Evaluation of food consumption and dietary patterns in Spain by the Food Consumption Survey: updated information.

BACKGROUND/OBJECTIVES: The Food Consumption Survey (FCS), conducted for over 20 years by the Spanish Ministry of Agriculture, Fisheries and Food (MARM), is the most reliable source of data to evaluate the food consumption and dietary patterns of Spain. The aim of this study was to assess population food availability per capita per day, which allows the calculation of energy and nutrient intake and comparison with the Recommended Nutrient Intakes for the Spanish population. In addition, different markers of the quality of the diet have been evaluated. SUBJECTS/METHODS: The sample consisted of consumption and distribution data, obtained from the nationwide representative FCS for the period 2000-2006. A two-stage sampling method was applied, where in the first stage the units to be sampled were towns or local entities, and in the second stage households that were going to be part of the final sample from those entities were selected. Units consisted of towns or local entities in the national territory. The sample size was 619 selected entities. Units in the second stage were households from the selected towns (8200 homes). The data allowed the calculation of energy and nutrient intakes, using food composition tables. The quality of the diet was also evaluated: the adequacy of the diet in meeting the recommended intakes for energy and nutrients; energy profile; dietary fat quality; dietary protein quality; nutrient density; and Mediterranean diet adequacy indices. The present data were compared with previous data obtained by our research group in 1964, 1981 and 1991. RESULTS: Using the most recent data, average intake comprised milk and derivatives (379 g/person/day), fruit (310 g/person/day), vegetables and greens (302 g/person/day), cereals and derivatives (214 g/person/day), meat and meat products (179 g/day), fish (100 g/person/day), oil and fat (48 g/person/day), precooked food (34 g/person/day), eggs (32 g/person/day), and legumes and pulses (11.9 g/person/day). There was also a high consumption of non-alcoholic beverages (433 g/person/day) and alcoholic beverages (247 g/person/day). In consequence, meat and meat product consumption was higher than the recommendations, whereas for cereals and their derivatives, vegetables and greens, fruit, and legumes and pulses, consumption was below recommendations for the Spanish population. Some staple and traditional Mediterranean foods (bread, potatoes and olive oil) showed a dramatic decline when compared with data from Household Budget Surveys in 1964 data. Energy intake declined by about 300 kcal/person/day, when compared with the 1964 mean consumption. Insufficient nutrient intakes were found in the young adult population for zinc and folic acid in both sexes, and for iron in women, when compared with dietary reference values. CONCLUSIONS: Food consumption patterns in Spain and energy and nutrient intakes have changed markedly in the last 40 years, differing at present from the traditional and healthy Mediterranean diet.

[Nutritional planning of menus of public schools of the community of Madrid]. / Planificación nutricional de los menús escolares para los centros públicos de la Comunidad de Madrid.

Some nutritional unbalances have been observed in menus served at dining rooms of schools from the Community of Madrid (CM): small portions, inter-day variations up to 50% of energy intake, unbalances in caloric and lipidic profiles, little variety, lack of parental information, etc. The Education Council of the CM considered necessary to plan and regulate the basic conditions that menus of these dinning rooms should meet. The Spanish Nutrition Foundation (FEN) and the Nutrition Department of the Complutense University of Madrid (UCM) were put in charge of elaborating the bases to develop the Regulation (BOCM 24-05-01, 10-09-02). Collective catering companies were called for a tender to provide menus adapted to such Regulation. This work describes the adaptation of programmed dietary schemes of officially approved companies and mainly the impact on energy and nutritional content of menus and their adaptation to the recommended caloric and lipidic profiles. So far, a random sample of 171 schools with dining rooms (more than 37,000 schoolboys) has been visited by nutritionists, with no previous announcement, to control served menus. For this, at each centre a duplicate of the portion served that day was gathered. The energy and nutrient content was determined and the fatty acid composition was analysed. The adaptation to the Regulation by catering companies has substantially improved the menus as compared to previous times: more presence of vegetables, better quality of fat and less amount of fat and proteins at the expense of carbohydrates.

Planificación nutricional de los menús escolares para los centros públicos de la Comunidad de Madrid / Nutritional planning of menus of public schools of the Community of Madrid

En los menús servidos en los comedores de los colegios públicos de la Comunidad de Madrid (CM) se venían detectando algunos desequilibrios nutricionales: cantidades insuficientes, desviaciones interdías de hasta el 50% de energía, desequilibrio en los perfiles calórico y lipídico, poca variedad, desinformación de los padres, etc. La Consejería de Educación de la CM, consideró necesario planificar y regular las condiciones básicas que deben reunir los menús para dichos comedores. La Fundación Española de la Nutrición (FEN) junto con el Departamento de Nutrición de la UCM, fueron los encargados de elaborar las bases para desarrollar la Normativa (BOCM 24-05-01, 10-09-02). Se convocó a las empresas de restauración colectiva a un concurso para el suministro de menús adaptados a dicha Normativa. En este trabajo se describe la adaptación a las pautas dietéticas programadas de las empresas homologadas y, principalmente, su repercusión en el aporte energético y nutricional de los menús así como la adecuación a los perfiles calórico y lipídico recomendados. Además, y hasta el momento, una muestra aleatoria de 171 centros, con servicio de comedor (más de 37.000 escolares), han sido visitados, sin anuncio previo de la fecha, por nutriólogos para llevar a cabo el control de los menús servidos. Para ello, en cada centro se recogió la porción duplicada del menú servido ese día. Se determinó su contenido en energía y nutrientes y se analizó su composición en ácidos grasos. La adaptación por parte de las empresas de restauración a la normativa fijada ha mejorado sustancialmente los menús respecto a periodos anteriores: mayor presencia de verduras y hortalizas, mejor calidad de la grasa y menor cantidad de grasas y proteínas a expensas de hidratos de carbono (AU)

