Comparative analysis of nutrition data from national, household, and individual levels: results from a WHO-CINDI collaborative project in Canada, Finland, Poland, and Spain

The growing Canadian energy gap: more the can than the couch?

OBJECTIVE

The present study describes the trajectory of the energy gap (energy imbalance) in the Canadian population from 1976 to 2003, its temporal relationship to adult obesity, and estimates the relative contribution of energy availability and expenditure to the energy gap. It also assesses which foods contributed the most to changes in available energy over the study period.

DESIGN

Annual estimates of the energy gap were derived by subtracting population-adjusted per capita daily estimated energy requirements (derived from Dietary Reference Intakes) from per capita daily estimated energy available (obtained from food balance sheets). Food balance sheets were used to assess which foods contributed to changes in energy availability. Adult obesity rates were derived from six national surveys. The relationship to the energy gap was assessed through regression analysis.

RESULTS

Between 1976 and 2003, per capita daily estimated energy availability increased by 18 % (1744 kJ), and increased energy availability was the major driver of the increased energy gap. Salad oils, wheat flour, soft drinks and shortening accounted for the majority of the net increase in energy availability. Adult obesity was significantly correlated with the energy gap over the study period.

CONCLUSIONS

The widening energy gap is being driven primarily by increased energy availability. The food commodities driving the widening energy gap are major ingredients in many energy-dense convenience foods, which are being consumed with increasing frequency in Canada. Policies to address population obesity must have a strong nutritional focus with the objective of decreasing energy consumption at the population level.

Using decomposed household food acquisitions as inputs of a Kinetic Dietary Exposure Model

Foods naturally contain a number of contaminants that may have different and long-term toxic effects. This paper introduces a novel approach for the assessment of such chronic food risk that integrates the pharmakokinetic properties of a given contaminant. The estimation of such a Kinetic Dietary Exposure Model (KDEM) should be based on long-term consumption data which, for the moment, can only be provided by Household Budget Surveys such as the TNS SECODIP panel in France. A semi-parametric model is proposed to decompose a series of household quantities into individual quantities which are then used as inputs of the KDEM. As an illustration, the risk assessment related to the presence of methylmercury in seafoods is revisited using this novel approach.

Mothers of young children cluster into 4 groups based on psychographic food decision influencers

This study explored how mothers grouped into clusters according to multiple psychographic food decision influencers and how the clusters differed in nutrient intake and nutrient content of their household food supply. Mothers (n = 201) completed a survey assessing basic demographic characteristics, food shopping and meal preparation activities, self and spouse employment, exposure to formal food or nutrition education, education level and occupation, weight status, nutrition and food preparation knowledge and skill, family member health and nutrition status, food decision influencer constructs, and dietary intake. In addition, an in-home inventory of 100 participants' household food supplies was conducted. Four distinct clusters presented when 26 psychographic food choice influencers were evaluated. These clusters appear to be valid and robust classifications of mothers in that they discriminated well on the psychographic variables used to construct the clusters as well as numerous other variables not used in the cluster analysis. In addition, the clusters appear to transcend demographic variables that often segment audiences (eg, race, mother's age, socioeconomic status), thereby adding a new dimension to the way in which this audience can be characterized. Furthermore, psychographically defined clusters predicted dietary quality. This study demonstrates that mothers are not a homogenous group and need to have their unique characteristics taken into consideration when designing strategies to promote health. These results can help health practitioners better understand factors affecting food decisions and tailor interventions to better meet the needs of mothers.

Using empirical likelihood to combine data: application to food risk assessment

This article introduces an original methodology based on empirical likelihood, which aims at combining different food contamination and consumption surveys to provide risk managers with a risk measure, taking into account all the available information. This risk index is defined as the probability that exposure to a contaminant exceeds a safe dose. It is naturally expressed as a nonlinear functional of the different consumption and contamination distributions, more precisely as a generalized U-statistic. This nonlinearity and the huge size of the data sets make direct computation of the problem unfeasible. Using linearization techniques and incomplete versions of the U-statistic, a tractable "approximated" empirical likelihood program is solved yielding asymptotic confidence intervals for the risk index. An alternative "Euclidean likelihood program" is also considered, replacing the Kullback-Leibler distance involved in the empirical likelihood by the Euclidean distance. Both methodologies are tested on simulated data and applied to assess the risk due to the presence of methyl mercury in fish and other seafood.

