Disparities in food habits in Europe: systematic review of educational and occupational differences in the intake of fat.

BACKGROUND: A higher socio-economic level is associated with healthier dietary habits. Nevertheless, socio-economic differences in the intake of fat have not consistently been reported in Europe. The objective of our study was to systematically assess differences in total fat (TF) intake and saturated fat (SF) intake across social groups. METHODS: Representative samples from nine European countries were used to perform a meta-analysis of surveys between 1985-1999, including both published and nonpublished results. RESULTS: Because important heterogeneity was found and the estimates for TF from Spain and Estonia were different from all others, we calculated the differences in intake excluding these two countries. We found a lower TF intake in the highest (versus the lowest) occupational level both for men (difference: -1.1% of total energy intake; 95% CI: -1.3 to -0.8%) and women (difference: -0.9%; 95% CI: -1.2 to -0.6%) when Estonia and Spain were excluded. CONCLUSION: European surveys indicate that people in the lowest category of occupation consume more fat and SF than people in the highest category.

Fuentes de información y nivel de confianza en las fuentes de información sobre dieta sana en la población española, para facilitar la promoción de hábitos dietéticos sanos / Sources of information on healthy eating in a mediterranean country and the level of trust in them: a national sample in a pan-european survey

Objetivos: Determinar las fuentes de información y el nivel de confianza en las fuentes de información sobre dieta sana en la población española, para facilitar la promoción de hábitos dietéticos sanos. Pacientes y métodos: Análisis de una muestra representativa española de adultos mayores de 15 años compuesta por 1009 individuos y seleccionada por un procedimiento aleatorio multietápico. Este estudio corresponde a la participación española en un estudio europeo multicéntrico coordinado por el Instituto Europeo de Estudios Nutricionales (IEFS) de Dublín. Se preguntó a cada individuo por las fuentes de las que procedía su información sobre dieta sana y su nivel de confianza en ellas. Se analizaron las cinco fuentes más frecuentemente mencionadas. Resultados: La fuente de información más citada y de mayor confianza fueron los "profesionales sanitarios". Aproximadamente, el 26 por ciento de los encuestados mencionaron a los "profesionales sanitarios" como su fuente de información acerca de la dieta sana. Sin embargo, la "radio/TV" (25,7 por ciento) fue casi tan seleccionada como los "profesionales sanitarios". Alrededor del 17,4 por ciento de los individuos declaró que no obtenía información sobre dieta sana. Los individuos con nivel de estudios universitarios citó con mayor frecuencia a los "profesionales sanitarios", mientras que los sujetos de nivel socio-económico elevado prefirieron la "radio/TV". El grado de confianza fue mayor para los mensajes obtenidos de los "profesionales sanitarios" (89,9 por ciento) y del "Departamento de Sanidad" (78,7 por ciento) y menor en el caso de la información obtenida de los "periódicos" (34,2 por ciento) y de los "anuncios publicitarios" (17,6 por ciento).Conclusión: Los profesionales sanitarios deben promover las guías dietéticas a través de los canales ade cuados para lograr que lleguen a los diferentes grupos de individuos (AU)

Sources of information on healthy eating in a Mediterranean country and the level of trust in them: a national sample in a pan-European survey.

OBJECTIVE: To know the sources of information and the level of trust in these sources in a population to facilitate the promotion of healthy dietary habits. PATIENTS AND METHODS: A national survey was carried out according to an established protocol on a representative sample of 1009 Spanish subjects over 15 years of age selected by a random multietapic procedure. This study belongs to the Spanish partnership in a pan-European Survey about sources of information on healthy eating and their level of trust. The analysis was focussed on the evaluation of the 5 most frequently chosen sources. RESULTS: There was a trend towards a greater use and trust in "Health professionals" than other sources. Thus, about 26% of the respondents mentioning "health professionals" as the source of information on healthy eating. However, "TV/radio" (25.7%) was almost so often selected as "Health professionals". About 17.4% of subjects declared that they obtained no information at all on healthy eating. Subjects with university level of studies exhibited a greater mention of "Health professionals", while individuals belonging to higher socio-economic levels preferred "TV/radio". The degree of trust was higher for messages obtained from "Health professionals" (89.9%) and the "Department of Health" (78.7%) and lower for information obtained from "newspaper" (34.2%) and "advertising" (17.6%). CONCLUSION: Nutrition and health educators must promote dietary guidelines through the appropriate channels for communicating messages to different targets groups.

Stages of dietary change and nutrition attitudes in the Spanish population.

