Operationalization of food consumption surveys in Europe: recommendations from the European Food Consumption Survey Methods (EFCOSUM) Project

Abstract

Background: The EFCOSUM (European Food Consumption Survey Methods) Project aims at harmonizing food consumption surveys in European countries within the perspective of an overall Public Health Monitoring Programme. Harmonization implies the need for a common framework of procedures and tools, that are applicable and feasible in all potentially interested countries. A major element in such a framework is the protocol for the operationalization of a food consumption survey, referring to all practical, logistical and material conditions that need to be fulfilled in order to guarantee a successful implementation of such a survey. Objective: The objective of this paper was to review a number of aspects of operationalization of food consumption surveys in detail. On the basis of the currently available knowledge and experience in Europe, consensus recommendations have been elaborated for an operationalization protocol that would be feasible for all European countries. Methods: The EFCOSUM recommendations with respect to operationalization of food consumption surveys in Europe are mainly based on three sources of information, which have been discussed at several ad hoc expert meetings: experience from previous collaborative epidemiological studies, literature searches and results of two questionnaires, distributed among representatives from 23 European countries -all experts affiliated with experienced organizations in the fields of nutrition research and related fields. Results: Consensus recommendations have been set up for the following topics: sampling, recruitment, fieldwork, biomarkers, interviewer qualifications and training and quality control. These recommendations have to be considered the best achievable common denominator within Europe at this time. In a number of cases, recommendations are presented in a hierarchical way, with a gradation from first choice options towards acceptable alternatives. Conclusions: It can be concluded that a high degree of standardization of fieldwork can be achieved within Europe. A number of specific problems and constraints will have to be solved in connection with the conduction of a real survey. These problems include, amongst others, country-specific decisions on, for example, target population, detailed sampling and recruiting procedures, interview setting and support. However, on the whole, these problems can be overcome and the main recommendations presented in this paper are considered feasible for every country in Europe. Application of the EFCOSUM operationalization protocol in European countries will contribute significantly to the quality and comparability of food consumption data across Europe. It is anticipated that the policy supporting and orienting potential of this type of databases -both at the national and at the EU supranational level -will be increased accordingly.

Comparison of food consumption and nutrient intake assessed with three dietary assessment methods: results of the German National Nutrition Survey II

“…The chosen setting of two times 4 days of recording caused an overlap of Wednesdays and Saturdays. It is known that food consumption differs between weekdays and weekends [12,15,16]. Internal analyses showed that intakes of energy and carbohydrates on Saturdays were significantly higher than the intakes on weekdays (data not shown).…”

Selection of methodology to assess food intake

“…They should be familiar with the nutritional habits (eg the foods usually eaten together) to be able to get detailed and complete answers and to control the accuracy of data. For an efficacious elaboration and evaluation, a coding system of foodstuffs and meals, and also a computerized program are needed (Beaton et al, 1979;Nelson & Bingham, 1997;De Henauw et al, 2002;Slimani & Valsta, 2002). Due to intra-individual variability, a single 24 h recall does not represent the usual individual intake but it characterizes the average intake of a group or population fairly well.…”

Design and results of the pretest of the IDEFICS study

“…23 However, it is rarely applied as a proxy instrument, as was planned for the IDEFICS study, which posed additional challenges to its development and application. The SACINA software can be administered in different ways (for example, as a face-to-face interview or as a self-administered interview) to collect dietary intake information.…”