National nutrition surveys in Europe: a review on the current status in the 53 countries of the WHO European region

Abstract

Objectives: The objectives of this study were (1) to determine the coverage of national nutrition surveys in the 53 countries monitored by the World Health Organization (WHO) Regional Office for Europe and identify gaps in provision, (2) to describe relevant survey attributes and (3) to check whether energy and nutrients are reported with a view to providing information for evidence-based nutrition policy planning.

Design: Dietary survey information was gathered using three methods: (1) direct email to survey authors and other relevant contacts, (2) systematic review of literature databases and (3) general web-based searches. Survey characteristics relating to time frame, sampling and dietary methodology and nutrients reported were tabled from all relevant surveys found since 1990.

Setting: Fifty-three countries of the WHO Regional Office for Europe, which have need for an overview of dietary surveys across the life course.

Subjects: European individuals (adults and children) in national diet surveys.

Results: A total of 109 nationally representative dietary surveys undertaken post-1990 were found across 34 countries. Of these, 78 surveys from 33 countries were found post-2000, and of these, 48 surveys from 27 countries included children and 60 surveys from 30 countries included adults. No nationally representative surveys were found for 19 of 53 countries, mainly from Central and Eastern Europe. Multiple 24hr recall and food diaries were the most common dietary assessment methods. Only 22 countries reported energy and nutrient intakes from post-2000 surveys; macronutrients were more widely reported than micronutrients.

Conclusions: Less than two-thirds of WHO Europe countries have nationally representative diet surveys, mainly collected post-2000. The main availability gaps lie in Central and Eastern European countries, where nutrition policies may therefore lack an appropriate evidence base. Dietary methodological differences may limit the scope for inter-country comparisons.

Keywords: WHO European region; dietary assessment methodologies; multi-criteria analysis; national diet surveys; nutritional epidemiology; scoping review – gaps.

Fig. 1

Screening and selection of national dietary surveys.

Fig. 2

Map of national dietary survey provision by country. Light grey – Post-2000 survey plus nutrient intakes (28 surveys in 22 countries). Medium grey – Post-2000 survey (78 surveys in 33 countries). Medium-dark grey – Pre-2000 survey (3 surveys in 1 country). Dark grey – No survey (19 countries). White – countries not in the WHO Europe remit.

Fig. 3

Number of macronutrients reported by each national dietary survey by country*: *Where 12 is the maximum potential number of selected macronutrients of interest being reported in NDS reports: energy, protein, carbohydrate, sugars, sucrose, starches, fibre, total fat, saturated fat, monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA) and trans-fatty acids (TFA).

Fig. 4

Number of micronutrients reported by each national dietary survey by country*: *Where 19 is the maximum potential number of selected micronutrients of interest being reported in NDS reports: folate (B9), niacin (B3), vitamin A, riboflavin (B2), thiamine (B1), vitamin B12 (biotin), vitamin B6 (pyridoxine), vitamin C, vitamin D, vitamin E, calcium, magnesium, potassium, sodium, iron, copper, iodine, selenium and zinc.