THE NUTRITION REPORT 2000 SUMMARY GERMAN NUTRITION SOCIETY 1 The Nutrition Report 2000 Summary Published by the German Nutrition Society On behalf of the Federal Ministry of Health and the Federal Ministry of Nutrition, Agriculture, and Forestry German Nutrition Society Deutsche Gesellschaft für Ernährung e. V., Im Vogelsgesang 40, D–60488 Frankfurt am Main; from 01. 04. 2001 Godesberger Allee 18, D–53175 Bonn Introduction The government of the Federal Republic of Germany commissioned the German Nutrition Society (DGE) in 1968 to prepare a report concerning the nutritional status of the German population. This Nutrition Report was well received when it was submitted in June of 1969 because for the first time it provided an overview of a wide range of data that was avail- able about nutrition in Germany. As a result the government decided to commission the DGE to prepare a comparable report every 4 years. In addition to an analysis of the nutrition situation in the Federal Republic of Germany the Reports of 1972, 1976, 1980, 1984, 1988, 1992 and 1996 contained reviews of important aspects covering current science of nutrition. The following topics were dealt with in 1972: • Nutrition habits in the Federal Republic of Germany • The importance of processed food in nutrition • Changes in food quality during storage, processing and packaging • Nutrition education in schools • Nutrition science and nutrition research. In 1976 detailed information was presented on aspects of: • Hygienic-toxicological and microbiological aspects of nutrition • Problems of large scale food preparation and delivery • The influence of advertisement on nutrition behaviour. The 1980 Nutrition Report discussed: • Nutrition behaviour • Eating away from home • Relationships between nutrition research and health policy. The Nutrition Report 1984 dealt with the following topics: • Development of the nutritional situation in the Federal Republic of Germany • Chemical-toxicological and hygienic-microbiological aspects of nutrition • Psychosocial evaluation of nutrition in families with children • The development of demand for foodstuff in the Federal Republic of Germany • Critical evaluation of alternative diets. The 1988 Nutrition Report discussed: • Development of the nutritional situation in the Federal Republic of Germany • Toxicological and microbiological aspects of nutrition • Documentation Chernobyl • Food allergies and food intolerance reactions • Influence on nutritional habits by federal measures • Influences of food intake by man • Meals eaten outside the home • Recommendations for covering the nutrient and food energy requirements • Research in nutrition in the Federal Republic of Germany. 3 The 1992 Nutrition Report presented 6 chapters: • The development of the nutritional situation in Germany • Toxicological and microbiological aspects of nutrition • Selected socio-cultural influences on nutritional behaviour • Food allergies and food intolerance reactions • Tumourigenesis – inhibiting and promoting effects of nutritive factors • Iodine supply and iodine deficiency prophylaxis in Germany. The 1996 Nutrition Report discussed: • The nutritional situation in Germany • Development of institutional meals in the new German states (former East- Germany) • Iodine deficiency prophylaxis in Germany • Toxicological aspects of nutrition • Microbiological aspects of nutrition • Tumourigenesis – inhibiting and promoting effects of nutritive factors • The importance of secondary plant products to health • Malnutrition of geriatric patients • Novel foods • The use of information from food labels as a buying aid in the food choice of German consumers. The Nutrition Reports provoked considerable interest both within and outside Germany. Thus it seemed appropriate to translate the summary of the 2000 Nutrition Report into English. The Report contains 10 chapters: • The nutritional situation in Germany • Breast-feeding and infant nutrition in Germany • The nutritional situation in day care centres: the Day Care Centres-Nutritional- Situation-Study • Eating habits and nutritional situation of children and adolescents • Nutrition of elderly persons • Toxicological aspects of nutrition • Microbiological aspects of nutrition • Technological aspects of food processing • Influence of nutrition on the intestinal flora • Prophylaxis of diseases with wholesome nutrition. 