Energy and nutrient intakes in spain.

In the 'national health survey Spain 2017', at the top of the list of chronic disorders prevalent in adults, the following conditions appear:

• In first place: arterial hypertension, affects 20 % of the male population and 19.7 % of the female population.

• In second place: chronic back pain (lumbar), affecting 14.77% of the male population and 22.1% of the female population.

• In third place: high cholesterol, affecting 18.1% of the male population and 17.7% of the female population.

• In fourth place: osteoarthritis (excluding arthritis), affecting 11.3 % of the male population and 23.5 % of the female population.

Overweight and obesity are the main risk factors in the appearance and development of these diseases. It is known that both are the result, with few exceptions, of the imbalance between the calories we receive through food and the level of physical activity performed daily, so they can be prevented in most cases, with an appropriate diet and physical activity.

Let us assess how energy and nutrient intakes behave in Spain, based on the Anibes scientific study, coordinated by the Spanish Nutrition Foundation (Fen).

Reduction in energy intakes

In Spain, a decreasing trend in energy intake has been observed. In studies carried out in the first half of the 60's, of the last century, the average intake, for the Spanish population, was around 3'000 kilocalories per day, in 2014 this figure was reduced to approximately 1'900 kilocalories per day, a figure that in the opinion of experts today may be lower.

In spite of the continuous reductions in energy intakes, no relevant changes have been observed, indicating a favorable impact on the overweight and obesity rates of the Spanish population. This behavior is probably due to the joint influence of the following factors:

The rates of physical activity are very depressed in a considerable part of the population, so that large sectors, need to consume lower levels of energy.There has been a change in the demographic composition in terms of age groups: there is a much larger number of older people, who consume lower amounts of energy. There has been an increase in the number of people on low-calorie diets in order to maintain a slim figure.

Transformation of the caloric profile of the diet

The following table shows the changes that have occurred in the caloric profile of the diet since the 1960s:

• It can be observed that in the year 1964, for a diet of approximately 3008 kilocalories, the contributions of energy to the diet for each of the macronutrients and alcohol, were within the recommended parameters.

• However, in the results of the 2013 Anibes studies on intakes, profile and sources of energy in the Spanish population, for an average energy intake of 1810 kilocalories per day, only the contribution produced by alcoholic beverages maintained positive figures, indicating that the energy contribution of proteins and lipids is higher than the recommended percentage, while the energy contribution of carbohydrates remains below the correct rates.

Causes that will provoke changes in the caloric profile:

• The changes in the caloric profile, were due above all, to the decrease in the consumption of cereals, fundamentally bread, potatoes and legumes. When these foods were no longer consumed, the percentage of energy obtained from products containing high levels of carbohydrates was significantly reduced.

• The caloric profile was affected, to a lesser extent, by the increase in the consumption of meat, milk and fish, which led to an increase in the energy provided by proteins, and above all by the fats contained in meat and milk.

Protein intakes in Spain

The average daily protein intake of the Spanish population is well above the recommended upper limits, a trend similar to that of the rest of the European countries.

The average protein intake in the Spanish population in the anibes studies was 74.5 grams per day. The research also showed that only 10% had a daily protein intake within the recommended ranges.

Sources of protein in order of importance:

• Meats and derivatives contributed 33.14 %, of which 21.83 % corresponded to meats, 10.95 % to sausages and other meat products and 0.35 % to viscera and offal.

• Cereals and derivatives contributed 17.38%, of which 8.35% corresponded to bread, 3.09% to pasta, 2.77% to pastries and cakes, 2.61% to grains and flours and 0.56% to breakfast cereals and cereal bars.

• Milk and dairy products contributed 17.17 %, of which milk accounted for 8.05 %, cheese for 5.34 %, yogurt and fermented milks for 2.86 % and other dairy products for 0.92 %.

• Fish and seafood contributed 10.63 %.

• Eggs accounted for 4.68%.

• Pre-cooked products 4.60 %.

• Vegetables 3.79 %.

• Legumes 3.32 %.

• Other foods 2.22 %.

• Fruits 1, 90 %.

• Non-alcoholic beverages 1.18 %.

Carbohydrate intakes in Spain

The most important change that has occurred in terms of nutrition in the last 50 years in Spain is the reduction in the levels of carbohydrate consumption. In 1964, the average daily intake of carbohydrates was 423 grams; this figure was reduced during the last decades of the last century until today, mainly due to the decrease in the consumption of bread, potatoes and legumes.

The average daily carbohydrate intake of Spaniards has been 185.4 grams per day, which corresponds to 41.1% of the total daily energy intake, a figure much lower than the recommended figure, which should be between 50% and 55%.

Sources of carbohydrates in order of importance:

• Carbohydrates contributed 48.97%, of which 23.37% corresponded to bread, 8.75% to grains and flours, 8.58% to pastries and cakes, 6.43% to pasta and 1.83% to breakfast cereals and cereal bars.

• Milk and dairy products contributed 9.90%, of which milk accounted for 5.02%, yogurt 3.09%, other dairy products 1.58% and cheese 0.21%.

• Non-alcoholic beverages accounted for 8.36%, of which 4.62% corresponded to soft drinks with sugar, 2.91% to juices and nectars, 0.84% to other beverages and 0.35% to coffee and other infusions.

• Fruits accounted for 8.21%.

• Vegetables accounted for 7.66%.

• Sugars and sweets 6.52%.

• Precooked foods 4.28%.

