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En los menús servidos en los comedores de los colegios públicos de la Comunidad de Madrid (CM) se venían detectando algunos desequilibrios nutricionales: cantidades insuficientes, desviaciones interdías de hasta el 50% de energía, desequilibrio en los perfiles calórico y lipídico, poca variedad, desinformación de los padres, etc. La Consejería de Educación de la CM, consideró necesario planificar y regular las condiciones básicas que deben reunir los menús para dichos comedores. La Fundación Española de la Nutrición (FEN) junto con el Departamento de Nutrición de la UCM, fueron los encargados de elaborar las bases para desarrollar la Normativa (BOCM 24-05-01, 10-09-02). Se convocó a las empresas de restauración colectiva a un concurso para el suministro de menús adaptados a dicha Normativa. En este trabajo se describe la adaptación a las pautas dietéticas programadas de las empresas homologadas y, principalmente, su repercusión en el aporte energético y nutricional de los menús así como la adecuación a los perfiles calórico y lipídico recomendados. Además, y hasta el momento, una muestra aleatoria de 171 centros, con servicio de comedor (más de 37.000 escolares), han sido visitados, sin anuncio previo de la fecha, por nutriólogos para llevar a cabo el control de los menús servidos. Para ello, en cada centro se recogió la porción duplicada del menú servido ese día. Se determinó su contenido en energía y nutrientes y se analizó su composición en ácidos grasos. La adaptación por parte de las empresas de restauración a la normativa fijada ha mejorado sustancialmente los menús respecto a periodos anteriores: mayor presencia de verduras y hortalizas, mejor calidad de la grasa y menor cantidad de grasas y proteínas a expensas de hidratos de carbono. Some nutritional unbalances have been observed in menus served at dining rooms of schools from the Community of Madrid (CM): small portions, inter-day variations up to 50% of energy intake, unbalances in caloric and lipidic profiles, little variety, lack of parental information, etc. The Education Council of the CM considered necessary to plan and regulate the basic conditions that menus of these dinning rooms should meet. The Spanish Nutrition Foundation (FEN) and the Nutrition Department of the Complutense University of Madrid (UCM) were put in charge of elaborating the bases to develop the Regulation (BOCM 24-05-01, 10-09-02). Collective catering companies were called for a tender to provide menus adapted to such Regulation. This work describes the adaptation of programmed dietary schemes of officially approved companies and mainly the impact on energy and nutritional content of menus and their adaptation to the recommended caloric and lipidic profiles. So far, a random sample of 171 schools with dining rooms (more than 37,000 schoolboys) has been visited by nutritionists, with no previous announcement, to control served menus. For this, at each centre a duplicate of the portion served that day was gathered. The energy and nutrient content was determined and the fatty acid composition was analysed. The adaptation to the Regulation by catering companies has substantially improved the menus as compared to previous times: more presence of vegetables, better quality of fat and less amount of fat and proteins at the expense of carbohydrates.

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. © 2006 Nature Publishing Group All rights reserved.

En los menús servidos en los comedores de los colegios públicos de la Comunidad de Madrid (CM) se venían detectando algunos desequilibrios nutricionales: cantidades insuficientes, desviaciones interdías de hasta el 50% de energía, desequilibrio en los perfiles calórico y lipídico, poca variedad, desinformación de los padres, etc. La Consejería de Educación de la CM, consideró necesario planificar y regular las condiciones básicas que deben reunir los menús para dichos comedores. La Fundación Española de la Nutrición (FEN) junto con el Departamento de Nutrición de la UCM, fueron los encargados de elaborar las bases para desarrollar la Normativa (BOCM 24-05-01, 10-09-02). Se convocó a las empresas de restauración colectiva a un concurso para el suministro de menús adaptados a dicha Normativa. En este trabajo se describe la adaptación a las pautas dietéticas programadas de las empresas homologadas y, principalmente, su repercusión en el aporte energético y nutricional de los menús así como la adecuación a los perfiles calórico y lipídico recomendados. Además, y hasta el momento, una muestra aleatoria de 171 centros, con servicio de comedor (más de 37.000 escolares), han sido visitados, sin anuncio previo de la fecha, por nutriólogos para llevar a cabo el control de los menús servidos. Para ello, en cada centro se recogió la porción duplicada del menú servido ese día. Se determinó su contenido en energía y nutrientes y se analizó su composición en ácidos grasos. La adaptación por parte de las empresas de restauración a la normativa fijada ha mejorado sustancialmente los menús respecto a periodos anteriores: mayor presencia de verduras y hortalizas, mejor calidad de la grasa y menor cantidad de grasas y proteínas a expensas de hidratos de carbono.

