Οργανωτική Επιτροπή. Organizing Committee

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2 Οργανωτική Επιτροπή Organizing Committee Ειρήνη Τσιγαρίδα Γεώργιος Μαράκης Σταµατίνα Λουκά Μαγδαληνή Ζήκα Irene Tsigarida Georgios Marakis Stamatina Louka Magdalini Zika

3 ΕΛΛΗΝΙΚΟ ΣΗΜΕΙΟ ΕΠΑΦΗΣ EFSA Ο Ενιαίος Φορέας Ελέγχου Τροφίµων στο πλαίσιο των δραστηριοτήτων του ως Εστιακό Σηµείο της Ευρωπαϊκής Αρχής Ασφάλειας Τροφίµων στην Ελλάδα σας προσκαλεί στην Ηµερίδα που διοργανώνει µε θέµα: Επιστηµονικές προκλήσεις και κατευθύνσεις στη χάραξη διατροφικής πολιτικής που θα πραγµατοποιηθεί στις 22 Οκτωβρίου 2010 στην Αθήνα στο Ξενοδοχείο N.J.V. Athens Plaza, Πλατεία Συντάγµατος Η Ηµερίδα θα εστιάσει στις τρέχουσες επιστηµονικές προκλήσεις οι οποίες πρέπει να αντιµετωπιστούν από την EFSA, τον ΕΦΕΤ αλλά και από όλους τους εταίρους σε θέµατα που άπτονται: α) στη συλλογή στοιχείων κατανάλωσης, β) στην εκτίµηση οφέλουςεπικινδυνότητας, γ) στους ισχυρισµούς διατροφής και υγείας και γενικότερα στα οφέλη υγείας τροφίµων και βοτάνων, δ) στα σηµαντικά διατροφικά θέµατα όπως πρόσληψη αλατιού και λιπών, ε) στις διατροφικές συνήθειες και οδηγίες καθώς και στ) στις προκλήσεις και δράσεις σχετικά µε τη διατροφή από τη πλευρά της βιοµηχανίας και των καταναλωτών. Σκοπός της ηµερίδας, είναι να δώσει τροφή για προβληµατισµό σε θέµατα διατροφικής πολιτικής και της έκθεσης του Έλληνα καταναλωτή σε διατροφικούς κινδύνους. The Hellenic Food Authority (EFET) as the EFSA Focal Point in Greece has the pleasure to invite you to a one-day conference: Scientific challenges and directions for policy making in nutrition The conference will be held on 22 nd October 2010 in Athens at the hotel N.J.V. Athens Plaza, Constitution Square (Syntagma) The aim of this conference is to address current scientific challenges faced by EFSA and consequently by the Hellenic Food Authority (EFET) and other stakeholders, on areas which cover - a) food consumption data collection (including food categorization), b) risk-benefit assessment, c) health benefits/health claims - foods/herbs, d) important nutritional issues as addressed by the Commission White Paper on a strategy for Europe on nutrition, overweight and obesity related health issues (focus on salt/fat), d) dietary patterns and dietary guidelines, e) industry and NGOs perspectives on nutritional matters - as well as provide food for thought for directions for policy making in nutrition.