Some nutritional unbalances have been observed in menus served at dining rooms of schools from the Community of Madrid (CM): small portions, inter-day variations up to 50% of energy intake, unbalances in caloric and lipidic profiles, little variety, lack of parental information, etc. The Education Council of the CM considered necessary to plan and regulate the basic conditions that menus of these dinning rooms should meet. The Spanish Nutrition Foundation (FEN) and the Nutrition Department of the Complutense University of Madrid (UCM) were put in charge of elaborating the bases to develop the Regulation (BOCM 24-05-01, 10-09-02). Collective catering companies were called for a tender to provide menus adapted to such Regulation. This work describes the adaptation of programmed dietary schemes of officially approved companies and mainly the impact on energy and nutritional content of menus and their adaptation to the recommended caloric and lipidic profiles. So far, a random sample of 171 schools with dining rooms (more than 37,000 schoolboys) has been visited by nutritionists, with no previous announcement, to control served menus. For this, at each centre a duplicate of the portion served that day was gathered. The energy and nutrient content was determined and the fatty acid composition was analysed. The adaptation to the Regulation by catering companies has substantially improved the menus as compared to previous times: more presence of vegetables, better quality of fat and less amount of fat and proteins at the expense of carbohydrates (AU)

Dietary patterns and their socio-demographic determinants in 10 European countries: data from the DAFNE databank.

OBJECTIVE: To describe the dietary patterns of 10 European countries and their socio-demographic determinants, using the comparable between-countries DAFNE data. DESIGN: Analysis of standardized and postharmonized data collected through the national household budget surveys. SETTING: Nationally representative surveys undertaken in 10 European countries, generally in the second half of the 1990s. RESULTS: The differences in the fruit and vegetable consumption previously identified between Mediterranean and Northern European countries seem to be leveling out, particularly in relation to fruit consumption. Pulses, however, still characterize the diet of the Mediterraneans. Straying from their traditional food choices, Mediterraneans recorded high availability of unprocessed red meat, while Central and Northern Europeans preferably consumed meat products. The household availability of beverages (alcoholic and non-alcoholic) is generally higher among Central and Northern European populations. Principal component (PC) analysis led to the identification of two dietary patterns in each of the 10 countries. The first was similar in all countries and indicated 'wide-range' food buyers. The second was slightly more varied and described 'beverage and convenience' food buyers. PC1 was common among households of retired and elderly members, while PC2 was common among households located in urban or semi-urban areas and among adult Scandinavians living alone. CONCLUSIONS: The dietary patterns identified point towards a progressive narrowing of dietary differences between North and South European countries. The comparable between-countries DAFNE data could prove useful in ecological studies, in the formulation of dietary guidelines and public health initiatives addressing specific population groups. SPONSORSHIP: European Commission.

Concentraciones plasmáticas de carotenos y vitaminas antioxidantes en personas de edad avanzada: influencia del tabaquismo. Proyecto HALE / Plasma concentrations of carotene and antioxidant vitamins in elderly people: the influence of smoking. HALE project

Introducción. Los carotenos y las vitaminas antioxidantes se asocian con un menor riesgo de aterosclerosis y enfermedad coronaria. Hay estudios que apoyan que el hábito tabáquico modifica el estado nutricional de estos micronutrientes. En este estudio se analizan las concentraciones plasmáticas de los carotenos y las vitaminas antioxidantes en varones y mujeres no fumadores, ex fumadores y fumadores. Pacientes y métodos. Se seleccionó aleatoriamente para participar en el estudio base (1988-1989) del proyecto SENECA (Survey in Europe on Nutrition and the Elderly, a Concerted Action), de la Unión Europea, a 2.200 habitantes de 19 ciudades europeas, Hamme (Bélgica), Roskilde (Dinamarca), Chateau Renault-Amboise, Haguenau y Romans (Francia), Markopoulo (Grecia), Anogia-Archanes (Creta), Monor (Hungría), Padua, Fara Sabina-Magliano y Sabina-Poggio Mirteto (Italia), Culemborg (Países Bajos), Elverum (Noruega), Vila Franca de Xila (Portugal), Betanzos (España), Yverdon-les-Bains, Burdorf y Bellinzona (Suiza), 1.091 varones y 1.109 mujeres, nacidos entre 1913 y 1918. El hábito tabáquico fue valorado usando un cuestionario estandarizado y categorizado en no fumadores, ex fumadores y fumadores. Se llevó a cabo una extracción de sangre y en laboratorios centrales determinaron los marcadores bioquímicos: concentraciones plasmáticas de carotenos, retinol y *-tocoferol con cromatografía líquida de alta presión (HPLC), y del ácido fólico mediante radioinmunoanálisis. El análisis estadístico de los datos se llevó a cabo con el programa R-SIGMA 2. Resultados. Los varones fumadores presentaron concentraciones (P50) más bajas de carotenos (0,34 µmol/l; p 30 µmol/l y cocientes de vitamina E/colesterol > 5,2 mmol/mol, con efectos protectores frente a enfermedades cardiovasculares según distintos estudios epidemiológicos entre los no fumadores que entre los fumadores. Conclusiones. A la vista de estos resultados la primera medida terapéutica debe ir dirigida al cese del consumo de tabaco. Los fumadores deberían consumir una dieta rica en frutas y vegetales con elevado contenido en vitaminas antioxidantes que les permitiera igualar el estado nutricional de estos micronutrientes al del grupo de los no fumadores