Differences in food supplies of U.S. households with and without overweight individuals

Household food supplies of families with at least one child 12 years or younger (n=100) were inventoried in order to describe its nutrient content and compare food supplies of families with and without overweight individuals (i.e., healthy vs. overweight mothers; healthy vs. overweight fathers; healthy vs. overweight child[ren]). Nutrient adequacy ratios (NAR) for carbohydrate, dietary fiber, calcium, iron, total fat, and saturated fat were approximately one indicating amounts available per 2000 calories approximately equaled the Daily Value. NARs for protein, sugar, vitamin A, vitamin C, and sodium exceeded one and cholesterol NAR was less than one. Households were similar in number of household members, days until they planned to grocery shop again, and total days of meals and snacks to be served from household food supplies until the next grocery shopping trip. Frozen vegetables contributed significantly greater amounts of calories, carbohydrates, fat, and protein and meat supplied significantly more fat and protein in households with overweight fathers than in households with healthy weight fathers. In households with an overweight child, grains supplied significantly more protein and carbohydrate than in comparison households. Encouraging healthful changes to the home food supply may result in improvements in dietary intake and overall weight status.

Why is the developed world obese?

Obesity has risen dramatically in the past few decades. However, the relative contribution of energy intake and energy expenditure to rising obesity is not known. Moreover, the extent to which social and economic factors tip the energy balance is not well understood. This exploratory study estimates the relative contribution of increased caloric intake and reduced physical activity to obesity in developed countries using two methods of energy accounting. Results show that rising obesity is primarily the result of consuming more calories. We estimate multivariate regression models and use simulation analysis to explore technological and sociodemographic determinants of this dietary excess. Results indicate that the increase in caloric intake is associated with technological innovations as well as changing sociodemographic factors. This review offers useful insights to future research concerned with the etiology of obesity and suggests that obesity-related policies should focus on encouraging lower caloric intake.

Estimations of daily energy and nutrient availability based on nationally representative household budget survey data. The Data Food Networking (DAFNE) project

OBJECTIVE

To describe a cost-efficient method for estimating energy and nutrient availability using household budget survey (HBS) data.

DESIGN

Four different approaches were tested and the results were compared with published nutrient intake data. The selected method was exemplarily applied in German and Greek data.

SETTING

Germany, 1998; Greece, 1998/99.

MATERIAL

Nationally representative HBSs.

RESULTS

Comparisons showed that HBS-based estimates were generally close to intake data when results were presented as contributions to daily energy intake. Daily energy and protein availabilities were similar in Germany and Greece. Differences were observed in the availability of carbohydrates (German households reported a 5 percentage points higher contribution to daily energy availability) and lipids (Greek households recorded higher values for total fat, but lower values for saturated fat). Meat, added lipids and potatoes were important energy suppliers in Germany, whereas in Greece the first three energy suppliers were added lipids, cereals and meat. In both countries, meat, cereals, milk and cheese were important protein sources and cereals, potatoes, fruits and nuts contributed more than 60% of the daily carbohydrate availability. Added lipids were the major source of fat in the daily diet of both countries, but their contribution amounted to less than one-third in Germany and two-thirds in Greece.

CONCLUSIONS

National HBS data can be used for monitoring and comparing nutrient availability among representative population samples of different countries. The ground is set for the development of a harmonised food composition table to be applied to HBS food data at international level.

The importance of harmonizing food composition data across Europe

OBJECTIVE

To examine the role of food composition data in Europe in four sectors, namely health, trade regulation and legislation, agriculture and the environment.

RESULTS

The need for further harmonization of data across Europe is clearly identified and evidenced from a number of previous successful European collaborations.

CONCLUSIONS

Data on the nutritional composition of foods are essential for a broad spectrum of activities, including public health nutrition, research, the food industry and government policy development and implementation. With the expansion of the European Union and the concomitant increase in cross border trade and cooperation harmonizing food composition data becomes a more important issue than ever. Harmonization is not solely a technical issue, but also involves creating durable and sustainable structures to maintain the viability of the data. These are some of the issues currently being addressed by the European Food Information Resource Network of Excellence.

Supermarket sales data: feasibility and applicability in population food and nutrition monitoring

Population food and nutrition monitoring plays a critical role in understanding suboptimal nutrition at the population level, yet current monitoring methods such as national surveys are not practical to undertake on a continuous basis. Supermarket sales data potentially address this gap by providing detailed, timely, and inexpensive monitoring data for informing policies and anticipating trends. This paper reviews 22 studies that used supermarket sales data to examine food purchasing patterns. Despite some methodological limitations, feasibility studies showed promising results. The potential and limitations of using supermarket sales data to supplement food and nutrition monitoring methods are discussed.

Dietary exposure of Brazilian consumers to dithiocarbamate pesticides—A probabilistic approach

A probabilistic estimation of the exposure of the Brazilian population to the dithiocarbamate pesticides was performed using the Monte Carlo Risk Assessment program (MCRA 3.5). Residue data, as CS2, for 3821 samples were obtained from the Brazilian national monitoring program on pesticide residues and from the monitoring program conducted in the Distrito Federal on rice, beans and nine fruits and vegetables. Food consumption data were obtained from a Brazilian household budget survey conducted between 2002 and 2003. Processing factors for washing, peeling or cooking were applied to the residues found in the crops. Daily intakes at the highest percentiles for the general population reached a maximum of 2.0 microg CS2/kg body weight per day (upper band of the 95% confidence interval at P99.99). Tomato, rice, apple and lettuce were the commodities which contributed most to the intake. Based on the registered uses and the toxicological profile of dithiocarbamates, the risk from exposure was evaluated assuming that all residues came from the use of ethylene-bis-dithiocarbamate (EBDC) or that a fraction of it came from the use of propineb. For this last scenario, a cumulative risk assessment was conducted. In the first scenario, the highest intake reached up to 11.9% EBDC ADI for the general population and up to 31.1% ADI for children. When 30% of the residues were considered as coming from propineb use, the values were 15.2% and 39.7% ADI, respectively.