4 ΕΛΛΗΝΙΚΟ ΣΗΜΕΙΟ ΕΠΑΦΗΣ EFSA Επιστηµονικό Πρόγραµµα «Επιστηµονικές προκλήσεις και κατευθύνσεις στη χάραξη διατροφικής πολιτικής» 22 Οκτωβρίου :30-09:00: Εγγραφή και καφές 09:00-09:30: Χαιρετισµοί Ενότητα Ι Προεδρείο: Ειρήνη Τσιγαρίδα, /νση ιατροφικής Πολιτικής και Ερευνών, ΕΦΕΤ 9:30-10:00 Τι υ άρχει στο µενού της Ευρώ ης; - ε ισκό ηση και ροκλήσεις για την ρώτη ανευρω αϊκή έρευνα κατανάλωσης τροφίµων 10:00-10:30 10:30-11:10 Liisa Valsta, DATEX, EFSA Προκλήσεις για την ανά τυξη ενός ανευρω αϊκού συστήµατος κατηγοριο οίησης των τροφίµων (εµ ειρίες α ό το EuroFIR και το ρόσφατο Colloquium της EFSA) Simone Bell, EuroFIR, AISBL Αξιολόγηση οφέλους-ε ικινδυνότητας η ροσέγγιση της EFSA Bernard Bottex, Scientific Committee, EFSA Νιτρικά στα λαχανικά εξισορρο ώντας τα οφέλη και τους κινδύνους Claudia Heppner, CONTAM, EFSA 11:10-11:30 ιάλλειµα καφέ Προεδρείο: Αθανάσιος Ράικος, /νση Αξιολόγησης και Εγκρίσεων, ΕΦΕΤ 11:30-12:00 Ποια τρόφιµα µ ορούν να φέρουν ισχυρισµούς διατροφής και υγείας; Ενηµέρωση α ό την EFSA Leng Heng, NDA, EFSA 12:00-12:30 Μείωση ρόσληψης αλατιού - η εµ ειρία της Ιρλανδίας 12:30-13:00 Mary Friel, Food Safety Authority Ireland Αλλαγές στην ρόσληψη λι αρών οξέων στην Ελλάδα τα τελευταία 50 χρόνια Αντώνιος Καφάτος, Ιατρική Σχολή Κρήτης

5 13:00-14:00 Ελαφρύ γεύµα Ενότητα ΙΙ Προεδρείο: Γεώργιος Μαράκης, /νση ιατροφικής Πολιτικής και Ερευνών, ΕΦΕΤ 14:00-14:30 Καθιέρωση διατροφικών κατευθυντήριων γραµµών στην Ευρώ η σε οιο βαθµό είναι εφικτή η εναρµόνιση; Παγώνα Λάγιου, Ιατρική Σχολή Αθηνών, EFSA member of NDA panel 14:30-15:00 ιατροφικές συνήθειες των αιδιών στην Ελλάδα υ άρχει ανάγκη λήψης µέτρων; Αντώνιος Ζαµ έλας, Γεω ονικό Πανε ιστήµιο Αθηνών 15:00-15:30 Αντιλήψεις των καταναλωτών σχετικά µε διατροφικά θέµατα - δράσεις ου αναλαµβάνονται α ό τις οργανώσεις καταναλωτών Γεώργιος Λεχουρίτης, ΙΝΚΑ/ΓΟΚΕ 15:30-16:00 Πρωτοβουλίες της βιοµηχανίας τροφίµων για ισορρο ηµένη διατροφή Βάσω Πα αδηµητρίου, ΣΕΒΤ 16:00-16:30 ιάλλειµα καφέ Προεδρείο: Γεώργιος Μαράκης, /νση ιατροφικής Πολιτικής και Ερευνών, ΕΦΕΤ Παραδοσιακή Ελληνική Μεσογειακή ιατροφή, άλλοτε και τώρα: 16:30-17:00 Η έρευνα ΕΠΙΚ στην Ελλάδα Αντωνία Τριχο ούλου, Ιατρική Σχολή Αθηνών 17:00-17:30 Οφέλη για την υγεία α ό τα βότανα της µεσογειακής κουζίνας Ann Walker, University of Reading, UK 17:30-18:00 Αντιοξειδωτικά Μεσογειακής δίαιτας: κόκκινο κρασί και ελαιόλαδο Νικόλαος Ανδρικό ουλος, Χαροκό ειο Πανε ιστήµιο Καλιώρα Ανδριάνα, Χαροκό ειο Πανε ιστήµιο 18:00 Συµπεράσµατα και κλείσιµο συνεδρίου

6 GREEK FOCAL POINT OF EFSA Scientific Programme Scientific challenges and directions for policy making in nutrition 22 October :30-09:00: Registration and welcome coffee 09:00-09:30: Welcome speeches Session 1 (morning session) Chair: Irene Tsigarida, Nutrition Policy and Research Directorate, EFET 9:30-10:00 What s on the menu in Europe? overview and challenges in the first pan-european food consumption survey 10:00-10:30 10:30-11:10 Liisa Valsta, DATEX, EFSA Challenges in developing a pan-european Food Classification system (experiences from EUROFIR and recent EFSA Colloquium) Simone Bell, EuroFIR, AISBL Risk-benefit assessment: EFSA s approach Bernard Bottex, Scientific Committee, EFSA Nitrate in vegetables balancing risks and benefits Claudia Heppner, EFSA 11:10-11:30 Coffee break Chair: Athanasios Raikos, Evaluation and Approval Directorate, EFET 11:30-12:00 Which foods may carry nutrition and health claims? Update from EFSA Leng Heng NDA, EFSA 12:00-12:30 Reducing salt intake the Irish experience Mary Friel, Food Safety Authority Ireland 12:30-13:00 Fatty acids intake changes in Greece the last 50 years Antonios Kafatos, Medical School of Crete, Greece

