Országos Táplálkozás és Tápláltsági Állapot Vizsgálat 2014. I. A magyar felnőtt lakosság tápláltsági állapota | Hungarian Diet and Nutritional Status Survey 2014 I. Nutritional status of the Hungarian adult population

Absztrakt: Bevezetés és célkitűzés: Az Országos Táplálkozás és Tápláltsági Állapot Vizsgálat ötévenként, országos reprezentatív mintán határozza meg a felnőtt lakosság tápláltsági állapotát és táplálkozási szokásait, kiegészítve 2014 óta a fizikai aktivitás mérésével. Módszer: A felmérés azonos típusú eszközökkel végzett antropometriai mérésekkel, nemzetközi protokoll alapján valósul meg. Eredmények: A jelen vizsgálattal megegyező módszertannal zajló első adatgyűjtés 2009-ben, az Európai Lakossági Egészségfelméréshez kapcsolódva történt. A 2014-es eredmények szerint a felnőttek csaknem kétharmada túlsúlyos vagy elhízott. A férfiak 28,2%-a, a nők 31,5%-a elhízott. A morbid elhízás aránya férfiak esetén 2,6%, nők esetén 3,3%. A hasi elhízás férfiaknál ritkább, mint nőknél (38% vs. 55%), előfordulása az életkorral nő. Az idősek körében a hasi elhízás a férfiak több mint 55%-át, a nők közel 80%-át érinti. Magyarországon a túlsúly, az elhízás és a hasi elhízás előfordulása igen magas. Következtetés: Az elhízás visszaszorítása érdekében célzott beavatkozásokra, illetve az intervenciók hatékonyságának monitorozására van szükség, amelyekhez a méréseken alapuló adatok elengedhetetlenek. Orv. Hetil., 2017, 158(14), 533–540. | Abstract: Introduction and aim: The Hungarian Diet and Nutritional Status Survey examines the obesity prevalence, dietary habits and, since 2014, physical activity in Hungarian adults in every 5 years. Method: The survey provides national data representative by age and gender, based on anthropometric measurements and international standards. Results: In 2014, nearly two-thirds of adults were overweight or obese. 28.2% of men and 31.5% of women were obese. Prevalence of morbid obesity were 2.6% and 3.3% in men and women, respectively. Abdominal obesity was more prevalent among women than men (55% vs. 38%), and the rate was increasing with age in both genders. In elderly, 55% of men and almost 80% of women were abdominally obese. Conclusion: In conclusion, the prevalence of overweight, obesity, and abdominal obesity is high in Hungarian adults. In order to tackle obesity, we need to obtain representative and measured data, which form the basis of targeted interventions and the assessment of their impact. Orv. Hetil., 2017, 158(14), 533–540

Long-term impact of unhealthy food tax on consumption and the drivers behind : a longitudinal study in Hungary

Several countries have introduced public health product taxes with the objective of reducing the absolute amount of consumption of unhealthy food and tackling obesity. This study aims to estimate the long-term impact of the Hungarian public health product tax introduced in 2011. To achieve this, a unique consumer purchase dataset was analysed to examine daily fast-moving consumer goods purchases from a representative sample of 2,000 households from 2010 to 2018. The results indicate that the tax has been fully reflected in consumer prices. A decline in consumption was observed initially, consistent with previous experiences in Hungary and other countries. However, over time, the data suggests a recovery and even an increase in line with the growth of disposable income. The proportion of taxed products in total fast-moving consumer goods purchases increased from 5.9 % (95 % CI: 5.7 % to 6.0 %) in 2010 to 7.4 % (95 % CI: 7.3 % to 7.6 %) in 2018. Furthermore, the tax has contributed to increased inequality as low-income households spend a higher proportion of their total expenditure on it. Although taxes on unhealthy foods have proven effective in the short-term, they may not be adequate for reducing overall consumption in the long-term, particularly as disposable income increases. In conclusion, implementing complex interventions is necessary to achieve sustainable positive changes in dietary habits

Országos Táplálkozás és Tápláltsági Állapot Vizsgálat – OTÁP2014. III. A magyar lakosság makroelem-bevitele | Hungarian Diet and Nutritional Status Survey – OTÁP2014 III. Macroelement intake of the Hungarian population

