Nutrition in Finland: Experiences in changing the diet of the population

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Nutrition in Finland Experiences in changing the
diet of the population

• Pirjo Pietinen
• Research Professor, Head of Nutrition Unit
• National Public Health Institute
• Helsinki, Finland
• 31.10.2008

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Nutrition in Finland

• Background
• Monitoring activities
• Trends in food consumption and nutrient intake
• Nutritional challenges of past and today
• Summary

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Main Emphasis in Nutrition Policy in Finland

• Historically (since 1940s)preventing various
  deficiencies- e.g. free school lunches,
  fortification programmes
• Chronic disease prevention since
  1970sreduction of blood cholesterol and
  blood pressure levels
• More recentlyalso weight control and prevention
  of diabetes

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How to influence?

• Research and monitoring
• Nutrition policy - collaboration
• Legislation
• Education (nutritionists, dietitians, nurses,
  doctors, teachers, food scientists)
• Nutrition recommendation and dietary guidelines
• Implementation programs of the recommendations
  and guidelines
• Enrichment of foods
• Food production
• Catering services

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Examples of legislation

• 1943 Law of free school lunches for all primary
  school pupils
• 1972 Primary Health Care Act passed
• 1993 Obligatory food labeling concerning salt

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NATIONAL NUTRITION COUNCIL

• An expert body established in1954
• It is appointed by the Ministry of Agriculture
  and Forestry
• The members serve three-year terms
• The members are representatives of authorities
  handling nutrition issues, consumer, health
  promotion and catering organisations, food
  industry and agricultural organisations.
• Chair Prof. Pekka Puska, secretary general Ms.
  Raija Kara since 2004 (raija.kara_at_evira.fi,
  acting secretary general kaisa.vaihia_at_evira.fi)

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Monitoring the Finnish diet
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Monitoring tools

• Food Balance Sheets since 1950s (Ministry of
  Agriculture and Forestry) per capita data
• FINRISK/Findiet Surveys every 5 years large
  population surveys (2007 6000/2000 persons)
• National Health Behaviour Questionnaires (AVTK)
  annual data since 1978 (questionnaire data)

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FINRISK/Findiet survey areas
Oulu area 1997-
Kuopio area 1982-
North Karelia 1982-
Southwestern Finland 1982 -
Helsinki area 1992 -
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Changes in food consumption in Finland
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Food consumption in Finland 1950-2007
kg/person/year
preliminary
Food balance sheets
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Plant food consumption in Finland
Kg/person/year
Food balance sheets
preliminary
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Fat consumption in Finland
kg/person/year
Food balance sheets
preliminary
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Milk and sour milk consumption in Finland
Kg/person/year
Food balance sheets
preliminary
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Milk product consumption in Finland
Kg/person/year
Food balance sheets
preliminary
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Beverage consumption in Finland
Kg/person/year
Food balance sheets
preliminary
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Meat and egg consumption in Finland
kg/person/year
Food balance sheets
preliminary
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Meat consumption in Finland
kg/person/year
Food balance sheets
preliminary
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Changes in fat intake
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Type of bread spread in Finland, men 1978-2005
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Fat used for cooking at home in Finland in
1978-2005
//
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Fat intake in Finland1982-2007
Recommendations
E
Year
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Intake of fat and fatty acids in 2002 and 2007
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Serum cholesterol in men aged 25-64 years
mmol/l
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Serum cholesterol in women aged 25-64 years
mmol/l
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Sodium and Salt
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30 years of systematic work concerning salt

• Recommendation to reduce salt intake by the
  National Nutrition Council in 1978
• 1979-1982 The North Karelia Salt project with
  population surveys in 1979 and 1982
• Mass media campaigns, cooperation with food
  industry to reduce salt voluntarily, education of
  health care personnel
• Expanded after the 3-year project to the whole
  country
• The public became aware of salt and BP, regular
  monitoring was established at KTL, and the first
  national labelling decrees were launched in the
  1980s

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Salt intake in Finland 1977-2007
NaCl g/d
Year
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Sources of salt in the Finnish diet
. Source Reinivuo et al. Eur J Clin Nutr, 2006
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Compulsory labelling of salt

• Cheese
• Sausages and other meat products
• Fish products
• Bread, crisp bread and thin crisp bread
• Broths, soups and sauces, also as powder and
  concentrate
• Other prepared or semi-prepared foods
• Mixed spices containg table salt

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Labelling of salt criteria
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Distribution of salt intake by choice of low or
high-salt products. Findiet 2002.
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Distribution of salt intake by choice of low or
high-salt products. Findiet 2002.
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Conclusions concerning salt

• Reducing salt intake in the population requres
  long-lasting, systematic work
• National legislation works especially setting
  maximum salt levels for normal products
• Consumer education is very important
• Overall agreement within Europe helps - food
  travels

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Conclusions concerning fats

• Changing the quality of fat in the population
  requres long-lasting, systematic work
• Cooperation with food industry is very important
  the availability of soft, healthy fats
• Consumer education is very important
• Changes in the quality of fat are reflected in
  lower serum cholesterol levels and further also
  in lower coronary heart disease mortality

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Future challenges

• How to increase daily physical activity in the
  whole population - obesity, aging population?
• How to avoid increase in fast food consumption
  especially in children?
• How to avoid increase in alcohol consumption
  because of a common alcohol policy in EU and,
  thus, cheaper alcohol?
• How to increase social equity?

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Publications

• Expert Committee of the Finnish National
  Nutrition Surveillance System. Nutrition in
  Finland, 2006
• http//www.ktl.fi
• National Nutrition Council (in English)http//ww
  wb.mmm.fi/ravitsemusneuvottelukunta/Etusivu_ENG.ht
  m