DOI

Received: May 2022 – Accepted: July 2022

¹ Semmelweis University, Faculty of Health Sciences, Department of Dietetics and Nutritional Sciences

Keywords

polyphenolic compounds, diabetes, medicinal food, estimated glomerular filtration rate (eGFR), DPPH, ABTS, ORAC, FRAP, CUPRAC, Folin-Ciocalteu methods, gallic acid equivalent, catechin equivalent

2. Introduction

Bees have been around for 125 million years, and their evolutionary success has allowed them to become a perennial species that can utilize virtually every habitat on Earth. This ability to survive is largely due to the chemical composition and application of the special products they produce (honey, beeswax, venom, propolis, pollen and royal jelly). Propolis, the bees’ remedy against pathogenic microorganisms, has been used by mankind as a medicine since ancient times [1].

Propolis, known in Hungarian as bee glue, is a sticky, resinous substance, produced by bees (Apis mellifera L.) from beeswax, saliva and sap from the bark, buds and leaves of trees [2, 3]. They collect mainly from poplar, but also from birch, willow, horse chestnut, pine, oak, elm and alder [4]. The composition of propolis is mostly made up of plant resins, waxes, essential oils and pollen. In addition to these, it also contains smaller amounts of other substances, such as compounds partially produced by bees [2].

Bees use propolis in the hive many ways, including for disinfection, construction and maintenance of the hive, and for protection [2, 4, 5, 6], as well as to keep the humidity and temperature in the hive stable throughout the year, to seal holes and cracks and the inner wall of the hive. Propolis is also an important element of the so-called social immune system of honeybees, which, thanks to its antipathogenic (antimicrobial) properties, provides a certain general protection to the entire bee family against infections and parasites [8, 9].

3. Characteristics of propolis

The physical and chemical components of propolis, its quality and the possibilities of using it for physiological and medicinal purposes depend on the origin of the propolis, i.e., the climate, the botanical source and the species of the bees [4, 10]. The color of the product also depends on the origin, it is usually brown, but at the same time all the shades from yellow to black appear in it, in many cases with a reddish or greenish hue. The smell of propolis is aromatic, with notes of honey, resin, wax and vanilla mixed in it. Its taste is very characteristic [4].

Raw propolis typically consists of 50% plant resin, 30% wax, 10% essential and aromatic oils, 5% pollen, and 5% of other organic matter. More than 300 components have been identified in propolis, which differ depending on the source [9].

The compounds found in propolis include polyphenolic compounds (phenolic acids, flavonoids and their esters, e.g., caffeic acid phenyl ester), diterpenes, sesquiterpenes, lignans, aromatic aldehydes, alcohols, amino acids, fatty acids, organic acids, hydrocarbons, vitamins and minerals [9, 11].

The main bioactive components of propolis are flavonoids, which greatly contribute to the pharmacological effects of propolis. The amount of flavonoids is used as a criterion when evaluating the quality of temperate climate propolis. Flavonoids have a wide spectrum of biological properties, such as antibacterial, antiviral and anti-inflammatory effects [9].

Although volatile substances make up only 10% of the components of propolis, they are responsible for the characteristic resinous smell and contribute of the beneficial effects of propolis on health. Volatile substances are dominated by terpenoids, which play an important role in distinguishing good quality propolis from poor quality or counterfeit propolis, and also exhibit antioxidant, antimicrobial and other biological effects [9].

Although different bee species prefer different plants, even the chemical profile of propolis produced by the same species is not always the same. The composition of propolis varies by bee colony, location and season, and this makes it difficult to study it and make consistent health claims [12]. The protective properties of the bioactive substances found in propolis can also provide significant benefits in maintaining human health [5].

In recent years, several studies have confirmed that different propolis samples can be completely different in terms of chemical composition and biological activity [1, 7].

4. Propolis-containing products

A significant number of propolis-containing products are available on the market: medical and over-the-counter preparations, foods and drinks that help maintain health [7].

Propolis tincture is an extract of raw propolis made with a solvent (most often a mixture of water and ethanol). According to our knowledge, there are practical and application questions related to propolis tincture that should be answered and uniform regulations should be applied:

• Various preparation recipes are known;
• Soaking raw propolis for different lengths of time results in different tinctures;
• Differences in the extraction solvent (different amount and ethanol concentration) affect the composition of the preparations;
• The relationship between raw propolis and the composition of the tincture is not known.

In addition to tinctures, other propolis-containing foods are also available, such as lozenges, propolis honey, capsules filled with propolis extract [3].

In some countries, standardized propolis products with a constant bioactive substance concentration are already available [13].

5. Dose and safety

Clinical studies on mice and humans report that propolis and its constituents are generally well tolerated and non-toxic, except when used in very large amounts [5].

Determining the exact dose of propolis, on the basis of the studied population, the dosage regimen, compliance (accurate taking of the substance) and the purity of the product, faces significant difficulties, since the phenolic compounds found in propolis vary according to geographical origin, the bioactivity can also differ significantly, which makes it difficult to determine the correct dosage [14]. According to a particular study, based on previous animal experiments and applying a margin of safety, the safe dose of propolis for healthy humans is 70 mg/day [14].

Egy tanulmány szerint a korábbi állatkísérletek alapján és egy biztonsági tartalékot alkalmazva az egészséges emberek számára a propolisz biztonságos dózisa 70 mg/nap [15].

6. Physiological and therapeutic effects of propolis

Propolis has received increasing attention in recent years due to its beneficial effects on the human body. It is increasingly accepted as a preventive and therapeutic agent. However, the bioavailability of the useful substances found in propolis varies, which is also influenced by individual physiological conditions. According to a study, as a result of the consumption of propolis, its active ingredients can also be detected in the blood plasma [16].

6.1. Fighting infections, the immune system

Propolis can be considered as a potential medicinal food (“nutraceuticals”). Propolis extracts have anti-bacterial, antiviral and antifungal effects [3]. The immunoprotective and antioxidant properties of propolis are explained by its bioactive phytochemical components, regardless of its origin. A 2019 review cited immune system support as a health benefit of propolis [5].

The effect of propolis supplementation has also been studied among patients infected with the COVID-19 virus. In a recent, high quality (double-blind, placebo-controlled) study conducted in 2020, the effect of propolis on clinical symptoms was investigated. Infection was confirmed with a PCR test in participants aged 18 to 75. Members of the intervention group (n=40) received tablets containing 300 mg of Iranian green propolis extract three times a day for 2 weeks, while the control group (n=40) received no such treatment. The main result of the study was that the clinical symptoms of the disease improved faster in the group receiving propolis in terms of the duration and severity of the initial symptoms [17].

6.2. Cancerous diseases

Propolis has an antioxidant effect, which can be beneficial for the body in terms of neutralizing free radicals formed in excess [3], thus it can contribute to the regulation and control of inflammatory processes, tumor formation and aging processes. Its anti-inflammatory properties have been demonstrated in connection with propolis samples of Brazilian, Chinese and Malay origin. Its antitumor effect has been proven not only in in vitro, but also in vivo experiments taking place in living organisms) [3].

According to the results of another research, Brazilian red propolis had antioxidant properties and significantly reduced the percentage of survival of human tumor cells under laboratory conditions [10]. Alcoholic extracts of Turkish propolis also exhibited an inhibitory effect on the growth of tumor cells against human tumor cells (liver, colon, breast, cervix, prostate) [18].

The study, the aim of which was to find out whether propolis and the polyphenolic/flavonoid compounds contained in it can have an inhibitory effect on the growth of human bladder tumors in a cell culture, ended with promising results. Based on this, propolis may be suitable for auxiliary treatment of the disease in addition to surgery, to reduce or prevent the chance of tumor recurrence [19].