Existen pocos estudios longitudinales que relacionen hábitos alimentarios, dietas, contenido nutricional y su repercusión en la salud. Por ello, Euronut, la Acción Concertada de la UE sobre Nutrición y Salud, organizó en 1988 un estudio longitudinal, de cohortes, internacional y multicéntrico, para tratar de analizar estos factores en diversas culturas alimentarias europeas. Este estudio recibió el nombre de SENECA (Survey in Europe on Nutrition and the Erdely: a Concerted Action). Para ello, se realizaron varios tipos de pruebas: cuestionario general (recogía información sobre: datos personales, situación sociodemográfica, situación socioeconómica, estilo de vida y actividad física y hábitos de vida y dietéticos), un estudio dietético, parámetros antropométricos y bioquímicos. En este trabajo se han tratado de valorar las diferencias debidas al sexo y la edad (en los mismos sujetos), para lo cual se recoge información sobre el consumo cuantitativo y cualitativo de alimentos, ingesta de energía y nutrientes y su aporte a las ingestas recomendadas, en un grupo de edades comprendidas entre 71 y 80 años. Los cuatro grupos de alimentos más consumidos en ambas partes del estudio fueron frutas, leche y derivados, verduras y hortalizas y cereales y derivados. En los cuatro años transcurridos se observó una disminución significativa en el consumo de algunos alimentos, tanto en el total de la muestra como en la distribución por sexos. Como consecuencia, según aumentó la edad en cuatro años, es decir, en la segunda parte del estudio, se ha observado una disminución de la ingesta energética con repercusión importante en el de la mayoría de los micronutrientes. La distribución en percentiles muestra que existen individuos sin o con un consumo muy bajo de algunos alimentos. Se observaron porcentajes elevados de personas que no cubren las ingestas recomendadas. There are few longitudinal studies linking eating habits, diets, nutritional content and their repercussions on health. For this reason, the European Union’s Concerted Action on Nutrition and Health, Euronut, organized an international, multi-centric longitudinal cohort study in 1988 in an attempt to analyze these factors in various food cultures of Europe. This study was given the name SENECA (Survey in Europe on Nutrition and the Elderly: a Concerted Action). To this end, several types of tests were performed: a general questionnaire (collecting information on: personal details, social and demographic status, socio-economic situation, lifestyle and physical activity and dietary or other living habits), a dietary study, anthropometric and biochemical parameters. The present paper has attempted to assess the differences due to gender and age (in the same subjects), for which purpose data has been collated from a group of individuals between 71 and 80 years of age on the quantitative and qualitative food consumption, energy and nutrient intake and their contribution to the recommended daily intake. The four groups of foods most consumed in both parts of the study were: fruit, milk and its derivatives, vegetables, and cereals and their derivatives, during the four years that have elapsed, a significant reduction was seen in the consumption of certain foods, both in the total of the sample and for the distribution by gender. As a result, with a four-year increase in age, i.e. in the second part of the study, a reduction in energy intake was observed to have a considerable impact on the intake of most micronutrients. The percentile distribution shows that there are individuals who consume very small amounts (or nothing at all) of certain foods. High percentages of individuals were seen not to cover the recommended intake.

Existen pocos estudios longitudinales que relacionen hábitos alimentarios, dietas, contenido nutricional y su repercusión en la salud. Por ello, Euronut, la Acción Concertada de la UE sobre Nutrición y Salud, organizó en 1988 un estudio longitudinal, de cohortes, internacional y multicéntrico, para tratar de analizar estos factores en diversas culturas alimentarias europeas. Este estudio recibió el nombre de SENECA (Survey in Europe on Nutrition and the Erdely: a Concerted Action). Para ello, se realizaron varios tipos de pruebas: cuestionario general (recogía información sobre: datos personales, situación sociodemográfica, situación socioeconómica, estilo de vida y actividad física y hábitos de vida y dietéticos), un estudio dietético, parámetros antropométricos y bioquímicos. En este trabajo se han tratado de valorar las diferencias debidas al sexo y la edad (en los mismos sujetos), para lo cual se recoge información sobre el consumo cuantitativo y cualitativo de alimentos, ingesta de energía y nutrientes y su aporte a las ingestas recomendadas, en un grupo de edades comprendidas entre 71 y 80 años. Los cuatro grupos de alimentos más consumidos en ambas partes del estudio fueron frutas, leche y derivados, verduras y hortalizas y cereales y derivados. En los cuatro años transcurridos se observó una disminución significativa en el consumo de algunos alimentos, tanto en el total de la muestra como en la distribución por sexos. Como consecuencia, según aumentó la edad en cuatro años, es decir, en la segunda parte del estudio, se ha observado una disminución de la ingesta energética con repercusión importante en el de la mayoría de los micronutrientes. La distribución en percentiles muestra que existen individuos sin o con un consumo muy bajo de algunos alimentos. Se observaron porcentajes elevados de personas que no cubren las ingestas recomendadas.

