A European food consumption survey method--conclusions and recommendations.

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.