L’impatto della crisi economica sull’alimentazione corretta in Europa

1. L’impatto della crisi economica sull’alimentazione corretta in Europa Alessandra Bordoni & Francesco Capozzi Dipartimento di Scienze e Tecnologie Agro- Alimentari Università di Bologna

2. The economic impact on healthynutrition • The food choice of low income group of consumers implies a greater tendency to consume unbalanced diets under- (micronutrient deficiency)or over-nutrition (overweight and obesity) • (WHO data). • All over EU: • low income families have highest percentage (22%) of the income expenditure for food (highest income families = 13%) • diets progressively become more unbalanced with decreasing socio-economic status • (Friel S et al, Eur J ClinNutr, 57(7): 865-875, 2003).

3. The economic impact on healthynutrition • All over Europe: • the socio-economic gradients in food and nutrient intake are observed, withstanding cultural diversity • healthy food habits are positively associated with higher economic level and greater disposable income • population clusters sharing a low purchasing power have the highest risk of diet-related diseases due to their sub-optimal nutrition.

4. The situation in the EU • A comprehensive overview of dietary pattern of low-income groups in Europe is lacking. • Only a few countries have conducted country-specific dietary assessment of low-income people, and these studies differ in methodologies which hinders cross-country comparisons (i.e. low-income groups are classified with different criteria) • (Nikolić M et al (2014) Nutrients 2014;6(4):1374-1393).

5. Cereal products, fibre and starchy foods • Consumption of wholegrain products is less frequent among lower-income groups • In some countries potatoes are the main source of starch. • The main sources of energy for lower-income groups are carbohydrates

6. Milk and dairy productsMeat, fish • Low-income groups show a greater consumption of milk and dairy, particularly related to high fat products • Results for meat and meat products are contradictory. In the most of European countries lower meat consumption has been found in lower-income groups. • Energy from protein is reduced in lower-income groups .

7. Fats and oilsSugar and sweets • Energy derived from fats is higher in more deprived households, and fats tend to be of the saturated type • Higher intakes of sugars are found for lower-income groups in the UK, Germany and France.

8. Energy intake • Although lower-income groups are found to purchase more energy-rich foods, mean energy intake generally decreases with increasing deprivation. • Frequent snacking and high consumption of fast foods is more common among lower socio-economic populations.

9. Fruit and vegetables • Lower consumption of fruits and vegetables amongst low-income groups is found uniformly across all countries studied. • Meeting recommendations for daily consumption, usually five portions per day, is more common for higher socio-economic populations

10. The CHANCE project • The EU project CHANCE (Low Cost technologies and traditional ingredients for the production of affordable, nutritionally correct, convenient foods enhancing health in population groups at risk of poverty – grant agreement 266331) had two specific objectives: • - the identification of the main nutrients which intake is critical in population groups at ROP, as well as the barriers to healthy food choice in these population subgroups; • - the selection of ingredients and raw materials to be exploited for the formulation of new food prototypes specifically addressed to the correction of the main malnutritions evidenced in the ROP groups

11. The «risk of poverty» • The CHANCE project accepted to use definition for the ‘at-risk-of-poverty’ (ROP) according to the EU definition. • The poverty risk threshold was set at 60% of the national household equivalised median income • In Italy, the poverty treshold was set at € 9122 (Living conditions in 2008, Eurostat news releases on the Internet 2010)

12. Identification of the main nutrients which intake is critical in population groups at ROP – the CHANCE survey • Collection of nutritional data using small, statistically-valid surveys on dietary patterns and nutrient intakes of selected ROP groups. Data collection was performed using validated methods (FFQs,repeated 24 hour recall). • Volunteers, were recruited from Finland, Italy, Lithuania, Serbia, and UK. Within each country, specific subgroups of population were identified as the best representative of the population at risk of poverty in the country.

13. Best representative of the population at risk of poverty in the different countries

14. In Italy the meanconsumption of fruits and vegetableswasabout200 g/day in ROP and 350g/dayin AFF. Reccomendation (5 a day) isatleast 500 g a day!

15. The Italian situation • About 60% of both ROP and AFF did not accomplish national recommendations fordietary fibers • The intake of all vitaminswas below recommendations in the 50% or more of both ROP and AFF, without significant differences between the two groups; • Folateand vitamin D intake appeared lower than recommended in the 100% of women in both groups.

16. The Italian situation • Comparing vitamins intake with the corresponding Lower Threshold Intake (LTI)1, folate intake appeared the main critical vitamin in both ROP and AFF, followed by vitamin C, B1 and A. • 1The Lower Threshold Intake (LTI) represents the level of intake believed to be sufficient for 2,5% of apparently healthy population in a given life stage, and below which, on the basis of current knowledge, almost all individuals will be unable to maintain “metabolic integrity”, according to the criterion chosen for each nutrient.

17. The Italian situation • The intake of minerals, in particular calcium, copper, magnesium, potassium and selenium, was below the recommendations in the most of ROP and AFF women regardless the socio-economic group. • In both groups intake of sodium exceeded recommendation in about 25% of participants. • Comparing minerals intake with the corresponding LTI, copper, magnesium, selenium, and iron appeared the main critical nutrents

18. Percentages of Italian ROP and AFF subjects whose intake is not sufficient to cover the requirement as indicated by the national DRVs is reported. Only percentages higher than 50% are reported.

19. WHY??? • ROP respondents have a slightly lower level of knowledge on nutrition and healthy eating habits • Both groups had similarly positive attitude towards healthy eating, but ROP respondents were less likely to believe that they can control their own healthy eating than AFF.

20. WHY??? • The most commonly agreed (about 40%) barrier to healthy eating in both groups was emotional eating • The second most important perceived barrier was limited choice of healthy foods in places outside home (canteens, restaurants, etc)

21. WHY?? • Other barriers perceived as important in both groups: • poor affordability of healthy foods (esp. among ROP), • preference for familiar and traditional foods • preference for pleasure over healthiness. • Low interest in healthy eating

22. The food choice criteria • good taste, • healthiness, • not expensive price, • suitable for the personal diet, • familiar, • satiating, • attractive in appearance, • convenient to use.

23. The food choice criteria • AFF group associated healthy eating significantly more often with locally produced foods than ROP • Both ROP and AFF believed that better food labels, and higher availability of healthy foods would encourage them to eat in more healthy way.

24. Thanks to: • Francesco Capozzi, coordinator of the CHANCE project • Francesca Pasqui andMarta Baldini, who contributed to the collection and analysis of IT nutritional data • Aldo Bertazzoli andAntonella Samoggia, who analysed IT socio-economic data • All the CHANCE Consortium