The Data Fd Netwrking (DAFNE) initiative EUROPEAN FOOD AVAILABILITY DATABANK BASED ON HOUSEHOLD BUDGET SURVEYS Executive Summary Reprt f the DAFNE IV prject Grant Agreement number SPC.2002336 between the Cmmissin f the Eurpean Cmmunities and the Natinal and Kapdistrian University f Athens (NKUA), Greece 1
TABLE OF CONTENTS Page List f participants 3 Intrductin The DAFNE initiative 5 The DAFNE IV prject 5 Descriptin f tasks Integrating new datasets in the DAFNE databank 7 Estimating the daily nutrient availability, using natinal HBS data 7 Cmpiling a prtcl fr cllecting infrmatin n meals taken ut f hme, in the cntext f the HBSs 8 Results Mnitring the mean daily fd availability in Eurpean cuntries 8 Mean daily nutrient availability. Estimates derived using natinal HBS data frm Greece and Germany 9 Organisatin f the prject 10 Activities f the prject 10 Disseminatin f research results 12 2
LIST OF PARTICIPANTS GREECE (crdinating centre) Prf. Trichpulu A. (c-rdinatr) Department f Hygiene and Epidemilgy, Schl f Medicine, University f Athens. Dr. Naska A. Department f Hygiene and Epidemilgy, Schl f Medicine, University f Athens. Ms. Dania P. Department f Hygiene and Epidemilgy, Schl f Medicine, University f Athens. Mr. Chlptsis Y. Department f Hygiene and Epidemilgy, Schl f Medicine, University f Athens. Mr. Fukas V. Department f Hygiene and Epidemilgy, Schl f Medicine, University f Athens. Ms. Frantzi A. Department f Hygiene and Epidemilgy, Schl f Medicine, University f Athens. Ms. Oiknmu E. Department f Hygiene and Epidemilgy, Schl f Medicine, University f Athens. Mr. Tsitas K. Department f Hygiene and Epidemilgy, Schl f Medicine, University f Athens. AUSTRIA Prf. Elmadfa I. Institute f Nutritinal Sciences, University f Vienna Mr. Freisling H. Institute f Nutritinal Sciences, University f Vienna Ms. Suchmel A. Institute f Nutritinal Sciences, University f Vienna FINLAND Dr. Berg M.A. Statistics Finland, Helsinki Dr. Pajunen A. Statistics Finland, Helsinki Dr. Hirvnen T. Natinal Public Health Institute, Helsinki 3
GERMANY Prf. Karg G. Lehrstuhl für Wirtschaftslehre des Haushalts, Technische Universität, München, TUM Dr. Gedrich K. Lehrstuhl für Wirtschaftslehre des Haushalts, Technische Universität, München, TUM Mr. Wagner K. Lehrstuhl für Wirtschaftslehre des Haushalts, Technische Universität, München, TUM PORTUGAL Dr. Vaz de Almeida M.D. Faculty f Fd and Nutritin Sciences, Prt University Ms. Rdrigues S. Faculty f Fd and Nutritin Sciences, Prt University. SWEDEN Prf. Sjöstrm M. Unit fr Preventive Nutritin, Department f Bisciences at Nvum, Karlinska Institutet Ms. Yngve A. Unit fr Preventive Nutritin, Department f Bisciences at Nvum, Karlinska Institutet Mr. Prtvliet E. Unit fr Preventive Nutritin, Department f Bisciences at Nvum, Karlinska Institutet 4
Intrductin The DAFNE initiative Since 1987, the Natinal Nutritin Center in Athens, Greece, has rganized a series f wrkshps, seminars, and research activities aiming at the develpment f the mst apprpriate way f using fd and sci-demgraphic data frm the natinal HBS. This apprach was granted financial supprt by the EC, thrugh the DAFNE I, II and III prjects, in rder t develp the methdlgy fr harmnizing the HBS data f the fllwing Eurpean cuntries: Belgium, France, Germany, Greece, Hungary, Ireland, Italy, Luxemburg, Nrway, Pland, Prtugal, Spain and the UK. In an attempt t better understand and deal with the limitatins f the HBS data, infrmatin retrieved frm the DAFNE database was used in rder t cmpare the HBS-derived fd data with thse cllected thrugh specially designed nutritin surveys (the FAIR-97-3096 prject: Cmpatibility f the husehld and individual nutritin surveys in Eurpe and disparities in fd habits ). The methdlgy was develped fr rendering the tw types f dietary data cmparable, at the level f the infrmatin cllected and cmparisns shwed that husehld budget and specially designed nutritin surveys generate bradly cmparable results. Over the years, the DAFNE databank has been recgnised as a tl t fllw-up trends in nutritinal practices; t identify ppulatin subgrups whse dietary habits are nt favurable accrding t the current scientific knwledge n the assciatin f diet and health; and t utline preventive interventins