6.3. Diabetes

In relation to the effect of propolis on the human body, the reduction of blood sugar levels has also been studied [2]. According to the reliable, aggregated, comprehensive analysis of the results of several studies with similar objectives, the use of propolis reduced the fasting blood sugar level by 0.8 mmol/l compared to the subjects who did not receive treatment. In addition, taking propolis also reduced the value of HbA1c (A subunit of hemoglobin. The Ed.), which indicates the evolution of the blood sugar level of the examined person in retrospect over a period of 1 to 3 months. It is interesting to mention that the treatment did not affect the insulin level, so it follows that the drop in blood sugar level was not due to the effect of insulin. Almost 400 diabetic patients took part in the study, who were treated with 226 to 1,500 mg of propolis per day for 56 to 180 days. According to the authors, despite the positive results, further research is still needed regarding the type (composition) and dosage of propolis. This is so because the dose ranges were wide and the places of origin of the propolis samples used were varied [2]. In the studies related to propolis, it was stated that it is important to know the geographical and botanical origin, because they can affect the biological activity of the propolis, its effect and the composition of its organic components [3].

The objective of another study was to investigate the effect of Brazilian green propolis on type 2 diabetes patients through changes in blood test data. 80 people participated in the study, of which 39 received a placebo. The 41 people in the other group received 226.8 mg Brazilian green propolis per day during the 8-week period. The results indicate that Brazilian green propolis used in the aforementioned quantity and frequency can reduce then deterioration of uric acid levels and eGFR (estimated Glomerular Filtration Rate) values, which indicate kidney complications, in patients with type 2 diabetes [20].

In connection with the healing of diabetic leg ulcers, a favorable effect was reported in the study of Australian propolis samples. A favorable wound-healing role was also mentioned in connection with Chinese propolis extracts [3].

6.4. Cardiovascular diseases

In a human study published in 2017, changes in blood lipid levels were investigated as a result of oral application of propolis solutions. In the double-blind, placebo-controlled clinical trial, 35 of the 67 subjects received propolis, while 32 were given a placebo supplement (without propolis). In the propolis group, a significant increase in HDL (High Density Lipoprotein) was observed after 90 days. This effect may contribute to the reduction of the risk of cardiovascular diseases [21].

A 2019 review paper mentions lowering blood pressure as one of the health benefits of propolis. In this literature review, a total of 63 publications were reviewed, the majority of which were reports on animal experiments, but some key human studies were also included. According to the results, propolis can be an effective antioxidant and anti-inflammatory agent. Based on this, it is presumably effective against various chronic diseases, e.g., in preserving the health of the cardiovascular system, reducing atherosclerosis and reducing high blood pressure [5].

6.5. The skin and the nervous system

The components of propolis can be widely used to heal wounds and the human skin itself, and can also contribute to reducing the symptoms of some nervous system diseases (Alzheimer’s disease, Parkinson’s disease) [5].

In addition to research related to nervous system diseases, the protective effects of propolis on retinal cells have also been reported [22]. Propolis can also be used to prevent various eye diseases, such as macular degeneration in the aging population and myopia in the younger generation, but further studies are needed to prove this [5].

The range of commercially available propolis-containing skin care products is expanding, with creams and body lotions predominating. According to the advertisements, the majority of skin care products have a „soothing, moisture-rich, anti-aging” effect, and are also effective against eczema [23].

6.6. Alimentary canal

When examining the beneficial properties of various propolises, in the case of Brazilian green propolis, the stimulation of the functioning of the intestinal system was mentioned, as well as its beneficial effect in the treatment of gastric ulcers, while the liver protective function of propolis was proven in animal experiments [3].

The polyphenols in propolis can support the development and maintenance of a healthy intestinal flora by limiting the growth of pathogenic bacteria and, in addition, prevent their adhesion to human intestinal cells [24]. The possible therapeutic effect of propolis on inflammatory bowel diseases is still being investigated today, but many experiments still need to be performed before clinical application can begin [5].

6.7. Allergizing effect

In addition to its many beneficial physiological effects, propolis can also trigger allergic reactions (swelling, dermatitis, hives) in susceptible individuals. This is most common among beekeepers, but it also depends on individual sensitivity [3]. Therefore, it is recommended that the therapeutic use of propolis products is always carried out under medical supervision [5].

6.8. Summary of physiological and therapeutic effects

Several studies have proven that the observed beneficial physiological effects are not the result of a single prominent compound, but rather the combined effect of the complex components of propolis [9].

Overall, it can be stated that as a natural substance with good medicinal properties, propolis and its components can be used in a wide range of ways, including wound and skin healing, and in the treatment of some neurological diseases and atherosclerosis. Interest in the health effects of propolis and the number of publications have been continuously increasing in the last 30 years. However, even more human clinical studies are needed to confirm the beneficial effect of propolis for specific population groups. Preclinical studies support the antioxidant and anti-inflammatory effect of propolis, which can prevent or slow the progression of various chronic diseases, including heart disease, diabetes, high blood pressure, tumors and neurodegenerative diseases (e.g., Alzheimer’s disease) [5].

7. New areas of application of propolis

One of the areas of use of propolis can be to improve the growth performance and productivity of farm animals. Based on our knowledge so far, it can be said that propolis has a beneficial effect on the normal laboratory values, growth and productivity of the animals included in the studies. In addition, it is considered as a possible alternative to antibiotics in the production of animal feed, because it has the advantage that it does not induce resistance in microorganisms [25].

Another area of intensive research in the last few years have been the application of propolis in food preservation. Food preservatives primarily include antimicrobial and antioxidant agents. Antimicrobial agents added to foods serve two purposes: to stop the natural spoilage of food and to avoid/control contamination by microorganisms, including pathogenic microorganisms. Antioxidants are used to extend shelf life and prevent spoilage. Propolis favorably combines antioxidant and antimicrobial properties. However, its large-scale use as a food preservative has not yet been realized, as this would require proper standardization of the product [7].

8. Antioxidant properties of propolis

The antioxidant properties of propolis are manly determined by the bioactive components found in it, primarily the phenolic compounds, depending on the botanical and geographical origin. The phenolic compound profile of propolis is slightly different from that of honey. While in the former, the profile is mainly determined by the botanical origin, and the dominant flavonoids are quercetin, myricetin, chrysin, apigenin, luteolin, pinocembrin and pinobanksin, and of phenolic acids, p-hydroxybenzoic acid, p-coumaric acid, cinnamic acid, gallic acid, ferulic acid and caffeic acid, in propolis, which typically comes from poplar and birch in Central Europe, chrysin, kaempferol, apigenin, pinocembrin and pinobanksin are the most characteristic and, in addition to phenolic acids, their esters (e.g., caffeic acid and ferulic acid esters) also occur. Among the latter, the phenylethyl ester of caffeic acid is outstanding in terms of tumor prevention properties (although its effect also depends on the synergistic effect of other accompanying phenolic compounds). The polyphenols in propolis have been proven to inhibit the formation of amino, oxide and peroxide type free radical, as well as the formation of complexes between free radicals and transition metals, and also lipid peroxidation [26].

In addition to the differences depending on the origin of propolis, the literature is not uniform regarding the extraction method of the antioxidant compounds, and the differences can significantly influence the extraction results.

Based on the available data, extraction was mainly carried out with different mixtures of ethanol and water in the experiments, but extraction with methanol and other solvent also occurs. Regarding the methods for determining the antioxidant properties, only the results of experiments based on in vitro spectrophotometry have been reported, including the determination of radical scavenging properties (DPPH – 2,2-diphenyl-1-picrylhydrazyl, ABTS – 2,2’-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid), ORAC (Oxygen Radical Absorbance Capacity), as well as total polyphenol content (Folin-Ciocalteu method) and total flavonoid content. Although in the case of propolis extracts from different locations, polyphenol contents of the same order of magnitude as in the case of honey were measured (typically in the 18-500 mg gallic acid equivalent/ml range), in the case of a Turkish sample there was also a value above 19,000 mg gallic acid equivalent/ml, and values above 1,000 mg gallic acid equivalent/ml were also measured for Brazilian samples. The situation is similar with regard to the total flavonoid content, where the majority of the samples stayed in the range typical of honey (1-25 mg catechin equivalent/ml), however, there were also extremely high values: nearly 5,000 mg catechin equivalent/ml in the case of an Algerian propolis, and a value over 29,000 mg catechin equivalent/ml in the case of a Turkish propolis. As for the radical scavenging ability, once again, values in the range of honey are reported by researchers (e.g., 50-80% inhibition in the case of DPPH radicals), but extreme values are also typical here (e.g., 90.7–99.34% inhibition in the case of a Malay honey). Similar to honey, numerous studies have confirmed in the case of propolis its effectiveness in the case of tests carried out on various animal and human bodily fluids and cell cultures, in terms of antioxidation properties.