UNLABELLED: A national survey was developed in a representative sample of the Spanish population (15 years old and upwards). This study belongs to a partnership in a pan-European survey about stages of dietary change where subjects were classified into six different categories according to their readiness for dietary change: precontemplation (not considering any changes), contemplation (considering changes), decision (making plans to change), action (carrying out the changes), maintenance (maintaining changes for more than six months) and relapse stage (reverting back to eating less healthily). The main objective was to investigate the distribution of the different stages of change concerning dietary habits across strata of socio-demographic variables (sex, age, educational level, socioeconomic level). Also, this study was conducted to assess the relationships between stages of dietary change and the influences on food choice as well as the definitions used to describe healthy eating. The survey was carried out, according to an established protocol, on a representative sample of 1009 Spanish subjects selected by an at random multistage procedure. Subjects completed a face-to-face interview-assisted questionnaire. To ensure representativeness data were weighted by population size, by sex, age and regional distribution. The proportion of subjects in precontemplation (56.0%) and maintenance (28.3%) stages was substantially larger than in the other stages of dietary change. More males (59.7%) and subjects from the oldest age groups (65.8%) were classified as belonging to the precontemplation stage, while more females (30.2%) and subjects between 25-34 years of age (34.5%) were in the maintenance stage. 'Trying to eat healthy' as an influence on food choice was more frequently mentioned by those in the dynamic and maintenance stages, while a high percentage of subjects from the precontemplation and relapse stages (61.1%) agreed they did not need to make changes to their diets because their diet was already sufficiently healthy. A very high proportion of the Spanish adult population do not contemplate a change in their dietary habits. Intervention strategies in health promotion programs should be available for people at the various stages of change. It would be more effective to attempt to increase people's awareness and personal concerns about nutrition and health, before introducing action strategies. IMPLICATIONS FOR RESEARCH AND PRACTICE: The adult population can be classified into different stages of dietary change, so the stages of change model may be applied to future nutrition interventions. This approach will help to focus more accurately strategies of nutrition education.

Perceived barriers of, and benefits to, healthy eating reported by a Spanish national sample.

OBJECTIVE: A national survey was developed in order to assess the difficulties and the potential benefits that the adult Spanish population perceive when they try to eat a healthier diet and also to help nutrition educators to develop relevant and specific strategies to promote healthy eating. DESIGN: The study survey was carried out according to an established protocol on a representative sample of 1009 Spanish subjects over 15 years of age selected by a multi-stage procedure. This study belongs to a partnership in a pan-European survey about food, nutrition and health. The analysis was focused on the evaluation of the seven most frequently chosen barriers and benefits. RESULTS: There was a trend to select as the main barriers: 'irregular work hours' (29.7%), 'willpower' (29.7%) and 'unappealing food' (21.3%), while 'prevent disease' (73.6%) was the most frequently selected benefit to healthy eating. About 20% of the subjects said they did not have any difficulty eating healthier and most people believed that healthy eating was associated with at least one benefit. CONCLUSIONS: In Spain, nutrition educators should be aware that an irregular and busy lifestyle, willpower and food-related factors (such as price and unappealing foods) are the main perceived barriers to healthy eating. Conversely, the prevention and health promotion aspects are the main perceived benefits.

Definition of healthy eating in the Spanish adult population: a national sample in a pan-European survey.

A national survey was carried out to find out how the Spanish adult population defined 'healthy eating'. Consumers were asked to describe in their own words what 'healthy eating' means to them. The sample included 1009 Spanish subjects over 15 y of age selected by a multietapic procedure. This study belongs to the Spanish partnership in a pan-European survey about attitudes to food, nutrition and health coordinated by the Institute of European Food Studies of Dublin. The results were shown as the percentages of the sample who gave one of the five most frequently mentioned descriptions ('more vegetables', 'balanced diet', 'more fruit', 'less fat' and 'more fish') and the distribution of responses by age, sex, region, socio-economic level and education level. A multivariable logistic regression model was fitted to assess the characteristics independently related to the use of the definition 'balance and variety' for healthy eating. The majority of the Spanish people defined 'healthy eating' as a diet with 'more vegetables' as the main description. Other descriptions commonly mentioned were 'less fat', 'more fruit', 'more fish', and 'more lean meat'. A higher age was associated with a lower likelihood of mentioning the concept of balanced diet. A higher educational level was also independently and strongly related to a higher prevalence of this definition. Differences between men and women showed only borderline significance. Our results suggest the need to improve nutritional education about fiber, low fat and cholesterol. It would be interesting to develop strategies in Spain to educate people on a definition of 'healthy eating' based upon 'balance and variety'.