in rder t supprt cnsumer chices twards a healthy nutritin. The DAFNE IV prject The Cnsrtium f the Eurpean Fd Availability Databank based n Husehld Budget Surveys DAFNE IV prject: assembled and harmnized natinal HBS datasets frm the fllwing five EU Member States: Austria, Finland, Germany, Prtugal and Sweden. The newly harmnised datasets were incrprated in the DAFNE database, which nw frms a bank f fd data frm multiple HBSs undertaken in each f 16 Eurpean cuntries (15 EU Member States and Nrway). develped the methdlgy fr estimating the daily availability f selected nutrients, using fd data frm the natinal HBSs. The methdlgical apprach was pilt tested in Greek 5
and German data and was applied in data f the Greek HBS undertaken in 1981-82, 1987-88 and 1998-99, which are already stred in the DAFNE database. cmpiled a prtcl fr cllecting, in the cntext f the HBS, infrmatin n meals taken utside the husehld, addressing thus a limitatin in the use f HBS data fr nutritinal purpses. T better emply the ptential f the DAFNE database and t ensure an efficient disseminatin f the results, the crdinating center integrated the DAFNE data in the DafneSft, a user-friendly applicatin tl. The prgramme allws the user t mnitr dietary chices and patterns within and between cuntries and t fllw trends in fd availability in Eurpe, using data presented in tables, bars, pie charts and maps. The tl further allws fr crss-linkages f fd availability data with sci-ecnmic and demgraphic indicatrs. T ensure its efficient disseminatin, the DafneSft prgramme is directly accessible as a webbased applicatin, thrugh the website f the DAFNE crdinating centre (www.nut.ua.gr). 6
Descriptin f Tasks The tasks undertaken in the cntext f the DAFNE IV prject can be summarized in the fllwing: Integrating new datasets in the DAFNE databank Tasks 1-6 included the: management and prcessing f the raw fd, demgraphic and sci-ecnmic infrmatin cllected in the HBS f the participating cuntries dcumentatin f the HBS variables, which wuld be used in the analysis incrpratin f the raw HBS data f each participating cuntry in the central database, perating at the crdinating centre harmnizatin f the fd, and sci-demgraphic infrmatin cllected in the natinal HBSs estimatin f the average daily fd availability fr the verall ppulatin and fr ppulatin grups, defined accrding t sci-demgraphic indicatrs. incrpratin f the derived data int the perating DAFNE databank, which frms integral part f the DafneSft prgram. Estimating the daily nutrient availability, using natinal HBS data Tasks 7 and 8 aimed at develping methdlgies fr estimating the mean daily nutrient availability, using data frm natinal HBS. The cnversin f husehld fd acquisitins int nutrient availability is nt a straightfrward ne, since HBS mstly prvide data n the level f fd grups, rather than n individual fd items. Thus, fd cmpsitin data need t be adjusted. Fur different appraches were decided t address the afrementined prblem and were develped in an attempt t cver varius situatins, in terms f data availability at the cuntry level. All appraches estimate the nutrient cntent f the HBS fd cdes, but they vary in the degree f effrt their applicatin requires. The applicatin f the appraches generated tw sets f fur fd cmpsitin tables, which were used fr the analysis f the German 1998 and the Greek 1998-99 data. Fr the analysis f the Greek data, a sftware interface prgramme written in Micrsft Visual FxPr was develped at the crdinating centre. 7
The results btained frm the analysis f the German and the Greek datasets were validated thrugh cmparisns with published nutrient intake data, cllected in individual nutritin surveys undertaken in the tw cuntries. The selected apprach was applied in the 1981/82, 1987/88 and in the 1998/99 Greek HBS datasets, in rder t timely cmpare the mean daily nutrient availability in Greece. Cmpiling a prtcl fr cllecting infrmatin n meals taken ut f hme, in the cntext f the HBSs Task 9 f the prject s Technical Annex was referring t tackling the issue f lacking infrmatin n eating ut in the natinal HBSs. T initiate prcedures, an inventry was develped and disseminated in rder t elucidate the type f infrmatin n eating ut currently cllected in