Introduction. Carotene and antioxidant vitamins are associated with lower arteriosclerotic risk and coronary disease. This association is supported by studies showing that smoking modifies the nutritional status of these micronutrients. Plasma levels of carotene and antioxidant vitamins in non-smokers, former smokers, and current smokers were analysed. Patients and methods. 2,200 elderly inhabitants 1,091 men, 1,109 women born between 1913 and 1918 of 19 European towns: Hamme (Belgium); Roskilde (Denmark); Chateau Renault-Amboise, Haguenau and Romans (France); Markopoulo (Greece); Anogia-Archanes (Crete); Monor (Hungary); Padua, Fara Sabina-Magliano Sabina-Poggio Mirteto (Italy); Culemborg (The Netherlands); Elverum (Norway); Vila Franca de Xila (Portugal); Betanzos (Spain); Yverdon-les-bains, Burdorf and Bellinzona (Switzerland) were randomly selected to participate in the baseline study (1988-1989) of the SENECA project (Survey in Europe on Nutrition and the Elderly, a Concerted Action) from the European Union. Smoking was assessed using a standardised questionnaire and categorised as-non, former and current smoker. Blood samples were collected and biochemical parameters: plasma levels of carotene, retinol and a-tocopherol by HPLC and folic acid by radioimmuno assay kits were measured at central laboratories, according to a strictly standardised methodology. Statistical analysis was perfomed out using the R-SIGMA 2 programme. Results. Male current smokers had levels (P50) of carotene (0.34 µmol/l; p < 0.001) and retinol (1.98 µmol/l; p < 0.01) lower than non-smokers (0.53; 2.0 µmol/l), respectively, whereas intermediate levels were observed in former smokers; carotene was the strongest parameter related to smoking consumption (r = -0.170; p < 0.006; Spearman). The marginal and deficient levels were less prevalent among non-smokers. a-tocopherol levels over 30 µmol/l or a-tocopherol/cholesterol ratios over 5.2 mmol/mol, with protective effects against cardiovascular disease, were more prevalent among non-smokers than current smokers. Conclusions. According to the results, smoking cessation would be the first measure advised. Current smokers, even former smokers, would require a diet rich in fruit and vegetables with a high antioxidant vitamin content, which would allow them to achieve the same nutritional status as non-smokers

Teenage girls and elderly women living in northern Europe have low winter vitamin D status.

OBJECTIVE: To determine the vitamin D status (serum 25-hydroxyvitamin D; S-25OHD) in adolescent girls and elderly community-dwelling women living in four countries of northern Europe and to explain differences in S-25OHD concentrations between and within the countries. DESIGN: A cross-sectional observational study conducted in a standardised way during February-March. S-25OHD was analysed by high-performance liquid chromatography. Vitamin D and calcium intake was calculated using a standardised food composition database. SETTING: Denmark, Finland, Ireland, and Poland. SUBJECTS: A total of 199 girls (mean (s.d.) age 12.6 (0.5) y) and 221 women (mean (s.d.) age 71.8 (1.4) y). RESULTS: The median (inter quartiles) concentration of S-25OHD was 29.4 (20.3, 38.3) nmol/l for the girls and 40.7 (28.0, 54.2) nmol/l for the women. S-25OHD below 25 nmol/l was found in 37% of the girls and 17% of the women, and S-25OHD below 50 nmol/l was found in 92% of the girls and 37% of the women. Positive significant determinants for S-25OHD in girls were use of vitamin D supplements, and in women sun habits, dietary vitamin D intake, use of vitamin D and calcium supplements. Body mass index and smoking were negative determinants in women. For women predictors could explain the differences between countries (P(country) = 0.09, R(2) = 0.39), but for girls the difference remained significant even after including predictors (P(country) = 0.03, R(2) = 0.15). CONCLUSION: Vitamin D status is low in northern Europe during winter. More than one-third of the adolescent girls have vitamin D status below 25 nmol/l and almost all are below 50 nmol/l. Two-thirds of the elderly community-dwelling women have vitamin D status below 50 nmol/l. Use of vitamin D supplements is a significant positive determinant for S-25OHD for both girls and women (P = 0.001). SPONSORSHIP: The European Fifth Framework Programme (Contract No. QLK1-CT-2000-00623).