7 13:00-14:00 LUNCH Session 2 (afternoon session) Chair: Georgios Marakis, Nutrition Policy and Research Directorate, EFET 14:00-14:30 Establishing food-based dietary guidelines across Europe to which extent is harmonization feasible? Pagona Lagiou, Medical School of Athens, EFSA member of NDA panel 14:30-15:00 Dietary habits of Greek children is there a need for intervention? Antonios Zampelas, Agricultural University of Athens, Greece 15:00-15:30 Consumers concerns on nutritional matters actions taken by NGOs Georgios Lechouritis, ΙΝΚΑ General Consumers Federation, Greece 15:30-16:00 Food industry actions for balanced diet 16:00-16:30 Coffee break Vasso Papadimitriou, SEVT, Greece Chair: Georgios Marakis, Nutrition Policy and Research Directorate, EFET 16:30-17:00 Traditional Greek Mediterranean Diet, past and present: EPIC study in Greece Antonia Trichopoulou, Medical School of Athens, Greece 17:00-17:30 Health benefits of herbs in Mediterranean cuisine Ann Walker, The University of Reading, UK 17:30-18:00 Mediterranean diet antioxidants focus on red wine and olive oil Nikolaos Andrikopoulos, Harokopion University, Greece Andriana Kaliora, Harokopion University, Greece 18:00 Closing remarks

8 What s on the Menu in Europe overview and challenges in the first pan- European food consumption survey Liisa Valsta, DATEX, EFSA The European Food Safety Authority (EFSA) has an important role in promoting and coordinating standardised data collection and uniform risk assessment methodologies as a basis to ensure a safe food supply and healthy diets in Europe. There is currently no harmonised, detailed enough food consumption information at individual level available at the EU needed for risk assessment purposes. Collecting high quality food consumption data with a standardised methodology covering populations from children to the elderly across the EU is a high priority task. Such an undertaking can only be achieved in close cooperation with all Member States and organisations operating in the field. In 2005, EFSA s Scientific Committee published an opinion on exposure assessment recommending the urgent collection of available consumption data at an aggregated level followed by an expanded collection of data at a detailed level. Since then, EU Member States have collaborated with EFSA in the establishment of the Concise European Food Consumption Database, operational since the end of February 2008 and the Comprehensive European Food Consumption Database building on existing information for adults and children at a detailed level. Although these data are already available from most European countries, it is not currently possible to get an overall picture of European food consumption due to differences in how information is collected. The collection of accurate and harmonised food consumption data at a pan- European level is therefore a primary long-term objective for EFSA. The What s on the Menu in Europe (EU Menu) is a pan-european food consumption survey that EFSA aims to establish in co-operation with Member States. Co-ordinated by EFSA, this survey will allow the collection of detailed and harmonised food consumption data from individuals of all ages across the EU. Data collection is planned to be carried out as a rolling programme over 5 years from the expected launch of the survey around 2012.

9 The EU Menu will provide standardised information on what people eat in all countries and regions across the EU. It will support risk managers in their decision making on food safety. It will also assist policy makers in assessing the nutritional status of population groups, setting targets regarding healthy diets and monitoring progress over time. In that way, the EU Menu will contribute to safer food and healthier diets for European citizens. The many challenges of a large and long-term survey vary from increasing of awareness of the data needs, motivating the Member States in their valuable work to the ways finding the feasible standardised methods to carry out the data collection and to get support for the efforts. A big step forward was seen in February 2010, when members of EFSA s Advisory Forum signed a declaration supporting the establishment of a pan-european food consumption survey. The methodological and feasibility challenges are worked out through the pilot phases of the study. The children s pilot phase is ongoing and the pilot phase concerning adults data collection is planned to be kicked off in autumn 2010.