9. Synergistic interaction of propolis and honey

Propolises of different origins can show a synergistic interaction not only with each other, but also when mixed with honey. Following the mixing of propolis extracts from Iraq, it was possible to prove a synergistic effect against various pathogens (E. coli, S. aureus, C. albicans) in microbiological tests. Similarly, in animal experiments, the extent of the wound healing effect (reepithelization) was increased in the case of a propolis mixture [27].

Due to the deterioration of sensory characteristics, propolis is typically mixed with honey in a proportion of no more than 1%. Even at this concentration, a four- to fivefold increase in the amount of phenolic compounds, phenolic acids and flavonoids was measured, and the anthocyanin and carotenoid content of the mixture also increased several times. Of the flavonoids, especially the amount of galangin, chrysin, pinocembrin and pinobanksin, while of phenolic acids, the amount of ferulic acid, caffeic acid and p-coumaric acid increased. The radical scavenging (ABTS, DPPH) and metal ion reducing capacity (FRAP – Ferric Reducing Antioxidant Power, CUPRAC – Cupric Reducing Antioxidant Capacity), measured by various in vitro methods, also showed multiple increases [26].

The synergistic interaction of propolis and honey was also confirmed in antimicrobial tests. In the research, in the case of antibiotic-resistant strains of E. coli, S. aureus and C. albicans, honey strengthened the effect of propolis both in cultures of individual strains and their mixtures [29].

10. Acknowledgment

Az anyag összeállításához Bencsik Boglárka demonstrátor hallgató is hozzájárult.

11. References

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[16] Yesiltas, B.; Capanoglu, E.; Firatligil-Durmus, E.; Sunay, A.E.; Samanci, T.; Boyacioglu, D. (2014): Investigating the in-vitro bioaccessibility of propolis and pollen using a simulated gastrointestinal digestion System. J. Apic. Res. 2014, 53, pp. 101–108.

[17] Miryan, M., Soleimani, D., Dehghani, L., Sohrabi, K., Khorvash, F., Bagherniya, M., Sayedi, S. & Askari, G. (2020): The effect of propolis supplementation on clinical symptoms in patients with coronavirus (COVID-19): A structured summary of a study protocol for a randomised controlled trial. Trials, 21.

[18] Turan, I., Demir, S., Misir, S., Kilinc, K., Mentese, A., Aliyazicioglu, Y. & Deger, O. (2015): Cytotoxic Effect of Turkish Propolis on Liver, Colon, Breast, Cervix and Prostate Cancer Cell Lines. Tropical Journal of Pharmaceutical Research, 14(5), pp. 777-782.

[19] Štajcar D. (2009): Propolis and its flavonoid compounds cause cytotoxicity on human urinary bladder transitional cell carcinoma in primary culture, Period biol, Vol 111, No 1, 2009.

[20] Fukuda, T., Fukui, M., Tanaka, M., Senmaru, T., Iwase, H., Yamazaki, M., Aoi, W., Inui, T., Nakamura, N. & Marunaka, Y. (2015): Effect of Brazilian green propolis in patients with type 2 diabetes: A double-blind randomized placebo-controlled study. Biomedical Reports, 3(3), pp. 355-360.

[21] Mujica, V., Orrego, R., Pérez, J., Romero, P., Ovalle, P., Zúñiga-Hernández, J., Arredondo, M. & Leiva, E. (2017): The Role of Propolis in Oxidative Stress and Lipid Metabolism: A Randomized Controlled Trial. Evidence-Based Complementary and Alternative Medicine, 2017, Article ID 4272940. DOI

[22] Nakajima, Y.; Shimazawa, M.; Mishima, S.; Hara, H. (2007): Water extract of propolis and its main constituents, caffeoylquinic acid derivatives, exert neuroprotective effects via antioxidant actions. Life Sci. 2007, 80, pp. 370–377

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DOI

Received: August 2022 – Accepted: September 2022

¹ University of Szeged, Faculty of Engineering, Institute of Food Engineering

Keywords

flexitarian, omnivore, vegetarian, vegan, plant-based, sustainability, sustainable food consumption

2. Food is a source of nutrients

Food is a source of vital macro- and micronutrients, vitamins. Foodstuffs, including water are sources of life, necessary and unavoidable for the functioning of our body and to maintain good health. The foods we eat also have influence on the composition of our microbiota. But foods are not only sources of energy, protein, fat and carbohydrates, but they are also a source of enjoyment by providing good taste and smell. Foodstuffs either eaten raw or cooked are part of our social life and our culture.

3. Our diet varies

Our diet varies depending on our geographical location, societal status, economical buying power, our education and cultural background. Mediterranean countries provide a more favourable environment for the production of a wide range of vegetables and fruits allowing a varied diet. Whether and lifestyle have an influence on the gastronomic culture. Seasonality would also influence the availability of foods. Religion, ethical, moral and animal welfare issues motivate consumers, as well. (Jewish, Muslim, Hindu and other religious restrictions not allowing the consumption of pork, beef and certain other types of foods are well-known for a long time.) Some societies are more conservative than others, high level of neophobia would be an obstacle in the acceptance of food innovation and that of novel products. Information, especially the lack of evidence-based information and fake news via social media have a major role in consumers’ decisions. On one hand, consumers are becoming more conscious, mainly health-conscious, more and more environment-conscious requesting healthy, ’natural’, clean label and sustainably produced foodstuffs to be marketed. On the other hand they follow trends as much as they set up those.

4. Planetary Health – the EAT-Lancet Report (2019) [1]

Food is the single strongest lever to optimize human health and environmental sustainability on Earth. An immense challenge facing humanity is to provide a growing world population with healthy diets from sustainable food systems.

Transformation to healthy diets by 2050 will require substantial dietary shifts. Global consumption of fruits, vegetables, nuts and legumes will have to double, and consumption of foods such as red meat and sugar will have to be reduced by more than 50%. A diet rich in plant-based foods and with fewer animal source foods confers both improved health and environmental benefits. Thus, the EAT-Lancet Report urges a radical transformation of the global food system.

As the goal set up in the EAT-Lancet Report is to achieve „Planetary Health Diets” for nearly 10 billion people by 2050, the Commission would continue its work and publish another report in 2024.

5. Different food consumption patterns – Omnivores, vegetarians, flexitarians and anything in between

The most relevant diets are summarized in Table 1. providing different definitions and data for the prevalence and consumption.

Varied diets – unless restricted by environmental, economic and social-cultural factors – allow the moral, ethical and spiritual approach of people being reflected.

We are mainly omnivores in Europe (72.3% based on a survey conducted in 2021 in six EU Member States) [2], such as North Americans (66% in 2019) [3], regularly consuming meats (pork, beef, mutton, goat, chicken and other poultry), but mainly red meat. An omnivore diet does not exclude any foods or food groups, unless the given consumer has food allergy, intolerance or other food-related health issue.

A small proportion of consumers are vegetarians (ovo-, lacto or ovo-lacto vegetarians) or vegans but they strictly follow their choice of diet, they are persistent and consistent in their decision to follow a meat-free, plant-based (e.g. vegetables, fruits, legumes, cereals etc.) diet. On average, 4.6% of Europeans are vegetarians, but it varies, 5-7% in the United Kingdom, 4.6% in Germary, 4.1 in Italy and Austria, 4.0% in AUT, 3.6% in Switzerland and as low as 2.1% in Estonia (see Table 1.), to name a few.

