A comparison of household food availability in 11 countries

Objective To identify intercountry food intake patterns, we compared the household food availability data collected by the Nationwide Food Consumption Survey (NFCS) in the United States and the Household Budget Surveys (HBS) from 10 European countries that participated in the DAta Food NEtworking (DAFNE) project, namely Belgium, Germany, Greece, Hungary, Ireland, Luxembourg, Norway, Poland, Spain and the United Kingdom.
Methodology The DAFNE project harmonized European household food availability data by clarifying which food items were included in each country's HBS, and then defining comparable food categories among countries. NFCS household data were harmonized with the HBS data by applying the same procedures used in the DAFNE project.
Results The results presented in this paper reveal a number of similarities and differences in household food availability among 11 nations. In nearly all countries studied, red meat was available in greater quantities than poultry and seafood combined. Most countries favoured bread and rolls over other types of grain products, had a low to moderate availability of seafood and legumes, had a moderate amount of sugar available, and consumed approximately two-thirds or more of fruits and vegetables in a fresh form. Milk availability tended to be inversely correlated with cheese availability. Only in Mediterranean households was vegetable oil, namely olive oil, the primary type of added lipid available. While the data presented in this paper can do much to improve our understanding of food availability in US and European households, it is important to remember that these data do not include foods purchased and consumed away from home.
Applications Despite the limitations of household food availability data, the results presented in this paper can help health professionals develop a more international perspective.     

The DAFNE databank: the past and future of monitoring the dietary habits of Europeans

Aim To develop a European, regularly updated databank of comparable food and sociodemographic information as a tool for monitoring trends in dietary habits in Europe.Materials and methods Household budget survey (HBS) data on food availability at household level, as well as relevant demographic and socio-economic characteristics are forwarded to the Greek centre coordinating the Data Food Networking (DAFNE) initiative. Central combination and post-harmonisation of the raw HBS data are undertaken according to procedures developed in the DAFNE project.Results The DAFNE data on mean food availability (g or ml/person per day) are integrated in DafneSoft (version 2.1), which is a software for the Microsoft Windows operating system allowing: (a) the presentation of dietary data in various formats (tables, bars, pie charts, map presentations) and at various levels of detail; (b) the follow-up of trends in food availability over time, within and between countries; (c) the study of the effect of the households locality and of the education and occupation of the household head on the daily food choices; and (d) the export of data for further uses.Conclusion The comparability of operational measures is crucial to the meaningful interpretation of comparisons among countries. This has been a key objective of the DAFNE initiative. A system allowing the regular update of the DAFNE database and the expansion of the network to embrace all European countries could provide a ready source of data for monitoring public health nutrition in Europe at reasonable cost.     

Availability of foods and beverages in nationally representative samples of Portuguese households from 1990 to 2000: the DAFNE initiative

The aim of the study was to identify time trends and socio-demographic disparities in Portuguese food habits and to compare Portuguese food habits to those of other European countries. Data collected through the Portuguese Household Budget Surveys (HBS) of 1989/1990, 1994/1995 and 2000/2001 were analysed. The classification scheme developed in the context of the Data Food Networking (DAFNE) initiative was applied to form comparable food and beverage groups. The mean availability in quantity/person per day was estimated for the overall population and by socio-demographic groups (according to locality of the dwelling, education and occupation of the household head). Trends in food availability suggest a departure from the traditional Mediterranean dietary pattern. In 2000, Portugal was among the European countries with high daily availability of several of the components of the Mediterranean diet. The Portuguese were identified among the highest consumers of cereals, pulses, fruits, potatoes, fish and seafood, fats and oils (mainly of vegetable origin) and alcoholic beverages (wine in particular), but also of meat and meat products, and among the lowest consumers of vegetables, milk and milk products, eggs, sugar and sugar products, fruit and vegetable juices, soft drinks and stimulants (coffee, tea and cocoa). Even if socio-demographic disparities in food availability have narrowed in the 1990s, they can still be identified in the most recent 2000 data. Despite some methodological constraints, data derived from the DAFNE databank contributed to better documentation of Portuguese food habits and allowed evaluation of the country’s situation compared to other European countries.     