Absztrakt: Bevezetés és célkitűzés: Az Országos Táplálkozás és Tápláltsági Állapot Vizsgálat 2014 – az Európai Lakossági Egészségfelméréshez kapcsolódva – a felnőtt magyar lakosság táplálkozási szokásait vizsgálta. E közlemény célja a makroelem-beviteli adatok bemutatása. Módszer: A felmérés a Magyarországon 2013. december 31-ig 18. életévét betöltött, nem intézményben élő lakosság makroelem-bevitelét reprezentálja. Eredmények: A magyar lakosság sóbevitele a 2009-es vizsgálathoz képest csökkent, azonban még mindig magas (férfiak: 15,9 g, nők 11,2 g). A káliumbevitel elmarad az ajánlástól, amely a magas nátriumbevitellel együttesen tovább növeli a magas vérnyomás kialakulásának kockázatát. A kalciumbevitel csak a 18–34 év közötti férfiak esetében éri el az ajánlott értéket, a legidősebb korcsoportok messze elmaradnak az ajánlásoktól. A magnéziumbevitel megfelel az ajánlásoknak, azonban a foszforbevitel, az előző vizsgálathoz hasonlóan, továbbra is csaknem kétszerese az ajánlásoknak. Következtetés: A makroelemek közül a legnagyobb népegészségügyi kockázat a minden korcsoportban megjelenő magas nátrium- (só-) bevitel. A lakosság nátriumbevitelében 2009 óta bekövetkező csökkenés azonban igazolhatja a prevenciós programok, az élelmiszeriparral történő együttműködés és következményes reformuláció, valamint a lakosság felvilágosításának hatásosságát, így ezen intézkedések további fenntartása elengedhetetlen. Orv Hetil. 2017; 158(17): 653–661. | Abstract: Introduction and aim: The Hungarian Diet and Nutritional Status Survey examined the dietary habits of the Hungarian adult population. The aim of the study is to present the macroelement intake of the population. Method: The study represents the macrolement intake of the population with age 18 or over on the day of 31 December 2013, of those who are non-institutionalised. Results: Salt intake decreased compared to the findings of the previous study in 2009 but it is still extremely high (15.9 g in men and 11.2 g in women). The potassium intake is below the recommendation, which together with a high sodium intake increases the risk of high blood pressure. Calcium intake in the youngest age group reached the recommendations, whereas the intake in the oldest age group was well below the references. Magnesium intake complied with the recommendation, the intake of phosphorus however exceeded it. High sodium intake still represents substantial public health risk. Conclusion: The reduction that occured in the population’s salt intake since 2009 demonstrates the effectiveness of implemented prevention programs, cooperation with the industry and public awareness campaigns. Orv Hetil. 2017; 158(17): 653–661

Országos Táplálkozás és Tápláltsági Állapot Vizsgálat – OTÁP2014. IV. A magyar lakosság mikroelem-bevitele | Hungarian Diet and Nutritional Status Survey – The OTAP2014 study. IV. Microelement intake of the Hungarian population