Vegans, who follow a more strict diet by excluding all meat, dairy, eggs and honey (all meat-based ingredients), form a small group of people. Data on the proportion of vegans in different countries are provided in Table 1. The production process must not use animal-derived products either, such as gelatine for clarifying juice or wine, or animal-based glue for product packaging.

Do we need definitions for vegetarian and vegan diets at all? Maybe not. However, in case food business operators (food processors and retailers) are willing to label foods as being suitable for vegetarian and vegan consumers, for example as „vegan food”, than we have to have a clear definition in order to be able to control the labelling. Furthermore, it would be useful to have an (and only one) internationally used, clear and harmonised logo for vegan foods. A symbol for labelling vegan and vegetarian products and services called „V-Label” exists. It was registered in 1996. [4]

Until today, there is no official definition for vegetarian and vegan diets. Despite the very detailed and comprehensive EU food legislation, there is no definition for vegetarianism and veganism, thus labelling rules for suitable food products have not been set up. In 2019, the European Commission (EC) began to define the concept of vegetarian and vegan food following the authorization given by a law passed in 2011. The EU Food Information Regulation stipulated that the EC is to issue an implementing act defining requirements for “information related to suitability of a food for vegetarians or vegans” (Article 36(3)(b) Regulation (EU) No 1169/2011). The European Vegetarian Organization (EVU is the umbrella organisation of vegan and vegetarian associations ad societies throughout Europe, „representing plant-based interests in the EU”, as they claim) together with FoodDrinkEurope (FDE is a food industry confederation in the European Union), have prepared proposals [5] for possible names. They point out, that the Commission has failed to act upon this responsibility since 2011 and does not consider the matter to be of high priority.

The proposed definition for food suitable for vegans is as follows: „Foods that are not products of animal origin and in which, at no stage of production and processing, use has been made of or the food has been supplemented with - ingredients (including additives, carriers, flavourings and enzymes), or - processing aids, or - substances which are not food additives but are used in the same way and with the same purpose as processing aids, that are of animal origin.

5.1. Vegetarian foods

Foods are belonging to this group, which are meet the requirements of vegan foods, with the difference that in their production and processing milk and dairy products, colostrum, eggs, honey, beeswax, propolis, or wool grease (including lanolin derived from the wool of living sheep or their components or derivatives) may be added or used.

Dedicated vegans usually start as vegetarians. According to the VeganZ study [2] conducted in six EU member states, 67.3% of vegans reported initially being vegetarian. In addition, 83% of vegetarians (FR) can imagine only buying plant-based products. As such, one can expect a proportion of vegetarian study participants to not only give up eating meat and fish in the future, but also to give up all animal-derived products. So, it is interesting to note that there is a trend towards veganism among vegetarians.

Besides that, 12.1% of omnivores are not opposed to a vegan diet, while 28.2% can imagine going vegetarian.

There are numerous variations between the omnivore and the vegan diets, such as – including but not limited to – reducetarian, flexitarian, semi-vegetarian, pescetarian (who exclude (red) meat from their diet, but eat fish), pesce-pollotarian, pollotarian diets, not to mention the ovo-, lacto- and ovo-lacto-vegetarian eating habits (Table 1.).

6. The flexitarian diet

6.1. Flexitarians

Consumers who are reducing their consumption of meat are also referred to in the literature as ’meat reducers’, ’low meat-eaters’ or ’semi-vegetarians’. [6]

Flexitarians deliberately aim to reduce animal products in their diet, but do not strictly exclude any meat. Flexitarian is a marriage of two words: flexible and vegetarian. The term was coined more than a decade ago by D. J. Blatner in her 2009 book “The Flexitarian Years to Your Life.” Blatner says you don’t have to eliminate meat completely to reap the health benefits associated with vegetarianism – you can be a vegetarian most of the time, but still enjoy a burger or steak when the urge hits. By eating more plants and less meat, it’s suggested that people who follow the diet will not only lose weight but can improve their overall health, lowering their rate of heart disease, diabetes and cancer, and live longer as a result.

According to the German Society for Nutrition, you can also call „flexitarians” „flexible vegetarians”. Even though they consume meat and fish, they do it less frequently than traditional omnivores. [7] Flexitarians are also known as casual vegetarians or vegivores. The flexitarian diet can be generally defined as a semi-vegetarian, plant-forward diet. It is a flexible eating style that emphasizes the addition of plant or plant-based foods and encourages meat to be consumed less frequently and/or in smaller portions.

Flexitarians, consumers reducing their consumption of meat are also referred to as „meat reducers” or „low meat-eaters”.

As the terms flexitarian and semi-vegetarian (even called earlier as partial- and pseudo-vegetarian) are often used as synonyms, neither vegetarian nor flexitarian have definitions, so it is rather difficult to compare these groups and to study their proportion. So in order to clearly differentiate them, they are arranged in Table 2. according to their attitude towards and consumption of meat.

Calories in the flexitarian diet mostly come from nutrient-rich foods such as fruits, legumes, whole grains and vegetables. When it comes to protein, plant-based foods (e.g., soy foods, legumes, nuts and seeds) are the primary source. Protein also comes from eggs and dairy, with lesser amounts coming from meat, especially red and processed meats. Due to the emphasis on nutrient-dense foods, the flexitarian diet encourages limiting one’s intake of saturated fat, added sugars and sodium. [8] Whether the latter is true or not, could be further studied. Following a flexitarian diet might not necessarily ensure a healthier nutrition, than that of omnivores. The interpretation of the term flexitarian is so diverse and its composition might differ so much, that we should be aware of the type of the food of animal origin and the frequency of its consumption to be able to judge.

The term flexitarian has been criticized by some vegetarians and vegans as an oxymoron because people following the diet are not vegetarians but omnivores as they still consume the flesh of animals. [9]

As there is no consensus regarding the definition of flexitarianism, it is rather difficult to measure or estimate the number and proportion of flexitarian consumers. Some consumers think of themselves as flexitarian when they cut meat consumption by half, only for one day, reduce it to 4 days/week, or even less. This discrepancy might have led to the following classification: „heavy flexitarian” (1 or 2 times per week meat for dinner), „medium flexitarian” (half of the week a meatless dinner) and „light flexitarian” (meat consumption frequency 5 or 6 times per week) [10]. This classification helps to overcome the huge differences in the interpretation of the term „flexitarian”.

Whether the classification of flexitarian consumers is based on a self-reported weekly meat consumption frequency or based on the measurement of the food consumption pattern by other means, it may lead to very different data. So we have to handle data on the proportion of flexitarians by care.

Even if the number of vegans and vegetarians has risen, most of the population is still consuming meat and other products of animal origin: on average 18.3% of Europeans consider themselves flexitarians. Their number is higher in Germany (27.3%) and Austria (25.8%) and lower in Spain (13.1%) and in Italy (12.1%). [2] (See Table 1. for more data.)

More than 50% of non-vegans in Germany intend to reduce their consumption of animal-derived products in the future. [2]

15.3% of flexitarians can imagine going vegan, while 54.8% would switch to a vegetarian diet.

Looking at all those, who actively reduce or fully exclude at least some animal products, including vegetarians, pescetarians and flexitarians, the group in total represents 30.8% of the population: 10 to 30 % of Europeans no longer consider themselves full meat-eaters anymore. [11].

7. Environmental concerns – plant-based solutions

In contrast to vegans and vegetarians, flexitarians attribute their main reasons for reduced meat consumption to the environment and sustainability (72.1%). [2]

Some authors [12, 13, 14] refer explicitly to a flexitarian diet as an important dietary change that significantly contributes to reducing the environmental footprint of the food system and providing more healthy eating patterns and nutritional benefits to food consumers. These studies define a flexitarian dietary pattern as predominantly plant-based complemented with modest amounts of animal foods (meat, dairy, fish). [10]

More and more people in Europe choose plant-based products over animal-based nutrition, occasionally or permanently. Almost all big supermarket chains list veggie meat and dairy alternatives.

