Analysis of the National Adult Nutrition Survey (Ireland) and the Food4Me Nutrition Survey Databases to Explore the Development of Food Labelling Portion Sizes for the European Union

The present study set out to explore the option of developing food portion size for nutritional labelling purposes using two European Union (EU) dietary surveys. The surveys were selected as they differed in (a) methodologies (food diary versus food frequency questionnaire), (b) populations (Irish National Adult Nutrition Survey (NANS) versus a seven-country survey based on the pan EU study Food4Me), (c) food quantification (multiple options versus solely photographic album) and (d) duration (4 consecutive days versus recent month). Using data from these studies, portion size was determined for 15 test foods, where portion size was defined as the median intake of a target food when consumed. The median values of the portion sizes derived from both the NANS and Food4Me surveys were correlated (r = 0.823; p < 0.00) and the mean of the two survey data sets were compared to US values from the Recognized as Customarily Consumed (RACC) database. There was very strong agreement across all food categories between the averaged EU and the US portion size (r = 0.947; p < 0.00). It is concluded that notwithstanding the variety of approaches used for dietary survey data in the EU, the present data supports using a standardized approach to food portion size quantification for food labelling in the EU

Factores con mayor influencia sobre la elección de alimentos en la población española

Fundamentos: Encuesta poblacional dirigida a conocer los factores que influyen en la elección de los alimentos de la población española. Métodos: Análisis de una muestra de todo el territorio español compuesta por 1009 individuos y seleccionada por un procedimiento aleatorio multietápico. Este estudio corresponde a la participación española en un estudio europeo sobre las actitudes de la población frente a la alimentación, nutrición y salud dirigido por el Instituto Europeo de Estudios Nutricionales de Dublín. Se determinó el porcentaje de individuos que situó a alguno de los cinco factores mencionados con más frecuencia (calidad, precio, dieta sana, condicionantes españoles, sabor) entre las tres primeras influencias en la elección de alimentos. Se ajustó un modelo multivariante para identificar los factores asociados a la elección de una dieta sana como una de las tres primeras influencias en la alimentación.Resultados: El precio influía más en los individuos de mayor edad, en niveles socioeconómicos más bajos y en individuos con menor nivel educativo. Fue mayor el impacto del precio en las mujeres de la zona Norte, Noreste y Noroeste. El sexo, la distribución geográfica, la edad y el nivel educativo presentaron un efecto independiente y significativo sobre la importancia concedida por la población a la elección de una dieta sana. Conclusiones: Los resultados sugieren la necesidad de una mayor educación sobre dieta y salud especialmente en hombre jóvenes, personas con menor nivel educativo y mujeres del Noroeste del país

Distribution and determinants of sedentary lifestyles in the European Union

Background Many studies have shown the health burden of a sedentary lifestyle. The main goal of this study was to determine the prevalence of sedentary lifestyles in the 15 Member States of the European Union (EU) and to identify the main correlates of a sedentary lifestyle. Methods Nationally representative samples (n ≈ 1000 subjects in each country; >15 years) completed a questionnaire concerning attitudes to physical activity, body weight, and health; in total 15 239 subjects. Sedentary people were defined in two ways: (1) those expending less than 10% of their leisure time expenditure in activities involving ≥4 metabolic equivalents (MET). (2) Those who did not practice any leisure-time physical activity and who also were above the median in the number of hours spent sitting down during leisure time. Logistic regression models were fitted to analyse the association between sedentary lifestyles and gender, age, body mass index (BMI), educational level, weight change in the last 6 months, and marital and smoking status. Results Percentages of sedentary lifestyles across European countries ranged between 43.3% (Sweden) and 87.8% (Portugal) according to the first definition. According to both definitions, a lower prevalence of sedentary lifestyle was found in Northern countries (especially Scandinavian countries) as compared with Mediterranean countries, whereas the prevalence was higher among older, obese, less educated, widowed/divorced individuals, and current smokers. Similar relative differences between countries and socio-demographic groups were found independently of the method used to define a sedentary lifestyle. Conclusion Prevalence of sedentary lifestyle in the EU is high, especially among inhabitants of some Mediterranean countries, obese subjects, less-educated people, and current smokers. This high prevalence involves important public health burdens and preventive strategies are urgently needed

Perception of body image as indicator of weight status in the European union

Objective To identify the factors associated with an adequate perception of body image in relation to body weight. Material and methods An observational, cross-sectional study was conducted in a representative sample of the European Union (7155 men and 8077 women). Body Mass Index (BMI) was grouped into four categories, perceived body image was assessed using the nine silhouettes drawing scheme. A multivariable logistic regression model for each sex was used to adjust for potentially confounding variables. Results Underweight men and women classi®ed themselves better than other groups (92.9% of correct answers among men and 79.3% among women). Overall, women classi®ed themselves better than men (57.6% vs. 32.7%). Discussion Perceived body image as a method of assessment for body weight has different validity depending on sociodemographic or attitudinal categories. Perceived body image as an estimate of the nutritional status has a limited individualized application. Thus, perhaps it could be applied as a proxy measure of adiposity among slim males and among slim and overweight females, but not among the other groups

