British Journal of Nutrition

Full Papers

Dietary Survey and Nutritional Epidemiology

Food balance sheet and household budget survey dietary data and mortality patterns in Europe

Androniki Naskaa1, Mari-Anna Berga2, Carmen Cuadradoa3, Heinz Freislinga4, Kurt Gedricha5, Matej Gregoriča6, Cecily Kellehera7, Emilia Leskovaa8, Michael Nelsona9, Lucienne Pacea10, Anne-Marie Remauta11, Sara Rodriguesa12, Wlodzimierz Sekulaa13, Michael Sjöstroma14, Kerstin Trygga15, Aida Turrinia16, Jean Luc Volatiera17, Gabor Zajkasa18, Antonia Trichopouloua1a19 c1 and on behalf of Data Food Networking (DAFNE) participants

a1 Department of Hygiene and Epidemiology, School of Medicine, University of Athens, 75 Mikras Asias Street, Athens 115 27, Greece

a2 Statistics Finland, Helsinki, Finland

a3 Departamento de Nutrición, Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain

a4 Department of Nutritional Sciences, University of Vienna, Vienna, Austria

a5 Department of Marketing and Consumer Research, TUM Business School, Technische Universität München, Munich, Germany

a6 Department of Nutrition and Physical Activity, Health Promotion Centre, National Institute of Public Health of the Republic of Slovenia, Ljubljana, Slovenia

a7 National Nutrition Surveillance Centre, School of Public Health and Population Science, University College Dublin, Belfield, Dublin, Republic of Ireland

a8 Department of Risk Assessment and Food Composition Data Bank, Food Research Institute, Bratislava, The Slovak Republic

a9 Division of Nutritional Sciences, King's College London, London, UK

a10 Health Promotion and Disease Prevention Department, Ministry of Health, Valletta, Malta

a11 Nutrition Unit, Faculty of Agricultural and Applied Biological Sciences, University of Gent, Gent, Belgium

a12 Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal

a13 National Food and Nutrition Institute, Warsaw, Poland

a14 Unit for Preventive Nutrition, Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden

a15 Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, PO Box 1046, Blinder, NO-0316 Oslo, Norway

a16 Unità di Statistica ed Economia Alimentare, Istituto Nazionale di Ricerca per gli Alimenti e la Nutrizione (INRAN), Rome, Italy

a17 French Food Safety Agency AFSSA, Paris, France

a18 National Institute of Food Safety and Nutrition, Budapest, Hungary

a19 Hellenic Health Foundation, Athens, Greece


Worldwide dietary data for nutrition monitoring and surveillance are commonly derived from food balance sheets (FBS) and household budget surveys (HBS). We have compared food supply from FBS and food availability data from HBS among eighteen European countries and have estimated the extent to which they correlate, focusing on food groups which are comparably captured by FBS and HBS and for which there is epidemiological evidence that they can have a noticeable impact on population mortality. Spearman's correlation coefficient was +0·78 (P < 10− 3) for vegetables (including legumes),+0·76 (P < 10− 3) for fruits, +0·69 (P < 10− 3) for fish and seafood and +0·93 (P < 10− 3) for olive oil. With respect to meat and meat products, the coefficient was lower at +0·39 (P = 0·08). Moreover, we have examined whether the supply (FBS) or the availability (HBS) of food groups known or presumed to have beneficial effect on the occurrence of CHD and total cancer can predict overall, coronary and cancer mortality in ecological analyses. After controlling for purchasing power parity-adjusted gross domestic product and tobacco smoking we found that for vegetables, fruits, fish and seafood, as well as for olive oil, both the FBS and the HBS estimates were inversely associated with all three indicators of mortality, although the number of countries with complete information on all study variables hindered formal statistical documentation (P>0·05 in some instances). FBS and HBS have their own strengths and weaknesses, but they may complement each other in dietary assessments at the population level.

(Received April 01 2008)

(Revised September 04 2008)

(Accepted September 04 2008)

(Online publication November 06 2008)


c1 Corresponding author: Dr Antonia Trichopoulou, fax +30 210 746 2079, email


†  DAFNE participants: Austria, I. Elmadfa and A. Suchomel; Belgium, A. P. Cueto Eulert; Finland, A. Pajunen and T. Hirvonen; France, J. Maffre; Germany, G. Karg and K. Wagner; Greece, V. Bountziouka, Y Chloptsios, E. Oikonomou and K Tsiotas; Hungary, P. Szivos; Italy, S. Barcherini and S. Martines; Malta, E. Caruana and N. Camilleri; Norway, E. Mork and K. Lund-Iversen; Poland, A. Bienkuska, M. Morawska and Z. Niedzialek; Portugal, M. D. Vaz de Almeida; Republic of Ireland, S. Friel; Slovak Republic, H. Sukenikova; Slovenia, M. Gabrijelcic, M. Adamic and M. Remec; Spain, O. Moreiras, M. L. Boned and P. Seoane Spiegelberg; Sweden, E. Poortvliet; UK, D. Rimmer and S. Burr.

Abbreviations: DAFNE, Data Food Networking; FBS, food balance sheet; GDP, gross domestic product; HBS, household budget survey