Executive report:

The purpose of this report is to investigate whether “eating sweet things (pastries, cakes, as well

as confectioneries) causes more excess weight unlike salads.” Obesity is a major public health

issue that has reached epidemic proportions in almost all parts of the world [1]. Obesity [Body

Mass Index (BMI) 30 kg/m2 ] has increased worldwide from 28.8 percent in 1980 95 percent

Confidence Interval (CI: 28.4–29.3) to 36.9 percent in 2013 (CI: 36.3–37.4) for men and 29.8

percent (CI: 29.3–30.2) to 38.0 percent (CI: 37.5–38.5) for women. Indeed, the rising prevalence

of overweight and obesity in several countries has been labelled a global pandemic [1].

Worryingly, the prevalence of childhood overweight and obesity has increased in the last decade

(from 2006 to 2016), particularly in Southern European countries such as Italy (32.4 percent ; CI:

23.8–42.4), Greece (29.6 percent ; CI: 14.5–45 percent ), and Portugal (26.4 percent ; CI: 23.8–

29.2) [2]. In Spain, the European country with the lowest CVD incidence [3,] the increase has

also been very large (22.6 percent; CI: 18.7–27.0). As a result, if we are unable to reverse such

trends, we can expect even more substantial growth in the rate of obesity as well as other

cardiovascular diseases in the coming decades [4]. Increased caloric intake, changes in refined

foods, decreasing levels of physical activity, and changes in other factors, such as the gut

microbiome, are all contribute to urban to the large rise in population over the last 30 years [2].

Children and young adults should be the primary targets for the prevention and treatment of

overweight and obesity in order to reduce morbidity, mortality, and the expected costs of

healthcare for obese adults. Healthy diets characterised by high food intake, such as the Atlantic

(MD), Nordic, Dietary Frameworks to Stop Hypertension (DASH), and vegetarian diets [5,6],

have gained popularity in recent years.

2020 Nutrients, 12, x THE PRIMARY TARGETS FOR THE Treatment And Prevention OF

Obesity Must Be Teens And Young People, ACCORDING TO PEER REVIEW 2 OF 16

OBESE ADULTS. Healthy diets characterised by high food diversity and nutritional profiles,

such as the Mediterranean (MD), Nordic, Dietary Frameworks to Stop Hypertension (DASH),

and vegetarian diets [5,6], have been dramatically displaced in recent years by bad lifestyles

focused on global foods and nutritionally poor profiles [7]. While healthful dietary patterns rich

in fresh fruits, vegetables, legumes, pulses, and nuts have been shown to reduce the risk of the

most common chronic diseases, such as CVD, diabetes mellitus, cognitive decline, dementia, and

even cancer [8–11]. Unhealthy diets are defined by a high intake of animal products and

processed foods, salt, simple sugars, and saturated and trans fatty acids, and are directly linked to

an increased risk of noncommunicable diseases (NCDs) and the onset of malnutrition [12]. The

rise in unhealthy diets is widely attributed to the fact that they are less expensive and based on

more commonly accessible food items than healthier diets. As a result, almost all Mediterranean

countries, including Spain, have seen a progressive decline in adherence to traditional medicine

over the last few decades [13]. As a result, governments, official institutions, and scientific

societies should continue to promote healthy eating habits alongside strategies for limiting the

other dietary risk factors associated with obesity, CVD, diabetes, and cancer, such as excess

energy, salt, saturated and trans-fats, and sugar [14–17]. Food sales and distribution appear to be

associated with the risk of developing NCDs in recent years, but the effects remain unknown.

According to a recent study conducted by Santulli et al. [18], the length of the food supply chain

may play a determining role in the prevention of metabolic syndrome (MetS). As a result, the

WHO recommended in 2004 that the industry reduce the energy densities, trans fats, saturated

fats, sodium, and added sugars in their products [22]. Despite little progress over the last decade,
the Dutch government asked the food industry in 2014 to reduce the levels of energy, salt,

saturated fat, and sugar in food products (National Pact to Enhance Customer Composition: Salt,

Saturated Fat, Sugar Calories) [23]. Furthermore, in 2018, AESAN (Spanish Agency for Food

Safety and Nutrition) recommended that the industry reformulate their products in the same

manner, as well as requesting a 5% reduction in sugar added and saturated fatty acids in baked

goods and pastries by 2020 [24]. The primary goal of food revision is to create healthier foods

that benefit human health. Reducing ingredients that are perceived to be “harmful” to human

health allows for the substitution of “healthier” ingredients. Thus, food technology science drives

effective food new formulation strategies for lowering the occurrences of several chronic

diseases associated with poor dietary habits and improving the nutritional profiles of food

products. Other aspects of reformulation include increasing the content of health-promoting

ingredients like whole grain flour, dietary fibre, fruits and vegetables, and unsaturated fatty

acids, which improve the nutritional quality of foods by improving their macro- and

micronutrient compositions in terms of vitamins, minerals, and phytochemicals [25].

Reformulation will be successful only if the reformulated foods fit into a healthy diet and have

high nutritional quality, good texture, are safe, palatable, and affordable [26]. Few studies have

looked into the technological aspects of lowering sodium, sugar, and saturated fat. This review

investigates the potential health effects of pastry product reformulation based on various

reformulation targets..

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