Energy, macronutrients and dietary fibre intake among adults in North Macedonia

Objective: The present research aimed to estimate macronutrients intake among adults in North Macedonia and to identify their predominant food sources. Methods: Within this cross-sectional study dietary data were collected using repeated 24h recall interviews. Nationwide, adults aged 18+ were recruited. Dietary data, anthropometric measures and socio-demographic characteristics were available for 496 participants. Nutrient intake was analyzed using the Balkan Food Composition Database and Diet Assess and Plan platform. Macedonian dietary guidelines were used for estimation of inadequacy. Results: Significant differences in macronutrients intake are noticed between age groups within certain socio-demographic factors. Total sugar intake was significantly higher among young adult females comparing with those older than 25 years (p = 0.049). Young urban females have significantly higher fats intake than older participants (p = 0.038). Higher total daily energy, proteins, fats and carbohydrates intake (p = 0.033, p = 0.043, p = 0.032, p = 0.042, respectively) was noticed among young urban males when compared to older ones. Only dietary fibre intake was higher among older urban males (p = 0.030). Univariate linear regression models showed that obese participants had significantly higher relative proteins intake comparing with those having BMI within recommended range (p = 0.024, beta = 1.21). Relative carbohydrates intake was significantly lower among males (p = 0.018, beta = -2.077) and among highly educated participants (p = 0.018, beta = -4.304). Participants with tertiary education had higher relative fats intake (p = 0.012, beta = 4.213). Conclusion: Macronutrients intake of adults should be improved. There is higher intake of dietary fats and need for an increase of complex carbohydrates intake, particularly dietary fibre. Findings of this survey should be used in shaping, fine-tuning and implementing food and nutrition policies that will stimulate healthier diets for prevention of diet related non-communicable diseases

Implementation of Harmonized Food Consumption Data Collection in the Balkan Region According to the EFSA EU Menu Methodology Standards

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

Evaluation of Dietary Intake and Anthropometric Status in 1–9-Year-Old Children Living in Serbia: National Food Consumption Survey according to the EU Menu Methodology

The Serbian Food Consumption Survey among 1–9-year-old-children was conceptualized and conducted in compliance with the principles, established protocols, and guidelines of the EU Menu project between 2017 and 2021. Valid data were collected for 576 individuals (290 1–3-year-old toddlers and 276 3–9-year-old children). Regardless of age and gender category, the majority (68.80%) of children had normal weights according to the Body Mass Index-for-age classification system. The median daily energy intake was 1406.71 kcal with no differences between the settlement types. The overall median contributions of carbohydrates, protein, and fat to the total energy intake were 47.54%, 14.06%, and 37.88%, respectively. The proportions of the macronutrient intake deviated from the dietary reference values with compliance to the recommendations being particularly poor for fat and fiber. The consumption of energy-dense food groups such as meat and meat products, fat and oil, sugar, and confections was more pronounced among older children. The survey results provide a valuable insight into the nutritional status and dietary habits of toddlers and children 1–9 years old living in Serbia. They may serve as an evidence platform for public health programs, a valuable asset for decision-makers, and a reliable reference to guide nutritional policies, diet monitoring, and interventions targeting this population group in the future

Supplementary data for the article: Djekic-Ivankovic, M.; Weiler, H. A.; Nikolic, M.; Kadvan, A.; Gurinovic, M.; Mandic, L. M.; Glibetic, M. Validity of an FFQ Assessing the Vitamin D Intake of Young Serbian Women Living in a Region without Food Fortification: The Method of Triads Model. Public Health Nutr. 2016, 19 (4), 437–445. https://doi.org/10.1017/S136898001500138X

Supplementary material for: [https://doi.org/10.1017/S136898001500138X]Related to published version: [http://cherry.chem.bg.ac.rs/handle/123456789/1905

Validity of an FFQ assessing the vitamin D intake of young Serbian women living in a region without food fortification: the method of triads model

Objective: The objective of the present study was to examine the external validity of an FFQ designed to estimate dietary vitamin D intake compared with a plasma biomarker and three repeated 24 h dietary recalls in women of reproductive age in Serbia, where there is no exposure to food fortified with vitamin D. The method of triads was applied. Design: In a cross-sectional study, 422 women completed the Women and Reproductive Health FFQ (WRH-FFQ) during the winter months. From a representative subgroup (n 44), three 24 h dietary recalls and anthropometric parameters were collected as well as a fasting blood sample for vitamin D biomarker analyses. Correlation coefficients were calculated between each of the dietary methods. Validity coefficients, as a correlation between the measured and estimated 'true' exposure, were calculated using the method of triads. Bland-Altman plots were also constructed. Setting: Three major universities in Serbia. Subjects: Healthy young women (n 422) aged 18-35 years. Results: The WRH-FFQ estimate of vitamin D intake for all participants was 4.0 (SD 3.3) mu g/d and 3.1 (SD 2.3) mu g/d for the subgroup. Bland-Altman plots for these intakes showed high agreement. Validity coefficients for the FFQ, 24 h recall and biomarker were. rho(QI) = 0.847 (95 % CI 0.564, 0.928), rho(RI) = 0.810 (95 % CI 0.537, 0.997) and rho(BI) = 0.499 (95 % CI 0.190, 0.840), while the correlation coefficients were 0.686, 0.422 and 0.404. Conclusions: The FFQ applied in the present study is a valid tool for assessing dietary vitamin D intake in women living in Serbia, a region without mandatory vitamin D food fortification

Assessment of vitamin D intake among Libyan women - adaptation and validation of specific food frequency questionnaire

