Objective: To study differences in dietary intake between adults with different socioeconomic status (SES) and trends over time. Design: Cross-sectional study based on data of three Dutch National Food Consumption Surveys (DNFCS-1 1987=88; DNFCS-2 1992; DNFCS-3 1997=98), obtained from a panel by a stratified probability sample of the non-institutionalized Dutch population. Subjects: A total of 6008 men and 6957 women aged 19 y and over. Methods: Dietary intake was assessed with a 2 day dietary record. Background information was obtained by structured questionnaire. Sociodemographic variables were available from panel information. SES, based on educational level, occupation and occupational position was categorized into (very) low, middle and high. Analysis of variance with age as covariable was used to explore the effects of SES on dietary intake and anthropometry. Statistical tests for trend were carried out with models in which week-weekend-day effects and an interaction term of time with SES were also included. Results: The prevalence of obesity and skipping of breakfast was higher among people with a low SES. In all three surveys, subjects in the (very) low SES group reported having a higher consumption of potatoes, meat and meat products, visible fats, coffee and soft drinks (men only). Subjects with a high SES reported consuming more vegetables, cheese and alcohol. As regards nutrients, in all surveys a higher SES was associated with higher intake of vegetable protein, dietary fibre and most micronutrients. A higher SES was also associated with a lower fat intake but the differences between social classes were rather small and not consistent when the contribution of alcohol to energy intake was taken into account. Conclusion: In general, dietary intake among subjects in higher SES groups tended to be closer to the recommendations of the Netherlands Food and Nutrition Council and this phenomenon was quite stable over a period of 10 y. Sponsorship: The present study was supported by the Dutch Ministry of Health, Welfare and Sports.

Objective:this paper aims to give a broad overview of published data on nutrition and health among migrants in the Netherlands, as well as data on determinants of health.Results and conclusions:Depending on the definition, 9 to 17% of the population belongs to the group ‘migrants’ and this proportion is expected to grow in the coming years. Roughly 2/3 of migrants are of the first generation and on average, they are younger than the Dutch population. Relatively few data concerning the health status of migrants are available. The diet of migrants showed both positive (macronutrients) and negative (micronutrients) differences with the general Dutch diet. The risk of overweight was high among both children and adult women, and the data suggest a higher risk for Turkish and Moroccan groups than for Dutch groups. The importance of health determinants, such as smoking, alcohol use and physical and social environment, was different for migrants than for the Dutch population; however, there were also differences between ethnic groups. The limited data on morbidity for migrants suggest higher risks than for the indigenous population. The same holds for mortality data, especially for the younger age groups. In general, the data that are available suggest that the health status of migrants was less favourable than that of the indigenous population. However, there were also differences between the various groups of migrants. The lower socio-economic position of migrant groups partly explained the differences in health status. Nevertheless, a study among Turkish people indicated that their health status was lower than that of Dutch people of comparable socio–economic status.

Objective: To discuss the general outcome and conclusions of a European project (EFCOSUM); to develop a method for a European food consumption survey that delivers internationally comparable data on a set of policy relevant nutritional indicators. Design and methods: The EFCOSUM project was carried out within the framework of the European Health Monitoring Programme by 14 Member States as well as nine other European countries. Activities of the project included plenary sessions, desk research and working group activities, building on existing experience from such projects as DAFNE, EPIC, FLAIR EurofoodsEnfant project, COST Action 99 and others. All participating states took part in one or more working group activities, which were discussed, adapted and finally approved in plenary sessions. Results and conclusions: For a limited number of countries available food consumption data can be made comparable at the food intake level, but not at the nutrient level. To achieve comparability at the food intake level, a considerable amount of work still has to be done. A minimum list of dietary indicators considered to be the most relevant to be collected for the Health information exchange and monitoring system was identified. As the most suitable method to get internationally comparable new data on population means and distributions of actual intake the 24 h recall was selected, to be conducted at least twice. This also allows for the estimation of usual intake by a modelling technique that separates intra-and inter-individual intake. For a number of micronutrients the use of biomarkers is recommended. Aspects of food classification and food composition were discussed thoroughly, as well as statistical and data collection aspects. For the implementation of a pan-European survey the establishment of a European co-ordinating centre is recommended. The standardization of field work work procedures and other aspects of operationalization have been discussed in detail. It is concluded that there is broad European consensus on the most suitable method for a pan-European dietary survey for the purposes of the EU Health Monitoring Programme. It is further concluded that such a pan-European survey is feasible, if the funds are made available.

Objective: To describe the rationale and methods for a European project (EFCOSUM) to develop a method for a European food consumption survey that delivers internationally comparable data on a set of policy-relevant nutritional indicators. Rationale and methods: Currently Member States are collecting data and information for use at national level. At an international level, such data are often of limited comparability and of varying quality. To promote the development and exchange of adequate, reliable and comparable indicators of public health, and the structures needed to exchange the relevant data, a programme of Community action on health monitoring was set up for the EU.

To assess the level of exposure to food contaminants (cadmium, lead, PCBs, DDT, hexachlorobenzene, nitrate and malathion) a total-diet study was carried out. A total of 226 food products were analysed individually; the concentration of contaminants in products not selected for analysis was estimated with the help of published data. The results of the analyses and estimations were used as input for the first Dutch National Food Consumption Survey (1987-1988) (n = 5898, age 1-85). Mean intakes of all contaminants analysed did not exceed the acceptable daily intake (ADI) or comparable values in any of the age-sex groups. Comparison of the results with those of previous total diet studies suggests that the intake of all contaminants analysed had declined between 1976-1978 and 1988-1989. In younger age groups an intake of lead and cadmium exceeding the tolerable daily intake (derived from the WHO/FAO provisional tolerable weekly intake) was found in 1.5% of individuals at most. For the older population groups and for the other contaminants in all population groups mean and maximum intakes were substantially below the ADL. However, individual intakes above the ADI for nitrate were found in 3-23% of individuals. For chronic exposure these percentages are likely to be overestimated because of the short time frame for food consumption measurement. In general, the difference between mean intake and tolerable daily intake was smallest for children aged 1-4. Therefore, it is recommended that future research is concentrated on the intake of contaminants in younger age groups.