Flexitarianism or ‘casual vegetarianism’ is an increasingly popular, plant-based diet that claims to reduce your carbon footprint and improve your health with an eating regime that’s mostly vegetarian yet still allows for the occasional meat dish. The rise of the flexitarian diet is a result of people taking a more environmentally sustainable approach to what they eat by reducing their meat consumption in exchange for alternative protein sources. [15]

Reducing meat and dairy consumption could cut greenhouse gas emissions by between 0.7-8 billion tons of CO₂eq annually by 2050 — that’s roughly between 1 percent and 16 percent of current emissions. But the Intergovernmental Panel on Climate Change (IPCC) is clear that in many poorer societies, it’s hard to find alternatives to animal protein. The EU has avoided policy that encourages citizens to cut meat eating, fearing political backlash. [16]

Another term should be mentioned here: „demitarian diet”. „Demitarianism” is the practice of making a conscious effort to reduce meat consumption largely for environmental reasons. The term was devised in 2009 in Barsac (France) at a workshop of environmental agencies, where they developed “The Barsac Declaration: Environmental Sustainability and the Demitarian Diet”. [17]

8. Plant-based diets

As there is an increasing need for alternative proteins, plant-based diets are gaining momentum. Plant-based diets have been praised for their benefit to our health and the environment. There is neither an official definition nor consensus on what defines a plant-based diet. It is used to describe a variety of dietary patterns, from the Mediterranean diet to Vegetarian and Vegan diets. The descriptions of plant-based diets mainly focus on the promotion of healthy plant foods, such as fruits, vegetables, bean, pulses, nuts etc., and they do not necessarily exclude the consumption of meat and dairy products, so these are not expecting the total avoidance of products of animal origin. [18, 19]

Although a plant-based diet is often used to describe a plant-only or vegan diet, it is not about the complete avoidance of animal products. Plant-based diets should be thought of as plant-forward diets or ‘flexitarian’ approaches, which emphasise eating healthy plant foods. While meat and dairy products are not necessarily avoided altogether, the frequency and portions that they are consumed will be reduced and most of the nutrients should come from healthy plant foods.

According to a Harvard Business Review [20] flexitarian consumers are the biggest market for plant-based products (accounting for 70% of sales in some categories [21], and 30% of overall shoppers [22]).

9. Food and Health

As mentioned before, in contrast to vegans and vegetarians, flexitarians attribute their main reasons for reduced meat consumption to the environment and sustainability. However, there are also health reasons and societal concerns pushing consumers to change their dietary habits. The health issues, the high prevalence of Non-Communicable Diseases (NCDs) is well-known. Whether it is hidden hunger, obesity or CVDs, tumors or other health issues in relation to food consumption, the non-balanced diet has long-term consequences. Short term changes, such as following fashion-diets are not appropriate in case we wanted to avoid the negative health consequences of our diet.

Consumers are becoming increasingly aware of the relationship between food and health and are changing their purchasing behaviour accordingly.

79% of Belgian respondents (n=17.000 (2021)) actively seek information on healthy living, and they expect regulators to play a stronger role in promoting health and environmental sustainability. BE consumers eat more fruit (51%) and vegetables (57%) than previously. [23]

10. Societal problems

The importance of societal problems – besides of health-related and environmental issues – should also be emphasized, as the increasing amount of non-evidence-based information spread most efficiently via social media and by bloggers and other influencers would undermine the reliability and trustfulness of science and its golden rules.

Another phenomenon is, when dogmas are being built. Numerous food-related dogmas were built in the last decades. These also endanger trust.

Consumers may also lose their trust in the food system due to greenwashing and similar attempts. When food companies are aiming to overdo and mimic environmental-friendly practices, consumers become most disappointed when the reality becomes evident.

11. Trend or fad?

An increasing group of food consumers are purposefully reducing their meat intake, without totally eliminating meat from their diet. They have no intention to become vegetarian or vegan, but for health and environmental reasons they are flexible and reduce their meat consumption.

The demand for vegan and vegetarian food products including alternatives to meat, milk, or eggs, has expanded considerably during recent years in Europe. [24]

Being a high-flying trend, a major innovation in the current decade, but will plant-based meat analogues continue to rise and generate enormous income for investors and for the time being, or is it going to be a fad?

„It is unlikely that plant-based meat will continue to grow as rapidly as it has the past few years. While it is certainly not a short-term fad, steep growth-rates will certainly cool down before 2025.” [25]

It was found that the percentage of heavy flexitarians (see definitions in Table 1. and above) decreased from more than 15 per cent in 2011 to less than 10 per cent in 2019, while the percentage of light flexitarians increased from 36 per cent in 2011 to 41 per cent in a Dutch survey. Such figures contribute to a slightly higher average in the number of days in which meat was eaten at dinner: from 4.6 days a week (2011) to 4.8 days a week (2019). And this outcome could be reconciled with the fact that per capita meat consumption in the Netherlands has been stable between 2011 and 2019 at approximately 39 kg. All this suggests that flexitarianism has made little progress in the past 10 years – at least, when it comes to overt behaviour. [10].

12. Generational differences

A recent US survey [26] examined the food priorities and buying power of Generation Z, how more Americans are concerned about environmental sustainability. The 17^th annual 2022 Food & Health Survey, conducted online (n=1,005, ages 18 to 80) oversampled Gen Z consumers (ages 18-24), who showed strong interest in the environment. When asked whether they believed their generation was more concerned about the environmental impacts of their food choices than other generations, Gen Z was the most likely to say yes at 73%, followed by millennials at 71%. Among all age groups, 39% said environmental sustainability had an impact on their purchasing decisions for foods and beverages, which was up from 27% in 2019.

13. Sustainable diets

The United Nations Food and Agriculture Organization (FAO) defines sustainable diets as having a low environmental impact, while meeting current nutritional guidelines, all while remaining affordable, accessible and culturally acceptable. [27]

Cultural and historical background, gastronomy, consumer habits and the role food plays in our culture have an immense effect on the way how and what we eat.

Consumer habits are rather difficult to change. Besides, it is widely known, that there can be large discrepancies between consumers’ self-perception and their actual behaviour, for example between the number of self-declared flexitarians and their actual meat consumption (frequency).

Despite all scientific evidence and scholarly consensus about what a healthy and sustainable dietary pattern consists of, in current practice mostly only small minorities of food consumers turn out to be able to meet such dietary recommendations. This indicates clearly that it must be expected that moving to a flexitarian diet style in which meat intake is limited to some degree is considered a dramatic dietary shift to many people. This implies that irrespective of the consensus about what a sustainable diet generally is, it is much less clear and uncontroversial how willing and helpful consumers could be to drive the transition to meat-restricted diets and dishes. [10]

Throughout human history, consumers abstained from eating meat on a regular basis, even if it was not a question of buying power or poverty, but a religious reason (see „Friday Fish” or „meat-free-Fridays”) or others.

We should not underestimate the role of meat in our diet, its sensory and nutritional value, its role in the national cuisine (see the examples of Germany, Switzerland and Hungary), how it is associated with wealth and power, traditional foods and tradition which might be an obstacle to innovation and novelty. The role animal husbandry plays in the economy, mainly in agricultural countries and numerous other factors would influence the way we relate to foods.

In case we will have a growing interest and commitment to increase our vegetable and fruit consumption, to reduce the meat intake than, with or without plant-based meat analogues, we may achieve healthier life for ourselves and for our fellow human beings.