Vitamin D deficiency (VDD) has pandemic proportions worldwide. Numerous studies report on high prevalence of VDD in sunny regions like Near East and North Africa (NENA). Previous studies indicated that Libyan population was at risk of VDD. To contribute to the body of evidence, measurement of vitamin D status on children, adults, in Misurata region was conducted, and confirmed with validated dietary intake study. Serum 25(OH)D was analysed using electrochemiluminescence protein binding assay. Existing Food Frequency Questionnaires (FFQ) were adapted to Libyan Women Food Frequency Questionnaire (LW-FFQ). Repeated 24h dietary recalls and LW-FFQ were employed in vitamin D intake evaluation. LW-FFQ was validated using 24h dietary recall and vitamin D status as referent methods. The questionnaires included anthropometry and lifestyle information. Vitamin D status assessment revealed inadequate levels (25(OH)D lt 50nmol/l) in almost 80% of participants. Women (25-64y) were identified as the most vulnerable group with vitamin D inadequacy present in 82% (61.6% had 25(OH)D lt 25nmol/l, and 20.2% had 25-50nmol/l 25(OH)D). Average Vitamin D intake within the study sample (n=316) was 3.9 +/- 7.9 mu g/d, with 92% participants below both Institute of Medicine (IOM) (10 mu g/d) and European Food Safety Authority (15 mu g/d) recommendations. Measured vitamin D status, in 13% of this group, correlated significantly (p=0.015) with intake estimates. Based on self-report, consumption of vitamin D supplements does not exist among study participants. Additional lifestyle factors influencing vitamin D status were analysed. Only 2% of study participants spend approximately 11 min on the sun daily, 60.4% were obese, 23.1% were overweight and 71.2% reported low physical activity. These findings confirm previous reports on high prevalence of VDD in women across NENA, and in Libya. The situation calls for multi-sectoral actions and public health initiatives to address dietary and lifestyle habits

Management of food composition database harmonized with EuroFIR criteria using a web application

Web application represents a form of an innovative research tool for capacity development in food and nutrition that is otherwise not commonly exploited. A web application for food composition database (FCDB) management has been produced by the research team of the Institute for Medical Research (IMR) in Belgrade, Serbia. In this web application that was also used for development of Serbian FCDB, basic entity is food. Every food has information on names, component values, other identifiers and physical properties, standard food classifications and general food description (coded with Langual thesaurus). Related entities are recipes with all ingredients and retention factors, as well as sample information. In our previous research we identified the need for new national/regional FCDB in the Balkan region. Use of this web application in managing FCDB can provide new quality data harmonized with proposed EuroFIR guidelines. This will enable good communication and easy data interchange between different FCDBs in Europe. In addition, this web application can be a useful training tool for FCDB capacity development on national and/or regional levels and can promote knowledge, skills development and vision in food composition research, training and education

Capacity development in food and nutrition in central and Eastern Europe: A decade of achievements

This article summarizes the activities performed by the Network for Capacity Development in Nutrition in Central and Eastern Europe and Balkan countries (NCDNCEE) in the past decade. The article gives a retrospective of the achievements and challenges in building capacity in nutrition research. Recognizing the lack of capacity and incoherent nutritional situation in CEE/BC, the United Nations University (UNU), Food & Nutrition Programme and the UN Standing Committee on Nutrition (SCN) encouraged the formation of NCDNCEE in 2005, which became CAPNUTRA in 2012. The network's aim was to initiate and support tailor-made activities for capacity development in food & nutrition in research and training in CEE/BC. To identify the challenges and needs of nutrition research in the region, the network performed inventories on existence of food composition databases, food systems elements, dietary surveys, micronutrient recommendations, application of dietary assessment methods and grey literature. Further on, the network focused on the development of food composition databases and concomitant data management software, the Diet Assess & Plan platform for food consumption collection, dietary intake assessment and nutrition planning. These and other elements form the Balkan Food Platform, which underpins harmonized nutrition research in CEE/BC. Among key actions promoted by the platform are EFSA-supported dietary surveys conducted in four Balkan countries, on children and adults, in which food consumption data are collected and analysed in a harmonized way. Cooperation with FAO and active participation in international research projects enhanced the exchange of information and knowledge and brought international recognition to the CAPNUTRA network

Fueling an epidemic of non-communicable disease in the Balkans: a nutritional survey of Bosnian adults

ObjectivesDietary surveys are essential for guiding national efforts to reduce the burden of non-communicable disease, but individual-level dietary data are lacking in many low- and middle-income countries. We aimed to estimate the prevalence of inadequate and excessive intakes of specific nutrients in Bosnia and Herzegovina.MethodsA dietary survey among 853 adults using two 24-h recalls.ResultsThe majority of men (73%) and women (66%) were overweight/obese, and gt 50% of participants had elevated blood pressure. Low intakes of N-3 polyunsaturated fatty acids, specifically alpha-linolenic acid (men: 94.4mg/day among, women: 96.6mg/day) and DHA+EPA (men: 18.2mg/day, women: 16.0mg/day), low fiber intake (women: 21.5g/day), and high sodium (men: 3244mg/day, women: 2291mg/) and saturated fatty acids intakes (men: 29.2g/day) were reported. There was also a suggestion of low intakes of vitamins A, B6, C and D (in both sexes), and of riboflavin, folate, B12 and calcium (in women).ConclusionsOur findings provide initial evidence on the Bosnian population's dietary habits and identify aspects that need attention. As the survey evolves into a continuing surveillance system, it will allow evaluation of dietary changes over time