Article Text
Abstract
Background The World Health Organisation (WHO) encourages national diet survey (NDS) implementation to obtain relevant data to inform policies aimed at addressing the burden of malnutrition and childhood obesity, which remain pressing health issues. However, we have previously shown that European NDS provision is inconsistent, and the majority of gaps lie in Central & Eastern European countries (CEEC). This paper provides an up-to-date review on energy, macro and selected micronutrient intakes in children across the WHO European Region (WER) using the latest available NDS intakes and WHO Recommended Nutrient Intakes (RNIs) to highlight vulnerable groups and areas of concern.
Methods NDS information was gathered primarily by internet searches and contacting survey authors and nutrition experts. WER countries were grouped into areas – Western, Northern and CEEC. Survey characteristics, reported energy, and nutrient intakes by gender and age group were taken from the latest NDS reports from post-2000 surveys. Population weighted means were calculated and presented by country, European area and WER-wide for both genders and age groups <10 y and ≥10 y. WHO RNIs were used to assess nutrient intake adequacy and highlight aspects of concern.
Results Child energy and nutrient intakes were only available from 21 NDS across a third (n=18) of WER countries. Energy and macronutrients, where boys and older children had higher intakes, were more widely reported than micronutrients. Trans fats, omega fats, added sugar and iodine were the least reported nutrients. Countries in all European areas had poor RNI attainment levels; most countries did not meet the carbohydrate, sugar, saturated fat or fibre RNIs in any age group. Older adolescents were more likely to meet RNIs based on absolute levels rather than %E. Micronutrient attainment was higher than macronutrients, but worst in girls and older children. Iron, vitamin D, folic acid and sodium intakes were of concern, particularly in girls and children aged ≥10 y. Only six surveys reported intakes by various socio-economic indicators.
Conclusion Only a third, mainly Western, WER countries provided published child nutrient intake data. Gaps in provision mean dietary inadequacies may go unidentified, preventing evidence-based policy formation. WHO RNI attainment was poor, particularly in girls and older children. Inconsistent age groups, dietary methodologies, nutrient composition databases and under-reporting hinder inter-country comparisons. Future efforts should encourage countries to conduct NDS in a standardised format by gender, age and socio-demographic variables. A European-wide policy focus to improve intakes, particularly in girls and children aged ≥10 y would be beneficial.
The authors are responsible for the views expressed in this publication and they do not necessarily represent the decisions or stated policy of WHO.