Absztrakt: Bevezetés és célkitűzés: Az Országos Táplálkozás és Tápláltsági Állapot Vizsgálat 2014 (OTÁP2014) a lakosság táplálkozási szokásait vizsgálta. Jelen közleményben öt nyomelem, a vas, a réz, a cink, a mangán és a króm napi átlagos bevitelét mutatjuk be. Módszer: A felmérés a Magyarországon 2013. december 31-ig 18. életévét betöltött, nem intézményben élő lakosság mikroelem-bevitelét reprezentálja. Eredmények: A vizsgált mikroelemek közül a férfiak vas-, réz- és mangánbevitele a magyar ajánlásoknak megfelelő volt, a nőké azonban elégtelennek mutatkozott. Kifejezetten kockázatosnak tekinthető a reproduktív korú nők ajánlástól jelentősen elmaradó vasbevitele (9,8 mg/nap). Az OTÁP2009-es vizsgálat eredményeihez képest kedvezőtlen változás a krómbevitelben bekövetkező szignifikáns csökkenés mindkét nem esetében (férfiak p = 0,000, nők p = 0,008), illetve a férfiak átlagos cinkbevitelének (9,6 mg/nap) az ajánlásban szereplő érték alá csökkenése. Következtetés: A magas nyomelemtartalmú teljes kiőrlésű gabonafélék fogyasztása hazánkban elenyésző, táplálkozás-egészségügyi szempontból előnyös lenne ezen élelmiszerek, valamint nők esetében a vasbevitelhez hozzájáruló egyéb élelmiszercsoportok (például húsok, gyümölcsfélék) fogyasztásának növelése. Nélkülözhetetlen továbbá a korszerű ajánlásoknak megfelelő táplálkozás fontosságának kommunikációja, valamint az egészséges élelmiszerekhez való hozzáférés biztosítása a teljes lakosság számára. Orv Hetil. 2017; 158(21): 803–810. | Abstract: Introduction and aim: The Hungarian Diet and Nutritional Status Survey examined the dietary habits of the Hungarian population. This publication presents the microelement intake. Method: The survey represents the microelement intake of the Hungarian non-institutionalised adult population of 18 years and older. Results: While the intake of iron, copper and manganese corresponded with the recommendations in males, in females it was insufficient. The iron intake of women in their reproductive age (9.8 mg/d) stayed well below the recommendation, thus representing a high health risk. In comparison to earlier Hungarian data chromium intake decreased significantly in both sexes (men p = 0.000, women p = 0.008) and the zinc intake of men (9.6 mg/d) decreased below recommended. Conclusion: Since the consumption of whole grain products with high microelement content in Hungary is very low, it would be favourable to increase the proportion of these foods in the diet. In case of women it is also necessary to increase the consumption of food groups (e.g. meat, fruits) contributing to the iron intake. Furthermore, communication of adequate nutrition, and the availability of healthy foods is essential for the entire population. Orv Hetil. 2017; 158(21): 803–810

Országos Táplálkozás- és Tápláltsági Állapot Vizsgálat – OTÁP2014. V. A magyar lakosság vitaminbevitele | Hungarian Diet and Nutritional Status Survey – The OTAP2014 study. V. Vitamin intake of the Hungarian population

Absztrakt: Bevezetés és célkitűzés: Az Országos Táplálkozás- és Tápláltsági Állapot Vizsgálat 2014 az előző vizsgálathoz hasonlóan az Európai Lakossági Egészségfelmérés egy kisebb almintáján valósult meg. A szerzők a jelen közleményben a magyar lakosság vitaminbevitelének adatait ismertetik. Módszer: A felmérés a Magyarországon 2013. december 31-ig a 18. életévét betöltött, nem intézményben élő lakosság vitaminbevitelét reprezentálja. Eredmények: A férfiak és a nők vitaminbevitele között jelentős eltérés állapítható meg. Férfiaknál a C-vitamin kivételével valamennyi vízben oldható vitamin bevitele nagyobb, mint a nőknél, a D- és E-vitamin esetében a különbség szignifikáns. Pozitívumnak tekinthető a lakosság ajánlásoknak megfelelő B1-, B2-, B6-, B12-, C-vitamin- és niacinbevitele, a férfiaknál azonban az előző vizsgálathoz képest csökkent az A-vitamin- és β-karotin-bevitel. Továbbra is alacsony a D-vitamin- és folsavbevitel, főleg az idősek D-vitamin-bevitele kritikusan alacsony. A biotin- és pantoténsav-bevitel sem érte el az ajánlott értéket. Következtetés: A megfelelő vitaminellátottság eléréséhez a lakosság tájékoztatása mellett nélkülözhetetlen az egészséges élelmiszer-választék elérhetővé tétele is. Orv Hetil. 2017; 158(33): 1302–1313. | Abstract: Introduction and aim: The Hungarian Diet and Nutritional Status Survey was implemented on a sub-sample of the European Health Interview Survey. In this paper, the authors present the data on the vitamin intake of the Hungarian population. Method: The survey represents the vitamin intake of the Hungarian non-institutionalised adult population of 18 years and older. There are significant differences between men’s and women’s vitamin intake. Results: The intake of all water-soluble vitamins except for vitamin C is higher in men than in women, and the difference between the genders regarding the intake of vitamin E and D is significant. The intake of vitamin B1, B2, B6, B12, niacin and vitamin C is in line with the recommendations, however, there is an unfavourable decrease in the intake of vitamin A and β-carotene in the case of men compared to the previous survey. Vitamin D and folic acid intakes are critically low, particularly in the elderly, and mainly in case of vitamin D. The population’s intake of panthotenic acid and biotin did not reach the recommendations. Conclusion: In order to reach the dietary reference intakes and to prevent deficiencies, it is necessary to inform the population and to make healthy food choices available. Orv Hetil. 2017; 158(33): 1302–1313