the HBSs f the participating cuntries. After evaluating the situatin in relatin t the currently cllected data n eating ut, participants decided n suggestins n hw t imprve the quality and the interpretability f the cllected data. These preliminary suggestins are described in detail in Annex V f the prject s final analytical reprt. Results Mnitring the mean daily fd availability in Eurpean cuntries In Annex VI f the prject s analytical reprt, tables presenting the mean availability f the 15 DAFNE fd grups by cuntry and year f survey are presented. Mean availability values by fur sci-demgraphic characteristics (lcality f the residence, husehld cmpsitin, educatin and ccupatin f the husehld head) are als presented fr each cuntry and survey year. Graphical presentatins f time changes and between cuntries differences in the daily individual fd availability are included in a glssy publicatin entitled Netwrk fr the Pan-Eurpean Fd Databank based n Husehld Budget Surveys The DAFNE IV prject. In this publicatin, disparities n the mean daily availability f fd grups with public health interest (vegetables; fruits; meat and meat prducts; milk and milk prducts; wine and beer) are presented fr all cuntries f the DAFNE netwrk. The publicatin is available in a printut frmat at the crdinating Centre s website (www.nut.ua.gr). Mean daily nutrient availability. Estimates derived using natinal HBS data frm Greece and Germany. 8
Accrding t results n the mean daily nutrient availability in the 1980s and the 1990s, the daily availability f energy and nutrients in a natinally representative sample f Greek husehlds is adequate. Fat cntributed t mre than 40% f the daily energy, with mnunsaturated fatty acids being the imprtant cntributr (22% f the energy intake). The intake f saturated fatty acids has substantially increased since the 1960s, when the first data n the diet f the Mediterraneans were cllected, and it is very clse t the upper recmmended level f 10% f ttal energy intake. The relative share f prtein t ttal energy availability is again within the ptinal range. The daily availability f sdium was als within the indicated range f 600-3500 mg/day; the availabilities f ptassium and calcium were abve the recmmendatins f 3100 and 700 mg/day, respectively. In terms f time changes, the daily availability f energy and all nutrients under study decreased in the 1990s. In terms f nutrient shares t ttal energy availability, hwever, the share f prtein, ttal fat and mnunsaturated fatty acids in particular increased, whereas the share f carbhydrates decreased. Meat, cereals, cheese and fish were imprtant prtein surces. Cereals, ptates and fruits cntributed mre than 70% f the daily carbhydrate availability. As expected, live il was identified as the main surce f lipids, fllwed by meat and cheese. The share f live il in the daily lipid availability substantially decreased in late 1980s. Part f the decrease was cmpensated by an increase in the cntributin f ther vegetable ils. The share f live il in the daily lipid availability increased in late 1990s, withut reaching, hwever, the levels f early 1980s. An increase in the share f the daily lipid availability was als nted in the case f cheese. Milk and milk prducts are imprtant cntributrs f saturated fatty acids in the Greek diet. Participants acknwledged the necessity fr a cmmn fd cmpsitin table t be used in a harmnized prcedure fr estimating nutrient availability frm HBS data. Cncerns were, hwever, expressed either in the use f the same cmpsitin data fr all the cuntries r in the magnitude f errrs that will be intrduced if different natinal tables are used. Participants als cncluded that the netwrk shuld aim t a DAFNE Fd Cmpsitin Table and nted that the utcme f running prjects related t fd cmpsitin data fr internatinal cmparisns (e.g. the EUROfir Netwrk f Excellence) will prve useful in the DAFNE nutrient estimatins. 9
