Monitoring Public Health Nutrition in Europe: nutritional indicators and determinants of health status

Public Health Nutrition (PHN) focuses on the promotion of good health through healthy food habits, a physically active lifestyle and the prevention of related illness in the population. Monitoring PHN in Europe has been a project within the European Health Monitoring System (HMS), currently under development by the EU Commission within the Health Information Strand of the Public Health Programme 2003–2008. The project aims were to: (1) develop a theoretical framework for the selection and prioritization of indicators; (2) identify indicators relevant to the monitoring; (3) examine the nutritional aspects and proposals from other monitoring projects; (4) consider other novel proposals; (5) integrate these into a recommended list of indicators; (6) integrate the surveillance system into training and educational systems, in particular the Program for the European Masters in PHN. Seven main categories for investigation were identified: health promotion; food and nutrient intake, including breastfeeding and alcohol; nutritional status, physical activity habits and fitness; sociodemographic factors; inequality. Three working parties provided useful comments on the prioritizing of the many indicators. These comments were then fed to the coordinators in the Executive Committee, who further developed a prioritization scheme and produced the list of recommended indicators. The Report Committee took responsibility for preparing the report. Meanwhile experience was presented and discussed at several international meetings. The information was finally transferred to the coordinator project, the ECHI (European Core Health Indicator) project, for inclusion of relevant indicators in the ECHI lists. Information was also disseminated through publications and newsletters, and through training at the Master’s and PhD levels across Europe. In most cases, operational measures could be defined in detail from their generic indicators. Standardized methods for data collection were also given. In future, we recommend that all European countries, and/or the HMS, should add questions to their surveys, according to the list of recommended indicators, to ensure that all the relevant areas of PHN are covered.