• Legumes 3.24%.

• Others 1.53%.

• Alcoholic beverages 1.34%.

Lipid intakes in Spain

The average daily intake of lipids by Spaniards was 78.1 grams per day, 38.5% of total energy intake, which is higher than the recommended figure of between 30% and 35%.

Sources of lipids in order of importance:

• Oils and fats contributed 32.19%, of which 24.41% corresponded to olive oil, 4.41% to other oils and 3.38% to butters, margarines and shortenings.

• Meat and meat products contributed 22.52%, of which 12.74% corresponded to meats, sausages and other meat products 9.65% and offal and offal 0.13%.

• Milk and dairy products contributed 13.48%, of which 5.34% corresponded to cheeses, 4.62% to milks, 1.77% to yogurt and fermented milks and 1.76% to other dairy products.

• Cereals and derivatives accounted for 10.35%.

• Precooked products contributed 4.48%.

• Fish and seafood accounted for 4.21%.

• Eggs accounted for 3.76%.

• Sauces and condiments 3.16%.

• Fruits 1.86%.

• Others 1.48%.

• Sugars and sweets 1.40%.

• Snacks 1.11%.

Dietary intakes and food sources of vitamins b1, b2, b3, b6, b9, b 12, c, a, d, and e.

Vitamin b1 (thiamine): 71.2% of the population met the daily intake recommendations. The main sources of thiamine were the group of meats and derivatives, contributing 28.23%, cereals and derivatives 23.90%, vegetables 11.56%, milk and dairy products 9.29%, fruits 6.40%, legumes 4.68% and precooked foods 3.91%.

Vitamin b2 (riboflavin): 72.0% of the population complies with the daily intake recommendations. The main sources of riboflavin were the group of milk and dairy products, contributing 32.22%, meat and meat products 19.76% and cereals and cereal products 11.46%.

Vitamin b3 (niacin): 99% of the population complies with the daily intake recommendations. The main sources of niacin were the group of meats and derivatives, contributing 34.62%, cereals and derivatives 16.84%, fish and seafood 12.08% and milk and dairy products 9.37%.

Vitamin b6 (pyridoxine): 77.2% of the population complies with the daily intake recommendations. The main sources of pyridoxine were the group of meats and derivatives, contributing 26.64%, vegetables 16.32% and cereals and derivatives 15.40%.

Vitamin b9 (folic acid): the average total intake of folates was 156.3 micrograms per day in women and 163.6 micrograms per day in men. There is a relevant percentage of the population that does not reach the recommended folate intakes. The food groups that contributed most to the total intake of folates, both in men and women, were vegetables and cereals and derivatives.

Vitamin b12: the mean total intake of vitamin b12 was 4.0 micrograms per day in women and 4.5 micrograms per day in men. Vitamin b12 intakes were adequate in all the individuals studied.

The main sources of vitamin b12, in the case of women, were the group of milk and derivatives, contributing 29.2%, the group of meats and derivatives with 24.8% and the group of fish and seafood with 10.6%. In the case of men, the main sources were the group of meats and derivatives, contributing 27.9%, milk and dairy products 25.3% and fish and seafood 19.4%.

Vitamin C: 42.5% of the population reported intakes below 80% of the Spanish and European daily intake recommendations.

The main contributors of vitamin C were the group of vegetables and fruits, behaving differently in the different age groups.

Vitamin a: 67% of the population reported intakes below 80% of the Spanish and European daily intake recommendations. The main sources of vitamin a were the group of oils and fats, contributing 5.6%, precooked foods 5.5% and cereals and derivatives 4.5%.

Vitamin d: vitamin d intake is well below the national and European recommendations. The main sources of vitamin d were the group of fish and seafood, contributing 25.6%, eggs 24.6%, milk and dairy products 22.6% and cereals and derivatives 14.9%.

Vitamin e: 80% of the population reported intakes below 80% of the Spanish and European daily intake recommendations. The main sources of vitamin E were the group of oils and fats, contributing 45.7%, vegetables 11.4%, fish and seafood 9.7% and fruits 4.8%.

Dietary intakes and dietary sources of the minerals calcium, iron, phosphorus and magnesium

Calcium: the mean reported intake of calcium in all age groups was much lower than the national and European recommendations. The main sources of calcium were the group of milk and dairy products, providing 53.1%, cereals and derivatives 11.2%, vegetables 7.9%, precooked foods 5.1%, fish and seafood 4.2%, fruits 3.6% and meats and derivatives 3.4%.

Iron: the levels of dietary iron intake observed were lower for women than for men. The food sources that provided a greater proportion of iron were cereals and derivatives in the entire population, which could indicate that the greatest proportion of iron comes from non-heme iron food sources.

Phosphorus: the mean reported intake of phosphorus almost entirely met the national and European recommendations. Neither a deficit of this mineral nor an excessive intake was observed. The main sources of phosphorus were the group of milk and dairy products, contributing 26.1%, meat and meat products 19.6%, cereals and cereal products 16.1%, fish and seafood 9.1%, vegetables 5.8%, eggs 4.6%, and precooked foods 4.1%.

Magnesium: magnesium intake was much lower than the national and European recommendations. The mean total magnesium intake was 222 mg/day. The main sources of magnesium were the group of cereals and derivatives with 22.6%, milk and dairy products with 15.7%, meats and derivatives with 12.5%, vegetables with 11.1%, fruits with 8.6%, fish and seafood with 6.3% and legumes with 5.4%.