10 Challenges in developing a pan-european food classification system (experiences from EuroFIR and recent EFSA Colloquium) Simone Bell, EuroFIR AISBL The European Commission funded Network of Excellence "European Food Information Resource" (EuroFIR) aimed to harmonize European food composition databases. The established EuroFIR food data platform is based on the standardisation of nutrient retention factors, calculation methods for components, e.g. energy values, nutrient definitions as well as description and classification of foods. In terms of food description, EuroFIR has used the LanguaL thesaurus, which is an automated system for describing, capturing and retrieving information about food. The presentation will show some results and lessons learnt while doing this exercise. As the activities on food classification are closely related to the food classification working group of the European Food Safety Authority (EFSA) and EuroFIR has also contributed to this working group, some of the results of this recent EFSA colloquium will be presented as well. The EuroFIR activities on food classification and standardised thesauri will continue within the scope of new funded project extension EuroFIR NEXUS. Furthermore, on a long-term basis the LanguaL thesaurus could be maintained by the non-profit organisation EuroFIR AISBL. EuroFIR AISBL is a member-based non-profit association based in Belgium. It represents a key interface between the FCDB compiler organisations and their national funders and stakeholders, including a network of laboratories producing the data, and the users of food information from industry, academia and regulatory affairs. The association provides a complete range of benefits comprising access to food information via innovative data interfaces including data on nutrients and on non-nutritive bioactive compounds with putative health benefits, comprehensive training opportunities, technical support and tailored advice to members. It seeks to promote and develop quality assurance and traceability principles considering the implementation of international standards. EuroFIR AISBL offers a single

11 and unique food information resource to academia, industry, public sector funding bodies and regulators as well as individuals such as researchers, students or dieticians.

12 Risk-benefit assessment: the EFSA approach Bernard Bottex, Scientific Committee, EFSA Risk-benefit assessments are performed in different disciplines, under various perspectives and use a wide range of quantitative or semi-quantitative tools. The Scientific Committee of the European Food Safety Authority (EFSA) published last July 2010 a guidance document for performing risk-benefit assessments of food related to human health risks and human health benefits. The document does not address social, economic and other considerations such as cost-effectiveness considerations. It is essential that formulation of the problem precedes the risk-benefit assessment as such. Agreement between the risk-benefit assessor and the riskbenefit manager on the terms of reference should be reached in order to ensure that the outcome of the assessment is useful and relevant for the riskbenefit manager goals. A stepwise approach is recommended for the riskbenefit assessment, i.e. i) initial assessment, addressing the question whether the health risks clearly outweigh the health benefits or vice versa, ii) refined assessment, aiming at providing semi-quantitative or quantitative estimates of risks and benefits at relevant exposure by using common metrics, and iii) comparison of risks and benefits using a composite metric such as DALYs or QALYs to express the outcome of the risk-benefit assessment as a single net health impact value. The outcome of each step of the assessment should also include a narrative of the strengths and weaknesses of the evidence base and its associated uncertainties. After each step of the risk-benefit assessment, discussion should take place between the risk-benefit assessor and the riskbenefit manager on whether sufficient information has been provided or whether the terms of reference should be refined in order to proceed with the next step of the assessment. The example of selenium as an indispensable nutrient will be used to illustrate the proposed approach for risk-benefit assessment.

