Improvement of comparability of dietary intake assessment using currently available individual food consumption surveys.
(41/804)
BACKGROUND: Food consumption data are used for monitoring dietary indicators of health. In this context, there is a need for comparable (individual) data at the European level. The preference is to perform a pan-European survey able to generate data collected on the same basis. Until this can be realized, the existing data have to be made as comparable as possible. OBJECTIVE: To identify solutions; to make existing food consumption data from nationally representative databases more comparable. METHODS: General guidelines for the comparison of food intake data using currently available data were discussed and agreed upon in the EFCOSUM project team. RESULTS AND CONCLUSIONS: Criteria were assessed with regard to the population involved, age of the survey, method of data collection, duration of the survey, the food classification system and the food composition tbl Based on these criteria, a maximum of 15 countries could provide food consumption data that can be made comparable at the individual level for the adult population. It is recommended to make data comparable at the food level, starting with vegetables (excluding potatoes), fruits (excluding fruit juices), fish (including shellfish) and bread. Comparability of foods is only possible at the 'raw edible' ingredient level. To achieve this, a large amount of work has to be undertaken. The approach of the EFG (Euro Food Groups) system is considered to be the best compromise between the different classification systems. Comparability at the nutrient level has to wait for the availability of a European Nutrient Database, like the one that is being developed within the EPIC context. (+info)
Selection of methodology to assess food intake.
(42/804)
OBJECTIVE: The aim of the EFCOSUM project was to develop a method to estimate both acute and usual consumption levels in European countries and for the sake of comparison, a common basic method for dietary assessment was needed. The method should allow a reliable comparison of the intake of relevant dietary indicators among large population groups. DESIGN AND RESULTS: The selection of methodology was based on the available literature and the expertise of the participants. To guide the selection process, decision trees containing all relevant moments of choice, alternatives and criteria for the selection of a method for food consumption measurement were developed. Considering that insight into average food and nutrient intake and their distribution in well-defined groups of individuals was important, it was decided that for the monitoring of the selected dietary indicators food consumption data should be collected at an individual level. Different methods were reviewed (24 h recall, dietary record, food frequency questionnaire, dietary history method). CONCLUSIONS: Since the 24 h recall method is applicable in large European populations of different ethnicity, has a relatively low respondent and interviewer burden, is open-ended and is cost-effective, this method can be considered as the best method for EFCOSUM to get population mean intakes and distributions for subjects aged 10 y and over in different European countries. Usual intake should be estimated by statistical modelling techniques, using two non-consecutive 24 h recalls and a food list to assess the proportion non-users for infrequently consumed foods. (+info)
Selection of a food classification system and a food composition database for future food consumption surveys.
(43/804)
OBJECTIVE: To harmonize food classification and food composition databases, allowing comparability of consumption at both food and nutrient levels in Europe. DESIGN: To establish the level of comparability at the food level, the EFCOSUM group benefited from the work already carried out within other European projects, which established a Euro Food Groups (EFG) classification system. Four food groups, ie bread, vegetables (excluding potatoes), fruits (excluding fruit juice) and fish and seafood, were judged on their applicability for making food consumption data comparable across countries at the food level. CONCLUSIONS: It was concluded that the EFG system could be used but that still much work has to be done. For food consumption data to be collected in the future, the software that will be used should enable conversion of foods 'as consumed' to foods at the 'raw edible' level. With respect to comparability of nutrient intake estimations, EFCOSUM advises waiting for the European Nutrient Composition Database (ENDB) currently being prepared by the EPIC group. Until this is available, comparison of consumption data at the nutrient level cannot be carried out between countries. (+info)
Some statistical aspects of food intake assessment.
(44/804)
OBJECTIVE: To present the results of the statistical working group of the EFCOSUM project on estimating the minimum sample size for a pan-European dietary survey. BACKGROUND AND METHODS: Numerous statistical issues are involved when planning a nutritional survey aimed at evaluating various indicators, especially if it will be carried out in different countries. The plenary workshop of the EFCOSUM project has chosen four relevant statistical topics: the sample size estimation for dietary surveys, the number of repeated measurements needed to estimate usual intake for each individual; the statistical presentation of data; and the statistical procedures for estimating the usual intake distribution from a limited number of days of observation. This article deals with the first three topics mentioned. The participants of the EFCOSUM project answered a small questionnaire in order to get agreement on the method of estimating a minimum sample size in the context of a monitoring of dietary indicators. Data on the variability of dietary indicators of interest was also collected, in order to calculate a minimum sample size. RESULTS AND CONCLUSION: The main result was that a minimum sample size of 2000 adults in each European country will be needed in order to identify trends in the mean intake of the most relevant foods and nutrients in Europe. This sample size should be higher if trends have to be indentified for socio-demographic subgroups. (+info)
Estimating the distribution of usual dietary intake by short-term measurements.
(45/804)
OBJECTIVE: To estimate the habitual dietary intake distribution in a population on the basis of repeated short-term measurements, especially of multiple 24 h diet recalls. METHODS: Six different statistical methods were evaluated and compared. The comparison referred to theoretical assumptions, admitted data transformations, statistical foundations, available software packages, and applications to real data of dietary intake. RESULTS: The Nusser method and a simplified version of it proposed in the paper have proved to be universally applicable methods for estimating the usual intake distribution for food groups and nutrients. Also, the Buck method seemed to be a robust estimation procedure suitable for the description of food consumption data, whereas the other considered methods were only applicable for log-normally distributed intake data or required a comprehensive data simulation. Characteristics of the estimated usual intake distribution were a decreased standard deviation, increased lower percentiles, and decreased upper percentiles compared to the observed sample distribution of individual means. Empirical results concerning total fat and vegetable intake in three different European consumption surveys showed that the estimated percentiles of the usual intake distribution did not depend markedly on the number of sampling days. CONCLUSIONS: Repeated short-term measurements like 24 h diet recalls can be used to describe the habitual dietary intake distribution in food consumption surveys. Recommended is a sampling design of two non-consecutive sampling days. The sampling days of all participants should be selected in such a way that they cover all seasons and days of the week. (+info)
Operationalization of food consumption surveys in Europe: recommendations from the European Food Consumption Survey Methods (EFCOSUM) Project.