Monitoring food and nutrient availability in a nationally representative sample of Bolivian households

The study objective was to estimate food and nutrient availability in Bolivian households using data from the nationally representative under the Programme for the household surveys undertaken yearly from 1999 to 2002 Improvement of Surveys and the Measurement of Living Conditions in Latin America and the Caribbean (MECOVI). In the present study, we analysed data from four repeated, cross-sectional surveys and applied European Data Food Networking (DAFNE) methodology for post-harmonising the data. Raw data of 19 483 households in Bolivia (3035 in 1999, 4857 in 2000, 5845 in 2001 and 5746 in 2002) were retrieved from the databases of the national household surveys. Results showed that the Bolivian diet is characterised by higher availability of foods of plant origin (cereals, fruits, potatoes and vegetables). Meat, milk and their products follow in the dietary preferences of Bolivians. Disparities in food availability within the country were also observed. Rural households systematically recorded lower amounts of food available, in comparison with the urban ones. Households of higher social status recorded higher availability values for all food groups, except for potatoes and cereals. Findings suggest that Bolivian households of lower socio-economic status prefer energy-dense and cheaper food sources. We concluded the dietary and socio-demographic data collected in the MECOVI household surveys could serve nutrition surveillance purposes. In addition, the application of DAFNE methodology for post-harmonising the data allows both national and international comparisons.     

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.     

The validity of household budget survey (HBS) data: estimation of individual food availability in an epidemiological context

Household budget surveys (HBS) are conducted in most European countries and they represent a unique source of dietary data. However, the information on food availability is at the family level, which limits the investigation of the dietary habits of individuals. The key stages required to establish the validity of HBS data at the household and individual level are reviewed. Using examples from British data, the paper identifies some of the limitations and valid applications of HBS data. A statistical method is proposed to estimate the food availability of household members of different types, for example different age groups, based on the family composition. The validity of the method is presented by using British data from the National Food Survey and the National Diet and Nutrition Survey.     

Multiple socio-economic circumstances and healthy food habits

OBJECTIVE: To examine associations between seven indicators of socio-economic circumstances and healthy food habits, while taking into account assumed temporal order between these socio-economic indicators. DESIGN AND SETTING: Data were derived from cross-sectional postal questionnaires in 2000-2002. Socio-economic circumstances were assessed by parental education, childhood economic difficulties, own education, occupational class, household income, home ownership and current economic difficulties. Healthy food habits were measured by an index consisting of consumption of fresh vegetables, fruit or berries, rye bread, fish and choosing vegetable fats on bread and oil in cooking. Sequential logistic regression models were used, adjusting for age and marital status. PARTICIPANTS: Employees of the City of Helsinki, Finland (n=8960, aged 40-60 years). RESULTS: Healthy food habits were reported by 28% of women and by 17% of men. Own education, occupational class, household income, home ownership and current economic difficulties were associated with healthy food habits. These associations were attenuated but mainly remained after mutual adjustments for the socio-economic indicators. Among women, a pathway was found suggesting that part of the effects of education on food habits were mediated through occupational class. CONCLUSIONS: Employees in higher and lower socio-economic positions differ in their food habits, and those in lower positions and economically disadvantaged are less likely to report healthy food habits. Health promotion programmes and food policies should encourage healthier food choices among those in lower socio-economic positions and among those with economic difficulties in particular.     

Food balance sheet and household budget survey dietary data and mortality patterns in Europe

Worldwide dietary data for nutrition monitoring and surveillance are commonly derived from food balance sheets (FBS) and household budget surveys (HBS). We have compared food supply from FBS and food availability data from HBS among eighteen European countries and have estimated the extent to which they correlate, focusing on food groups which are comparably captured by FBS and HBS and for which there is epidemiological evidence that they can have a noticeable impact on population mortality. Spearman's correlation coefficient was +0.78 (P < 10- 3) for vegetables (including legumes),+0.76 (P < 10- 3) for fruits, +0.69 (P < 10- 3) for fish and seafood and +0.93 (P < 10- 3) for olive oil. With respect to meat and meat products, the coefficient was lower at +0.39 (P = 0.08). Moreover, we have examined whether the supply (FBS) or the availability (HBS) of food groups known or presumed to have beneficial effect on the occurrence of CHD and total cancer can predict overall, coronary and cancer mortality in ecological analyses. After controlling for purchasing power parity-adjusted gross domestic product and tobacco smoking we found that for vegetables, fruits, fish and seafood, as well as for olive oil, both the FBS and the HBS estimates were inversely associated with all three indicators of mortality, although the number of countries with complete information on all study variables hindered formal statistical documentation (P>0.05 in some instances). FBS and HBS have their own strengths and weaknesses, but they may complement each other in dietary assessments at the population level.     