Országos Táplálkozás és Tápláltsági Állapot Vizsgálat – OTÁP2014. II. A magyar lakosság energia- és makrotápanyag-bevitele | Hungarian Diet and Nutritional Status Survey – OTÁP2014 II. Energy and macronutrient intake of the Hungarian population

Absztrakt: Bevezetés és célkitűzés: A vizsgálat célja a magyar felnőtt lakosság táplálkozási szokásainak, tápanyagbevitelének és ezek időbeli változásainak monitorozása. Módszer: A táplálkozási adatfelvétel háromnapos táplálkozási naplóval történt. A minta a 18 éves és a 18 évesnél idősebb lakosságot reprezentálja nem és életkor szerint. Eredmények: A magyar lakosság táplálkozásában kimutatható a túlzott zsírbevitel (38 E% férfiak, 37 E% nők), ezzel szemben a szénhidrátok energiaaránya túl kevés (45 E% férfiak, 47 E% nők), míg a fehérjebevitel megfelelő. Következtetés: Kedvezőtlen változás a 2009-es táplálkozási vizsgálathoz képest a nők zsír és telített zsírsavak energiaarányának növekedése, és mindkét nem esetén a zöldség-, gyümölcsfogyasztás csökkenése, amely utóbbi magyarázza a rostbevitel csökkenését. A hozzáadott cukor energiaaránya a 2009-es vizsgálathoz képest mindkét nem minden korosztályában növekedést mutat. Így a zöldség- és gyümölcsfogyasztás növelésére, a hozzáadott cukor és telített zsírsavak energiaarányának csökkentésére fókuszáló beavatkozások szükségesek a lakosság egészségi állapotának javítása érdekében. Orv. Hetil., 2017, 158(15), 587–597. | Abstract: Introduction and aim: The aim of the study was to assess and monitor the dietary habits and nutrient intake of Hungarian adults. Method: Three-day dietary records were used for dietary assessment, the sample was representative for the Hungarian population aged ≥18ys by gender and age. Results: The mean proportion of energy from fat was higher (men: 38 energy%, women: 37 energy%), that from carbohydrates was lower (men: 45 energy%, women: 47 energy%) than recommended, the protein intake is adequate. Conclusion: Unfavorable change compared to the previous survey in 2009 was the increase of fat and saturated fatty acid energy percent in women, the decrease in fruit and vegetable consumption, which explains the decreased fiber intake. An increasing trend in added sugar energy percent in each age groups of both genders was observed compared to 2009. Interventions focusing on the promotion of fruit and vegetable consumption and decreasing of saturated fat and added sugar intake are needed. Orv. Hetil., 2017, 158(15), 587–597

Substantial variation across geographic regions in the obesity prevalence among 6–8 years old Hungarian children (COSI Hungary 2016)

Abstract Background There have been previous representative nutritional status surveys conducted in Hungary, but this is the first one that examines overweight and obesity prevalence according to the level of urbanization and in different geographic regions among 6–8-year-old children. We also assessed whether these variations were different by sex. Methods This survey was part of the fourth data collection round of World Health Organization (WHO) Childhood Obesity Surveillance Initiative which took place during the academic year 2016/2017. The representative sample was determined by two-stage cluster sampling. A total of 5332 children (48.4% boys; age 7.54 ± 0.64 years) were measured from all seven geographic regions including urban (at least 500 inhabitants per square kilometer; n = 1598), semi-urban (100 to 500 inhabitants per square kilometer; n = 1932) and rural (less than 100 inhabitants per square kilometer; n = 1802) areas. Results Using the WHO reference, prevalence of overweight and obesity within the whole sample were 14.2, and 12.7%, respectively. According to the International Obesity Task Force (IOTF) reference, rates were 12.6 and 8.6%. Northern Hungary and Southern Transdanubia were the regions with the highest obesity prevalence of 11.0 and 12.0%, while Central Hungary was the one with the lowest obesity rate (6.1%). The prevalence of overweight and obesity tended to be higher in rural areas (13.0 and 9.8%) than in urban areas (11.9 and 7.0%). Concerning differences in sex, girls had higher obesity risk in rural areas (OR = 2.0) but boys did not. Odds ratios were 2.0–3.4 in different regions for obesity compared to Central Hungary, but only among boys. Conclusions Overweight and obesity are emerging problems in Hungary. Remarkable differences were observed in the prevalence of obesity by geographic regions. These variations can only be partly explained by geographic characteristics. Trial registration Study protocol was approved by the Scientific and Research Ethics Committee of the Medical Research Council (61158–2/2016/EKU)

