but probably also fat, would
have a neutral taste. We would only be able to taste predigested food that already contains individual amino acids and sugars.
The calcium and phosphate ions leached from hydroxyapatite through the action of water and unbuffered acids would not be
replaced. The dental enamel would be demineralised and become porous. Bacteria could spread undisturbed and would cause
caries through increased production of acids.
Further information
Article shortened and slightly modified from Dr Rainer Wild Stiftung, Internationaler Arbeitskreis für Kulturforschung des
Essens.
Mitteilungen
2008,
H.
16,
S.
34–42.
ernaehrung.org/mediadb/Arbeitskreis/Mitteilungen/H_16BildschirmPDF.pdf
References
1. Pedersen AM et al. (2002). Saliva and gastrointestinal functions of taste, mastication, swallowing and digestion. Oral
Diseases 8:117–129.
2. Offner GD, Troxler RF. (2000). Heterogeneity of Highmolecularweight Human Salivary Mucins. Advances in Dental
Research 14:69–75.
3. Humphrey SP, Williamson RT. (2001). A review of saliva: Normal composition, flow, and function. Journal of Prosthetic
Dentistry 85:162–169.
4. Mese H, Matsuo R. (2007). Salivary secretion, taste and hyposalivation. Journal of Oral Rehabilitation 34:711–723.
5. Schilke R. (1997). Das NursingBottleSyndrom. Monatsschrift Kinderheilkunde 145:693–698.
6. EUFIC The Basics (2006). Dental health. Available at:
www.eufic.org/article/en/expid/basicsdentalhealth/
7. Robinson C et al. (2000). The Chemistry of Enamel Caries. Critical Reviews in Oral Biology and Medicine 4:481–495.
8. Wetton S et al. (2006). Exposure Time of Enamel and Dentine to Saliva for Protection against Erosion: A Study in vitro.
Caries Research 40:213–217.
9. Lendenmann U et al. (2000). Saliva and Dental Pellicle – A Review. Advances in Dental Research 14:22–28.
10. PrietoPrieto J, Calvo A. (2004). Microbiological Bases in Oral Infections and Sensitivity to Antibiotics. Medicina Oral,
Patología Oral y Cirugía Bucal 9 Suppl:11–18.
11. Kolenbrander PE et al. (2006). Bacterial interactions and successions during plaque development. Periodontology 2000
42:47–79.
12. Rudney JD. (2000). Saliva and Dental Plaque. Advances in Dental Research 14:2939.
13. Doel JJ et al. (2004). Protective effect of salivary nitrate and microbial nitrate reductase activity against caries.
4
European Journal of Oral Sciences 112:424–428.
14. Winter JW et al. (2007). NNitrosamine Generation From Ingested Nitrate Via Nitric Oxide in Subjects With and Without
Gastroesophageal Reflux. Gastroenterology 133:164–174.
5
Was that milk warm or cold, pasteurised or raw? Was that piece of fish full of healthy omega3s or
laced with mercury? How about that folic acid, how much is beneficial and how much is risky? Just
how do you weigh the benefits and risks of food?
Weighing the Need: Background & Study
Optimal nutrition plays an important role in disease prevention making the analysis of the benefits and risks of food imperative
for public health. Considerable disparity exists in the assessment of the benefits and risks of foods, with recommendations
often relying on subjective judgements. Therefore, there exists a need for a common strategy for the assessment of food
benefits and risks. Introducing BRAFO – BenefitRisk Analysis of Foods – a European Commission Specific Support Action to
investigate the benefitrisk analysis of foods.
Coordinated by the International Life Sciences Institute (ILSI) Europe and funded by the European Commission, BRAFO seeks
to develop a common framework for comparing health benefits and risks of food and food components (i.e., specific nutrients
or chemicals). One of the goals is to create a stronger scientific base for communication of benefits and risks to policy makers,
including appropriate expression of uncertainty throughout the European Union (EU).
