Abstract

Central Europe comprises a heterogeneous group of some 120 million persons from 11 countries which differ greatly in food availability and preferences. The region has undergone dramatic changes in food consumption patterns and in the patterns of nutritionally related diseases. The changes in the political situation in central Europe have provided a unique natural experiment which allows the study of the effects of different eating behaviors on health within a genetically homogeneous population and an analysis of the time frame in which effects can be seen at the national level. This is in particular the case for the FRG and the GDR. Epidemics of nutritionally related disease have arisen, including cardiovascular disease, cancers of the colon and breast and obesity. These occur at very different rates in neighboring countries. Furthermore, unknown factors, probably including food-hygienic factors and methods of storage and preparation, have resulted in drastic reductions in the rates of stomach cancers in all countries. These have only recently been detected, as no systematic nutritional surveillance systems are currently in effect in Europe. Due to the chronic nature of the diseases in question, we are noticing too little, too late. Food patterns provide a realistic and sensitive predictor of disease incidence. They are timely enough to detect changes before they are reflected in a diminished health status of the population or specific risk groups. Details on the patterns of intake and secular trends, as far as they are available for individual countries, reveal that eating behavior is quite labile and subject to dramatic changes within decades. The current information status does not allow a closer examination of specific population groups, such as the behavior of children or the elderly, the intakes of pregnant or breast-feeding women, or the eating behavior of men at high risk of heart disease. The foundations of a European nutrition surveillance system need to be laid, to make possible the timely detection of high-risk-related changes in food consumption, unfavorable trends and early signs of nutritionally related epidemics. The regular, standardized assessment of eating patterns will be an important building stone in such a system.

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