Probabilistic assessment of the cumulative acute exposure to organophosphorus and carbamate insecticides in the Brazilian diet

In the present study, the cumulative exposure of 25 acetylcholinesterase (AChE) inhibiting pesticides through the consumption of nine fruits and vegetables by the Brazilian population was assessed. Food consumption data were obtained from a household budget survey conducted in all Brazilian states from July 2002 to June 2003. Residue data from 4001 samples were obtained from the Brazilian national monitoring program on pesticide residues. Relative potency factors (RPF) were calculated with methamidophos or acephate as index compounds (IC), using BMD(10) or NOAEL for AChE inhibition, mostly in rat brain, obtained from national and international pesticide evaluations. Monocrotophos and triazophos, in addition to aldicarb, had the highest calculated RPF in any scenario. The exposure to AChE inhibiting pesticides for the general population at P99.9, represented 33.6% of the ARfD as methamidophos and 70.2% ARfD as acephate. The exposure calculated as acephate could exceed the ARfD at the upper bound of the 95% confidence interval for this percentile. Exposure for children aged up to 6 years were, on average, 2.4 times higher than the exposure for the general population. Tomato represented about 67% of the total intake of AChE inhibiting pesticides. The highest calculated equivalent residues in tomato, which drove most of the estimated intakes at the high percentiles, were related to the illegal use of monocrotophos and triazophos in this crop.

[Household food availability in Brazil: distribution and trends (1974-2003)]

OBJECTIVE

Data from household food budget surveys were examined in order to describe the regional and socio-economic distribution of household food availability in Brazil in 2002-2003 and trends from 1974 to 2003.

METHODS

The study uses data from the "Pesquisa de Orçamento Familiar 2002-2003" budget survey conducted by the Brazilian Institute for Geography and Statistics (Instituto Brasileiro de Geografia e Estatística) from July 2002 to June 2003, including a national sample of 48,470 households. In each household, during seven consecutive days, all monetary and non-monetary expenses with food and beverages for family consumption were registered. Crude weights of purchased foods were transformed into calories and nutrients with the use of food composition tables.

RESULTS

Adequate protein content and a high proportion of animal protein were found in all regions and income strata. These were the most important positive aspects identified in the household food availability in Brazil. On the other hand, all regions and socio-economic strata showed excess calories from sugar and little availability of fruits and vegetables. An excessive proportion of calories came from total and saturated fat in the more economically developed regions and in the urban milieu, as well as among higher-income families. Time-trends in metropolitan areas indicated a decline in the consumption of basic, traditional foods, such as rice and beans; notable increases (up to 400%) in the consumption of processed food items, such as cookies and soft drinks; maintenance of the excessive consumption of sugar; and a continuous increase in total fat and saturated fat content in the diet.

CONCLUSIONS

Patterns and trends regarding household food availability in Brazil are consistent with the increasing participation of chronic non-communicable diseases in morbidity and mortality and with the continuous increase in the prevalence of obesity.

Lifestyle-related risks: are trends in Europe converging?

OBJECTIVES

What has become of lifestyle differences in a united Europe, where member states become more and more similar on aspects such as welfare systems and population dynamics? In this paper, we try to answer the question whether the gap in lifestyle-related risk factors in Europe has narrowed over the past 30-40 years.

METHODS

Smoking, alcohol consumption, physical activity, obesity and food consumption all have an impact on cancer, cardiovascular disease and other non-communicable diseases. Databases of Eurostat, OECD (Organisation for Economic Co-operation and Development) and the World Health Organisation were screened for data on lifestyle-related risk factors in the European Union, and a literature search was performed for studies that collected international comparable data about the selected factors.

RESULTS

The gap in European lifestyle has narrowed over the past 30-40 years for smoking (women), alcohol consumption and total fat intake. For fruit and vegetable consumption, convergence is not occurring. For some risk factors, such as smoking and obesity, intranational differences surpass the international differences.

CONCLUSIONS

The results support the notion of convergent lifestyles among Europeans over time. We also found that there is a serious lack of reliable data on lifestyle-related risk factors that are suitable for international comparison. It is essential to invest in reliable and internationally comparable data, obtained according to best evidence, to get more insight into real differences regarding risk factors in Europe. The European Public Health programme may be an opportunity to realize these goals.