BRAFO follows a series of European Commission benefitrisk assessment studies – FOSIE (Food Safety in Europe: Risk
Assessment of Chemicals in Food), PASSCLAIM (Process for the Assessment of Scientific Support for Claims on Foods),
QALIBRA (Quality of Life integrated Benefit and Risk Assessment), BEPRARIBEAN (Best Practices in RiskBenefit Analysis) –
and narrows in on how best to assess foods and food components. Currently in its third and final year, the BRAFO study was
designed with three components: methodology (year 1), case study (year 2), and consensus (year 3).
Building the Model: Methodology Component
In September 2007, BRAFO created a European network to compile expert methodologies for benefitrisk analysis from
several disciplines including risk assessment, nutrition, benefitrisk analysis, and included collaborators from academia,
regulatory agencies, and the food industry. Most classical methodologies for benefit or risk analysis examine benefits and risks
separately; however, BRAFO integrates both benefits and risks when determining net health impacts of food (ingredients).
After reviewing current methodologies for benefit or risk analysis, researchers developed a paradigm for performing benefit
risk assessments of food.
1
The model is based on a tiered approach, and where needed compares benefits and risks using a
common metric such as quality adjusted life years (QALY) and disability adjusted life years (DALY). The tiered approach starts
with preassessment and problem formulation to set the scope of the assessment and comprises four tiers. The tiers differ
principally in the way benefits and risks are integrated. At Tier 1, benefits and risks are assessed separately, while in Tiers 2–4
they are integrated using increasingly sophisticated approaches generating a measure of net health impact.
Testing the Model – Case Study Component
After the BRAFO methodology was designed, based on the above mentioned tiered approach, the second year of BRAFO
focused on testing such methodologies using case studies on three food topics: natural foods (fish, soy), dietary interventions,
and heat processing of food. Case studies on natural foods weighed the benefits of components in fish such as omega3 fatty
acids, with the risks from components such as mercury. Case studies on dietary interventions applied the benefitrisk model to
benefits and risks from different exposure levels; for example, beneficial versus potentially adverse levels of folic acid
fortification. Finally, case studies on heat processing of foods applied the benefitrisk model to measure net health impacts of
this type of food processing.
Implementing the Model: Consensus Component
BRAFO’s final stage is to review the applicability of the methodology to the different case studies, and to develop a consensus
on a revised BRAFO methodology. Afterwards, the project results will be disseminated to academic scientists, industry,
consumer organisations and regulators. Findings from BRAFO will feed into another EU project, FoodRisC, which aims to
produce a toolkit and practical guidance that target and tailor coherent food benefit and risk messages to consumers across
Europe.
While the BRAFO project is still ongoing, the European Food Safety Authority (EFSA) has issued a guidance document on
human health riskbenefit assessment of foods, to help risk assessors accomplish their challenging task.
2
This document takes
into account results from BRAFO and other EU projects mentioned above that deal with benefit and risk assessment of foods.
Further information
EU project BenefitRisk Assessment of Foods (BRAFO)
EU project Process for the Assessment of Scientific Support for Claims on Foods (PASSCLAIM)
http://www.ilsi.org/Europe/Pages/PASSCLAIM_Pubs.aspx
EU
project
Food
Safety
in
Europe:
Risk
Assessment
of
Chemicals
in
Food
(FOSIE)
http://www.ilsi.org/Europe/Pages/FOSIE.aspx
EU project Quality of Life integrated Benefit and Risk Assessment (QALIBRA)
EU project Food Risk Communication (FoodRisC)
www.eufic.org/article/en/show/euinitiatives/rid/foodrisc/
EU Safefood era project Best Practices in RiskBenefit Analysis (BEPRARIBEAN)
http://en.opasnet.org/w/Bepraribean
References
1. Hoekstra J et al. BRAFO tiered approach for benefitrisk assessment of foods. Food Chemical Toxicology (2010).
2. European Food Safety Authority (2010). SCIENTIFIC OPINION Guidance on human health riskbenefit assessment of
foods. EFSA Journal 8(7):1673. Available at:
http://www.efsa.europa.eu/en/scdocs/doc/1673.pdf
Weighing the Benefits & Risks of Food: Introducing the BRAFO Study
6