Comparing nutrition indicators in adult population monitoring systems in Italy, Estonia and Belgium

Background

Population-based monitoring systems are essential for tracking nutrition-related risk factors and informing noncommunicable disease (NCD) prevention. However, nutrition indicators across countries remain heterogeneous, limiting comparability and joint surveillance efforts. Within the Joint Action PreventNCD, efforts are underway to improve NCD monitoring methods across European countries. The present analysis compares nutrition indicators from adult population monitoring systems in Italy, Estonia and Belgium.

Methods

We mapped nutrition indicators from four adult population monitoring systems, PASSI (Italy), TKU (Estonia), and the Belgian Food Consumption Survey (FCS) and HIS, and compared indicators by domain coverage, conceptual alignment, measurement depth, and gaps.

Results

All three countries monitor fruit and vegetable consumption, although level of detail varies considerably. PASSI focuses on indicators such as compliance with five-a-day recommendation, whereas TKU has more granularity, including daily, very low, and insufficient intake for both foods. Belgium additionally includes mean intake (g/day) and weekly frequency through the FCS. For salt consumption, PASSI covers awareness, advice, and iodized salt use, TKU captures high intake and lack of reduction, while the FCS quantifies sodium intake by food group. Moreover, PASSI does not include indicators on sugary/salted foods, while Belgian and Estonian systems do and also uniquely capture wholegrain/fiber intake. TKU details nutrition counselling and intentional dietary changes, while such behavioral indicators are more limited in the other systems.

Conclusions

Despite broad thematic overlap, differences in indicator definitions and measurement depth limit cross-country comparability. Developing a shared core set of nutrition indicators and expanding coverage in less detailed systems would strengthen European NCD surveillance and better support evidence-informed prevention policies.

Key messages

• Nutrition domains overlap across Italy, Estonia, and Belgium, but indicator detail and the timing of data collection vary substantially, especially for fruit, vegetables, and salt consumption.

• Leveraging and harmonising nutrition indicators, particularly where systems are less extensive, contribute to enhance NCD evidence-based prevention in Europe.