13 Nitrate in vegetables balancing risks and benefits Claudia Heppner, CONTAM, EFSA There is general consensus that eating vegetable and fruits has beneficial health effects due to the content of macronutrients (e.g. fibre), micronutrients (e.g. vitamins), and bioactive substances in spite of the concerns related to the presence of inter alia anti-nutrients (e.g. leptins, glucosinolates), nitrate, allergens, mycotoxins, contaminants and pesticide residues in vegetables and fruits. Leafy vegetables, in particular (e.g. lettuce, rucola, spinach) contain naturally high levels of nitrate (NO3-) which together with its metabolites (nitrite (NO2-) and nitric oxide(no)) have physiological and potential beneficial roles in the body (e.g. vasoregulation) but also potential for adverse effects such as methaemoglobinaemia and carcinogenesis. Therefore, the Panel on Contaminants in the Food Chain (CONTAM) of the European Food Safety Authority (EFSA) was asked to address the risks from nitrate in vegetables for consumers. The assessment included dietary exposure estimates to nitrate for different groups of the population and relevant considerations on the possible balance between health risks and benefits. The CONTAM Panel noted that the critical driver for a high dietary exposure to nitrate is not the absolute amount of vegetables consumed but the type of vegetable (e.g. leafy vegetables) and the conditions of production. The CONTAM Panel reconfirmed the acceptable daily intake (ADI) for nitrate of 3.7 mg/kg body weight per day. The ADI could be exceeded for a small part of the population (2.5%) in some Member States when high amounts of leafy vegetables are consumed. The CONTAM Panel also noted that consumption of more than 47 g of rucola would lead to an excursion above the ADI without taking into account any other source of nitrate exposure. Risks are controlled by a combination of Good Agricultural Practice, setting and reviewing maximum levels for vegetables, particularly leafy vegetables, processing, cooking and customary practice, e.g. washing and peeling. Overall, the CONTAM panel concluded that the estimated exposures to nitrate from vegetables are unlikely to result in appreciable health risks, therefore the recognised beneficial effects of consumption of vegetables prevail.

14 Which foods may carry nutrition and health claims? Leng Heng, NDA, EFSA Regulation (EC) No 1924/2006 harmonises the provisions that relate to nutrition and health claims and establishes rules governing the Community authorisation of health claims made on foods. This Regulation requires that scientific substantiation should be the main aspect to be taken into account for the use of nutrition and health claims and the food business operators using claims should justify them. A claim should be scientifically substantiated by taking into account the totality of the available scientific data, and by weighing the evidence. In addition, in order to bear claims, foods will have to have appropriate nutrient profiles which will be set. This will enhance the consumers' ability to make informed and meaningful choice. In order to ensure harmonised scientific assessment of these claims, the European Food Safety Authority (EFSA) should carry out such assessments. Within EFSA, the Panel on Dietetic Products, Nutrition and Allergies (NDA) adopts scientific opinions on health claims submitted by member states or applicants. The substantiation of health claims includes the assessment of whether or not the food/constituent is sufficiently defined and characterised, to assure EFSA that the food/constituent for which the claim is made is the same as that for which the evidence on efficacy is provided. Also the claimed effect should be defined and comprise a beneficial physiological effect ( beneficial to human health ). Finally, an assessment will be made of whether or not a cause and effect relationship exists between the consumption of the food/constituent and the claimed effect. In case the Panel considers that a cause-effect relationship is established, it needs to be assessed whether the quantity of food/pattern of consumption required to obtain the claimed effect can be consumed within a balanced diet, whether the proposed wording reflects the scientific evidence

15 (consumer understanding is not addressed by EFSA), and whether the proposed conditions of use are appropriate. In every case, in assessing each food/health relationship that forms the basis of a claim, all the evidence from the pertinent studies is weighed with respect to its overall strength, consistency and biological plausibility, taking into account the quality of individual studies and with particular regard to the target population group and the conditions of use proposed for the claimed effect. In this presentation an update on the EFSA s work on claims will be given.

16 Reducing Salt Intake The Irish Experience Mary Friel, The Food Safety Authority of Ireland The FSAI has been working with the Irish food industry to achieve gradual, sustained and universal reductions in the salt content of processed and prepared foods since This work has centred on raising awareness in the general food industry of the salt and health issue, the role of processed food in salt intake and the health gains to the Irish population of reducing salt in processed food. The primary focus has been on the manufacturers of food in the food groups that contribute most salt to the diet, and secure gradual and sustained reductions in the salt content of their food working on a united front across each sector. The FSAI has also engaged with catering representative bodies and retailers. In the case of retailers, this was both in the context of their own brand processed food and the strong influence they have on manufacturers through their buying power. Work with other Irish State bodies whose role it is to increase consumer understanding of the salt and health issue and bring about behavioural change in consumers has run in parallel to this process. The FSAI s national salt reduction policy was formally initiated following the publication of its scientific report in April 2005 (Salt and Health: Review of the Scientific Evidence & Recommendations for Public Policy in Ireland) 1 which highlighted that Irish people are consuming far in excess of the recommended daily allowance for salt and that excessive salt intake is a major factor in the number of deaths from cardiovascular disease and stroke. It was estimated that Irish adults consumed an average of 10 grams of salt per day, which should be reduced to 6 grams per day. The report outlined a range of recommendations which included engaging with food industry stakeholders to secure gradual and sustained reductions in the salt content of food stuffs available on the Irish market. 1 See:

