Abstract
BackgroundThe high cardiovascular mortality in Eastern Europe has often been attributed to poor diet, but individual-level data on nutrition in the region are generally not available. This paper describes the methods of dietary assessment and presents preliminary findings on food and nutrient intakes in large general population samples in Russia, Poland and the Czech Republic.MethodsThe HAPIEE (Health, Alcohol and Psychosocial factors In Eastern Europe) study examined random samples of men and women aged 45-69 years at baseline in Novosibirsk (Russia), Krakow (Poland) and six Czech urban centres in 2002-2005. Diet was assessed using a food frequency questionnaire (at least 136 items); complete dietary information was available for 26,870 persons.ResultsTotal energy intakes among men ranged between 8.7 MJ in the Czech sample and 11.7 MJ in the Russian sample, while among women, energy intakes ranged between 8.2 MJ in the Czech sample and 9.8 MJ in the Russian sample. A Healthy Diet Indicator (HDI), ranging from a score of 0 (lowest) to 7 (highest), was developed using the World Health Organisation's (WHO) guidelines for the prevention of chronic diseases. The mean HDI scores were low, ranging from 1.0 (SD = 0.7) among the Polish subjects to 1.7 (SD = 0.8) among the Czech females. Very few subjects met the WHO recommended intakes for complex carbohydrates, pulses or nuts; intakes of saturated fatty acids, sugar and protein were too high. Only 16% of Polish subjects met the WHO recommendation for polyunsaturated fat intake. Consumption of fruits and vegetables was lower than recommended, especially among those Russian subjects who were assessed during the low intake season. Fewer than 65% of subjects consumed adequate amounts of calcium, magnesium and potassium, when compared with the United Kingdom's Reference Nutrient Intake.ConclusionThis first large scale study of individual-based dietary intakes in the general population in Eastern Europe implies that intakes of saturated fat, sugar and complex carbohydrates are a cause for concern. The development of country-specific nutritional tools must be encouraged and nutritional campaigns must undergo continuing development.
Highlights
The high cardiovascular mortality in Eastern Europe has often been attributed to poor diet, but individual-level data on nutrition in the region are generally not available
By the 1970s, while life-expectancy in the West had continued to rise, in Central and Eastern Europe (CEE) and in the Former Soviet Union (FSU), life expectancy began to plateau, or more worryingly, decrease
We present the dietary data assessed using a food frequency questionnaire (FFQ) in Russia, Poland, and the Czech Republic, and we compare the dietary intakes in these populations with those recommended by the World Health Organisation (WHO) and by the United Kingdom Department of Health
Summary
The high cardiovascular mortality in Eastern Europe has often been attributed to poor diet, but individual-level data on nutrition in the region are generally not available. By the 1970s, while life-expectancy in the West had continued to rise, in Central and Eastern Europe (CEE) and in the Former Soviet Union (FSU), life expectancy began to plateau, or more worryingly, decrease This gap in life expectancy, still evident today, is mainly due to mortality from circulatory diseases [1,2,3]. Even though diet has been strongly implicated in the CVD epidemic in CEE/ FSU, most of the available data are ecological; there are very few individual-based studies of nutrient intake in the region [11,12,13,14]. The lack of individual-level studies is exacerbated by the limited and often inconsistent information on the composition of foods (including traditional dishes), along with limited expertise in population-based assessment of diet
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