The ability to manage basic activities of daily living (ADL) is a significant predictor for being housebound, placement in a nursing home and death. The aim of the study was to assess the capacity to perform activities of daily living in the Spanish sample (30 men and 49 women aged 80-85 y) from SENECA's Finale study (1999) and changes respect to the same sample ten years ago. The total ADL score (assessed by 16 questions) and the partials (mobility ADLm and self-care ADLc) show that the total ADL average in 1999 has been 23.9+/-10.2 (p0.05) and 25.3+/-9.6 (p0.001), being in 1989, 18.8+/-4.4 and 19.9+/-4.8 for men and women respectively. The ADL score from deceased subjects participating in 1989 was significantly worse (p0.01 in men and p0.001 in women) than ADL score from survivor subjects. Activities of daily living as a measurement of functionality decline with increasing age and in our study a better ADL score was found as survival factor.

Recasting the role of fruit and vegetables (F and 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 and V availability patterns in ten European countries and examine compliance with current recommendations. The mean and median F and V availability (g/person per d) was estimated based on household budget survey data retrieved from the Data Food Networking (DAFNE) databank. Low F and V consumers were identified based on WHO international recommendations (minimum combined F and 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 and V availability were found among the surveyed European populations. Only in Mediterranean countries did the mean daily population intake clearly exceed combined F and 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 population 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 and V promoting strategies may be enhanced if F and V are addressed separately; furthermore, interventions that would specifically focus on vegetables are probably needed.

Objective: We have undertaken a study to examine whether Household Budget Sun ey (HBS)-derived nutritional patterns are related to mortality from diseases with strong nutritional components, namely coronary heart disease, colorectal cancer and cancer of the female breast. Design: Ecological correlation study. In the contest of the Data Food Networking projects of the European Union, raw data from the national HBS of 10 European countries were provided. For each of the 10 participating countries, daily food availability per capita around 1990 was calculated. Individual foods were aggregated into 12 major food groups that were linked with the diseases under consideration. Mortality data were available from a World Health Organisation database. We have used a composite score to summarise the postulated influence of diet. Setting: Ten European countries circa 1990. Results: The correlation coefficients between the composite score and the age-adjusted mortality fi om each of the studied diseases were. + 0.51 (P similar to 0.14) for colorectal cancer; + 0.72 (P similar to 0.02) for female breast cancer; and + 0.60 (P similar to 0.07) for coronary heart disease, after adjustment for tobacco smoking. Conclusions: We conclude that dietary information from HS is sufficiently reliable to reveal correlations with mortality rates from chronic diseases with fairly strong nutritional roots. HBS data could be used, with little cost, for monitoring secular trends in dietary patterns with a view to their health implications.

With the aim of obtaining information as to whether the desire to lose weight responds to criteria of health, or whether this is only a question of esthetics, the relation between the body mass index (BMI) as an indicator of obesity, and some attitudes with respect to weight, were analyzed in a group of 254 apparently healthy women between the ages of 14 and 55 with a variety of occupations (students, housewives, and women working outside the home), using a questionnaire designed for the study. An analysis was also made of the types of methods used for the voluntary loss of weight, as well as other aspects of slimming. The sample was classified into three groups according to the BMI: low weight (BMI20 kg/m2), adequate weight (BMI = 20-25 kg/m2), and overweight (BMI25 kg/m2). Of the total number of women studied, only 42% were satisfied with their weight. Of those with a low weight, 35% manifested discontent, and of these, 69% wanted to lose weight and only 19% had attempted to increase it. Among the women with and adequate BMI, 71% indicated not being content with their weight, with 95% wishing to reduce it. In the group of overweight women only 13% were satisfied and all the rest expressed a desire for losing weight. The size and volume of the thighs (28%), hips (22%), buttocks (20%), and abdomen (19%) were the areas producing the greatest amount of discontent. The most common methods for losing weight were: no snacking between meals (54%), physical exercise (53%), and low calorie diets (33%). Only 19% went to see a specialist. The use of laxatives (1.5%) and other slimming products (3.5%) was minimal.