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DOI: https://doi.org/10.52091/JFI/2021/1-2-ENG

Received: November 2020 – Accepted: January 2021

¹ Ministry of Agriculture, Department of Food Economics and Quality Policy
² Hungarian University of Agriculture and Life Sciences
³ National Institute of Pharmacy and Nutrition
⁴ University of Veterinary Medicine
⁵ National Food Chain Safety Office, Directorate for Risk Management

Keywords

Food labeling, nutrition labeling, voluntary labeling, mandatory labeling, Codex Alimentarius Commission, harmonization of food law, Big 8, Big 4, Traffic light, Battery, Nordic Keyhole, Nutri Score, GDA (Guideline Daily Amount)

2. Introduction

At the international level, the cornerstone of nutrition labeling decree was laid in 1985 by the Codex Alimentarius established by the FAO/WHO, in the form of a guide to nutrition labeling. Nutrition labeling decree was based both in the European Union and Hungary on the Codex Alimentarius (Figure 1).

* MÉM-SZEM: former Ministry of Agriculture and Food – former Ministry of Social Affairs and Health

** MÉ: Codex Alimentarius Hungaricus

*** FM-NM-IKM: former Ministry of Agriculture – former Ministry of Public Health – former Ministry of Industry and Trade

Nutrition labeling was first regulated by the Council of the European Community in 1990 with the adoption of Directive 90/496/EEC. Compliance with the directive was voluntary and it applied to all foods intended for normal public consumption (Figure 2).

In Hungary, indicating the “essential” elements of nutrition labeling of foods was voluntary until the mid-1970s and 1980s, then, from 1988, indication of the energy content became mandatory. From 1996, rules for the nutrition labeling of foods had been defined by the Hungarian Food Codex (Codex Alimetarius Hungaricus), with a definite content but still on a voluntary basis [1], and this remained in force until December 13, 2014.

Prior to December 13, 2014, nutrition labeling was a mandatory element on the packaging only if the manufacturer, using today’s regulatory terminology, made a nutrition or health claim, or such a claim was published in relation to the product, or if it was a food for people with special nutritional needs (e.g., baby food) [2].

In the meantime, more and more countries have introduced mandatory nutrition labeling at the international level, mainly for public health purposes, in order to reduce obesity and to prevent certain chronic diseases [3]. Recognizing the growing public interest in the link between the diet and health [4] and also because solutions were needed to the health challenges related to overweightness and obesity [5,6], it has become clear that the creation of harmonized rules at the EU level was urgent and essential to ensure adequate consumer information. In light of this, Regulation (EU) No 1169/2011 on the provision of food information to consumers was adopted, which defines the general principles, requirements and obligations for the labeling of foods, and also makes it mandatory to indicate the nutrient content of foods. The primary purpose of nutrition labeling is to provide information to consumers about the nutritional composition of foods, helping them to make informed decisions [7].

* MÉM: former Ministry of Agriculture and Food

** MÉM-SZEM: former Ministry of Agriculture and Food – former Ministry of Social Affairs and Health

*** FM-NM-IKM: former Ministry of Agriculture – former Ministry of Public Health – former Ministry of Industry and Trade

Of course, food labeling alone is not enough. In order for information to achieve its purpose, it is also necessary to motivate consumers and for them to know the principles of good nutrition. Education and informing consumers for educational purposes are indispensable for consumers to better understand food information and thus incorporate the given foods correctly into their own diets [8, 9, 10, 11, 12, 13, 14].

In this article, the development of the European Union and Hungarian regulations regarding the nutrition labeling of foods intended for normal public consumption are described, as well as the related practices and experiences. Due to the complexity of the topic, laws on foods for special dietary uses and on foods containing claims are not discussed in detail in this publication.

3. Nutrition labeling at the international level (Codex Alimentarius)

3.1. Operation and purpose of the Codex Alimentarius Commission

The main purpose of the Codex Alimentarius Commission (hereinafter referred to as the: Codex), operating within the framework of the specialized agencies of the United Nations FAO and WHO, is to develop food standards, guidelines and other related documents in order to achieve global harmonization, which also facilitates international trade. Behind all this is the protection of consumer health and also the establishment of fair practices in the food chain. It can be said that the Codex seeks international agreement and therefore shows suitable flexibility. It allows individual countries to incorporate Codex standards and guidelines into their own laws and recommendations. This is also the case with the Codex guideline on nutrition labeling. The Codex operates within the framework of committees specialized for certain areas, and the documents drawn up and adopted by it are finalized with the approval of the main committee [15, 16].

3.2. The Codex and nutrition labeling

With regard to nutrition labeling, two specialized committees play key roles, one of which is the Codex Committee on Nutrition and Foods for Special Dietary Uses (CCNFSDU) which, through its activities in this field, contributes, among other things, to the enforcement of scientific and professional basis and to the determination of dietary intake reference values. The other such specialized committee is the Codex Committee for Food Labelling (CCFL), which finalizes the information on nutrient composition related to food labeling in this area. A guide on nutrition and health claims has been developed within the framework of a similar collaboration. One of the objectives of the guidelines is to provide consumers with an understanding of the labels on the products and to provide them with sufficiently detailed information [17].

The basic requirements for nutrition labeling were first defined in guideline CXG 2-1985 in 1985 as a voluntary labeling element (except for food intended for specific groups, for which nutrition labeling was already mandatory at that time and was regulated by a separate standard that is CODEX STAN 146-1985), which applied to both prepacked and non-prepacked foods. The guideline is still being developed and refined to this day, and in this spirit there have been complete revisions in 1993 and 2011, and nine amendments between 2003 and 2017. Initially, nutrition labeling was voluntary, however, with a modification in 2012, it became mandatory for prepacked foods. In 2011, an annex defining the general principles of the Nutrient Reference Values (NRVs) for the population over 36 months of age was added to the guideline, which was revised four times between 2013 and 2017.

At international level, the general guideline for claims (CXG-1-1979) was adopted by the Codex in 1979. The principles of nutrition and health claims were defined for guidance in 1997, supplemented by terms such as „low fat”, „high fat”, etc. (CXG-23-1997).

The Codex guideline makes the data in Table 1 mandatory, but if a nutrition or health claim is made on food, the labeling should be supplemented with the nutrient claimed or the other substances with physiological effects, e.g. caffeine content. When there is a claim related to fatty acids, the amounts of the different fatty acids (saturated, monounsaturated, polyunsaturated) and, where required by member state regulation, the trans fatty acid content, in addition to the mandatory elements. The amounts of vitamins and minerals may be indicated if the product contains significant amounts of them.

It also allows for the voluntary indication of additional nutrients if, for example, required by national regulation, formulated by national recommendations or simply considered to be useful by the producer of the food. In all cases (mandatory, voluntary), the data must be expressed for 100 g weight or 100 ml volume, or portion, and it may be supplemented by the percentage of the Nutrition Reference Value (NRV). Regarding the presentation (font size, order of energy and nutrients, etc.), general principles have been formulated in the recommendations [18].

In addition to consumer education programs, the Codex guideline provides the opportunity to use other forms of voluntary expression through eye-catching graphic elements or symbols. These can help the consumer to get to know and understand the given nutrition declaration, and thus the nutrient content of the food, more easily.

4. Regulation of nutrition labeling in the European Union

4.1. Antecedents of legal harmonization

The basic objective of the regulation of food labeling, and thus of nutrition labeling, is to properly inform the consumer. In 1979, Council Directive 79/112/EEC on the labeling of foodstuffs in the European Union [19, 1], did not yet cover the topic of nutrition labeling. Nutrition labeling was first regulated in 1990 by Council Directive 90/496/EEC as a voluntary labeling option, following the Codex Alimentarius guidelines on nutrition labeling. An exception was the regulation of foods for special dietary uses. At that time, however, it was agreed among food legislators that food business operators, especially small and medium-sized enterprises, should be encouraged to gradually introduce nutrition labeling [20].

Council Directive 90/496/EEC provided two options for nutrition labeling, the elements of which are shown in Table 1. Quantities could be indicated per 100 g weight or 100 ml volume, or per portion, provided that the number of portions in the package was also indicated. There were specific rules for their display: they had to be indicated in a tabular form or in a linear, quantity-by-quantity manner, in a clearly visible way, depending on the space available (at that time, the applicable minimum font size had not yet been determined). Mandatory elements of the label showed the quantities of energy, protein, carbohydrate, fat or energy, protein, carbohydrate, sugars, fat, saturates, dietary fiber and sodium.

