Capacity building in dietary monitoring and public health nutrition in the Eastern Mediterranean Region Countries

In common with many Western countries, the Eastern Mediterranean Region (EMR) has a major problem with obesity and the associated public health issues. The World Health Organization (WHO) has been developing new health policies to lower intakes of sugar, saturated fats, trans fats and salt with the aim of reducing the risk of non-communicable diseases (diabetes, cardiovascular disease and obesity) in children and adults. To implement these policies successfully it is essential to have high quality food composition and food intake data to underpin research into the links between diet and health and to enable effective dietary monitoring and policy development. Most EMR countries use international food composition tables that include foods consumed in western diets with different nutrient composition, especially for mixed and traditional dishes. Some of these data from other countries are outdated and do not reflect the composition of foods currently consumed in EMR countries, meaning that calculated nutrient intakes are inaccurate. Methods of measuring dietary intake also need to be up-to-date and use appropriate food information.
This project intends to provide technical and scientific support for researchers (mainly food and nutrition experts) in LMIC countries in the EMR, and will also provide training in the use of improved standardized methods for production and management of food composition and food intake data and also identify appropriate biological markers of food nutritional value and measurements of health outcomes. A review will be undertaken of food and nutrient intakes in the LMICs to develop strategies for reducing sugary and fatty foods in these diets based on new WHO guidelines.
The Quadram Bioscience Institute, that aims to develop solutions to worldwide challenges in human health, food and infectious disease and non communicable disease, will lead the project in partnership with the WHO EMR office. The latter will help to coordinate and co-align regional activities to ensure public health priorities are targeted effectively. Three main activities will underpin capacity building in the EMR with a focus on 10 target LMICs (Morocco, Tunisia, Egypt, Jordan, Palestine, Sudan, Lebanon, Pakistan, Iran & Afghanistan). The project will build on existing links with the WHO EMR and will develop and extend activities with LMIC in the EMR. Four main activities are planned: (1) Training and knowledge exchange workshops; (2) Short-term exchanges of researchers; (3) Development and application of harmonised protocols for pilot sample collection, food analysis, data generation and creation of online regional food composition datasets; (4) Development of possible dietary and other strategies to support reduction in intake of sugary and fatty foods.
The main outcomes will be to build capacity and practical skills in the LMIC to improve production, management and use of food composition and dietary intake data, and biomarkers. Knowledge of European and International standards will be disseminated, with support from WHO, to experts across the region. Networks of expertise within the region will also be an important outcome leading to increased collaboration and effective data sharing. The project will enable more efficient use of better quality, region specific, food composition and intake data that can be used for research, monitoring and policy development. This will benefit LMICs in the region by providing data and tools that can encourage reduction of sugar, saturated fat, trans fats and salt and thereby reduce the incidence of diet related disease.

High quality food composition and food intake data are essential to underpin research into the links between diet and health and to enable effective dietary monitoring and policy development. Most Eastern Mediterranean Region countries use international food composition tables that include foods consumed in western diets with different nutrient composition. Some of these data from other countries are outdated and do not reflect the composition of foods currently consumed in EMR countries, meaning that calculated nutrient intakes are inaccurate. Methods of measuring dietary intake also need to be up-to-date and use appropriate food information.
This project will provide technical and scientific support for researchers (mainly food and nutrition experts) in LMIC countries in the EMR. The project will provide training in the use of improved standardized methods for production and management of food composition and food intake data and also identify appropriate biological markers of food nutritional value and measurements of health outcomes.
Training workshops and exchanges between EMR, UK and possibly European experts will review status and support development of regional food composition databases using European and International Standards. Dietary monitoring methods and use of biomarkers for intake validation, and public health nutrition will also be reviewed for use in LMIC. Existing data and current plans for producing data will be reviewed and harmonized sampling and analysis protocols produced. A network of expertise aimed at ensuring sustainability and producing a regional database will be established. The project will enable more efficient use of better quality, region specific, food composition and intake data for research, monitoring and policy development. This will benefit LMICs by providing data and tools that can encourage reduction of sugar, saturated fat, trans fats and salt and thereby reduce the incidence of diet related disease.

The main outcome of the project will be to build capacity in LMIC in the Eastern Mediterranean Region (EMR) to improve production, management and use of food composition and dietary intake data. The project workshops and training exchanges will build on and develop previous World Health Organisation (WHO) initiatives that have included researchers from the region and will establish networks of expertise within LMIC and within the region. The network will lead to increased collaboration and effective data sharing within regional clusters and the wider region. The data generated, either directly or indirectly, are also expected to be available to a wider user group to underpin research, policy development and nutritional education. The regional datasets produced will be widely used to support research questions and stimulate research opportunities related to the composition of foods, dietary intake and public health. Outcomes from the resulting research will inform development of public health nutrition policy and will have an impact on the food industry that will be expected (or required by legislation) to produce foods that are in line with public health policies.
Participants in the workshops and exchanges will be representatives of universities and research institutes in the region and all activity will be coordinated with the WHO EMR office to ensure that the main stakeholders in the region are represented. The collaboration with WHO is vital to ensure that the participants are key influencers and are willing and able to effectively participate in the project activities and disseminate effectively. New and improved datasets will be published nationally and made available through a regional online database that can be used by researchers, health professionals, policy makers and also consumers.
This project will particularly benefit the LMIC organizations by providing them with access to expertise and tools that are needed to help improve the relevance and quality of data available in the region. The networks formed will provide support for organizations and individuals to share experience and expertise to work more effectively at both national and regional levels. The outcomes of this project will enable more efficient use of better quality, region specific, food composition and intake data that can be used for research, monitoring and policy development and this information will be expected to have a positive impact on public health and regional economies through reduction of diet related disease.