To assess longitudinal changes in intakes of energy and macronutrients in elderly Europeans.Longitudinal study including a dietary assessment in 1988/1989, which was repeated in 1993.Serial data were collected in nine European towns: Belgium: Hamme (H/B); Denmark: Roskilde (R/DK); France: Haguenau (H/F) and Romans (R/F); Italy: Padua (P/I); the Netherlands: Culemborg (C/NL); Portugal: Vila Franca de Xira (V/P); Spain: Betanzos (B/E) and Switzerland: Yverdon (Y/CH). In other centres dietary intake data were collected in 1993 only: Portugal: Coimbra (C/P); Poland: Marki (M/PL); Northern Ireland: Ballymoney-Limavady-Portstewart (BLP/NI/UK) and United States: Mansfield (Connecticut) (M/CT/USA).Using standardized methodologies, data were collected from a random stratified sample of elderly men and women born between 1913 and 1918. In 1993 dietary intake data were collected from 1125 subjects by a modified validated dietary history method.Over the 4-year study period, a decline in mean energy intake of one MJ or less per day was observed in most towns, which was significant (P0.01) in only four of the towns. The within- and between-centre variation of change was large. Overall, a slight decline was reported for all macronutrients and with the exception of protein, large within and between centre variations were observed in both men and women.Intake of energy and macronutrients was found to decline with age. This may be of special concern for small eaters.

A case-control study has been designed to analyze the possible role of the energy intake and obesity, judged by the body mass index, on the incidence of breast cancer in a group of 275 women (139 cases and 136 controls), coming from three hospital populations (Madrid, Mérida, and Santiago de Compostela). There are no significant differences in the of cases and controls, which, additionally, does not seem to be significantly related to the risk of breast cancer. On the other hand, the weight and the body mass index of women with breast cancer is significantly higher than that of the controls. The oods ratio, as a measure of the relative risk for breast cancer, shows that a high body mass index behaves as a risk factor (OR = 2.49; 95% IC, = 1.33-4.67, Chi2 = 8.30), a trend which remains after adjusting for energy. When considering the pre or post menopausal status, it is observed that a body mass index higher than 29, adjusted for energy intake, behaves as a risk factor only in the post-menopausal women (OR = 2.28; 95% IC = 0.95-5.46 Chi2 = 3.41).

The vitamin (B1, B2, B6, retinol, beta-carotene, E and ascorbic acid) status of 56 young women (aged 21-30 years) has been analysed by studying dietary intakes and biochemical parameters and relating them to energy intake. Only 25% of the sample consumed more than 2000 kcal/day and a high percentage of apparently healthy women had low vitamin intakes, especially in the case of vitamin E, B6 and retinol. Except for retinol and beta-carotene, significant correlations between energy and vitamin intakes were found. With respect to blood levels, 86% of women had deficient or marginal levels for B1, 71% for B2, 75% for B6 and 64% for beta-carotene. An adequate or optimal situation has been shown in the case of vitamin C (92%), E (88%) and retinol (77.5%). No correlation between energy intake and vitamin blood levels was found, except for vitamin B6. These data show that young women are vulnerable to developing vitamin deficiencies, especially those consuming low energy diets.

Dietary habits were studied in 135 pregnant Spanish women. Their consumption of cereals, sugars, oils, vegetables, legumes and alcoholic drinks was lower, that of meat and eggs similar and that of fruit, milk and fish higher than the Spanish national average. The percentages for intakes lower than 100% of the recommended allowances, taking into account the dietary intake were 12, 23, 88, 8, 12, 34, 94, 2, 71, 98, 97 and 93% for thiamin, riboflavin, folates, vitamin B12, C, A, D, iodine, calcium, zinc magnesium and iron, respectively. If the supplements prescribed halfway through the pregnancy are added to the dietary provisions, the percentages for consumption below 100% of recommendation were considerably reduced. Furthermore, since the supplements prescribed did not include zinc or magnesium, there were 98% and 97% of pregnant women, respectively, with intakes below 100% of recommendations of these minerals. In the other cases the dietary intake plus the supplement are higher than the recommended amount. These imbalances may have harmful effects on the health of the women and their newborns and highlight the need for studying in depth the nutritional problems of pregnant women and for reconsidering the supplements that must be prescribed.