[Age-related changes in the dietary intake of elderly individuals. The Euronut-SENECA study]. / Cambios con la edad en la ingesta dietética de personas de edad avanzada. Estudio Euronut-SENECA.

There are few longitudinal studies linking eating habits, diets, nutritional content and their repercussions on health. For this reason, the European Union's Concerted Action on Nutrition and Health, Euronut, organized an international, multi-centric longitudinal cohort study in 1988 in an attempt to analyze these factors in various food cultures of Europe. This study was given the name SENECA (Survey in Europe on Nutrition and the Elderly: a Concerted Action). To this end, several types of tests were performed: a general questionnaire (collecting information on: personal details, social and demographic status, socio-economic situation, lifestyle and physical activity and dietary or other living habits), a dietary study, anthropometric and biochemical parameters. The present paper has attempted to assess the differences due to gender and age (in the same subjects), for which purpose data has been collated from a group of individuals between 71 and 80 years of age on the quantitative and qualitative food consumption, energy and nutrient intake and their contribution to the recommended daily intake. The four groups of foods most consumed in both parts of the study were: fruit, milk and its derivatives, vegetables, and cereals and their derivatives, during the four years that have elapsed, a significant reduction was seen in the consumption of certain foods, both in the total of the sample and for the distribution by gender. As a result, with a four-year increase in age, i.e. in the second part of the study, a reduction in energy intake was observed to have a considerable impact on the intake of most micronutrients. The percentile distribution shows that there are individuals who consume very small amounts (or nothing at all) of certain foods. High percentages of individuals were seen not to cover the recommended intake.

Cambios con la edad en la ingesta dietética de personas de edad avanzada. Estudio Euronut-SENECA / Are-related changes in the dietary intake of elderly individuals. Euronutseneca study

Existen pocos estudios longitudinales que relacionen hábitos alimentarios, dietas, contenido nutricional y su repercusión en la salud. Por ello, Euronut, la Acción Concertada de la UE sobre Nutrición y Salud, organizó en 1988 un estudio longitudinal, de cohortes, internacional y multicéntrico, para tratar de analizar estos factores en diversas culturas alimentarias europeas. Este estudio recibió el nombre de SENECA (Survey in Europe on Nutrition and the Erdely: a Concerted Action). Para ello, se realizaron varios tipos de pruebas: cuestionario general (recogía información sobre: datos personales, situación sociodemográfica, situación socioeconómica, estilo de vida y actividad física y hábitos de vida y dietéticos), un estudio dietético, parámetros antropométricos y bioquímicos.En este trabajo se han tratado de valorar las diferencias debidas al sexo y la edad (en los mismos sujetos), para lo cual se recoge información sobre el consumo cuantitativo y cualitativo de alimentos, ingesta de energía y nutrientes y su aporte a las ingestas recomendadas, en un grupo de edades comprendidas entre 71 y 80 años.Los cuatro grupos de alimentos más consumidos en ambas partes del estudio fueron frutas, leche y derivados, verduras y hortalizas y cereales y derivados. En los cuatro años transcurridos se observó una disminución significativa en el consumo de algunos alimentos, tanto en el total de la muestra como en la distribución por sexos. Como consecuencia, según aumentó la edad en cuatro años, es decir, en la segunda parte del estudio, se ha observado una disminución de la ingesta energética con repercusión importante en el de la mayoría de los micronutrientes. La distribución en percentiles muestra que existen individuos sin o con un consumo muy bajo de algunos alimentos. Se observaron porcentajes elevados de personas que no cubren las ingestas recomendadas (AU)

There are few longitudinal studies linking eating habits, diets, nutritional content and their repercussions on health. For this reason, the European Union’s Concerted Action on Nutrition and Health, Euronut, organized an international, multi-centric longitudinal cohort study in 1988 in an attempt to analyze these factors in various food cultures of Europe. This study was given the name SENECA (Survey in Europe on Nutrition and the Elderly: a Concerted Action). To this end, several types of tests were performed: a general questionnaire (collecting information on: personal details, social and demographic status, socio-economic situation, lifestyle and physical activity and dietary or other living habits), a dietary study, anthropometric and biochemical parameters. The present paper has attempted to assess the differences due to gender and age (in the same subjects), for which purpose data has been collated from a group of individuals between 71 and 80 years of age on the quantitative and qualitative food consumption, energy and nutrient intake and their contribution to the recommended daily intake. The four groups of foods most consumed in both parts of the study were: fruit, milk and its derivatives, vegetables, and cereals and their derivatives, during the four years that have elapsed, a significant reduction was seen in the consumption of certain foods, both in the total of the sample and for the distribution by gender. As a result, with a four-year increase in age, i.e. in the second part of the study, a reduction in energy intake was observed to have a considerable impact on the intake of most micronutrients. The percentile distribution shows that there are individuals who consume very small amounts (or nothing at all) of certain foods. High percentages of individuals were seen not to cover the recommended intake (AU)

Selection of relevant dietary indicators for health.