Organisatin f the prject The prject was crdinated by the Department f Hygiene and Epidemilgy, Medical Schl University f Athens. Fur plenary meetings tk place in the curse f the prject and eight bilateral meetings were undertaken between the crdinating centre and the participating cuntries t address cuntry-specific prblems. Activities f the prject The new updated DAFNE sftware The DafneSft v3.0 Upn cmpletin f the DAFNE IV prject, the enlarged databank was integrated in the DafneSft applicatin tl. Sme amendments n the tl s interface, ptins and facilities were further decided. The new DafneSft is available since August 1 st, as a web-based applicatin, accessible thrugh the Crdinating Centre s website (www.nut.ua.gr). Educatin Undergraduate, Graduate and PhD studies The presentatin f the DAFNE prject frms an integral part f the prgramme f the Summer Schl EU Basics in Public Health Nutritin, rganised yearly by the Unit fr Preventive Nutritin f the Karlinska Institute. The Summer Schl is included in the curriculum f the EU Masters in Public Health Nutritin. In the cntext f the ERASMUS/SOCRATES prgramme, staff frm the Athens Crdinating Centre visited the University f Kupi, Finland and the Karlinska Institute, Sweden and presented the DAFNE initiative and the DafneSft applicatin tl t undergraduate and graduate students f nutritin and nutritinal epidemilgy. The DAFNE databank and the DafneSft tl were als presented t undergraduate students f the Department f Fd Technlgy and Bitechnlgy f the Athens Agricultural University Three members f the DAFNE team are undertaking their PhD theses in subjects related t the use f HBS data fr nutritin purpses. The titles f their theses are the fllwing: 10
- Fd and nutrient availability in Austria, based n husehld budget survey data. Alexandra Suchmel, University f Vienna, Austria - Time series analyses using German husehld budget survey data. Krnelius Wagner, TUM, Munich Germany - Trends in husehld fd and nutrient availability during the last decade (1990 2000) in Prtugal sci-demgraphic and reginal disparities in assciatin with mrtality patterns. Sara Rdrigues, University f Prt, Prtugal Participatin in the Natinal Nutritin Plicy Cmmittee f the Greek Ministry f Health and Welfare T assess the dietary habits f the Greek ppulatin and frmulate actins and measures, the Greek Natinal Nutritin Plicy Cmmittee utilized DAFNE data cllected in Greece in the 1980s and the 1990s. The assessment included evaluatin f the current situatin, identificatin f vertime changes and f sci-demgraphic characteristics that may shape fd chices. The cnclusins f the abve effrt were presented in the Cmmittee s reprt. Actins twards the enlargement and sustainability f the DAFNE databank Το ensure the cntinuity f the DAFNE initiative n expliting the HBS data and t expand the DAFNE databank, the Athens Crdinating Centre has submitted tw prpsals, which have bth been psitively evaluated. The first refers t a Supprt Actin in the cntext f Specific Measures in Supprt f Internatinal Cperatin (INCO) fr Western Balkan Cuntries (DG-RTD). The title f the prject is: The use f husehld budget survey data as a tl fr nutritin interventins in the pst-cnflict Western Balkan cuntries the Eurpean Data Fd Netwrking (DAFNE) apprach (Acrnym: DAFNE-WBC). In this prject, the DAFNE netwrk will expand t three West Balkan cuntries (Albania, Cratia, Serbia and Mntenegr). The Reginal Office fr Eurpe f the WHO will als cntribute in the analysis and interpretatin f the mnitring indicatrs. On February 8, 2005, the Athens Centre submitted a prpsal fr a C-rdinatin Actin entitled: Eating Out: Habits, Determinants, and Recmmendatins fr Cnsumers and the Eurpean Catering Sectr (Acrnym: HECTOR). The prject aims at, amng ther things, addressing the HBS limitatin f lacking data n eating ut and has been psitively evaluated 11
(scre f 28/30). The prject will get int the negtiatin phase n September 2005. Lastly, the DAFNE team is cntributing in the EFCOVAL prject, als submitted n February 8, 2005 (Full title: Eurpean Fd Cnsumptin Validatin. Acrnym: EFCOVAL). The DAFNE cntributin refers t evaluating an apprach fr cllecting harmnized dietary data at the Eurpean level, cmbining the EFCOVAL methd (24-hur recall) with the standardized HBSs. Disseminatin f research results Cntributin t the Eurpean Nutritin and Health Reprt The DAFNE team cntributed with a chapter entitled Fd availability in Eurpe. Data retrieved frm the DAFNE databank t the Eurpean Nutritin and Health Reprt. The cmpilatin f the reprt was crdinated by the