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Gurinović M, Nikolić M, Zeković M, Milešević J, Kadvan A, Ranić M, Glibetić M. Implementation of Harmonized Food Consumption Data Collection in the Balkan Region According to the EFSA EU Menu Methodology Standards. Front Nutr 2022; 8:809328. [PMID: 35127791 PMCID: PMC8811292 DOI: 10.3389/fnut.2021.809328] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/21/2021] [Indexed: 12/15/2022] Open
Abstract
Initiatives in the Capacity Development in Nutrition Research in the Balkan region in the last decade have been toward the creation of contemporary, harmonized Research Infrastructure (RI) compliant with European standards. This study describes the process of creation and implementation of the European Food Safety Authority (EFSA) EU Menu methodology in the Balkan region during the EFSA support projects for food consumption data collection in four countries (Serbia, Montenegro, Bosnia and Herzegovina, and North Macedonia). This process entailed the application and improvement of an innovative tool, the DIET ASSESS and PLAN (DAP), a platform for standardized food consumption data collection and dietary intake assessment. DAP comprises computerized food consumption, anthropometric measurements, and physical activity questionnaires, validated food picture book, and FoodEx2 exposure hierarchy with sets of facet descriptors of the interest. It hosts the Balkan food platform with a Serbian food composition database (FCDB) and Regional FCDB, compliant with European Food Information Resource (EuroFIR™) standards. The implementation of the DAP platform in national dietary surveys conducted with the support of the EFSA EU Menu project in Balkan countries enabled harmonized food consumption data compilation and reporting. Application of the methodology entailed the development of study protocol and extensive education and training of study personnel. The entire data collection process was managed by internal and external survey coordinators. A pilot study was conducted to test the entire data collection and control process and was afterward used to make necessary improvements and adjustments to meet EU Menu requirements. Data collected are internationally comparable with food consumption data in other European countries within the framework of the EU Menu program. The existence of such data in the Balkan region will catalyze research activities in emerging topics, such as identification of dietary patterns, the establishment of national nutrient reference values and food-based dietary guidelines (not only in Serbia, but in the whole Balkan region), dietary exposure assessments, the endorsement and evaluation of new food legislations, the environmental and other effects of diet on the food system. The developed and implemented methodology underpins evidence-based policy-making processes lacking in the field of public health nutrition in the region.
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Affiliation(s)
- Mirjana Gurinović
- Institute for Medical Research, National Institute of Republic of Serbia, Centre of Research Excellence in Nutrition and Metabolism, University of Belgrade, Belgrade, Serbia
- Capacity Development Network in Nutrition in Central and Eastern Europe (CAPNUTRA), Belgrade, Serbia
| | - Marina Nikolić
- Institute for Medical Research, National Institute of Republic of Serbia, Centre of Research Excellence in Nutrition and Metabolism, University of Belgrade, Belgrade, Serbia
| | - Milica Zeković
- Institute for Medical Research, National Institute of Republic of Serbia, Centre of Research Excellence in Nutrition and Metabolism, University of Belgrade, Belgrade, Serbia
- Capacity Development Network in Nutrition in Central and Eastern Europe (CAPNUTRA), Belgrade, Serbia
| | - Jelena Milešević
- Institute for Medical Research, National Institute of Republic of Serbia, Centre of Research Excellence in Nutrition and Metabolism, University of Belgrade, Belgrade, Serbia
- Capacity Development Network in Nutrition in Central and Eastern Europe (CAPNUTRA), Belgrade, Serbia
| | - Agnes Kadvan
- Capacity Development Network in Nutrition in Central and Eastern Europe (CAPNUTRA), Belgrade, Serbia
| | - Marija Ranić
- Institute for Medical Research, National Institute of Republic of Serbia, Centre of Research Excellence in Nutrition and Metabolism, University of Belgrade, Belgrade, Serbia
- Capacity Development Network in Nutrition in Central and Eastern Europe (CAPNUTRA), Belgrade, Serbia
| | - Maria Glibetić
- Institute for Medical Research, National Institute of Republic of Serbia, Centre of Research Excellence in Nutrition and Metabolism, University of Belgrade, Belgrade, Serbia
- Capacity Development Network in Nutrition in Central and Eastern Europe (CAPNUTRA), Belgrade, Serbia
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Quarta S, Massaro M, Chervenkov M, Ivanova T, Dimitrova D, Jorge R, Andrade V, Philippou E, Zisimou C, Maksimova V, Smilkov K, Ackova DG, Miloseva L, Ruskovska T, Deligiannidou GE, Kontogiorgis CA, Sánchez-Meca J, Pinto P, García-Conesa MT. Persistent Moderate-to-Weak Mediterranean Diet Adherence and Low Scoring for Plant-Based Foods across Several Southern European Countries: Are We Overlooking the Mediterranean Diet Recommendations? Nutrients 2021; 13:nu13051432. [PMID: 33922771 PMCID: PMC8145023 DOI: 10.3390/nu13051432] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 01/15/2023] Open
Abstract
The Mediterranean diet (MD) has been sponsored worldwide as a healthy and sustainable diet. Our aim was to update and compare MD adherence and food choices across several Southern European countries: Spain (SP), Portugal (PT), Italy (IT), Greece (GR), and Cyprus (CY) (MED, Mediterranean), and Bulgaria (BG) and the Republic of North Macedonia (NMK) (non-MED, non-Mediterranean). Participants (N = 3145, ≥18 y) completed a survey (MeDiWeB) with sociodemographic, anthropometric, and food questions (14-item Mediterranean Diet Adherence Screener, 14-MEDAS). The MED and non-MED populations showed moderate (7.08 ± 1.96) and weak (5.58 ± 1.82) MD adherence, respectively, with significant yet small differences across countries (SP > PT > GR > IT > CY > BG > NMK, p-value < 0.001). The MED participants scored higher than the non-MED ones for most of the Mediterranean-typical foods, with the greatest differences found for olive oil (OO) and white meat preference. In most countries, ≥70% of the participants reported quantities of red meat, butter, sweet drinks, and desserts below the recommended cutoff points, whereas <50% achieved the targets for plant-based foods, OO, fish, and wine. Being a woman and increasing age were associated with superior adherence (p-value < 0.001), but differences were rather small. Our results suggest that the campaigns carried out to support and reinforce the MD and to promote plant-based foods have limited success across Southern Europe, and that more hard-hitting strategies are needed.