OBJECTIVE: To define a set of dietary components that are relevant determinants for health in Europe. The selected components are intended to serve as nutrition indicators for health in the European Health Monitoring Programme and, as such, must be limited in number, relevant to health in Europe and practical for all involved countries with respect to data gathering and comparability of data. DESIGN: Major nutrition factors were determined by reviewing relevant epidemiological and clinical literature in nutrition and health as well as referring to reports from international expert groups, including the report from the project Nutrition and Diet for Healthy Lifestyles in Europe. The selection of factors was also based on the relative ease and cost involved for participating countries to obtain comparable and valid data. RESULTS: The selected factors include foods or food groups as well as individual nutrients. Biomarkers are suggested for selected nutrients that pose the greatest difficulty in obtaining valid and comparable data from dietary studies. CONCLUSIONS: The following list of diet indicators for health monitoring in Europe was agreed upon by the EFCOSUM group in 2001, in order of priority: vegetables, fruit, bread, fish, saturated fatty acids as percentage of energy (%E), total fat as %E, and ethanol in grams per day. Biomarkers were suggested for the following nutrients: folate, vitamin D, iron, iodine and sodium. Energy has to be assessed in order to calculate %E from total fat and saturated fatty acids.

Estudio comparativo de la ingesta dietética y de factores de riesgo cardiovascular en dos poblaciones gallegas / Comparative study of dietetic intake and of cardiovascular risk factors in two Galician villages

Objetivo: Se analizan los hábitos alimentarios y el estado nutricional, juzgado por la dieta, y su relación con parámetros clínicos, bioquímicos y antropométricos de riesgo cardiovascular, en dos poblaciones rurales gallegas: del interior (Pastoriza, Lugo) y de la costa (Fontán, La Coruña), con patrones alimentarios y estilos de vida diferentes. Diseño: Estudio transversal, observacional. Pacientes: 160 personas, elegidas al azar, con edades comprendidas entre 30 y 61 años. Metodología: Se valoraron las ingestas diarias de alimentos mediante una frecuencia de consumo y una técnica de pesada precisa individual, calculándose su contenido en nutrientes y su adecuación a las ingestas recomendadas, los perfiles calóricos y lipídico y la calidad de la grasa y de la proteína. Se analizaron parámetros antropométricos (talla, peso, índice de masa corporal), bioquímicos (colesterol total, triglicéridos, LDL-colesterol, HDL-colesterol) y clínicos (presión arterial). Se analiza la relación entre parámetros dietéticos, antropométricos, bioquímicos y clínicos de las muestras correspondientes a las dos zonas y a ambos sexos. Conclusión: Los hábitos alimentarios y de estilo de vida de la muestra residente en Pastoriza caracterizados principalmente por el mayor consumo de hidratos de carbono, procedentes de cereales, verduras y hortalizas; mayor consumo de aceite de oliva, menor ingesta de colesterol y mayor actividad física son más satisfactorios, lo que se refleja en unos valores medios bioquímicos y antropométricos más saludables, con la excepción debida al gran consumo alcohólico que pueden estar influyendo las cifras medias de presión arterial sistólica (AU)

Objective: The food habits and nutritional status was analyzed, judged through the diet and its relation to clinical, bio-chemical and anthropometric parameters of cardiovascular risk, in two Galician villages: the interior (Pastoriza, Lugo) and the coast (Fontan, A Coruña) with different food patterns and life-style. Design: Transversal-observational study. Patients: 160 people, randomly chosen, with ages ranking from 30 to 61. Methodology: The daily intake of food was valued through a consumption frequency and a precise individual weighing technique, calculating its contents in nutrients and its adequacy to recommended intake, the calorie and lipid profiles, and the quality of facts and protein.Anthropometric parameters (height, weight, body mass index), biochemical (cholesterol total, triglicerides, LDL-cholesterol, HDL-cholesterol and clinical (blood pressure) were all analyzed. The relationship between dietetic, anthropometric, biochemical and clinical parameters corresponding to the samples in the two zones and in both sexes were analyzed. Conclusion: The food habits and life-style of the sample resident in Pastoriza characterized mainly by the higher consumption of carbohydrates, from cereals, greens and vegetables; the higher consumption of olive oil, less intake of cholesterol and greater physical activity are more satisfactory, which is reflected in healthier biochemical and anthropometric average values, with the exception, due to the large consumption of alcohol that may be having an influence on the average systolic blood pressure figures (AU)

Ten-year changes in anthropometric characteristics of elderly Europeans.

OBJECTIVE: Assess longitudinal (10-y) changes in height, body weight and circumferences in elderly Europeans. DESIGN: Longitudinal assessments including baseline measurements taken in 1988/1989 which were repeated in 1993 (follow-up) and in 1999 (Finale). SETTING: Longitudinal data were collected in nine European research towns: Hamme/Belgium (H/B), Roskilde/Denmark (R/DK), Haguenau/France (H/F), Romans/France (R/F), Padua/Italy (P/I), Culemborg/the Netherlands (C/NL), Vila Franca de Xira/Portugal (V/P), Betanzos/Spain (B/E), Yverdon/Switzerland (Y/CH). SUBJECTS: Using standardised methodologies data were collected from a random stratified sample of elderly men and women born between 1913 and 1918 including a total of 662 subjects in 1999. RESULTS: On average stature had decreased by 1,5-2 cm. Mean weight changed by -2.6 kg to - 4.2 kg in only three towns. An increase of at least 5 kg of body weight had taken place in 13 % of both men and women whereas 23 % of men and 27 % women had lost at least 5 kg of their baseline weight. Such weight loss over the first 4 years of follow-up was associated with higher mortality rates in men (crude RR 2.2, p<0.0001). Serial changes in arm circumference were small but waist circumference had increased by 3-4 cm. CONCLUSIONS: Whilst small-to-modest average changes in height, body weight and circumferences emerged over SENECA's 10-year follow-up period, considerable gains and losses of body weight had occurred in a significant proportion of the SENECA populations, whereby early weight loss might be predictive of subsequent survival.

