British Journal of Nutrition

Research Article

Food sources of nutrients in the diet of Spanish children: the Four Provinces Study

M. A. Royo-Bordonadaa1 c1, L. Gorgojoa1, M. de Oyaa2, C. Garcésa2, F. Rodríguez-Artalejoa3, R. Rubioa2, J. L. del Barrioa2 and J. M. Martín-Morenoa1a3

a1 Institute of Health Carlos III, Ministry of Health & Consumer Affairs, Madrid, Spain

a2 Lipids Laboratory, Jiménez Díaz Foundation, Madrid, Spain

a3 Department of Preventive Medicine and Public Health, Autonomous University of Madrid, Madrid, Spain


The aim of the present study was to assess the principal food sources of energy and nutrients among Spanish children. We used a cross-sectional study design, based on results obtained from a food-frequency questionnaire. The sample included 1112 children, aged 6–7 years, from Cadiz, Madrid, Orense and Murcia, Spain. Children were selected through random cluster-sampling in schools. We analysed the percentage contributed by each food item to total energy and nutrient intake. The most important food sources were: white bread in the case of carbohydrate (13·4 %); olive oil in the case of total lipids (18·3 %) and monounsaturated fatty acids (29·2 %); whole milk in the case of protein (10·2 %) and saturated fatty acids (14·9 %); chips (French fried potatoes) in the case of polyunsaturated fatty acids (30·4 %). The greatest proportion of Na, consumed in excess, came from salt added to meals. Ham ranked second as a source of saturated fats. Fruits and green leafy vegetables proved to have great relevance as sources of fibre and vitamins, though with regard to the latter, it was observed that fortified foods (breakfast cereals, dairy products, fruit juices, etc.) had come to play a relevant role in many cases. In conclusion, the nutritional profile of Spanish school-aged children aged 6–7 years could be improved by nutritional policies targeted at limiting their consumption of ham (cured or cooked) and of salt added to meals, replacing whole milk with semi-skimmed milk, encouraging the consumption of products rich in complex carbohydrates already present in children's diets (bread, pasta, rice) and promoting less fatty ways of cooking food.

(Received February 04 2002)

(Revised July 15 2002)

(Accepted September 06 2002)


c1 *Corresponding Author: Dr Miguel A. Royo-Bordonada, fax +34 91 3877862, email


† On behalf of the investigators of the Four Provinces Study: M. Benavente and A. Studer (Jiménez Díaz Foundation, Madrid), M. A. Lasunción and H. Ortega (Ramón y Cajal Hospital, Madrid), O. Fernández (Cristal Piñol Hospital, Orense), J. Fernández Pardo (Red Cross Hospital, Murcia), A. Macías and A. Mangas (Cadiz University).