What is the problem? 
Malnutrition, both in the form of micronutrient deficiency and excess energy and macronutrient intake, is a major issue in populations across Europe. It affects individual health outcomes in children and adolescents, which has implications for health problems in adulthood. It also impacts on broader society, for example through increased healthcare costs.

National dietary surveys can provide information on population nutrient intakes, to form an evidence base for policies to address malnutrition. For this reason, the World Health Organisation encourages countries to conduct surveys as part of a regular monitoring system.

What did we do and what did we find?
We gathered information on national dietary surveys undertaken on children and adolescents across the 53 WHO European Member States and compared the latest available energy, macro and micronutrient intakes to WHO Recommended Nutrient Intakes (RNIs).

Worryingly, only a third of countries conducted national diet surveys with available nutrient intakes. Fewer still reported intakes by socio-economic status, with no consensus on how this was defined, which made comparisons between countries difficult. Not all countries reported the same number or combination of nutrients; energy and macronutrients were the most widely reported. Other factors that hindered inter-country comparisons included inconsistent age groups across surveys, different dietary assessment methodologies and differences in the origin, completeness and accuracy of the nutrient composition databases forming the basis of nutrient intake data.

Most countries met under half of the WHO RNIs for the nutrients reported and age groups included in their national diet survey. RNI attainment was worst in girls and older children, with excessive intakes of total fat, saturated fat and sodium, and inadequate intakes of vitamin D, total folate and iron being of greatest concern. This has implications for various health problems, including obesity-related disorders, hypertension, rickets, iron-deficiency anaemia and prevention against neural tube defects when girls reach child-bearing age.

Our findings show that many European countries lack evidence to identify vulnerable groups and specific areas of concern relating to nutrient intakes within their child and adolescent populations. In particular, countries in Central & Eastern Europe were more likely to have no accessible, published data on child nutrient intakes. This means data is lacking to inform policies that prevent nutrition-related deficiencies in childhood becoming major health problems in adulthood.

What do we need to do next?
Establishing a comprehensive and accurate monitoring system that enables health professionals, governments and policymakers to identify and target priority areas of need is vital. Countries across Europe should be encouraged to conduct national diet surveys in a regular and uniform manner and that barriers to this are addressed.

The open access article ‘Child and adolescent nutrient intakes from current national dietary surveys of European populations’ is the highest Altmetric Scoring article for Nutrition Research Reviews to date (July 2019).

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