Activities of daily living in the Spanish elderly. Association with mortality.

The ability to manage basic activities of daily living (ADL) is a significant predictor for being housebound, placement in a nursing home and death. The aim of the study was to assess the capacity to perform activities of daily living in the Spanish sample (30 men and 49 women aged 80-85 y) from SENECA's Finale study (1999) and changes respect to the same sample ten years ago. The total ADL score (assessed by 16 questions) and the partials (mobility ADLm and self-care ADLc) show that the total ADL average in 1999 has been 23.9+/-10.2 (p<0.05) and 25.3+/-9.6 (p<0.001), being in 1989, 18.8+/-4.4 and 19.9+/-4.8 for men and women respectively. The ADL score from deceased subjects participating in 1989 was significantly worse (p<0.01 in men and p<0.001 in women) than ADL score from survivor subjects. Activities of daily living as a measurement of functionality decline with increasing age and in our study a better ADL score was found as survival factor.

Nutrición y salud en personas de edad avanzada en Europa. Estudio SENECA's FINALE en España. 2. Estilo de vida. Estado de salud y nutricional. Funcionalidad física y mental / Nutrition and health of the elderly persons in Europe "SENECA's FINALE" study in Spain

OBJETIVO: Se describe el estado nutricional juzgado por dieta, antropometría y bioquímica, así como el estilo de vida, salud subjetiva, capacidad física, cognitiva y estado de depresión de 33 hombres y 48 mujeres españoles, de 80 a 85 años, participantes en el estudio europeo y multicéntrico SENECA's FINALE. MATERIAL Y MÉTODO: La metodología incluía un cuestionario general sobre estilo de vida, actividad física, salud y consumo de fármacos. Se midieron peso, talla, altura de rodilla, envergadura y circunferencias corporales. Se analizaron vitamina A, E, B12, ácido fólico, carotenos, otros carotenoides y colesterol plasmáticos. Para el estudio dietético se utilizó el Mini Nutritional Assessment (MNA). La funcionalidad se valoró mediante el Physical Performance Test (PPT) y según la capacidad para realizar las actividades de la vida diaria (ADL). Se incluyeron dos cuestionarios sobre estado mental, cognitivo (Minimental State Examination; MMSE) y afectivo (Geriatric Depression Scale; GDS). RESULTADOS: Un 45,5 por ciento de los hombres y un 37,5 por ciento de las mujeres se consideraban más activos que las personas de su misma edad y un 3 por ciento y un 21 por ciento, respectivamente, con menor actividad. Un 61,7 por ciento de los hombres y un 63 por ciento de las mujeres respondieron ser menos activos que cinco años atrás. Los hombres se mostraron más optimistas al considerar su salud como buena en un 61 por ciento, y mejor que los individuos de su misma edad en un 54,5 por ciento (50 por ciento y 39,6 por ciento en las mujeres, respectivamente). Los hombres presentaron, con respecto a las mujeres, medias superiores (p< 0,001) en talla, peso (163,06 ñ 7,39 cm/ 71,82 ñ 9,03 kg y 151,09 ñ 7,02 cm/61,4 ñ 11,68 kg), envergadura (167,12 ñ 7,7 cm y 153,5 ñ 7,7 cm), altura de la rodilla (50,9 ñ 2,85 cm y 46,98 ñ 2,62 cm), circunferencia de cintura (99,42 ñ 7,98 cm y 90,8 ñ 9,85 cm) y relación cintura/cadera (0,95 ñ 0,48 y 0,87 ñ 0,0662, en hombres y mujeres, respectivamente). La prevalencia de obesidad fue del 23,4 por ciento en mujeres y del 16,7 por ciento en hombres; un 3,3 por ciento y un 6,4 por ciento, respectivamente, tenían bajo peso. Las concentraciones vitamínicas pueden considerarse satisfactorias excepto para tocoferol (54,5 por ciento de hombres y 21,15 por ciento de mujeres con deficiencias) y folatos (72,7 por ciento y 68,4 por ciento con deficiencias, respectivamente). Según el MNA (27,3 ñ 2,1 en hombres y 26,5 ñ 3,0 en mujeres), un 91,9 por ciento de los individuos gozaba de un estado nutricional óptimo y un 8 por ciento se encontraba en situación de riesgo. La funcionalidad física, juzgada por el PPT y ADL, no se diferenció entre sexos. La puntuación del MMSE fue menor (p< 0,05) en las mujeres (21,9 ñ 5,40) que en los varones (24,14 ñ 4,27) y el 31 por ciento de los hombres y el 44, por ciento de las mujeres se situaron por debajo del límite de funcionalidad cognitiva (23). Igualmente, la puntuación del GDS reflejó un estado depresivo en el 12,9 por ciento de los varones y 28,3 por ciento de las mujeres. CONCLUSIONES: En los diez años de seguimiento (1989-1999), aunque la muestra mantiene una salud y funcionalidad que le permiten gozar de cierta independencia, se observa un claro descenso en la actividad física y en el estado cognitivo (AU)

