The burden of disease attributable to nutrition in Europe.
OBJECTIVE
This review examines the extent to which differences in nutrition could explain the diversity of health in Europe and how dietary patterns might contribute to the overall burden of disease in the region.


METHODS
Europe.


METHODS
Between-country variations and time trends in dietary and health patterns in Europe are described, taking into account recent evidence on east-west mortality differentials. Existing information on the contribution of dietary factors to the overall burden of disease in Europe and to the burden of cardiovascular diseases and cancer is then reviewed, including a discussion of the methodological challenges that face those seeking to quantify this burden accurately.


RESULTS
While evidence from ecological data have long suggested that variations in health patterns in Europe may be at least partly attributed to differences in dietary intake, recent research into the major risks to disease, disability and death is confirming the importance of poor nutrition to major health problems and overall disease burden in Europe. Findings from the Global Burden of Disease 2000 study suggest that 4.4% of the overall burden of disease in the region could be attributed to low fruit and vegetable intake, and 7.8% to overweight and obesity.


CONCLUSIONS
The burden of disease attributed to poor nutrition in Europe appears to be substantial and probably underestimated. However, better quantification of the contribution of nutrition to the region's burden of disease awaits further research to assess the dietary intake of Europeans and to explore the relationship between nutritional factors and health outcomes in diverse parts of Europe.
Pomerleau
Joceline
J
European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, UK. Joceline.Pomerleau@lshtm.ac.uk
McKee
Martin
M
Lobstein
Tim
T
Knai
Cécile
C
D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000401:mortality*; D003431:Cross-Cultural Comparison; D004032:Diet; D005060:Europe / Q000453:epidemiology; D005247:Feeding Behavior; D005638:Fruit; D006304:Health Status; D006801:Humans; D009017:Morbidity; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000401:mortality*; D009765:Obesity / Q000150:complications / Q000453:epidemiology / Q000401:mortality*; D014675:Vegetables