Aida Turrini

Food consumption patterns in Italy: the INN-CA Study 1994-1996.

Objectives: The present study was aimed at surveying the Italian food consumption patterns in the 90s. It represented the second nationwide food intake survey that was carried out by the Istituto Nazionale di Ricerca per gli Alimenti e la Nutrizione (INRAN).Design: Cross-sectional study.Setting: Free-living households.Subjects: Sampled subjects: 1147 households randomly selected to be representative of the four main geographical areas (North-West, North-East, Centre, South). Analysed subjects: 1978 individuals out of 2734 initially collected in 15 Collaborative Centres strategically scattered through the national territory.Methods: A mixed 7-day based survey technique was applied in order to survey both individual and household consumption. At individual level, food intake was recorded by a self-compiled diary. At household level food data collection was by compilation of a food inventory by the dietician, a purchased/wasted foods diary and a recipes form both compiled by the person responsible for food related activities (decision of purchase, purchase, preparation of meals) in the household. All recorded data were monitored by the dieticians who visited the households participating in the study, at least three times. Household members were interviewed in order to collect socio-demographic, lifestyle and motivational information. Furthermore, field-workers performed the food coding and the input of data by an ad hoc developed software. The survey design allowed an internal quantitative check of food data. Several check steps were centrally performedResults: The complex methodology caused the 46.8% response rate and afterwards a reduction of the analysed units (72% of the surveyed individuals). However, the analysed sample provided sufficiently reliable data for outlining the most relevant aspects of dietary patterns in Italy. In order to better interpret the results, controversial aspects are also illustrated and discussed in the text. The disparity analysis found that traditional diversities among Italian regions are still alive. In general, males eat more than females. Analysis according to the age class (children: 1–9 years old; adolescents: 10–17; adults: 18–64; elderly: >64) showed differences especially between the group of children vs all the others, but also in the two groups of young individuals vs adults and the elderly, that could represent clues of an incorrect way of eating.Conclusions: Taking into account the different methodology, the comparison with previous results showed changes in the Italian average diet complying with an increasing attention to healthy aspects by large sectors of the population, but also opposite tendencies that should be carefully monitored.Sponsorship: Minister delle Politiche Agricole e Forestali (Mi.P.A.F.).European Journal of Clinical Nutrition (2001) 55, 571–588

Policies to promote healthy eating in Europe: a structured review of policies and their effectiveness

This review provides a classification of public policies to promote healthier eating as well as a structured mapping of existing measures in Europe. Complete coverage of alternative policy types was ensured by complementing the review with a selection of major interventions from outside Europe. Under the auspices of the Seventh Framework Programmes Eatwell Project, funded by the European Commission, researchers from five countries reviewed a representative selection of policy actions based on scientific papers, policy documents, grey literature, government websites, other policy reviews, and interviews with policy-makers. This work resulted in a list of 129 policy interventions, 121 of which were in Europe. For each type of policy, a critical review of its effectiveness was conducted, based on the evidence currently available. The results of this review indicate a need exists for a more systematic and accurate evaluation of government-level interventions as well as for a stronger focus on actual behavioral change rather than changes in attitude or intentions alone. The currently available evidence is very heterogeneous across policy types and is often incomplete.

Intake of selected nutrients from foods, from fortification and from supplements in various European countries

Background Recent European Union regulation requires setting of maximum amount of micronutrients in dietary supplements or foods taking into account the tolerable upper intake level (ULs) established by scientific risk assessment and population reference intakes. Objective To collect and evaluate recently available data on intakes of selected vitamins and minerals from conventional foods, food supplements and fortified foods in adults and children. Intake of calcium, copper, iodine, iron, magnesium, phosphorus, selenium, zinc, folic acid, niacin and total vitamin A/retinol, B6, D and E was derived from nationally representative surveys in Denmark, Germany, Finland, Ireland, Italy, the Netherlands, Poland, Spain and the United Kingdom. Intake of high consumers, defined as the 95th percentile of each nutrient, was compared to the UL. Results For most nutrients, adults and children generally consume considerably less than the UL with exceptions being retinol, zinc, iodine, copper and magnesium. The major contributor to intakes for all nutrients and in all countries is from foods in the base diet. The patterns of food supplements and voluntary fortification vary widely among countries with food supplements being responsible for the largest differences in total intakes. In the present study, for those countries with data on fortified foods, fortified foods do not significantly contribute to higher intakes for any nutrient. Total nutrient intake expressed as percentage of the UL is generally higher in children than in adults. Conclusion The risk of excessive intakes is relatively low for the majority of nutrients with a few exceptions. Children are the most vulnerable group as they are more likely to exhibit high intakes relative to the UL. There is a need to develop improved methods for estimating intakes of micronutrients from fortified foods and food supplements in future dietary surveys.