On the nutrition and health situation in the European Union

The nutrition and health situation in different countries of the European Union was first documented in 2004 in the European Nutrition and Health Report. Fourteen European countries participated in this project—13 member states of the European Union and Norway. The trends in food supply in the participating countries and the EU were calculated on the basis of food balance sheets of the FAO/UN (Food and Agriculture Organization of the United Nations). An increasing trend could be observed for most food groups. Only the average supply of potatoes, cereals and wine decreased in the EU average during the observation period of 1961–2001. The availability of the relevant food groups at the household level was derived from data of the DAFNE (Data Food Networking) databank. Differences in consumption habits between households of different countries and regions and between households with household heads of different educational level are presented. Apart from food supply and availability, the intake of energy and nutrients was assessed based on national surveys at the individual level. In general, the proportion of fat and especially of saturated fatty acids in total energy was too high, whereas the intake of complex carbohydrates was too low. Critical nutrients among the different age groups of the participating countries were in particular vitamin D, folic acid, calcium, iodine, and iron (in women only), but also potassium and magnesium were critical in some countries. The sodium intake was on average too high among all age groups of the participating countries. A major health problem in European countries was the high prevalence of overweight and obesity, which had already been observed in the younger age groups. Further, the average blood cholesterol levels were in general too high in European adults. In all participating countries the leading causes of mortality were cardiovascular diseases, followed by malignant neoplasms.     

A multilevel analysis of socioeconomic (small area) differences in household food purchasing behaviour

STUDY OBJECTIVE: To examine the association between area and individual level socioeconomic status (SES) and food purchasing behaviour. DESIGN: The sample comprised 1000 households and 50 small areas. Data were collected by face to face interview (66.4% response rate). SES was measured using a composite area index of disadvantage (mean 1026.8, SD = 95.2) and household income. Purchasing behaviour was scored as continuous indices ranging from 0 to 100 for three food types: fruits (mean 50.5, SD = 17.8), vegetables (61.8, 15.2), and grocery items (51.4, 17.6), with higher scores indicating purchasing patterns more consistent with dietary guideline recommendations. SETTING: Brisbane, Australia, 2000. PARTICIPANTS: Persons responsible for their household's food purchasing. MAIN RESULTS: Controlling for age, gender, and household income, a two standard deviation increase on the area SES measure was associated with a 2.01 unit increase on the fruit purchasing index (95% CI -0.49 to 4.50). The corresponding associations for vegetables and grocery foods were 0.60 (-1.36 to 2.56) and 0.94 (-1.35 to 3.23). Before controlling for household income, significant area level differences were found for each food, suggesting that clustering of household income within areas (a composition effect) accounted for the purchasing variability between them. CONCLUSIONS: Living in a socioeconomically advantaged area was associated with a tendency to purchase healthier food, however, the association was small in magnitude and the 95% CI for area SES included the null. Although urban areas in Brisbane are differentiated on the basis of their socioeconomic characteristics, it seems unlikely that where you live shapes your procurement of food over and above your personal characteristics.     

Consumption Pattern of Low Income Rural Households in Nigeria

Abstract

Information on consumption pattern and food preparation methods of Igbo people in rural Nigerian communities from 242 households in two different ecological zones showed these communities still adhered to traditional food habits that are related to socio-economic status, production, distribution, utilization and household size. Starchy staples were the main foods consumed by 100% of respondents, followed by cereals, legumes, fruits and vegetables (60–80%) which were eaten when in season. Occasionally fish or meat was consumed by 40–50% of respondents. Intake of protein-rich foods was limited by purchasing power and availability; carbonated beverages, tea and coffee were rarely consumed as elicited from the questionnaire. Food items such as milk, sugar and rice are considered essential commodities due to scarcity and cost. Meals are usually consumed two times a day. Only on weekends and festival occasions do meals exceed this number. Rice is washed twice or more before boiling; other food commodities are overcooked or cooked in large quantities of water; vegetables are chopped before washing and cooking; these are practices that tend to destroy nutrients. Parboiled vegetables or undercooked meat are infrequent and unpopular. Malnutrition and starvation resulting from food insecurity (no link between production, distribution and utilization) for the expanding rural population may never be closed if food distribution, utilization and consumption patterns of food producers are neglected.     