The nutrition labeling may have included one or more of the following: starch, polyols, mono-unsaturates, polyunsaturates, cholesterol. Vitamins and minerals present in significant amounts could also be indicated. The annex to the directive also contained the recommended daily allowances for some vitamins and minerals, as well as the definitions of significant amounts (when determining the significant amount, 15% of the recommended intake in this annex should normally be taken into account for each 100 grams, 100 milliliters or one package of the food, if the package contains only one portion). Graphic display was allowed, but special rules were not defined.

The calculation of nuritional value could be based on the results of the tests performed by the food manufacturer, or on calculations based on known or actual average values of the ingredients used, or on calculations based on generally established and accepted data.

Nutrition and health claims appeared more and more frequently on food labels throughout the European Union. Member state regulations were quite diverse, therefore harmonization was necessary, resulting in Regulation (EC) No 1924/2006 on nutrition and health claims made on foods, which specifies which claims (e.g., low energy, energy reduced, source of protein, etc.) may appear on the label and under what conditions. The foods on which a claim is made can have an effect on dietary habits and overall nutrient intake, therefore consumers should be aware of their nutrient content. This goal can be achieved by the mandatory nutrition labeling of such foods [21]. Nutrition labeling is also mandatory in case of addition of vitamins, minerals and certain other substances to foods (Regulation (EC) No 1925/2006).

According to a 2003 study by the DG SANCO (Directorate-General Health & Consumer Protection), 35 to 85% of pre-packaged products in EU member states bore nutrition labeling. The survey pointed out that consumers are interested in nutrition labeling, especially in the case of processed foods, but the majority only requires it, but do not actually use this information.

The results of a consultation in member states in 2003 drew attention to the fact that the voluntary nutrition labeling system was not working satisfactorily and that a legal change was inevitable. Mandatory nutrition labeling was required. The mode of display was particularly important, because the use of small font sizes and multilingual labels made labels confusing, and there was also a need to define exceptions (e.g. packaging materials with small surface areas, non-prepacked products, alcohols etc.). Legislators have recognized that the obligation to provide nutrition labeling may present a problem to businesses because of the additional costs, to which a long transition period and the development of guidelines could be a solution. It was found that alternative nutrition labeling could also be useful, however, if there are too many labeling methods on the market, a great variety can also confuse consumers and the functioning of the internal market. As a result of the survey, the options „Big 4” (energy, protein, carbohydrate, fat) and „Big 8” („Big 4” supplemented by saturated fatty acids, sugar, fiber and salt) were proposed by member states. It was noted that consumers do not understand the indication of the amount of sodium, so it is necessary to use the term salt (table salt). It was also judged that providing the energy content in kJ was not understandable for everyone, therefore the introduction of the use of Kcal was also on the agenda [22, 23].

Regarding the use of other alternative forms of nutrition labeling (in addition to the nutrition labeling) there was a consensus that it should be clear and easy to understand. They also agreed that GDA (guideline daily amount) is a useful and easy to understand form of expression for all stakeholders of the food chain, but it can only be successful if it is harmonized at the EU level and developed by EFSA (European Food Safety Authority) or another independent scientific body [23].

A 2005 consumer survey by BEUC (The European Consumers’ Organisation), conducted in five countries (Germany, Denmark, Spain, Hungary and Poland), showed that nutrition labeling is of paramount importance to respondents; 74 to 84% of those interviewed stated that nutrition labeling was necessary. However, price, date of minimum durability/shelf-life and brand name are the most sought after information, nutrition labeling is read by only a few people, but the amount of fat and portion size are read by 50% of respondents. They spoke in support of other simplified forms of display. They also found that nutrition claims attract consumers’ attention and influence their purchases. 80% of respondents stated that nutrition labeling was easy to find and 70% thought it was easy to understand, while for 50% this information was also reliable. Survey data have shown that the marketing value of claims is markedly high [24].

The Commission’s 2007 White Paper on nutrition, overweight and obesity related health issues noted that the number of overweight and obese people in the European Union, especially children, had risen significantly over the previous three decades. Although the individual is primarily responsible for their own and their children’s lifestyles, it is an indisputable fact that the environment also effects behavior. Also, only a well-informed consumer is able to make rational decisions. Finally, an optimal outcome in this area can only be achieved if the different policy areas (horizontal approach) and the various levels of action (vertical approach) complement each other and are integrated.

It pointed out the need to think about making nutrition labeling mandatory and the regulation of the simplified labeling used on the front side of packaging.

The Commission’s findings in the White Paper, growing consumer interest in the relationship between the diet and health, as well as the need to select a diet that meets the individual’s needs have necessitated the implementation of a nutrition labeling systems that is uniform and mandatory throughout the European Union [25, 26].

EU rules on food labeling, pertaining to all foods, were laid down by Directive 2000/13/EC, most of which reached back to the regulatory principles that emerged in 1978, while Council Directive 90/496/EEC had become obsolete, therefore it was time to amend it [27, 7].

4.2. Legal harmonization

Based on the findings of the White Paper and the results of the surveys, Regulation (EU) No 1169/2011 (hereinafter referred to as: the Regulation) on the provision of food information to consumers, which ensures a high level of consumer protection, the free movement of goods and a level playing field, was established. The Regulation contains detailed rules on the labeling of prepacked foods, but also covers the labeling of non-prepacked foods to some extent. Since mandatory nutrition labeling imposes a significant burden on food business operators, the regulation allowed stakeholders a five-year preparation time, i.e., nutrition labeling on prepacked foods became mandatory from December 13, 2016 [7]. The goal of the legislation was to enable food information to reach the average consumer and to help them make a decision, despite their limited nutritional knowledge, while not creating barriers to trade [22, 25].

Nutrition labeling according to the Regulation must be applied to all foods. Exceptions are food supplements and natural mineral waters. Unlike before, the new type of nutrition labeling prioritizes as mandatory elements energy content and nutrients whose excessive intake carries a health risk. Exceptions to this are carbohydrates and protein, which have become mandatory items due to the increasing frequency of diabetes and the resulting kidney disease. The elements in yellow in Table 2 are mandatory, but it is possible to provide additional elements (marked in blue) on a voluntary basis. Nutrition labeling is also mandatory for the use of nutrition and health claims (on the packaging in the case of prepacked foods, while it does not have to displayed on non-prepacked foods, but the information should be available). Vitamins and minerals present in significant amounts may also be indicated, in accordance with the rules on specific values.

Certain foodstuffs are exempt from labeling in accordance to Annex V to Regulation (EU) No 1169/2011.

The information may be given per 100 g weight or 100 ml volume but may also be expressed per portion or unit of consumption (for specific portion/packaging unit or characteristic unit of consumption due to the nature of the food). The amounts of vitamins and minerals referred to in Part A of Annex XIII to the Regulation should also be expressed as a percentage of the nutrient reference value (NRV) per 100 grams or 100 milliliters of the product. The energy content and the amounts of nutrients may also be expressed as a percentage of the nutrient reference value, expressed per 100 g weight or 100 ml volume, or per portion or unit of consumption. For nutrient reference values expressed per 100 grams 100 milliliters, the following information should also be provided: „Reference intake of an average adult (8400 kJ / 2000 kcal).

In terms of presentation, the Regulation is quite precise and clear; the elements of the nutrition labeling shall be presented in a specific order, preferably in a tabular form (if this is not possible, then continuously, without interruption) following each other, in the same field of vision, in a specific font size. The nutrition labeling is a closed list to which, in the case of foods for normal public consumption, additional elements cannot be added within the list, only to the end of the list (e.g. the amount of lactose should not be included with the sugars, it can only be displayed following the table).

The calculation of nutritional value could be based on the results of the tests performed by the food manufacturer, or on calculations based on known or actual average values of the ingredients, or on calculations based on generally established and accepted data.

