Identifying & Updating Tunisian’s Key Foods list for Food Composition Database Pr Jalila EL ATI (Tunisia) & Dr Eric VERGER (France) with collaborators from: Tunisia (Radhouene Doggui, Chiraz Beji, Houda Ben Gharbia, Samia Cherif,, Asma Bahrini, Tarek Trabelsi) France (Pierre Traissac, Edwige Landais, Francis Delpeuch, Claire Mouquet-Rivier, Marie-Claude Dop) Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

Brief History on FCT in Tunisia 1954: 1st FCT from analysis of some vegetables (tomato, pepper, onion, potato) 1974: 2nd FCT from analysis of few cereals, nuts, legumes, fruits, vegetables 1975: 3rd after compilation from local and international food composition database by experts from FAO/INS. 240 food items (raw and cooked). 2004: update the FCT as one of the deliverables of the European project (TAHINA) 2006: Edition of the 4th CFT for use in Tunisia 2018: Finalising the 5th CFT for Tunisian use Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

Brief History on FCT in Tunisia 1954: 1st FCT from analysis of some vegetables (tomato, pepper, onion, potato) 1974: 2nd FCT from analysis of few cereals, nuts, legumes, fruits, vegetables 1975: 3rd after compilation from local and international food composition database by experts from FAO/INS. 240 food items (raw and cooked). 2004: update the FCT as one of the deliverables of the European project (TAHINA) 2006: Edition of the 4th CFT for use in Tunisia 2018: Finalising the 5th CFT for Tunisian use Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

Brief History on FCT in Tunisia 1954: 1st FCT from analysis of some vegetables (tomato, pepper, onion, potato) 1974: 2nd FCT from analysis of few cereals, nuts, legumes, fruits, vegetables 1975: 3rd after compilation from local and international food composition database by experts from FAO/INS. 240 food items (raw and cooked). 2004: update the FCT as one of the deliverables of the European project (TAHINA) 2006: Edition of the 4th CFT for use in Tunisia 2018: the 5th CFT for Tunisian use is being finalized Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

Key foods list: Overview of the procedure The Key Foods approach developed by the United States Department of Agriculture (USDA) was used: Combination of: 1. Data on national consumption foods and beverages AND 2. Existing nutrient composition Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

Key foods list: Overview of the procedure A scoring system to rank the foods and identify “Key Foods” Key Foods = Foods that contribute to the diet with significant amounts of nutrients of public health interest We need: National food consumption data AND list of food nutrients of public health interest Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

Key foods list: Overview of the procedure 1. National food consumption data The National nutrition surveys 1996 Cross-sectional survey based on a national stratified two-level stage sample Conducted by the National Institute of Nutrition and Food Technology Representative sample of households (n= 1800); 7218 subjects, age 2 – 80 years 3-day food record (two weekdays and one weekend day‎) everything they ate and drank was reported and household utensils, food photographs or models are used for estimating portion size Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

Key foods list: Overview of the procedure 1. National food consumption data The National nutrition surveys 1996 2005 Cross-sectional survey based on a national stratified three-level sample Conducted by the National Institute of Nutrition and Food Technology Representative sample of households (n= 7500); 7350 subjects, age 35-70 years Validate quantitative food frequency questionnaire over a 1-month period Household utensils, food photographs or models are used for estimating portion size Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

Key foods list: Overview of the procedure 1. National food consumption data The National nutrition surveys 1996 2005 The National on the budget, food consumption and living conditions of households 2015 Conducted by the National Institute of Statistics Representative sample of households (n= 13000) 7-day weighed food records method is used twice a year Each consumed food is weighted prior to consumption and recorded in a booklet Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

Key foods list: Overview of the procedure 1. National food consumption data The National nutrition surveys 1996 2005 The National on the budget, food consumption and living conditions of households 2015 2. List of nutrients with public health interest Energy, proteins, fats, saturated fats, iron, calcium, sodium and fiber Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

Key foods list: Overview of the procedure Example: the foods list from the national survey of 2015 1. The average nutrient contribution from each food (column C) is calculated by multiplying the average intake of the food item (column B) with the content of the key nutrient (column A) Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

Key foods list: Overview of the procedure Example: the foods list from the national survey of 2015 2. Divide nutrient consumed for each food by total quantity of nutrient consumed for all foods to calculate nutrient contribution in percent (column D) Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

Key foods list: Overview of the procedure Example: the foods list from the national survey of 2015 3. Cumulative percentage is calculated and foods are ranked in descending order according the cumulative percentage (column E) Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

Key foods list: Overview of the procedure Example: the foods list from the national survey of 2015 4. Key foods are defined as those foods that contribute at least by 75% of the intake of the key nutrients. Example Total Fats: from a list of 182 food items, 9 are Key foods Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

Key foods list: Overview of the procedure Example: the foods list from the national survey of 2015 4. The procedure is repeated for all key nutrients. Of the 182 food items, only 38 are Key foods, contributing by 75% of food intake 38 Key Foods Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

Management of food composition data Examples from the MEDINA project Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

