Nutritional objectives for the Spanish population. Consensus from the Spanish Society of Community Nutrition

Abstract

In Europe, iron deficiency is considered to be one of the main nutritional deficiency disorders affecting large fractions of the population, particularly such physiological groups as children, menstruating women and pregnant women. Some factors such as type of contraception in women, blood donation or minor pathological blood loss (haemorrhoids, gynaecological bleeding,..) considerably increase the difficulty of covering iron needs. Moreover, women, especially adolescents consuming lowenergy diets, vegetarians and vegans are at high risk of iron deficiency. Although there is no evidence that an absence of iron stores has any adverse consequences, it does indicate that iron nutrition is borderline, since any further reduction in body iron is associated with a decrease in the level of functional compounds such as haemoglobin. The prevalence of iron-deficient anaemia has slightly decreased in infants and menstruating women. Some positive factors may have contributed to reducing the prevalence of iron-deficiency anaemia in some groups of population: the use of ironfortified formulas and iron-fortified cereals; the use of oral contraceptives and increased enrichment of iron in several countries; and the use of iron supplements during pregnancy in some European countries. It is possible to prevent and control iron deficiency by counseling individuals and families about sound iron nutrition during infancy and beyond, and about iron supplementation during pregnancy, by screening persons on the basis of their risk for iron deficiency, and by treating and following up persons with presumptive iron deficiency. This may help to reduce manifestations of iron deficiency and thus improve public health. Evidence linking iron status with risk of cardiovascular disease or cancer is unconvincing and does not justify changes in food fortification or medical practice, particularly because the benefits of assuring adequate iron intake during growth and development are well established. But stronger evidence is needed before rejecting the hypothesis that greater iron stores increase the incidence of CVD or cancer. At present, currently available data do not support radical changes in dietary recommendations. They include all means for increasing the content of dietary factors enhancing iron absorption or reducing the content of factors inhibiting iron absorption. Increased knowledge and increased information about factors may be important tools in the prevention of iron deficiency in Europe.

Compliance with the European and national nutritional objectives in a Mediterranean population

“…The population goals for nutrients consistent with prevention of major public health problems in the European countries (Kafatos and Codrington, 2003) and the intermediate nutritional objectives for the Spanish population (Serra-Majem and Aranceta, 2001) are shown in Table 3. The percentage of compliers in the Catalan sample with the former objectives can be seen in Table 4.…”

“…A clear example of a healthy dietary pattern is the 'traditional' Mediterranean diet, which has been shown to be protective against mortality for several causes and the development of coronary heart disease, stroke, hypertension and other chronic diseases (Martinez-Gonzalez et al, 2002;Psaltopoulou et al, 2004;Sanchez-Villegas et al, 2005;Trichopoulou et al, 2005). The nutritional objectives for the Spanish population are therefore based in the development of dietary guidelines within a Mediterranean context (Serra-Majem and Aranceta, 2001). However, the compliance with these nutritional goals should be periodically verified.…”

Does the diet of the Balearic population, a Mediterranean-type diet, ensure compliance with nutritional objectives for the Spanish population?

“…The consumption of fats, fruit and vegetables, dairy products, wine and alcohol, fish and meat, and the prevalence of obesity, for example, vary considerably among Spanish regions. As such, in our country diet and nutrition represent the main sources of variability in the geographic distribution of health indicators related to noninfectious diseases 1 . Promoting adequate eating habits, which follow healthy dietary models, constitutes one of the most important components within heath promotion strategies.…”

Communication of scientific uncertainty: international case studies on the development of folate and vitamin D Dietary Reference Values

“…Countries/regions were originally selected from Europe with a subsequent opportunity taken to also collect data in Australia and New Zealand. The countries/regions sampled represented diversity in the age and method of (27) , HCN update 2008 (39) HCN 2000 (40) , HCN update 2008 (41) NOC 4 80 NNR 2004 (42) NNR 2004 (42) , *NNR 2012 published subsequent to data collection (26) PL 4 100 Jarosz and Bułhak-Jachymczyk 2008 (43) Jarosz & Bułhak-Jachymczyk 2008 (43) ES 3 100 Moreiras 2011 (44) , Ortega 2011 (45) , Serra Majem 2001 (SENC) (46) , Martínez 2010 (FESNAD) (47) Moreiras 2011 (44) , Ortega 2011 (45) , Martínez 2010 (FESNAD) (47) UK 2 33 COMA 1991 (48) , SACN folate 2006 (49) COMA 1991 (48) , developing DRV as well as in geographical location, sociocultural factors and institutional infrastructure. Data sets were collected from December 2010 to June 2011.…”