17 The FSAI has modelled salt intakes of adults based on Irish food consumption data from 1999 and salt monitoring data from surveys of foods on the Irish market since Average adult salt intake from non-discretionary sources decreased by 7.1% between 2005 and 2007 (from 8.5g/day to 8g/day) as a result of the FSAI salt reduction programme. Modelling of salt intakes in children and teenagers based on new consumption data was conducted in Salt intakes from non-discretionary sources for children were estimated to be 5.5g/day (target 4g/day) and for teenagers, 6.8g/day (target 6g/day). A new adult consumption survey is due in 2011 and the FSAI will assess salt intakes in adults again at that point. The FSAI anticipate that changes in adult eating patterns since 1999 due to salt awareness will result in a further reduction in the estimated salt intake of adults. Since 2003 the FSAI salt reduction programme has made a difference; it has halted, and reversed the trend for increasing salt use in processed foods. In line with European Union commitments the FSAI salt reduction programme will run to 2012 targeting a 16% salt reduction in bread, meat products, cheeses and ready meals. The FSAI has already set salt reduction targets for bread and processed meat products since 2007 which were challenging and lower in most cases than similar United Kingdom targets at the time. These targets will be reviewed before the end of 2010 in light of progress and bearing in mind new, more stringent 2012 targets have been published by the UK. The FSAI also needs to set targets for the remaining EU categories of cheese and ready meals. Meetings with the cheese industry on this matter have commenced and baseline surveys on salt levels in cheese and ready meals have been completed. Given the FSAI s need for new targets, in 2009 a public consultation on whether to adopt the UK 2012 salt reduction targets was held. This consultation was carried out because a large proportion of Irish food products are exported to UK. The results of the consultation were polarised. Industry did not want the UK targets adopted in Ireland but health organisations and the public did. Since

18 the consultation the FSAI has engaged with the industry to understand their viewpoint and make them aware of the public viewpoint. In 2008 the FSAI warned that the 6g/day population salt intake target would not be met by 2010; it hasn t been achieved and neither has it been realised in the UK or elsewhere in the world. Salt reduction is a gradual process that is subject to overcoming technical barriers and consumer resistance on taste. It may take even longer than 2012 to approach 6g/day average salt intake. It has become clear over the years that salt reduction in foods is a marathon not a sprint and therefore it is perhaps more appropriate to focus on sustained progress towards 6g/day over a longer period, knowing that research has shown that every gram of salt that comes out of the diet leads to measurable improvements in health to the Irish population. However, the food industry can only do so much and their efforts will mean nothing if the consumer just adds more salt at the table or during cooking. If consumers can be encouraged to be salt aware and actively select lower salt foods, then they will drive change faster in the food industry and ultimately improve their own health.