4 Chapter 1: The nutritional situation in Germany This chapter is a continuation of earlier reports on the nutritional situation in Germany. The aim of these reports is to offer – as far as possible – the most recently available, differentiated, comparable as well as valid data. Since these various goals cannot be achieved at the same time under realistic conditions data is retrieved from various information sources for the characterization of the nutrition situation, which fulfill the different aspects to varying degrees. As an example, the strong point of the data of the Income and Consumption Survey (house- hold budget survey) is the size of the sampling. For this reason, a strongly differentiating refined analysis is possible in terms of individuals. Theoretically consumption studies offer the most valid nutritional data since only in this manner indirect measurements of the food actually consumed by people are carried out. Both data sources are especially suitable for the evaluation of the nutritional situation in a limited period of time (cross-sectional analysis). The data of the statistics of agriculture, in contrast, are characterised by their special relevance to the present situation and their good comparability in the course of time. Therefore, this data source is preferably used for the analysis of trends in nutrition (time- row analysis). All these different data are elements for the description and assessment of the nutritional situation in Germany, that is presented in the following sections. Food consumption The Income and Consumption Survey 1993 provides food consumption data of 38,924 study participants. On this basis, the quantitative average consumption of approximately 100 food groups per day were calculated for each of the 16 individual states in Germany. These data were examined in a cluster analysis, to investigate the differences and the similarities of food consumption of the population in each state. This analysis showed con- siderable differences in the nutrition of the old (West) and new (East) states of Germany. But, there were distinct food consumption differences also among the old states, e. g. Schleswig-Holstein, Berlin (West), Bremen and Lower-Saxony differed distinctly from the remaining old states. Furthermore remarkable similarities in the average food consumption are found for the old states of Hamburg, Northrhine-Westphalia and Hesse as well as for Rhineland-Palatinate and Baden-Württemberg. In the new states, two groups evolved that had similar consumption habits. One group comprised Brandenburg, Saxony, Saxony- Anhalt and Thuringia; the other group consisted of Mecklenburg-Vorpommern and Berlin (East). When comparing the average amounts for single food groups consumed, a higher con- sumption of meat, milk and milk products, cheese and soft curd cheese, confectionary, cereal products and alcohol-free beverages is notable in the old states in comparison to the new states. Conversely, higher consumption amounts of meat products and sausages, edible fats and oils (including butter), tropical and subtropical fruits as well as bread and bakery products can be found in the old states. 5 Energy and nutrient intake On the basis of the German Nutrient Food Code and Data Base (Bundeslebensmittel- schlüssel [BLS]; version II.2) and the Income and Consumption Survey food consumption data, the mean intake of energy and nutrients for different groups of persons defined according to age and sex was calculated. As already shown in other studies, regional differences in food consumption led to only marginal differences in the energy and nutrient intake. A comparison of the calculated intake data with the corresponding reference data for nutrient intake leads to the following results (Table 1): The average energy intake of the adult population up to under 51 years of age was near or only marginally above the guidelines, assuming moderate physical activity (PAL-value 1.4). In the group above 51 years of age, the average energy intake was significantly above the corresponding guidelines. This indicates a positive energy balance and explains the high prevalence of overweight in these population groups. For all male and female age groups the mean protein intake is far more than adequate, the fat consumption (especially in form of saturated fatty acids) is too high and the intake of carbohydrates (especially in form of polysaccharides) too low. Also, the average intake of dietary fibre of 20 g per day is significantly under the guideline of at least 30 g per day. The average alcohol intake of 20 g per day for males between 25 and under 65 years accounts for nearly 6 % of the total energy intake. In females of the same age the average alcohol intake is about 12 g per day, accounting for 4 % of the total energy intake. These quantities are above the amount considered healthy and should be reduced further. For most vitamins the average supply is sufficient for the population. This is the case for vitamin A and the majority of B-vitamins (especially thiamine, riboflavin, niacin, pyridoxine and vitamin B12) as well as for vitamin C. The supply of folic acid, however, is critical. The mean intake of folate