Socioeconomic differences in food habits among 6- to 9-year-old children from 23 countries-WHO European Childhood Obesity Surveillance Initiative (COSI 2015/2017)

Background: Socioeconomic differences in children's food habits are a key public health concern. In order to inform policy makers, cross-country surveillance studies of dietary patterns across socioeconomic groups are required. The purpose of this study was to examine associations between socioeconomic status (SES) and children's food habits. Methods: The study was based on nationally representative data from children aged 6-9 years (n = 129,164) in 23 countries in the World Health Organization (WHO) European Region. Multivariate multilevel analyses were used to explore associations between children's food habits (consumption of fruit, vegetables, and sugar-containing soft drinks) and parental education, perceived family wealth and parental employment status. Results: Overall, the present study suggests that unhealthy food habits are associated with lower SES, particularly as assessed by parental education and family perceived wealth, but not parental employment status. We found cross-national and regional variation in associations between SES and food habits and differences in the extent to which the respective indicators of SES were related to children's diet. Conclusion: Socioeconomic differences in children's food habits exist in the majority of European and Asian countries examined in this study. The results are of relevance when addressing strategies, policy actions, and interventions targeting social inequalities in children's diets.The authors gratefully acknowledge support from a grant from the Russian Government in the context of the WHO European Office for the Prevention and Control of NCDs. Data collection in the countries was made possible through funding from Albania: WHO through the Joint Programme on Children, Food Security and Nutrition “Reducing Malnutrition in Children,” funded by the Millennium Development Goals Achievement Fund, and the Institute of Public Health; Bulgaria: Ministry of Health, National Center of Public Health and Analyses, WHO Regional Office for Europe; Croatia: Ministry of Health, Croatian Institute of Public Health and WHO Regional Office for Europe; Czechia: Ministry of Health of the Czech Republic, grant nr. AZV MZČR 17-31670 A and MZČ–VO EÚ 00023761; Denmark: Danish Ministry of Health; Georgia: WHO; Ireland: Health Service Executive; Italy: Ministry of Health and Italian National Institute of Health; Kazakhstan: Ministry of Health of the Republic of Kazakhstan and WHO Country Office; Kyrgyzstan: World Health Organization; Latvia: Ministry of Health, Centre for Disease Prevention and Control; Lithuania: Science Foundation of Lithuanian University of Health Sciences and Lithuanian Science Council and WHO; Malta: Ministry of Health; Montenegro: WHO and Institute of Public Health of Montenegro; Norway: Ministry of Health and Norwegian Institute of Public Health; Poland: National Health Programme, Ministry of Health; Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of Health, Regional Health Directorates and the kind technical support from the Center for Studies and Research on Social Dynamics and Health (CEIDSS); Romania: Ministry of Health; Russian Federation: WHO; San Marino: Health Ministry, Educational Ministry; Serbia: This study was supported by the World Health Organization (Ref. File 2015-540940); Spain: Spanish Agency for Food Safety and Nutrition (AESAN); Tajikistan: WHO Country Office in Tajikistan and Ministry of Health and Social Protection; Turkmenistan: WHO Country Office in Turkmenistan and Ministry of Health; Turkey: Turkish Ministry of Health and World Bank. The CO-CREATE project has received funding from the European Union's Horizon 2020 research and innovation program under grant agreement No. 774210.info:eu-repo/semantics/publishedVersio

Methodology and implementation of the WHO European Childhood Obesity Surveillance Initiative (COSI)