Nutrición y salud en personas de edad avanzada en Europa. Estudio SENECA's FINALE en España. 1. Objetivo, diseño y metodología / Nutrition and health of the elderly persons in Europe "SENECA's FINALE" study in Spain

OBJETIVO: El posible papel beneficioso de la dieta y el estilo de vida en la salud y la supervivencia a edades avanzadas requiere estudios multicéntricos. Con este objetivo y, ante los resultados del estudio SENECA (1989-1993), se planteó el SENECA's FINALE (1999) que pretende identificar en ocho ciudades europeas, entre ellas Betanzos (España), los factores dietéticos, de salud y estilo de vida importantes en la supervivencia y el mantenimiento de la salud de los participantes del SENECA. En este trabajo se presentan el diseño y metodología utilizados en Betanzos. MÉTODO: Se recogió información sobre el estado vital en 1999 (superviviente o muerto, fecha y causa de muerte) de los 94 hombres y 120 mujeres participantes en el estudio base del SENECA, e indicadores de salud de los supervivientes, de 80 a 85 años, recogidos según un protocolo estandarizado que incluye: un cuestionario general sobre situación sociodemográfica, estilo de vida, actividad física, relaciones sociales y salud; antropometría (peso, talla, envergadura, altura de la rodilla, circunferencias de cintura, cadera, brazo y pantorrilla); bioquímica (vitaminas A, E, carotenos, carotenoides y colesterol) y un estudio dietético basado en el Mini Nutritional Assessment. La funcionalidad física se valoró mediante el Physical Performance Test y las actividades de la vida diaria. Se incluyeron además una escala de depresión (Geriatric Depresion Scale), de estado mental (Mini Mental State Examination), y dos cuestionarios de calidad de vida y valoración del gusto, olfato y apetito. La información, codificada y almacenada en el Departamento de Nutrición Humana de la Universidad de Wageningen (Holanda), se sometió a un tratamiento estadístico local (AU)

Fruit and vegetable availability among ten European countries: how does it compare with the 'five-a-day' recommendation? DAFNE I and II projects of the European Commission.

Recasting the role of fruit and vegetables (F&V) in the diet, and planning national and international campaigns to enhance their consumption are major public health service objectives. The present study seeks to describe F&V availability patterns in ten European countries and examine compliance with current recommendations. The mean and median F&V availability (g/person per d) was estimated based on household budget survey data retrieved from the Data Food Networking (DAFNE) databank. Low F&V consumers were identified based on WHO international recommendations (minimum combined F&V intake of about 400 g/person per d) and current conservative guidelines of a minimum daily intake of three portions of vegetables and two portions of fruit. Considerable disparities in F&V availability were found among the surveyed European populations. Only in Mediterranean countries did the mean daily population intake clearly exceed combined F&V recommendations. Dietary patterns were positively skewed in all populations studied, on account of the presence of exceptionally high values among segments of the populations. Moreover, the correlation was unexpectedly weak between the proportion of low fruit and low vegetable consumers (Spearman's correlation coefficient +0.18). More than 50% of the households in the surveyed populations are likely to consume less than the recommended daily vegetable intake of three portions, and this applies even to the two Mediterranean populations. The efficiency of F&V promoting strategies may be enhanced if F&V are addressed separately; furthermore, interventions that would specifically focus on vegetables are probably needed.

Body perceptions and slimming attitudes reported by Spanish adolescents.

OBJECTIVE: To assess the relationship between body mass index (BMI) and the desire to lose weight, body parts wanted to be reduced and weight-loss practices. DESIGN: A standardized questionnaire was self-completed by the participants. Anthropometric measurements were obtained by a research assistant. SUBJECTS: Forty males and 105 females from 12 to 18 y old randomly selected from education centers in Madrid, Spain. RESULTS: Body dissatisfaction in 56% of the females and the 27% of the males was observed. In spite of the low prevalence of overweight (10% males and 6% females), many adolescents reported themselves to be overweight: more girls (27%) than boys (12.5%) (P < 0.05) by Q2 (6.26) were cognitively inclined to weight loss even though they were not overweight (body mass index, BMI > 25 kg/m2). Adolescents desired a slimming of the abdomen (82% males and 52% females), thighs (18% boys and 39% girls), hips (6% and 18% males and females, respectively) and buttocks (23% males and 42% females). Methods selected to lose weight were: physical activity or sport (73% boys and 68% girls), not to have snacks (66% girls and 23% boys), select foods with low energy content (42% boys and 37% girls), follow own diet (31% girls and 23% boys), follow medical advice (31% boys and 17% girls) and trying to be amused to forget foods (13% girls and 11% boys).

Association between trans fatty acid intake and cardiovascular risk factors in Europe: the TRANSFAIR study.