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Affiliation(s)
- Stefano Quarta
- Laboratory of Biochemistry and Molecular Biology, Department of Biological and Environmental Sciences and Technologies, University of Salento, 73100 Lecce, Italy;
| | - Marika Massaro
- National Research Council (CNR), Institute of Clinical Physiology, 73100 Lecce, Italy;
| | - Mihail Chervenkov
- Faculty of Veterinary Medicine, University of Forestry, 1797 Sofia, Bulgaria;
- Slow Food in Bulgaria, 9 Pierre De Geytre St. bl. 3, 1113 Sofia, Bulgaria; (T.I.); (D.D.)
| | - Teodora Ivanova
- Slow Food in Bulgaria, 9 Pierre De Geytre St. bl. 3, 1113 Sofia, Bulgaria; (T.I.); (D.D.)
- Department of Plant and Fungal Diversity and Resources, Institute of Biodiversity and Ecosystem Research, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria
| | - Dessislava Dimitrova
- Slow Food in Bulgaria, 9 Pierre De Geytre St. bl. 3, 1113 Sofia, Bulgaria; (T.I.); (D.D.)
- Department of Plant and Fungal Diversity and Resources, Institute of Biodiversity and Ecosystem Research, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria
| | - Rui Jorge
- Instituto Politécnico de Santarém, Escola Superior Agraria, 2001-904 Santarém, Portugal; (R.J.); (V.A.)
- Life Quality Research Centre (CIEQV), IPSantarém/IPLeiria, 2040-413 Rio Maior, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, 2829-511 Monte de Caparica, Portugal
| | - Vanda Andrade
- Instituto Politécnico de Santarém, Escola Superior Agraria, 2001-904 Santarém, Portugal; (R.J.); (V.A.)
| | - Elena Philippou
- Department of Life and Health Sciences, School of Sciences and Engineering, University of Nicosia, Nicosia 1700, Cyprus; (E.P.); (C.Z.)
- Department of Nutritional Sciences, King’s College London, London SE1 9NH, UK
| | - Constantinos Zisimou
- Department of Life and Health Sciences, School of Sciences and Engineering, University of Nicosia, Nicosia 1700, Cyprus; (E.P.); (C.Z.)
| | - Viktorija Maksimova
- Faculty of Medical Sciences, University Goce Delcev, str. Krste Misirkov, No. 10-A, POB 201, 2000 Stip, North Macedonia; (V.M.); (K.S.); (D.G.A.); (L.M.); (T.R.)
| | - Katarina Smilkov
- Faculty of Medical Sciences, University Goce Delcev, str. Krste Misirkov, No. 10-A, POB 201, 2000 Stip, North Macedonia; (V.M.); (K.S.); (D.G.A.); (L.M.); (T.R.)
| | - Darinka Gjorgieva Ackova
- Faculty of Medical Sciences, University Goce Delcev, str. Krste Misirkov, No. 10-A, POB 201, 2000 Stip, North Macedonia; (V.M.); (K.S.); (D.G.A.); (L.M.); (T.R.)
| | - Lence Miloseva
- Faculty of Medical Sciences, University Goce Delcev, str. Krste Misirkov, No. 10-A, POB 201, 2000 Stip, North Macedonia; (V.M.); (K.S.); (D.G.A.); (L.M.); (T.R.)
| | - Tatjana Ruskovska
- Faculty of Medical Sciences, University Goce Delcev, str. Krste Misirkov, No. 10-A, POB 201, 2000 Stip, North Macedonia; (V.M.); (K.S.); (D.G.A.); (L.M.); (T.R.)
| | - Georgia Eirini Deligiannidou
- Laboratory of Hygiene and Environmental Protection, School of Medicine, Democritus University of Thrace, Dragana, 68100 Alexandroupolis, Greece; (G.E.D.); (C.A.K.)
| | - Christos A. Kontogiorgis
- Laboratory of Hygiene and Environmental Protection, School of Medicine, Democritus University of Thrace, Dragana, 68100 Alexandroupolis, Greece; (G.E.D.); (C.A.K.)
| | - Julio Sánchez-Meca
- Department of Basic Psychology & Methodology, Faculty of Psychology, University of Murcia, 30100 Murcia, Spain;
| | - Paula Pinto
- Instituto Politécnico de Santarém, Escola Superior Agraria, 2001-904 Santarém, Portugal; (R.J.); (V.A.)
- Life Quality Research Centre (CIEQV), IPSantarém/IPLeiria, 2040-413 Rio Maior, Portugal
- Correspondence: (P.P.); (M-T.G.-C.); Tel.: +34-(968)396-276 (M-T.G.-C.)
| | - María-Teresa García-Conesa
- Research Group on Quality, Safety and Bioactivity of Plant Foods, Centro de Edafología y Biología Aplicada del Segura-Consejo Superior de Investigaciones Científicas (CEBAS-CSIC), Campus de Espinardo, P.O. Box 164, 30100 Murcia, Spain
- Correspondence: (P.P.); (M-T.G.-C.); Tel.: +34-(968)396-276 (M-T.G.-C.)
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