Background
The World Health Organisation (WHO) encourages countries to conduct national dietary surveys to inform preventative policies targeting malnutrition and noncommunicable diseases. This research reviews the provision of national dietary surveys across the 53 countries of the WHO European Region and uses intake data from these surveys to assess selected topics that are of concern to WHO.
Methods
National dietary surveys were gathered, survey characteristics were collated and survey-reported energy and selected nutrient intakes were examined in relation to recommended intakes for adults and children. Raw datasets were gathered from 12 countries and age-standardised weighted mean nutrient intakes presented by individual education level and Gross Domestic Product (GDP). Socio-economic and food consumption characteristics of high trans fatty acid (TFA) consumers were compared in the Dutch and UK surveys. The impact of body mass index (BMI) on consumed portion size was investigated in the French and UK surveys. Means and nutritional content of commercial UK serving-sizes were compared to consumed portion sizes in the UK survey in popular energy-dense foods.
Results
Less than two thirds of WHO European Member States conducted national dietary surveys; the main survey gaps lie in Central & Eastern European countries, where nutrition policies may lack an evidence base. Nutritional issues appeared widespread, particularly in females and Central & Eastern Europe, but differences in age group, methodology, under-reporting and nutrient composition databases hinder inter-country comparisons. Lower income countries and lower education groups had poorer diet, particularly for micronutrients. Higher educational status appeared to have a mitigating effect on poorer diet in lower income countries. Although voluntary national reduction programmes may successfully reduce average TFA intakes, as shown in the Dutch and UK national dietary surveys, inequalities in TFA consumption may be hidden. Limited evidence of associations between portion size and BMI was found. UK consumed portion sizes were greater than on-pack serving sizes, suggesting that portion size guidance may need updating.
Conclusion
This project produced the first review of national dietary survey provision across the lifecourse, within the whole WHO European region, with reference to disadvantaged groups, obesity and nutrients of concern. All European countries should be encouraged to conduct harmonised national dietary surveys, which could facilitate effective, coordinated policy development to deliver dietary improvement across Europe.
