Abstract
Eating out of home (OH) is increasingly popular in Balkan countries, among them Albania. To date there is only anecdotal evidence regarding nutritional quality of food consumed OH and the contribution to diet. This study assessed intake of foods and drinks consumed OH and at home (AH), as well as their nutritional contribution to the daily diet of university students in Tirana, Albania. Using a single day Automated Multiple Pass Method (AMPM) 24-hour dietary recall, we examined food intake among 289 students aged 18–24 years old, from three major universities in Albania. Contribution of eating OH to total energy intake per day, as well as to daily consumption of macronutrients by eating OH intensity tertiles were assessed. Foods and drinks consumed OH contributed 46.9% [95%CI:41.4–52.8] of total daily energy intake, representing, on average, 1169.1kcal [95%CI:1088.3–1249.9]. Sweets, soft drinks and meat products were more frequently consumed OH, while fruits and vegetables consumption was extremely low. The average quantity of sugars and dietary fats per day was higher AH, 76.9g [95%CI:70.3–83.5] and 173.7g [95%CI:163.2–184.2] respectively, compared to OH, 33.7g [95%CI:30.4–37.0] and 142.0g [95%CI:131.5–152.5] respectively. Dietary composition of AH intake was richer in sugars, total fats and proteins, while OH intake was richer in saturated fats. The overall diet appeared unhealthy, when nutrients were assessed as energy percentage against WHO proposed nutrient standards for sugar and saturated fats. Eating OH, even though was associated with lower fruits and vegetables intake, was not clearly associated with poor diet quality, as AH foods were also characterized by increased saturated fats and sugars intake as energy percentage. This study provides data on the first assessment of current dietary patterns of the studied population and can be used as baseline for designing and conducting future studies and interventions targeting malnutrition in all its forms.
Highlights
Since its transition from a central planned to a market-oriented economy in early 1990s, Albania has experienced economic growth, fast urbanization and regional trade liberalization, which are some of the major drivers of ‘westernization’ of diets: increased intake of meat, fat, processed foods, sugar and salt [1]
We considered OH foods to include all foods that were not prepared at home and were obtained near fast foods, restaurants, street food vendors and other OH sources of food, including food products purchased ready-to-eat from food stores, such as supermarkets, convenience stores and some special food market
Concerning the fact that there is no standard portion size booklet for Albania, certain modifications were introduced, namely a universally recognizable picture of a 100 LEK Albanian life-size coin was attached to the models aiming at increasing accuracy of the estimated portion size of foods and drinks consumed
Summary
Since its transition from a central planned to a market-oriented economy in early 1990s, Albania has experienced economic growth, fast urbanization and regional trade liberalization, which are some of the major drivers of ‘westernization’ of diets: increased intake of meat, fat, processed foods, sugar and salt [1]. There is a clear urgency for evidence on diet and food consumed in the country, which is currently absent, as noted from a recent review of nutritional survey in 53 European countries of the WHO European region, including Albania [3]. Such evidence is yet needed to aid development of effective policy measures and interventions. Food service providers, such as cafes and fast-food vendors are popular in the Balkan countries and are increasingly important sources of foods and drinks for Albanian consumers [4]. The available fast-food items are mainly meat-based wraps, pizzas, chips, soft drinks, croissants, processed meat products and different types of sandwiches, characterized by high macronutrient density and degree of processing
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