19 Αλλαγές στην πρόσληψη λιπαρών οξέων στην Ελλάδα τα τελευταία 50 χρόνια Αντώνης Καφάτος, Ιατρική Σχολή, Πανεπιστήµιο Κρήτης Πριν από τη δεκαετία του 1960, η κύρια πηγή λιπαρών στον ελληνικό πληθυσµό ήταν το ελαιόλαδο και οι ξηροί καρποί. Τα λιπαρά από κρέας, γαλακτοκοµικά, αυγά, ψάρια και θαλασσινά ήταν περιορισµένα λόγω των οικονοµικών δυσχερειών αλλά κυρίως λόγω των νηστειών της Ορθοδόξου Εκκλησίας, τις οποίες τηρούσε µε ακρίβεια για 180 περίπου ηµέρες το χρόνο πάνω από το 60% του πληθυσµού. Από τις µελέτες του Ινστιτούτου Ροκφέλερ το 1948 και αργότερα το 1960 από τον Ancel Keys στη µελέτη των επτά χωρών διαπιστώθηκε ότι η µέση ηµερήσια κατανάλωση ελαιολάδου από τους Κρήτες ήταν 120g, ενώ το 29% της ενέργειας που έπαιρναν οι Κρήτες καθηµερινά προερχόταν από µονοακόρεστα λιπαρά οξέα. Το 1960 η κατανάλωση κρέατος στην Κρήτη ήταν κατά µέσο µόνο όρο 35g/ηµέρα σε σύγκριση µε 274g/ηµέρα στις ΗΠΑ. Ψάρια και θαλασσινά καταναλώνονταν περί τα 40g/ηµέρα κατά µέσο όρο, ενώ η χρήση γαλακτοκοµικών ήταν µικρή έως µέτρια. Μόλις 8% της ενέργειας προέρχονταν από κορεσµένα λιπαρά οξέα σε σύγκριση µε 18% στη βόρεια Ευρώπη και τις ΗΠΑ. Η µέση ηµερήσια κατανάλωση φρούτων και λαχανικών στην Κρήτη υπερέβαινε το ένα κιλό ενώ στην Κέρκυρα ήταν πολύ χαµηλότερη. Το διαιτολόγιο των Κρητών τη δεκαετία του 1960 σε σχέση µε τη λήψη λιπαρών οξέων επιβεβαιώθηκε από την ανάλυση του υποδόριου λίπους από τον καθηγητή Christakis το 1962 όπου διαπιστώθηκε υψηλή περιεκτικότητα του υποδορίου λίπους των Κρητών σε µονοακόρεστα λιπαρά οξέα, χαµηλή περιεκτικότητα σε κορεσµένα λιπαρά και µέτρια σε απαραίτητα λιπαρά οξέα. υστυχώς το άριστο αυτό διαιτολόγιο των Κρητών της δεκαετίας του 1960 αλλοιώθηκε στις επόµενες δεκαετίες µε την παραγωγή και εισαγωγή πλήθους επεξεργασµένων τροφίµων και µαργαρινών που διατίθενται στις υπεραγορές,

20 στα ταχυεστιατόρια και τα περίπτερα κάθε γειτονιάς στο αστικό περιβάλλον. Η Ελλάδα είναι σήµερα η έβδοµη χώρα στον κόσµο σε κατανάλωση κόκκινου κρέατος. Οι Έλληνες καταναλώνουν 100 κιλά κόκκινου κρέατος κατά κεφαλή ετησίως ενώ οι Αµερικανοί 88kg ετησίως. Οι αλλαγές αυτές στο διαιτολόγιο και τον τρόπο ζωής των Κρητών επιβεβαιώθηκε µε περιοδικές αναλύσεις του υποδορίου λίπους σε λιπαρά οξέα καθώς και µε την επιδηµική έξαρση της παχυσαρκίας τα τελευταία χρόνια σε παιδιά και ενήλικες. Το ποσοστό λίπους από κορεσµένα λιπαρά οξέα φτάνει σήµερα στα επίπεδα των ΗΠΑ και της βόρειας Ευρώπης (15-18%). Η περιεκτικότητα πολλών τροφίµων σε λιπαρά αποδεικνύεται µε αναλύσεις από το Πανεπιστήµιο Κρήτης και άλλα ερευνητικά κέντρα ότι είναι εξαιρετικά δυσµενής και προάγει τα χρόνια νοσήµατα όπως τα καρδιαγγειακά νοσήµατα και τους περισσότερους καρκίνους. Παραδείγµατα τέτοιων προϊόντων είναι τα παγωτά που είναι ιδιαίτερα δηµοφιλή στα παιδιά και τους ενήλικες. Τα περισσότερα παγωτά δεν είναι γαλακτοκοµικά προϊόντα γιατί το πρώτο συστατικό τους είναι το λάδι της ινδικής καρύδας (κορεσµένο κατά 80%), το δεύτερο συστατικό είναι η ζάχαρη και το τρίτο είναι η αποβουτυρωµένη σκόνη γάλακτος, ενώ ακολουθούν δεκάδες πρόσθετων ουσιών. Γι αυτό ορισµένες εταιρείες τα ονοµάζουν παγωµένο γλύκισµα. Άλλο παράδειγµα είναι τα πατατάκια τσιπς που εκτός από το πολύ αλάτι περιέχουν µεγάλη ποσότητα κακής ποιότητας λιπαρών ενώ στην έκθεσή τους σε υψηλές θερµοκρασίες παράγεται η τοξική ουσία ακρυλαµίδη που είναι εξαιρετικά αθηρογόνος και καρκινογόνος. Οι µαργαρίνες που κυκλοφόρησαν από τα µέσα του περασµένου αιώνα στη χώρα µας ήταν υψηλής περιεκτικότητας σε τρανς λιπαρά οξέα που έφθαναν το 15%. Τα τελευταία χρόνια η βιοµηχανία ελάττωσε τα trans κάτω από 1% αλλά αύξησε την περιεκτικότητα σε κορεσµένα λιπαρά οξέα κατά περίπου 18% για να είναι σε στερεή µορφή στη συνήθη θερµοκρασία.