1 – Including wild food in the Tunisian food composition database Need to include new food items in the Tunisian food composition database Wild food usually consumed in the Sidi Bouzid Governorate have been identified during an ethnobotanical study Lack of information about these foods in the Food Processor Software which constitute the core of the Tunisian food composition database Need to include new information into the database while respecting its current format  nutritional values for energy and 27 nutrients : protein, available carbohydrate, sugar, free sugar, fiber, total fat, SFA, MUFA, PUFA, vitamin A, thiamin, riboflavin, niacin, pantothenic acid, vitamin B6, folate, vitamin B12, vitamin C, vitamin E, calcium, copper, magnesium, zinc, phosphorus, potassium, iron and sodium Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

1 – Including wild food in the Tunisian food composition database The process in a nutshell Consider the primary sources of the data Compile and select the best information Compile and check data 1 2 3 Illustration with the case of wild fennel (Besbes arbi) Source: Greenfield & Southgate. 2003. Food composition data - production, management and use. FAO, Rome. Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

1 – Including wild food in the Tunisian food composition database Consider the primary sources of the data (1/2) 3 samples of wild fennel (2 from local market and 1 from irrigated farm) Fibrea : Lee, Prosky et al, 1992 (AOAC 991.43) Carotenoidsa : HPLC (Taunbodhitham et al, 1998) Folatea : microbiological method (Kariluoto & Piironen, 2009) Vitamin Cb : HPLC (Fontanaz et al, 2006) Mineralsb : atomic absorption spectrometry (Hama et al, 2011) Common name Scientific name Dry matter (g/100g) Fibre βcarotene* (μg/100g) Folate Vitamin C (mg/100g) Fe Zn Calcium K Wild fennel leaves Anethum graveolens 18.1 6.5 5908 172 42.9 1.8 0.4 252 475 a assays done in triplicate; b assays done in duplicate; * α-carotene and β-cryptoxanthin were absent in the samples Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

1 – Including wild food in the Tunisian food composition database Consider the primary sources of the data (2/2) Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

1 – Including wild food in the Tunisian food composition database Compile and select the best information Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

1 – Including wild food in the Tunisian food composition database Compile and check data (1/2) Keep records Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

1 – Including wild food in the Tunisian food composition database Compile and check data (2/2) Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

1 – Including wild food in the Tunisian food composition database Checks on components Check Proximate 95 ≤ Water + Ash + Protein + Fat + Total Carbohydrates ≤ 105 Check Fat Total Fat - (SFA+MUFA+PUFA) ≥ 0 Check PUFA PUFA - (n3+n6) ≥ 0 Check Ash Ash - (Calcium + Copper + Iron + Magnesium + Phosphorus + Potassium + Sodium + Zinc) ≥ 0 Check Vit A Vitamin A RAE = (Retinol) + (Beta-carotene/12) Many other checks available in the document FAO/INFOODS Guidelines Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

2 – Calculation of the composition of dishes prepared from recipes Need to calculate the food composition of dishes collected in the MEDINA Study Food intakes of women assessed by a 24-h recall conducted by trained personnel, every three months over a year Detailed recipes for dishes (e.g. couscous with wild fennel and traditional soup) consumed by the women Portion sizes of the foods, beverages and ingredients used in dishes were estimated using: booklet with photographs of calibrated portion sizes; extensive household measure; and weight indicated on packaged foods Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

2 – Calculation of the composition of dishes prepared from recipes Information on the quantity of ingredients and the cooking process Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

2 – Calculation of the composition of dishes prepared from recipes Three approaches for recipe calculation Recipe calculation method Yield factor Retention factor Total Recipe Method recipe level Mixed Method ingredient level Ingredient Method Because the weight of the cooked dishes were not collected during the survey, we had to use the Ingredient Method, except for the soups. Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

2 – Calculation of the composition of dishes prepared from recipes Ingredient Method - Couscous with wild fennel Assign a nutrient composition to each ingredient Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

2 – Calculation of the composition of dishes prepared from recipes Ingredient Method - Couscous with wild fennel Assign the most relevant yield and retention factors to each ingredient according to the cooking method (Bognár 2002) Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

2 – Calculation of the composition of dishes prepared from recipes Ingredient Method - Couscous with wild fennel Estimate the final weight of cooked dish (sum the weight of each raw ingredient multiplied by the relevant yield factor) Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

2 – Calculation of the composition of dishes prepared from recipes Ingredient Method - Couscous with wild fennel Calculate the nutrient contribution of each ingredient to the final dish Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

2 – Calculation of the composition of dishes prepared from recipes Ingredient Method - Couscous with wild fennel Sum the nutrient contribution of each ingredient to the final dish and calculate the energy content (optional: nutrient profile) Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

2 – Calculation of the composition of dishes prepared from recipes Ingredient Method - Couscous with wild fennel Compare with external data (e.g. French database) Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018

2 – Calculation of the composition of dishes prepared from recipes Mixed Method – Traditional soup Very similar process with two exceptions: The final weight of cooked dish is not estimated but measured (replication in laboratory) The nutrient contribution of water (minerals) is taken into account Workshop on standardized methodologies for food composition databases. Ras Jebel, Tunisia, 5 – 8 November 2018