Sustainability is the integration of actions focused on three pillars: environmental, social, and economical. Implementing sustainable development ranges from the pursuit of quality of life, and from environmental balance to break with the current pattern of development. Therefore, the objective of this work was to understand and analyze the sustainability indicators implemented in the production of meals in food services. The authors developed specific search strategies for Scopus, Web of Science, Pubmed, Lilacs, Google Scholar, and ProQuest Dissertations & Theses Global to perform the systematic review. The authors evaluated the methodological quality of the included studies using the Meta-analysis Statistical Assessment and Review Instrument (MASTARI). A total of 31 cross-sectional studies were analyzed. Twenty four (77.41%) of the studies had activities that covered the three indicators (environmental, social, and economic); 22.59% (n = 7) used two indicators in which 12.90% (n = 4) presented environmental and economic indicators and 9.67% (n = 3) with environmental and social indicators. This research indicates that the studies in food services are seeking to insert indicators that cover the three pillars of sustainable meal production. It is worth mentioning that in the literature, many works encompasses the importance of sustainability, but few explore which indicators are most applied or detail their implementation in food services. More studies are needed to estimate better the indicators being applied in food services.

We evaluated the effects of eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids enriched fish oil (FO) on nutritional and immunological parameters of treatment naïve breast cancer patients. In a randomized double blind controlled trial, the FO group (FG) patients were supplemented with 2 g/ day of FO concentrate containing 1.8 g of n-3 fatty acids during 30 days. The placebo group (PG) received 2 g/ day of mineral oil. At baseline and after the intervention, plasma levels of n-3 fatty acids, dietary intake, weight, body composition, biochemical and immunological markers were assessed. At the end of the intervention period, no between group differences were observed regarding anthropometric parameters. There was a significant increase in the plasma phospholipid EPA (p = 0.004), DHA (p = 0.007) of the FG patients. In FG patients the percentages of peripheral blood CD4+ T lymphocytes and serum high sensitivity C-reactive protein (hsCRP) levels were maintained while in PG patients there was a significant increase in hsCRP (p = 0.024). We also observed a significant reduction in the percentage of CD4+ T lymphocytes in the peripheral blood (p = 0.042) of PG patients. No changes in serum proinflammatory cytokine and prostaglandin E2 levels were observed. Supplementation of newly diagnosed breast cancer patients with EPA and DHA led to a significant change in the composition of plasma fatty acids, maintained the level of CD4+ T cells and serum levels of hsCRP, suggestive of a beneficial effect on the immune system and less active inflammatory response. Brazilian Clinical Trials Registry (REBEC): RBR-2b2hqh. Registered 29 April 2013, retrospectively registered.

Gluten-related disorders (GRD) affects approximately 10% of the general population. The only treatment for GRD is still so far is the lifelong complete exclusion of gluten from the daily diet. The correct information about the presence/absence of gluten in food is very important to this group. The present study aimed to evaluate the prevalence of gluten contamination in gluten-free industrial and non-industrial products. In this systematic review, 24 cross-sectional studies were analyzed. The authors developed specific search strategies for Science Direct, Scopus, Web of Science, Google Scholar and ProQuest Dissertations & Theses Global. The authors evaluated the methodological quality of the included studies using criteria from Meta-analysis of Statistics Assessment and Review Instrument (MASTARI). We performed the statistical meta-analysis by metafor package of R program. 95.83% (n = 23) of the studies presented positive results for contamination (over 20 ppm). In industrial food products, studies showed a contamination prevalence of 13.2% (95% CI: 10.8%–15.7%). In non-industrial food products, studies showed a contamination prevalence of 41.5% (95% CI: 16.6%–66.4%). Despite the non-industrial products presented higher contamination prevalence than the industrial products, the difference was not significant (p = 0.072). The findings indicate cross-contamination in industrialized and non-industrialized products. As expected, industrial products labeled as gluten-free showed a lower percentage of gluten-contamination than non-industrialized. Despite that, any contaminated sample found in this group present greater relevance than non-labeled foods. It indicates that foods labeled as “gluten-free” should not be considered safe for patients with GRD since information on the label regarding the presence/absence of gluten is unreliable. Therefore, any gluten-contamination in products labeled as gluten-free is a serious problem to whom present GRD. Further studies are needed to estimate gluten cross-contamination in food service meals and industry better.

This study aimed to perform a systematic review and meta-analysis of the glycemic index (GI) of gluten-free bread (GFB) and its main ingredients. The systematic review followed PRISMA guidelines, using seven electronic databases (PubMed, EMBASE, Scopus, Science Direct, Web of Science, gray literature research with Google Scholar, and patents with Google Patent tool), from inception to November 2020. Eighteen studies met the inclusion criteria evaluating 132 GFB samples. Five articles tested GI in vivo, eleven in vitro; and two studies tested both methods. The analysis showed that 60.7% (95% CI: 40.2–78.1%) of the samples presented high glycemic indexes, evidencing a high glycemic profile for GFB. Only 18.2% (95% CI: 11.7–27.2%) of the bread samples presented in the studies were classified as a low GI. Meta-analysis presented moderate/low heterogenicity between studies (I² = 61% and <1% for both high and low GIs) and reinforced the proportion of high GIs. Lower GIs were found in formulations based on Colocasia esculenta flour or enriched with fiber, yogurt and curd cheese, sourdough, psyllium, hydrocolloids, enzymes, fructans, and resistant starch, highlighting the efficacy of these ingredients to lower GFBs’ GI. GFB tends to present high GI, impacting the development of chronic diseases when consumed.

This study aimed to develop and carry out content validation, semantic evaluation, reproducibility, and internal consistency of a checklist designed to verify the sustainability indicators in foodservice. The preliminary version of the checklist was prepared based on the international standards ISO (International Organization for Standardization) 14000, ISO 14001, ISO 14004 and documents from the Sustainable Restaurant Association (SRA) Certification, Green Seal Certifications, and Green Restaurant Association (GRA) certification, in addition to the American Dietetic Association (ADA) position. Thirteen experts in the study topic performed the content validation and semantic evaluation of the checklist (a minimum of 80% agreement among experts and mean value ≥4 on a 5-point Likert scale were needed to keep the item in the instrument). After consensus was reached by the experts’ panel, two different researchers applied the checklist in 20 restaurants (at the same time, in the same place, without communication between them) for the analysis of reproducibility and internal consistency (Federal District, Brazil). The agreement among answers was verified by Cohen’s Kappa coefficient. The final version of the checklist consisted of 76 items, divided into three sections (1. water, energy, and gas supply; 2. menu and food waste; 3. waste reduction, construction materials, chemicals, employees, and social sustainability). The developed checklist was validated concerning the content, approved in the semantic evaluation, reproducible, and with good reliability (Intraclass Correlation Coefficient (ICC) > 0.9 and alpha > 0.672).