Prevalence of physical activity during leisure time in the European Union

PURPOSE: To estimate the prevalence of physical activity during leisure time in adults from the 15 member states of the European Union and the relationship with sociodemographic variables. METHODS: A representative sample, with approximately 1000 adults, aged 15 and upward, was selected from each member state to complete a questionnaire on attitudes to physical activity, body weight, and health by a face-to-face interview, summing a total of 15,239 subjects. The amount of leisure-time physical activity was quantified by assigning metabolic equivalents (METs) to each activity. Multiple linear regression models with MET-h.wk(-1) as the dependent variable were fitted. RESULTS: Northern European countries showed higher levels of physical activity than southern ones. The highest prevalence (91.9%) was found in Finland, and the lowest (40.7%) in Portugal. A higher percentage of men practiced any leisure-time physical activity and also showed higher mean of MET-h.wk(-1). In both genders, the multivariate models showed a significant trend to higher leisure time activity in participants with higher educational levels and in nonsmokers. Also, an inverse association between body mass index and leisure-time physical activity was found. CONCLUSION: The prevalence of any physical activity during leisure time in the adult European population was similar to the U.S. estimates. Nevertheless, the amount of activity is low, and a wide disparity between countries exists. To our knowledge, this is the first study determining the prevalence and amount of leisure-time physical activity, which is the first step to define strategies to persuade populations to increase their physical activity

Percepción de la imagen corporal como aproximación cualitativa al estado de nutrición

Objetivo. Comparar la percepción de la imagen corporal con el índice de masa corporal (IMC) calculado a partir del peso y la talla declarados por los sujetos y valorar su capacidad para clasificar el estado de nutrición. Material y métodos. Se eligió una muestra representativa de la población de España, integrada por 517 hombres y 483 mujeres mayores de 15 años. Las variables fueron sexo, edad, nivel educativo, IMC e imagen corporal percibida. Las diferencias entre grupos se estimaron con la prueba de c2. La capacidad de clasificación de la imagen corporal se comparó con el IMC empleando la sensibilidad y la especificidad. Resultados. El estado nutricional para ambos indicadores mostró mayor sobrepeso en hombres y mayor obesidad en mujeres. Se observó que el sobrepeso y la obesidad se incrementan conforme aumenta la edad, y con mayor educación disminuyen. La percepción de la imagen corporal fue distinta entre sexos, así como por edad y nivel educativo (p<0.01). La comparación entre el IMC y la imagen corporal notificó valores superiores a 0.90 para sensibilidad y especificidad, así como para los valores predictivos positivos y negativos en sujetos que presentaron un estado nutricional que alcanzaba los rangos extremos. La precisión fue mayor para la sensibilidad que para la especificidad. La capacidad de clasificación fue mejor en mujeres que en hombres. La correlación de Spearman fue mayor en mujeres que en hombres (p<0.001) y la concordancia W de Kendall notificó valores altos para ambos sexos. Conclusiones. La percepción de la imagen corporal permitió identificar a los sujetos que presentaban nutrición normal y deficiente o excesiva; por tal motivo, este indicador puede resultar útil en estudios epidemiológicos, aunque tiene algunas limitaciones para diagnósticos individuales

Sources of information on healthy eating in a mediterranean country and the level of trust in them: a national sample in a pan-european survey

Objetivos: Determinar las fuentes de información y el nivel de confianza en las fuentes de información sobre dieta sana en la población española, para facilitar la promoción de hábitos dietéticos sanos. Pacientes y métodos: Análisis de una muestra representativa española de adultos mayores de 15 años compuesta por 1009 individuos y seleccionada por un procedimiento aleatorio multietápico. Este estudio corresponde a la participación española en un estudio europeo multicéntrico coordinado por el Instituto Europeo de Estudios Nutricionales (IEFS) de Dublín. Se preguntó a cada individuo por las fuentes de las que procedía su información sobre dieta sana y su nivel de confianza en ellas. Se analizaron las cinco fuentes más frecuentemente mencionadas. Resultados: La fuente de información más citada y de mayor confianza fueron los "profesionales sanitarios". Aproximadamente, el 26% de los encuestados mencionaron a los "profesionales sanitarios" como su fuente de información acerca de la dieta sana. Sin embargo, la "radio/TV" (25,7%) fue casi tan seleccionada como los "profesionales sanitarios". Alrededor del 17,4% de los individuos declaró que no obtenía información sobre dieta sana. Los individuos con nivel de estudios universitarios citó con mayor frecuencia a los "profesionales sanitarios", mientras que los sujetos de nivel socio-económico elevado prefirieron la "radio/TV". El grado de confianza fue mayor para los mensajes obtenidos de los "profesionales sanitarios" (89,9%) y del "Departamento de Sanidad" (78,7%) y menor en el caso de la información obtenida de los "periódicos" (34,2%) y de los "anuncios publicitarios" (17,6%). Conclusión: Los profesionales sanitarios deben promover las guías dietéticas a través de los canales adecuados para lograr que lleguen a los diferentes grupos de individuos.Objeclive: To know the sources of information and the level of trust in these sources in a population to facilitate the promotion of healthy dietary habits. Palienls and methods: A national survey was carried out according to an established protocol on a representative sample of 1009 Spanish subjects over 15 years of age selected by a random multietapic procedure. This study belongs to the Spanish partnership in a pan-European Survey about sources of information on healthy eating and their level of trust The analysis was focussed on the evaluation of the 5 most frequently chosen sources. Results: There was a trend towards a greater use and trust in "Health professionals" !han other sources. Thus, about 26% of the respondents mentioning "health professionals" as the source of information on healthy eating_ However, "TV/radio" (25.7%) was almos! so often selected as "Health professionals". About 17.4% of subjects declared that they obtained no information at all on healthy eating. Subjects with university level of studies exhibited a greater mention of "Health professionals", while individuals belonging to higher socio-economic levels preferred "TV/radio". The degree of trust was higher for messages obtained from "Health professionals" (89.9%) and the "Department of Health" (78.7%) and lower for information obtained from "newspaper" (34.2%) and "advertising" (17.6%). Conclusion: Nutrition and health educators must pro-J mote dietary guidelines through the appropriate channels for communicating messages to difieren! targets groups