The impact on eating habits of temporary translocation from a Mediterranean to a Northern European environment

OBJECTIVE: To assess the effect of temporary translocation from a Mediterranean to a Northern European environment on the eating habits of a group of foreign students. DESIGN: Cross-sectional survey of eating habits before and after moving from Greece to Glasgow, Scotland. SETTING: University of Glasgow. SUBJECTS: Eighty post-graduate Greek students. INTERVENTIONS: A self-administered questionnaire comprising of three major sections: (1) general eating habits; (2) frequency of eating selected food items; (3) opinion of food availability in Glasgow. RESULTS: After moving to Glasgow, significant decreases were reported in the frequency of consuming fresh fruit, raw vegetables, fish, legumes, meat, poultry and fresh fruit juice. The frequency of eating biscuits, savoury snacks, soft/fizzy drinks, alcoholic drinks and mayonnaise, dips and sauces increased. The estimated median daily consumption of fruit and vegetables decreased from 363 g in Greece to just 124 g in Glasgow, well below the Scottish and WHO dietary target of 400 g/day. The main perceived barriers to maintaining customary eating habits were the price of food, the lack of familiar tastes, the greater availability of convenience food and the limited variety of food available in Glasgow, when compared to Greece. CONCLUSIONS: These findings highlight the difficulties that migrant populations face in retaining traditional, often healthier, eating habits when migrating to a foreign country. Barriers of high cost, limited availability and poor quality of familiar foods, need to be addressed in order for migrants to maintain their customary eating patterns. Furthermore, these barriers need to be addressed before nutritionists can expect to see the widespread adoption of the Mediterranean diet by Western populations less familiar with this eating pattern.     

Household food availability in Brazil: distribution and trends (1974-2003)

OBJECTIVE: Data from household food budget surveys were examined in order to describe the regional and socio-economic distribution of household food availability in Brazil in 2002-2003 and trends from 1974 to 2003. METHODS: The study uses data from the "Pesquisa de Or?amento Familiar 2002-2003" budget survey conducted by the Brazilian Institute for Geography and Statistics (Instituto Brasileiro de Geografia e Estatística) from July 2002 to June 2003, including a national sample of 48,470 households. In each household, during seven consecutive days, all monetary and non-monetary expenses with food and beverages for family consumption were registered. Crude weights of purchased foods were transformed into calories and nutrients with the use of food composition tables. RESULTS: Adequate protein content and a high proportion of animal protein were found in all regions and income strata. These were the most important positive aspects identified in the household food availability in Brazil. On the other hand, all regions and socio-economic strata showed excess calories from sugar and little availability of fruits and vegetables. An excessive proportion of calories came from total and saturated fat in the more economically developed regions and in the urban milieu, as well as among higher-income families. Time-trends in metropolitan areas indicated a decline in the consumption of basic, traditional foods, such as rice and beans; notable increases (up to 400%) in the consumption of processed food items, such as cookies and soft drinks; maintenance of the excessive consumption of sugar; and a continuous increase in total fat and saturated fat content in the diet. CONCLUSIONS: Patterns and trends regarding household food availability in Brazil are consistent with the increasing participation of chronic non-communicable diseases in morbidity and mortality and with the continuous increase in the prevalence of obesity.     

Confidence to Cook Vegetables and the Buying Habits of Australian Households

Cooking skills are emphasized in nutrition promotion but their distribution among population subgroups and relationship to dietary behavior is researched by few population-based studies. This study examined the relationships between confidence to cook, sociodemographic characteristics, and household vegetable purchasing. This cross-sectional study of 426 randomly selected households in Brisbane, Australia, used a validated questionnaire to assess household vegetable purchasing habits and the confidence to cook of the person who most often prepares food for these households. The mutually adjusted odds ratios (ORs) of lacking confidence to cook were assessed across a range of demographic subgroups using multiple logistic regression models. Similarly, mutually adjusted mean vegetable purchasing scores were calculated using multiple linear regression for different population groups and for respondents with varying confidence levels. Lacking confidence to cook using a variety of techniques was more common among respondents with less education (OR 3.30; 95% confidence interval [CI] 1.01 to 10.75) and was less common among respondents who lived with minors (OR 0.22; 95% CI 0.09 to 0.53) and other adults (OR 0.43; 95% CI 0.24 to 0.78). Lack of confidence to prepare vegetables was associated with being male (OR 2.25; 95% CI 1.24 to 4.08), low education (OR 6.60; 95% CI 2.08 to 20.91), lower household income (OR 2.98; 95% CI 1.02 to 8.72) and living with other adults (OR 0.53; 95% CI 0.29 to 0.98). Households bought a greater variety of vegetables on a regular basis when the main chef was confident to prepare them (difference: 18.60; 95% CI 14.66 to 22.54), older (difference: 8.69; 95% CI 4.92 to 12.47), lived with at least one other adult (difference: 5.47; 95% CI 2.82 to 8.12) or at least one minor (difference: 2.86; 95% CI 0.17 to 5.55). Cooking skills may contribute to socioeconomic dietary differences, and may be a useful strategy for promoting fruit and vegetable consumption, particularly among socioeconomically disadvantaged groups.     