Institute f Nutritin f the University f Vienna. Cmpilatin f a DAFNE pamphlet and f the third issue f the DAFNE glssy publicatins The DAFNE crdinating team designed and develped a pamphlet presenting backgrund infrmatin n the prject, a selectin f titles f DAFNE publicatins, as well as details fr the cntact pints in all cuntries f the netwrk. The pamphlet will be widely disseminated in meetings, sympsia and cnferences. Furthermre, the crdinating team cmpiled the third issue f the DAFNE glssy publicatins. All issues are available at www.nut.ua.gr fr direct dwnlading. Cmpilatin f a publicatin entitled THE DAFNE FOOD CLASSIFICATION SYSTEM: Operatinalisatin in 16 Eurpean cuntries This publicatin aims at presenting the applicatin f the DAFNE fd classificatin system in the 16 cuntries f the netwrk. The DAFNE classificatin scheme is presented in the frms f tables, specific fr each cuntry and survey year, and can serve as a basis fr the integratin f fds in a platfrm, which can cntribute in making the Eurpean fd data interperable, allwing internatinal cmparisns. 12
DAFNE wrkshp in Durban A wrkshp presenting the DAFNE prject and results, as well as the DafneSft applicatin tl is rganised t be held n September 19, 2005 in the cntext f the 18 th Internatinal Nutritin Cngress (ICC Durban, Suth Africa, 19-23 September 2005). Presentatin f DAFNE activities in a meeting f the EurFir Netwrk f Excellence. The DAFNE activities twards the develpment f a DAFNE Fd Cmpsitin Table were presented in a wrking sessin f the Eurpean Fd Infrmatin Resurce Netwrk (EurFIR), which aims at develping and integrating a cmprehensive, cherent and validated databank prviding a single, authritative surce f fd cmpsitin data in Eurpe. Scientific papers Trichpulu A, Naska A, and the DAFNE III Grup. Eurpean fd availability databank based n husehld budget surveys-the Data Fd Netwrking initiative Eur J Public Health 2003;13(3 Suppl):24-28 Trichpulu A, Naska A, Oiknmu E. The DAFNE databank: the past and the future f mnitring the dietary habits f Eurpeans J Public Health 2005;13:69-73. Naska A, Fuskakis D, Oiknmu E, Almeida MDV, Berg MA, Gedrich K, Mreiras O, Nelsn M, Trygg K, Turrini A, Remaut AM, Vlatier JL, Trichpulu A and DAFNE participants. Dietary patterns and their sci-demgraphic determinants in ten Eurpean cuntries. Data frm the DAFNE databank (Eurpean Jurnal f Clinical Nutritin, in press). Gedrich K, Naska A, Wagner K, Trichpulu A, Karg G Fd Cnsumptin Away- Frm-Hme: An Estimatin Based n German Husehld Budget Survey Data (submitted fr publicatin t the British Jurnal f Nutritin) A Pérez-Cuet, A. Naska, J. Mnterrey, A-M Remaut, M. Almanza, A. Trichpulu, P. Klsteren Mnitring fd and nutrient availability in a natinally representative sample f Blivian Husehlds (submitted t the Public Health Nutritin Jurnal). A. Trichpulu, G. Glfis, Μ. Kammenu, A. Naska. Traditinal diet and Glbalisatin: Nutritinal pririties in Greece. Iatriki 2005;87 (3):228-33 (in Greek). 13
Methdlgical apprach fr mnitring the daily nutrient availability, using the DAFNE databank (under preparatin) Cnference Presentatins Fur ral and five pster presentatins in internatinal cnferences and sympsia (The Internatinal Cnference n Health benefits f Mediterranean diet. Highlights n Cancer and Cardivascular Diseases. Crete, June 2003; The Internatinal Cnference n Pverty Fd & Health in Welfare, current issues, future perspectives. Lisbn, July 2003; The 9 th Eurpean Nutritin Cnference, Rme Octber 2003; The 3 rd Nrdic Cnference in Epidemilgy. Kupi, June 2004; The Internatinal Cnference n Traditinal Mediterranean Diet Past, Present and Future Fcusing n Olive Oil and Traditinal Fd Prducts. Athens, April 2005; The First Hellenic Cnference n cntemprary trends in fats and ils. Athens, June 2005). 14
This reprt was prduced by a cntractr fr Health & Cnsumer Prtectin Directrate General and represents the views f the cntractr r authr. These views have nt been adpted r in any way apprved by the Cmmissin and d nt necessarily represent the view f the Cmmissin r the Directrate General fr Health and Cnsumer Prtectin. The Eurpean Cmmissin des nt guarantee the accuracy f the data included in this study, nr des it accept respnsibility fr any use made theref.