Tolerance limits for nutrition labeling are important because, due to the natural variations in the composition of the raw materials and the effects of production and storage, it is not possible to determine the nutrient content of foods accurately within the analytical error.

However, the values given on the label must not deviate from the actual values to such a significant extent as to mislead or harm consumers. In relation to this, a guide has been developed under the coordination of the European Commission to help establish tolerance limits for nutrition values displayed on food labels.

According to the Regulation, specific elements of the nutrition labeling can be repeated in the main field of vision in two ways:

1. energy, or
2. energy, fat, saturates, sugars, salt.

In addition to the mandatory display, the Regulation also allows the use of graphic forms and symbols.

There are many voluntary graphic expressions and representations of nutrition labeling in the European Union. These display formats differ from each other. These display categories are not comparable, as they are based on completely different principles and have different uses.

Currently, we can basically distinguish four categories (Table 3).

5. Legal environment in Hungary

From the middle of the 19th century, the authorities of developed European countries began to adopt food laws. The first legal regulation of food in Hungary was Act XLVI of 1895 (on the prohibition of counterfeiting agricultural produce, products and articles) [29].

In the first decades of the 20th century, severe food crises occurred on the continents, from malnutrition to overnutrition. Over time, overeating in Europe started to pose an increasing health risk, leading to obesity and other health disorders. As a result, health organizations in developed and developing countries have become increasingly concerned with the regulated satisfaction of human nutritional needs. They were looking for the amount of energy, protein, fat, vitamins etc. which was absolutely necessary to maintain health, but at the same time they also studied the excessive intake of these nutrients and its consequences.

Starting from 1949, the Institute of Food Science (former name of the National Institute of food and Nutrition Science (OÉTI) regularly examined the diet of the Hungarian population and continuously modified the domestic nutrient requirements and created nutrient tables [30].

Statutory order no. 27 of 1958 was the first legal act that regulated the production and distribution of foods and beverages and ordered the establishment of the Hungarian Food Codex [31]. Nutrition labeling did not appear as such in this order, but the importance of the diet and nutritional health was already emphasized for the „health of our people”. As a result of joining the work of the Codex Committee (1963), the ideas and current issues appeared in food regulation in Hungary as well [32].

As regards nutrition labeling, MÉM decree 25/1976 (VII. 11.) on the implementation of Act IV of 1976 on foodstuffs [33] provided that „…where possible, essential nutrients should also be indicated on the packaging of the food to promote modern nutrition” [34]. The concept of “essential nutrient” was not defined in the decree, however, the nutrient table based on the work of OÉTI and edited by Dr. Róbert Tarján and Dr. Károly Lindner names them: energy content, carbohydrate, protein, fat [30]. At that time, laws did not define every detail and, as a result, individual professional decisions, evaluations and authorizations in connection with the given product played important roles.

Hungary recognized the importance of communicating nutrition labeling to consumers and, accordingly, MÉM decree 25/1976 (VII. 11.) provided the opportunity for voluntary nutrition labeling. During this period, a Codex document on the subject did not yet exist.

Strict rules applied to the fortification of foods with vitamins (e.g. only vitamins that also occurred in the food naturally were allowed to be added as fortification to the food). The name of the vitamin and its amount in the food had to be indicated and, in case of „diet” foods, the amounts of the important nutrients, in addition to the otherwise mandatory general labeling data had to be added.

For certain products/product groups, salt, fat, protein, starch, carbohydrate and energy content were also mentioned in the standards as quality criteria, but their indication was not mandatory in all cases. For example, in case of breads containing whole wheat flour, the carbohydrate content (per 100 g of product) had to be indicated in addition to the energy content (expressed in kJ) (MSZ-08-1377-86).

MÉM (former Ministry of Agriculture and Food) decree 25/1976 (VII. 11.) was replaced in 1988 by MÉM-SZEM (former Ministry of Agriculture and Food – former Ministry of Social Affairs and Health) decree 10/1988 (VI. 30.), which required the mandatory indication of the energy content per 100 grams (cm3) of the product, expressed in kJ, in case of prepacked foods. Among other things, the decree included the main types of „diet foods”, e.g. the categories of energy reduced foods; low energy; energy free; reduced sodium content and low purine, and their criteria. Nutrition labeling was mandatory on these foods, i.e., the energy content and the amounts of the nutrients that provided the energy, as well as the nutrients characteristic to the food and , possibly vitamins had to be indicated. Foods were allowed to be fortified or supplemented with certain vitamins (retinol, calciferol tocopherol, thiamine, pyridoxine, pantothenic acid, folic acid, cobalamin, ascorbic acid) [35].

This regulation provided that the product information sheet and the certificate of analysis must include the nutritional composition of the food „(protein, fat, carbohydrate, etc.) and other characteristics, energy content (per 100 grams or 100 cm3)”. On the packaging of the food had to be indicated: „the name of the food as specified in the standard, manufacturing authorization, product data sheet or other specification (e.g., marketing authorization in case of imported foods), and other mandatory information specified in the relevant standard (e.g., dry matter content, fat content, etc.)”.

Hungary’s application for membership of the European Union, submitted in April 1, 1994, made it necessary to prepare for legal harmonization. Council Directive 90/496/EEC on nutrition labeling was incorporated into Regulation 1-1-90/496 of the Hungarian Food Codex. Joint FM-NM-IKM decree 1/1996 (I. 9.) on foodstuffs stated that the energy content of foods must be given according to the Hungarian Food Codex. In addition to the data required for a given type of food, foods for special dietary uses and foods with claims (today these are called nutrition and health claims) had to bear the nutrition labeling required by the Hungarian Food Codex [36, 37, 38].

Before 1996, about five thousand kinds of food could be bought, but this number increased sevenfold by the turn of the millennium, because in the meantime new requirements, consumer needs and expectations appeared. Food production had shifted towards the manufacture of higher quality foods, and for this reason, as well as in preparation for accession, the creation of a new legal framework became necessary [29].

The elaboration of Act No. LXXXII of 2003 (the fifth Hungarian food act) was necessitated by Hungary’s membership in the European Union. The basic ideas of the law included the protection of the interests and health of consumers, the protection of the environment, and the promotion of fair competition and the free movement of goods [39]. In Hungary, during the preparation period between 1995 and 2004, the regulations of the European Union were gradually adopted into the food act and ministerial decrees, however, with the accession to the EU on May 1, 2004, these transitional legal acts became obsolete [36, 29].

In 2004, Directive 2000/13/EC on the labeling of foodstuffs was transposed in accordance with the specifications of joint FVM-ESzCsM-GKM (former Ministry of Agriculture and Rural Development – Ministry of Health Social and Family Affairs – former Ministry of Economy and Trade Affairs) decree 19/2004 (II. 26.), so the legal harmonization of food labeling had been completed. Nutrition labeling remained a voluntary labeling element (with the exception of foods with claims, fortified foods and foods for special dietary uses) until the entry into force and mandatory application of Regulation (EU) No 1169/2011.

6. Conclusions and the future of nutrition labeling

Nutrition labeling of foods has come a long way in the European Union, creating the opportunity for consumers to enjoy uniform and detailed information in all member states of the Community. EU and national legislators still face a number of challenges. From health and environmental points of view, our current food consumption habits are receiving increasing criticism. Average energy intake, the consumption of sugars, salt and fats remains above recommended levels, while the consumption of whole grains, fruits and vegetables, legumes and nuts is low [40]. The increase in the incidence of overweight and obesity is critical, so this trend needs to be reversed according to the guidance of FAO and WHO, which requires a shift towards a plant-based diet. The consumption of more fruits and vegetables could also reduce the risk of diet-related diseases and, according to some calculation, the environmental impact of the human diet [41]. The regulation of food labeling must therefore continue to follow scientific developments and provide consumers with the information that can form the basis for a balanced and sustainable consumption of food that meets individual needs in the most comprehensible way possible.

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