Fruit and vegetable availability among ten European countries: how does it compare with the 'five-a-day' recommendation? DAFNE I and II projects of the European Commission

Recasting the role of fruit and vegetables (F&V) in the diet, and planning national and international campaigns to enhance their consumption are major public health service objectives. The present study seeks to describe F&V availability patterns in ten European countries and examine compliance with current recommendations. The mean and median F&V availability (g/person per d) was estimated based on household budget survey data retrieved from the Data Food Networking (DAFNE) databank. Low F&V consumers were identified based on WHO international recommendations (minimum combined F&V intake of about 400 g/person per d) and current conservative guidelines of a minimum daily intake of three portions of vegetables and two portions of fruit. Considerable disparities in F&V availability were found among the surveyed European populations. Only in Mediterranean countries did the mean daily population intake clearly exceed combined F&V recommendations. Dietary patterns were positively skewed in all populations studied, on account of the presence of exceptionally high values among segments of the populations. Moreover, the correlation was unexpectedly weak between the proportion of low fruit and low vegetable consumers (Spearman's correlation coefficient +0.18). More than 50% of the households in the surveyed populations are likely to consume less than the recommended daily vegetable intake of three portions, and this applies even to the two Mediterranean populations. The efficiency of F&V promoting strategies may be enhanced if F&V are addressed separately; furthermore, interventions that would specifically focus on vegetables are probably needed.     

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.     

Paternal smoking is associated with greater food insecurity among poor families in rural Indonesia

Food insecurity is common in developing countries and related to the physical well being of families. Household food insecurity is intended to reflect a household's access, availability, and utilization of food. The relationship between paternal smoking and household food insecurity has not been well characterized. The objective of this study was to examine the relationship of paternal smoking with household food insecurity among poor families in rural Indonesia. In a cross-sectional study of 26,380 rural households in the Indonesian Nutrition Surveillance System in 2003, we examined the relationship between paternal smoking and household food insecurity score, as measured using a 9-item food security questionnaire. The prevalence of paternal smoking was 72.9%. In families with and without a father who smoked, the mean (standard error) household food insecurity score was 1.83 (0.01) and 1.48 (0.02), respectively (p<0.0001). Paternal smoking was associated with greater household food insecurity score (p<0.0001) in a multivariable linear regression model, adjusting for maternal age, maternal education, weekly household expenditure per capita, and province. Among poor families in rural Indonesia, households with a father who smokes are at greater risk of household food insecurity.     

Does the Timing of Food Stamp Distribution Matter? A Panel‐Data Analysis of Monthly Purchasing Patterns of US Households

In this paper, we examine the relationship between the timing of food stamp receipt and purchasing patterns. We combine data on state distribution dates of food stamps with scanner data on a panel of households purchases tracked between 2004 and 2011. We find that purchases of a variety of goods are meaningfully higher on receipt days, consistent with previous work that suggests that recipients are very impatient. Additionally, and importantly, estimates indicate that when food stamp receipt days fall on weekends, total monthly purchases within the same households are affected. In particular, monthly purchases of beer are higher when food stamps are distributed on a weekend rather than in months where benefits are distributed on weekdays. For these households, total beer purchases are between 4 and 5% higher in those months. Among households ineligible for food stamps, no effect is identified. These results demonstrate that the ‘day‐of‐the‐week’ of SNAP treatment may have important impacts on household purchase habits. Copyright © 2016 John Wiley & Sons, Ltd.     

Household factors associated with older Australian's purchasing a varied diet: Results from household expenditure data

Objective: To examine the household factors associated with older Australian's (aged 55 years and over) purchasing a varied diet. Design and methods: National cross‐sectional survey. Setting: All states and territories of Australia. Subjects: A total of 1898 households headed by adults aged 55 years and over. Main outcome measures: Food diversity was measured using the Dietary Variety Score (DVS). The DVS is the total number of food items purchased within a two‐week period, from a possible 110 individual food expenditure items. Data analysis: Negative binomial regression was used to examine the association between the respondent's individual and household characteristics with the DVS, after controlling for all factors in the model. Results: Among the demographic factors, living arrangements, age and education are found to be associated with dietary diversity. Lone males, lone females, and households headed by people with no secondary school education, or aged over 75 years were most likely to experience lower levels of dietary diversity. Conclusions: The finding that both poor education and low income in old age are associated with dietary diversity suggests the need for early life‐course interventions to improve nutritional outcomes. Nutrition education programs that also focus on those with poor education and low income, as well as lone person households and those aged over 75 years, may improve nutritional wellbeing, and thereby reduce public health costs.