Association between diet-quality scores, adiposity, total cholesterol and markers of nutritional status in European adults: findings from the Food4Me study

Diet-quality scores (DQS), which are developed across the globe, are used to define adherence to specific eating patterns and have been associated with risk of coronary heart disease and type-II diabetes. We explored the association between five diet-quality scores (Healthy Eating Index, HEI; Alternate Healthy Eating Index, AHEI; MedDietScore, MDS; PREDIMED Mediterranean Diet Score, P-MDS; Dutch Healthy Diet-Index, DHDI) and markers of metabolic health (anthropometry, objective physical activity levels (PAL), and dried blood spot total cholesterol (TC), total carotenoids, and omega-3 index) in the Food4Me cohort, using regression analysis. Dietary intake was assessed using a validated Food Frequency Questionnaire. Participants (n = 1480) were adults recruited from seven European Union (EU) countries. Overall, women had higher HEI and AHEI than men (p < 0.05), and scores varied significantly between countries. For all DQS, higher scores were associated with lower body mass index, lower waist-to-height ratio and waist circumference, and higher total carotenoids and omega-3-index (p trends < 0.05). Higher HEI, AHEI, DHDI, and P-MDS scores were associated with increased daily PAL, moderate and vigorous activity, and reduced sedentary behaviour (p trend < 0.05). We observed no association between DQS and TC. To conclude, higher DQS, which reflect better dietary patterns, were associated with markers of better nutritional status and metabolic health

Analysis of dietary pattern impact on weight status for personalised nutrition through on-line advice: The food4Me Spanish cohort

Obesity prevalence is increasing. The management of this condition requires a detailed analysis of the global risk factors in order to develop personalised advice. This study is aimed to identify current dietary patterns and habits in Spanish population interested in personalised nutrition and investigate associations with weight status. Self-reported dietary and anthropometrical data from the Spanish participants in the Food4Me study, were used in a multidimensional exploratory analysis to define specific dietary profiles. Two opposing factors were obtained according to food groups’ intake: Factor 1 characterised by a more frequent consumption of traditionally considered unhealthy foods; and Factor 2, where the consumption of “Mediterranean diet” foods was prevalent. Factor 1 showed a direct relationship with BMI (β = 0.226; r2 = 0.259; p < 0.001), while the association with Factor 2 was inverse (β = −0.037; r2 = 0.230; p = 0.348). A total of four categories were defined (Prudent, Healthy, Western, and Compensatory) through classification of the sample in higher or lower adherence to each factor and combining the possibilities. Western and Compensatory dietary patterns, which were characterized by high-density foods consumption, showed positive associations with overweight prevalence. Further analysis showed that prevention of overweight must focus on limiting the intake of known deleterious foods rather than exclusively enhance healthy products

Self-efficacy, habit strength, health locus of control and response to the personalised nutrition Food4Me intervention study

YesPurpose – Randomised controlled trials identify causal links between variables but not why an outcome has occurred. This analysis sought to determine how psychological factors assessed at baseline influenced response to personalised nutrition. Design/methodology/approach – Web-based, randomised, controlled trial (RCT) was conducted across seven European countries. Volunteers, both male and female, aged over 18 years were randomised to either a non-personalised (control) or a personalised (treatment) dietary advice condition. Linear mixed model analysis with fixed effects was used to compare associations between internal and external health locus of control (HLoC), nutrition self-efficacy (NS-E) and self-report habit index (S-RHI) at baseline (N 5 1444), with healthy eating index (HEI) and Mediterranean diet index (MDI) scores between conditions post-intervention (N 5 763). Findings – An increase in MDI scores was observed between baseline and six months in the treatment group which was associated with higher NS-E (pEU FP7 Project “Personalised nutrition: an integrated analysis of opportunities and challenges” (Contract No. KBBE. 2010.2.3–02, Project No. 265494