BACKGROUND: High intakes of trans fatty acids (TFA) have been found to exert an undesirable effect on serum lipid profiles, and thus may increase the risk for cardiovascular disease. OBJECTIVES: Investigation of the association between TFA intake and serum lipids. DESIGN: Cross-sectional study in eight European countries (Finland, France, Greece, Iceland, The Netherlands, Portugal, Spain, Sweden) among 327 men and 299 women (50-65 y). Using a dietary history method, food consumption was assessed and TFA intake was calculated with recent figures on TFA levels of foods, collected in the TRANSFAIR study. RESULTS: Mean (+/-s.d.) TFA intake was 2.40+/-1.53 g/day for men and 1.98+/-1.49 g/day for women (0.87+/-0.48% and 0. 95+/-0.55% of energy, respectively), with the highest consumption in Iceland and the lowest in the Mediterranean countries. No associations were found between total TFA intake and LDL, HDL or LDL/HDL ratio after adjustment for cardiovascular risk factors. Additional adjustment for other fatty acid clusters resulted in a significant inverse trend between total TFA intake and total cholesterol (Ptrend<0.03). The most abundantly occurring TFA isomer, C18:1 t, contributed substantially to this inverse association. The TFA isomers C14:1 t9, C16:1 t9 and C22:1 t were not associated or were positively associated with LDL or total cholesterol. CONCLUSIONS: From this study we conclude that at the current European intake levels of trans fatty acids they are not associated with an unfavourable serum lipid profile. SPONSORSHIP: Unilever Research Laboratorium, the Dutch Dairy Foundation on Nutrition and Health, Cargill BV, the Institute of Food Research Norwich Laboratory, the Nutrition Branch of the Ministry of Agriculture, Fisheries and Food, the International Fishmeal and Oil Manufacturers' Association, Kraft Foods, NV Vandemoortele Coordination Center, Danone Group, McDonalds Deutschland Inc, Danish Veterinary and Food Administration, Valio Ltd, Raisio Group. European Journal of Clinical Nutrition (2000) 54, 126-135

Household budget survey nutritional data in relation to mortality from coronary heart disease, colorectal cancer and female breast cancer in European countries. DAFNE I and II projects of the European Commission. Data Food Networking.

OBJECTIVE: We have undertaken a study to examine whether Household Budget Survey (HBS)-derived nutritional patterns are related to mortality from diseases with strong nutritional components, namely coronary heart disease, colorectal cancer and cancer of the female breast. DESIGN: Ecological correlation study. In the context of the Data Food Networking projects of the European Union, raw data from the national HBS of 10 European countries were provided. For each of the 10 participating countries, daily food availability per capita around 1990 was calculated. Individual foods were aggregated into 12 major food groups that were linked with the diseases under consideration. Mortality data were available from a World Health Organisation database. We have used a composite score to summarise the postulated influence of diet. SETTING: Ten European countries circa 1990. RESULTS: The correlation coefficients between the composite score and the age-adjusted mortality from each of the studied diseases were: + 0.51 (P approximately 0.14) for colorectal cancer; +0.72 (P approximately 0.02) for female breast cancer; and +0.60 (P approximately 0.07) for coronary heart disease, after adjustment for tobacco smoking. CONCLUSIONS: We conclude that dietary information from HBS is sufficiently reliable to reveal correlations with mortality rates from chronic diseases with fairly strong nutritional roots. HBS data could be used, with little cost, for monitoring secular trends in dietary patterns with a view to their health implications.

Intake of fatty acids in western Europe with emphasis on trans fatty acids: the TRANSFAIR Study.

OBJECTIVE: To assess the intake of trans fatty acids (TFA) and other fatty acids in 14 Western European countries. DESIGN AND SUBJECTS: A maximum of 100 foods per country were sampled and centrally analysed. Each country calculated the intake of individual trans and other fatty acids, clusters of fatty acids and total fat in adults and/or the total population using the best available national food consumption data set. RESULTS: A wide variation was observed in the intake of total fat and (clusters) of fatty acids in absolute amounts. The variation in proportion of energy derived from total fat and from clusters of fatty acids was less. Only in Finland, Italy, Norway and Portugal total fat did provide on average less than 35% of energy intake. Saturated fatty acids (SFA) provided on average between 10% and 19% of total energy intake, with the lowest contribution in most Mediterranean countries. TFA intake ranged from 0.5% (Greece, Italy) to 2.1% (Iceland) of energy intake among men and from 0.8% (Greece) to 1.9% among women (Iceland) (1.2-6.7 g/d and 1.7-4.1 g/d, respectively). The TFA intake was lowest in Mediterranean countries (0.5-0.8 en%) but was also below 1% of energy in Finland and Germany. Moderate intakes were seen in Belgium, The Netherlands, Norway and UK and highest intake in Iceland. Trans isomers of C18:1 were the most TFA in the diet. Monounsaturated fatty acids contributed 9-12% of mean daily energy intake (except for Greece, nearly 18%) and polyunsaturated fatty acids 3-7%. CONCLUSION: The current intake of TFA in most Western European countries does not appear to be a reason for major concern. In several countries a considerable proportion of energy was derived from SFA. It would therefore be prudent to reduce intake of all cholesterol-raising fatty acids, TFA included.