(46/804)
BACKGROUND: The EFCOSUM (European Food Consumption Survey Methods) Project aims at harmonizing food consumption surveys in European countries within the perspective of an overall Public Health Monitoring Programme. Harmonization implies the need for a common framework of procedures and tools, that are applicable and feasible in all potentially interested countries. A major element in such a framework is the protocol for the operationalization of a food consumption survey, referring to all practical, logistical and material conditions that need to be fulfilled in order to guarantee a successful implementation of such a survey. OBJECTIVE: The objective of this paper was to review a number of aspects of operationalization of food consumption surveys in detail. On the basis of the currently available knowledge and experience in Europe, consensus recommendations have been elaborated for an operationalization protocol that would be feasible for all European countries. METHODS: The EFCOSUM recommendations with respect to operationalization of food consumption surveys in Europe are mainly based on three sources of information, which have been discussed at several ad hoc expert meetings: experience from previous collaborative epidemiological studies, literature searches and results of two questionnaires, distributed among representatives from 23 European countries-all experts affiliated with experienced organizations in the fields of nutrition research and related fields. RESULTS: Consensus recommendations have been set up for the following topics: sampling, recruitment, fieldwork, biomarkers, interviewer qualifications and training and quality control. These recommendations have to be considered the best achievable common denominator within Europe at this time. In a number of cases, recommendations are presented in a hierarchical way, with a gradation from first choice options towards acceptable alternatives. CONCLUSIONS: It can be concluded that a high degree of standardization of fieldwork can be achieved within Europe. A number of specific problems and constraints will have to be solved in connection with the conduction of a real survey. These problems include, amongst others, country-specific decisions on, for example, target population, detailed sampling and recruiting procedures, interview setting and support. However, on the whole, these problems can be overcome and the main recommendations presented in this paper are considered feasible for every country in Europe. Application of the EFCOSUM operationalization protocol in European countries will contribute significantly to the quality and comparability of food consumption data across Europe. It is anticipated that the policy supporting and orienting potential of this type of databases-both at the national and at the EU supranational level-will be increased accordingly. (+info)
A European food consumption survey method--conclusions and recommendations.
(47/804)
OBJECTIVE: To discuss the general outcome and conclusions of a European project (EFCOSUM); to develop a method for a European food consumption survey that delivers internationally comparable data on a set of policy relevant nutritional indicators. DESIGN AND METHODS: The EFCOSUM project was carried out within the framework of the European Health Monitoring Programme by 14 Member States as well as nine other European countries. Activities of the project included plenary sessions, desk research and working group activities, building on existing experience from such projects as DAFNE, EPIC, FLAIR Eurofoods-Enfant project, COST Action 99 and others. All participating states took part in one or more working group activities, which were discussed, adapted and finally approved in plenary sessions. RESULTS AND CONCLUSIONS: For a limited number of countries available food consumption data can be made comparable at the food intake level, but not at the nutrient level. To achieve comparability at the food intake level, a considerable amount of work still has to be done. A minimum list of dietary indicators considered to be the most relevant to be collected for the Health information exchange and monitoring system was identified. As the most suitable method to get internationally comparable new data on population means and distributions of actual intake the 24 h recall was selected, to be conducted at least twice. This also allows for the estimation of usual intake by a modelling technique that separates intra- and inter-individual intake. For a number of micronutrients the use of biomarkers is recommended. Aspects of food classification and food composition were discussed thoroughly, as well as statistical and data collection aspects. For the implementation of a pan-European survey the establishment of a European co-ordinating centre is recommended. The standardization of field work work procedures and other aspects of operationalization have been discussed in detail. It is concluded that there is broad European consensus on the most suitable method for a pan-European dietary survey for the purposes of the EU Health Monitoring Programme. It is further concluded that such a pan-European survey is feasible, if the funds are made available. (+info)
A chair on alternatives?
(48/804)
An overview is given on the legal framework in Europe for the use of experimental animals set by EU (European Union) Directive 86/609/EEC and on the activities of EU member states to implement this directive in the field of regulatory testing in animals. The significant decrease in the number of experimental animals in Germany during the past decade is described with particular reference to the recent increase that is due to transgenic animal models. From the regulatory and the animal welfare perspective the international harmonisation of test guidelines and the mutual acceptance of data are the way forward for chemical safety testing. The recent White Paper of the EU Commission for the future chemicals policy calls for an immediate increase in the number of validated in vitro toxicity tests to be accepted for regulatory purposes in the EU. In addition, deficits of properly educating young scientists in Germany in conducting animal experiments and implementing the 3-Rs concept of Russel and Burch are described. It is therefore, quite urgent to establish new chairs on animals and alternatives at universities in Europe. They should focus on both education young students of the biomedical sciences in the humane use of laboratory animals according to the 3-Rs concept and on developing new toxicity tests to be validated for regulatory purposes under the new EU chemicals policy by the established validation centres in Europe. (+info)