Dietary patterns and their socio-demographic determinants in 10 European countries: data from the DAFNE databank

Objective:To describe the dietary patterns of 10 European countries and their socio-demographic determinants, using the comparable between-countries DAFNE data.Design:Analysis of standardized and postharmonized data collected through the national household budget surveys.Setting:Nationally representative surveys undertaken in 10 European countries, generally in the second half of the 1990s.Results:The differences in the fruit and vegetable consumption previously identified between Mediterranean and Northern European countries seem to be leveling out, particularly in relation to fruit consumption. Pulses, however, still characterize the diet of the Mediterraneans. Straying from their traditional food choices, Mediterraneans recorded high availability of unprocessed red meat, while Central and Northern Europeans preferably consumed meat products. The household availability of beverages (alcoholic and non-alcoholic) is generally higher among Central and Northern European populations. Principal component (PC) analysis led to the identification of two dietary patterns in each of the 10 countries. The first was similar in all countries and indicated ‘wide-range’ food buyers. The second was slightly more varied and described ‘beverage and convenience’ food buyers. PC1 was common among households of retired and elderly members, while PC2 was common among households located in urban or semi-urban areas and among adult Scandinavians living alone.Conclusions:The dietary patterns identified point towards a progressive narrowing of dietary differences between North and South European countries. The comparable between-countries DAFNE data could prove useful in ecological studies, in the formulation of dietary guidelines and public health initiatives addressing specific population groups.Sponsorship:European Commission.

Isoflavone intake in four different European countries : The VENUS approach

The aim of this study was to identify the level of isoflavone intake (total isoflavones, daidzein and genistein) in four European countries: Ireland, Italy, The Netherlands and the UK. For this purpose national food composition databases of isoflavone content were created in a comparable way, using the Vegetal Estrogens in Nutrition and the Skeleton (VENUS) analytical database as a common basis, and appropriate food consumption data were selected. The isoflavone intake in Ireland, Italy, The Netherlands and the UK is on average less than 1 mg/d. Small groups of consumers of soya foods could be identified in Ireland, The Netherlands and the UK. The estimated intake levels are low compared with those found in typical Asian diets (approximately 20-100 mg/d) and also low compared with levels where physiological effects are expected (60-100 mg/d). The results (including a subgroup analysis of soya product consumers) showed that such levels are difficult to achieve with the European diets studied here.

The third Italian National Food Consumption Survey, INRAN-SCAI 2005-06--part 1: nutrient intakes in Italy

BACKGROUND AND AIMS Italian National Food Consumption Survey, INRAN-SCAI 2005-06, is the third national food consumption survey performed in Italy. This study describes energy and nutrient intakes in Italy. METHODS AND RESULTS A national cross-sectional food consumption survey was conducted using consecutive 3-day food records between October 2005 and December 2006. A sample of 3323 males and females aged 0.1-97.7 years living in private households was investigated. Individual food records were converted into energy and nutrient intakes with the use of recently updated national food composition databases. For each subject, intakes of energy and of 27 nutrients were calculated, including six minerals (i.e., iron, calcium, phosphorus, magnesium, potassium and zinc) and 10 vitamins (i.e., thiamine, riboflavin, vitamin C, vitamin B₆, retinol, β-carotene, vitamin A as retinol equivalents (REs), vitamin E, vitamin D and vitamin B₁₂. On average, 36% of calories appeared to derive from fat (11% from saturated fatty acids) and 45% from available carbohydrates (15% from soluble carbohydrates). CONCLUSIONS The results of the INRAN-SCAI 2005-06 survey in terms of nutrient intakes provide an important piece of information for nutrition surveillance of the population and may also be used to identify priorities for further research.

