EUROPEAN COMMISSION DIRECTORATE-GENERAL FOR AGRICULTURE AND RURAL DEVELOPMENT Directorate C. Economics of agricultural market and single CMO C.2. Olive oil, Horticultural products Bruxelles March 14 2013 Member States meeting jointly with the Advisory Group on "Fruit and vegetables" and the SFS Experts Group School Fruit Scheme Pre school and school children's nutritional needs in Europe Margherita Caroli MD PhD on behalf of the SFS Group of experts
School age children s nutritional needs Energy Protein Fat Carbohydrates Fibers
How are children s nutritional safe intake assessed? Energy the average of the assessed energy expenditure in homogeneous groups of subjects Fat Protein max 30% of the assessed energy intake the average of the assessed need + 2 SDS Carbohydrates around 55-60% of the assessed energy intake Fibers age + 5= g of fibers/day
Pre and School age children s energy needs (Kcal/day) Age groups Moderate physical activity Average intake Kcal/day* Observed intakes Kcal/day** Males Females 4-6 1250-1575 1293-1878 1244-2342 7-10 1550-2150 1707-2463 1634-2341 11-14 2150-2775 1888-3659 1658-2658 * Human energy requirements: Report of a Joint FAO/WHO/UNU Expert Consultation. 2004 ** Lambert J, Agostoni C. et al. Dietary intake and nutritional of children and adolescents in Europe. BrJ Nutr. 2004 92 Suppl 2, S147-S211
Health situation Prevalence of overweight (incl. obesity) (%), 2007-2008 6-year-olds 7-year-olds 8-year-olds 9-year-olds 50.0 46% 40.0 38% Prevalence (%) 30.0 20.0 19% 32% 10.0 0.0 Belgium Bulgaria Czech Republic Ireland Italy Latvia Lithuania Malta Norway Portugal Slovenia Sweden Source: WHO Regional Office for Europe,. Estimate Countries Is based on the 2007 WHO Growth Reference (>+1sd). The most urgent public health issue in paediatric age in Europe is overweight control
Pre and School age children s energy needs (Kcal/day) Age groups Moderate physical activity Average intake Kcal/day* Observed intakes Kcal/day** Males Females 4-6 1250-1575 1293-1878 1244-2342 7-10 1550-2150 1707-2463 1634-2341 11-14 2150-2775 1888-3659 1658-2658 Comments The energy need is usually more than satisfied and covered among the European children. Thus, a provision of energy rich foods in schools is not necessary and could potentially be even harmful.
Pre and School age children s protein safe intake (g/day) Age groups Safe intake P g/day* Males Females Observed intakes P g/day** Males Females 4-6 17.1 16.2 38-72 38-72 7-10 11-14 25.9 40.5 26.2 41 53-85 61-118 53-85 53-88 * Protein and amino acid requirements in human nutrition: Report of a Joint FAO/WHO/UNU Expert Consultation. Geneva 2005. ** Lambert J, Agostoni C. et al. Dietary intake and nutritional of children and adolescents in Europe. BrJ Nutr. 2004 92 Suppl 2, S147-S211 Just to give an idea Food (100g) Protein content (g%) cow milk 3.6 rice 9 wheat bread 10 pasta 10 fish 20 meat steak 20 dairy products 20-35 Etc
Protein intake excess Risk of: obesity, atherosclerosis, diabetes mellitus, intestinal cancer, hypertension, renal glomerulal damage; modification of intestinal microbiota.
Pre and School age children s protein safe intake (g/day) Safe intake P g/day* Observed intakes P g/day** Age groups Males Females Males Females 4-6 17.1 16.2 38-72 38-72 7-10 25.9 26.2 53-85 53-85 11-14 40.5 41 61-118 53-88 COMMENTS The protein intake is much higher than the recommended one among the European children. In addition, the protein intake is unbalanced on the side of too much animal protein intake as compared to vegetable ones (right ratio 1:1) (Lin 2011, Whitton 2012, Italian national report COSI 2010) Thus, a provision of protein rich foods in schools is not necessary and could potentially be even harmful.
Pre and School age children s Fat safe intake (g/day) Just to give an idea Foods (100g) Fat content (g%) meat steak 3-6 cow milk 3.6 dairy products 20-35 chips 27 chocolate 36 nuts & cocoa cream 31.6 Etc
Fat excess intake: Hypercholesterolemia Hypertension Cardiovascular diseases Obesity There are no published data on the total fat intake in children across European countries. From what available it seems that the fat intake is unbalanced on the side of saturated fats. (Whitton 2012, Italian national report COSI 2010, PERISCOPE PROJECT 2010 unpublished data) Thus, a provision of fat rich foods in schools is not necessary and could potentially be even harmful.
Pre and School age children s carbohydrates safe intake 55-60 % of the recommended daily intake (fructose + glucose + sucrose + lactose) < 10-15% Just to give an idea Food (100g) CHO content (g%) Cow milk 5 Fruit 9-15 Wheat bread 60-70* Pasta/rice 80* Plain Yogurt 4 Flavored yogurt 8-12 Flavored milk 8-15 Etc *mainly starches
Preschool and school age children sugar excess intake: Risk of: Obesity Caries Diabetes mellitus From what available it seems that European children in many countries have an excess of sugar rich foods and beverages intake. (Whitton 2012, Italian national report COSI 2010, Ludwig 2005) Thus, a provision of sugar rich foods and beverages in schools is not necessary and could potentially be even harmful.
Fibers Recommended daily intake in childhood and adolescence age + 5= g of fibers/day Just to give an idea Food (100g) Fibers content (g%) Cow milk 0 Fruit 3-7 Whole bread 6.5 Vegetables 1.5-7 Legumes 7-18 Flavored yogurt 0 Flavored milk 0 Etc
Pre and School age children s fibers safe intake Insufficient intake risk of: Cancer, Obesity, Cardiovascular diseases, Diverticula. The most important source of fibers intake are fruit and vegetables. From several papers seems that European children and adolescents do not reach the recommended levels. (Pro-children, PERISCOPE, HELENA, IDEFICS, Whitton et al. 2012, Lambert et al. 2004)
RRs and 95% CI of selected cancers according to VEGETABLE and Fruit consumption. Italy, 1983-1997. Vegetables Fruit (La Vecchia et al., 1999)
Fibers Comments There is a public health and an ethical need to keep increasing fruit and vegetables intake through school programmes using adequate approaches Proposal Continuing implementing SFS using an EBM approach.
Health situation Under Article 11 health education at school must be a priority of Inter-Service public health Steering policy. It Group should Meeting be provided throughout schooling Bruxelles and should January form part 22 2013 of the curricula. There should be a particular focus on smoking, drugs, alcohol abuse, health nutrition and sex education.
Convention on the rights of the Child (resolution 44/25 of 20 November 1989) States are responsible for creating environments to protect children, as stated in the Convention on the Rights of the Child A State that has ratified the Human Rights Convention is legally obliged to implement measures toward the enjoyment of the rights, including the right to adequate food and the right to the highest attainable standard of health found in the Convention on the Rights of the Child.