21 Κατάλληλη εκπαίδευση του έλληνα καταναλωτή από την παιδική ηλικία είναι άµεσης προτεραιότητας ώστε να είναι σε θέση να κάνει σωστές επιλογές στην καθηµερινή διατροφή του. Να αποφεύγει τρόφιµα υψηλής ενεργειακής πυκνότητας που οφείλεται κυρίως σε κακής ποιότητας λιπαρά και µαργαρίνες µε συνέπεια την παχυσαρκία και την αύξηση των παραγόντων κινδύνου για όλα τα χρόνια νοσήµατα.

22 Καθιέρωση διατροφικών κατευθυντήριων γραµµών στην Ευρώπη σε ποιο βαθµό είναι εφικτή η εναρµόνιση; Παγώνα Λάγιου, Ιατρική Σχολή Πανεπιστηµίου Αθηνών, EFSA member of NDA panel Οι διατροφικές οδηγίες σε επίπεδο τροφίµων αποτελούν συστάσεις που βασίζονται σε επιστηµονικά δεδοµένα και έχουν στόχο την υιοθέτηση από τον πληθυσµό διατροφικών συνηθειών που προάγουν την υγεία. Αποσκοπούν κυρίως στην ενηµέρωση και εκπαίδευση του κοινού και για το λόγο αυτό πρέπει να είναι πολιτισµικά αποδεκτές, πρακτικά εφαρµόσιµες, κατανοητές και εύκολες στη µνηµονική ανάκληση. Όπως επισηµαίνεται και σε σχετική γνωµοδότηση της Ευρωπαϊκής Αρχής Ασφάλειας Τροφίµων (EFSA), η σύνταξη διατροφικών οδηγιών προϋποθέτει τη συνεκτίµηση των δεδοµένων για τα θρεπτικά συστατικά, τα τρόφιµα και την υγεία. Στις περισσότερες χώρες της Ευρωπαϊκής Ένωσης, η παχυσαρκία, τα καρδιαγγειακά νοσήµατα, οι κακοήθεις νεοπλασίες, η υπέρταση, οι δυσλιπιδαιµίες, ο σακχαρώδης διαβήτης τύπου 2 και η οστεοπόρωση αποτελούν σηµαντικά προβλήµατα δηµόσιας υγείας, αλλά η επίπτωσή τους διαφέρει από χώρα σε χώρα. Υπάρχουν ορισµένα θρεπτικά συστατικά που είναι σηµαντικά από πλευράς δηµόσιας υγείας για τους πληθυσµούς της Ένωσης, καθώς παρεκκλίσεις στην κατανάλωσή τους µπορούν να επηρεάσουν την εµφάνιση των καταστάσεων που προαναφέρθηκαν. Έτσι, προβλήµατα µπορούν να δηµιουργήσουν η υπερκατανάλωση π.χ. κορεσµένων λιπιδίων, ζάχαρης και αλατιού, η αυξηµένη ενεργειακή πρόσληψη, αλλά και η µειωµένη πρόσληψη ακόρεστων λιπαρών οξέων, διαιτητικών ινών, νερού ή κάποιων ιχνοστοιχείων. Η συχνότητα των παρεκκλίσεων στις καταναλώσεις θρεπτικών συστατικών ποικίλει όµως από χώρα σε χώρα. Συνεκτιµώντας τις διαφορές που παρατηρούνται ως προς τα διατροφοεξαρτώµενα νοσήµατα και τις παρεκκλίσεις στις διατροφικές προσλήψεις, αλλά και την ποικιλοµορφία που παρατηρείται σε διατροφικές