Intestinal and Peripheral Immune Response to MON810 Maize Ingestion in Weaning and Old Mice

This study evaluated the gut and peripheral immune response to genetically modified (GM) maize in mice in vulnerable conditions. Weaning and old mice were fed a diet containing MON810 or its parental control maize or a pellet diet containing a GM-free maize for 30 and 90 days. The immunophenotype of intestinal intraepithelial, spleen, and blood lymphocytes of control maize fed mice was similar to that of pellet fed mice. As compared to control maize, MON810 maize induced alterations in the percentage of T and B cells and of CD4(+), CD8(+), gammadeltaT, and alphabetaT subpopulations of weaning and old mice fed for 30 or 90 days, respectively, at the gut and peripheral sites. An increase of serum IL-6, IL-13, IL-12p70, and MIP-1beta after MON810 feeding was also found. These results suggest the importance of the gut and peripheral immune response to GM crop ingestion as well as the age of the consumer in the GMO safety evaluation.

Vegetable and fruit: the evidence in their favour and the public health perspective.

There is strong evidence that the intake of vegetables and fruits reduces the risk of cardiovascular disease (CVD) and is inversely associated with several forms of cancer. In contrast, information concerning specific macro- or micronutrients in relation to chronic diseases is limited and largely inconclusive. The beneficial role of vegetable and fruit consumption can also be inferred by considering the health effects of two dietary patterns, the Mediterranean and Japanese ones, in both of which the consumption of plant foods holds a prominent position. Time-trend data, retrieved from the DAFNE databank on the vegetable and fruit availability in four European countries (Greece, Ireland, Italy and Norway) indicate that, during the last decade, fruit availability decreased in Greece and Italy and increased in Ireland and Norway, whereas vegetable availability decreased only in Italy. In Greece, Italy and Norway, the daily fruit availability was higher than that of vegetables, a dietary pattern not in accordance to recommendations for higher vegetable consumption. This information, which is crucial for nutrition policies and health education, also demonstrates the value of the DAFNE surveillance system.

Assessment of the dietary exposure to non-dioxin-like PCBs of the Italian general population

The dietary intake of non-dioxin-like polychlorinated biphenyls (NDL-PCBs) has been estimated using the sum of six indicator PCBs (Sigma(6)(PCBs)) in the Italian general population. Data from a national food consumption survey were combined with the mean concentration values of the individual six indicator PCBs (IUPAC Nos. 28, 52, 101, 138, 153, and 180) in foodstuffs available on the European market. Mean concentrations were estimated from the raw data set provided by the European Commission (DG SANCO). The purpose was to describe the distribution of NDL-PCB dietary intake in the Italian population, and to investigate to what extent the variability in dietary habits may cause higher exposures to the aforesaid contaminants. Results indicated a mean dietary intake of Sigma(6)(PCBs) corresponding to 24.6, 16.1, and 10.9 ng kg-bw(-1) day(-1) for toddlers (0.5-6 years old, excluding breastfeeding), children (7-12 year old), and adults (13-94 years old), respectively. Fish and fishery products and milk and dairy products were the major contributors to the total dietary intake. The highest exposures due to variation in dietary habits were in general two-three times higher than the corresponding mean values and they were generally due to a higher fish consumption rate. The NDL-PCB dietary intake decreased with age until about 10-12 years; afterwards it appeared to remain constant. The tolerable daily intake (TDI) has not been established for these contaminants; however, action and maximum allowed levels in feeding stuffs and food recently established by the European Commission for dioxin-like PCBs could also protect consumers from exposure to NDL-PCBs.

Dietary exposure assessments for children in europe (the EXPOCHI project): rationale, methods and design.

Background/purposeThe number of dietary exposure assessment studies focussing on children is very limited. Children are however a vulnerable group due to their higher food consumption level per kg body weight. Therefore, the EXPOCHI project aims [1] to create a relational network of individual food consumption databases in children, covering different geographical areas within Europe, and [2] to use these data to assess the usual intake of lead, chromium, selenium and food colours.MethodsEXPOCHI includes 14 food consumption databases focussed on children (1-14 y old). The data are considered representative at national/regional level: 14 regions covering 13 countries. Since the aim of the study is to perform long-term exposure assessments, only data derived from 24 hr dietary recalls and dietary records recorded on at least two non-consecutive days per individual were included in the dietary exposure assessments. To link consumption data and concentration data of lead, chromium and selenium in a standardised way, categorisation of the food consumption data was based on the food categorisation system described within the SCOOP Task report 3.2.11. For food colours, the food categorisation system specified in the Council Directive 94/36/EC was used.ConclusionThe EXPOCHI project includes a pan-European long-term exposure assessment of lead, chromium, selenium and food colours among children living in 13 different EU countries. However, the different study methods and designs used to collect the data in the different countries necessitate an in-depth description of these different methods and a discussion about the resulting limitations.