Establishment of the WHO European Childhood Obesity Surveillance Initiative (COSI)has resulted in a surveillance system which provides regular, reliable, timely, andaccurate data on children's weight status—through standardized measurement ofbodyweight and height—in the WHO European Region. Additional data on dietaryintake, physical activity, sedentary behavior, family background, and schoolenvironments are collected in several countries. In total, 45 countries in the EuropeanRegion have participated in COSI. The first five data collection rounds, between 2007and 2021, yielded measured anthropometric data on over 1.3 million children. In COSI,data are collected according to a common protocol, using standardized instrumentsand procedures. The systematic collection and analysis of these data enables inter-country comparisons and reveals differences in the prevalence of childhood thinness,overweight, normal weight, and obesity between and within populations. Furthermore,it facilitates investigation of the relationship between overweight, obesity, and poten-tial risk or protective factors and improves the understanding of the development ofoverweight and obesity in European primary-school children in order to supportappropriate and effective policy responses.The authors gratefully acknowledge support through a grant from the Russian Government in the context of the WHO European Office for the Prevention and Control of NCDs. The ministries of health of Austria, Croatia, Greece, Italy, Malta, Norway, and the Russian Federation provided financial support for the meetings at which the protocol, data collection procedures, and analyses were discussed. Data collection in countries was made possible through funding from the following: Albania: WHO through the Joint Programme on Children, Food Security and Nutrition “Reducing Malnutrition in Children,” funded by the Millennium Development Goals Achievement Fund, and the Institute of Public Health. Austria: Federal Ministry of Labor, Social Affairs, Health and Consumer Protection of Austria. Bulgaria: Ministry of Health, National Center of Public Health and Analyses, and WHO Regional Office for Europe. Bosnia and Herzegovina: WHO country office support for training and data management. Croatia: Ministry of Health, Croatian Institute of Public Health, and WHO Regional Office for Europe. Czechia: Ministry of Health of the Czech Republic, grant number 17-31670A and MZCR—RVO EU 00023761. Denmark: Danish Ministry of Health. Estonia: Ministry of Social Affairs, Ministry of Education and Research (IUT 42-2), WHO Country Office, and National Institute for Health Development. Finland: Finnish Institute for Health and Welfare. France: Santé publique France (the French Agency for Public Health). Georgia: WHO. Greece: International Hellenic University and Hellenic Medical Association for Obesity. Hungary: WHO Country Office for Hungary. Ireland: Health Service Executive. Italy: Ministry of Health. Kazakhstan: Ministry of Health of the Republic of Kazakhstan, WHO, and UNICEF. Kyrgyzstan: World Health Organization. Latvia: Ministry of Health and Centre for Disease Prevention and Control. Lithuania: Science Foundation of Lithuanian University of Health Sciences and Lithuanian Science Council and WHO. Malta: Ministry of Health. Montenegro: WHO and Institute of Public Health of Montenegro. North Macedonia: Government of North Macedonia through National Annual Program of Public Health and implemented by the Institute of Public Health and Centers of Public Health; WHO country office provides support for training and data management. Norway: the Norwegian Ministry of Health and Care Services, the Norwegian Directorate of Health, and the Norwegian Institute of Public Health. Poland: National Health Programme, Ministry of Health. Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of Health, Regional Health Directorates, and the kind technical support from the Center for Studies and Research on Social Dynamics and Health (CEIDSS). Romania: Ministry of Health. Russian Federation: WHO. San Marino: Health Ministry, Educational Ministry, and Social Security Institute and Health Authority. Serbia: WHO and the WHO Country Office (2015-540940 and 2018/873491-0). Slovakia: Biennial Collaborative Agreement between WHO Regional Office for Europe and Ministry of Health SR. Slovenia: Ministry of Education, Science and Sport of the Republic of Slovenia within the SLOfit surveillance system. Spain: Spanish Agency for Food Safety and Nutrition. Sweden: Public Health Agency of Sweden. Tajikistan: WHO Country Office in Tajikistan and Ministry of Health and Social Protection. Turkmenistan: WHO Country Office in Turkmenistan and Ministry of Health. Turkey: Turkish Ministry of Health and World Bank.info:eu-repo/semantics/publishedVersio