29 April 1994

Doc. 7083

1403-26/4/94-1-E

REPORT

on food and health

(Rapporteur: Mr ALEXANDER,

United Kingdom, European Democratic Group)

Summary

      Wrong eating habits are causing Europeans serious health problems. The premature mortality rates resulting from food-related diseases are alarmingly high in eastern and parts of northern Europe. Hungary and Bulgaria, for example, have reported mortality rates from diseases of the circulatory system in 1990, four times higher than in France. Mortality from cancers in the period 1985-89 was almost double in Lille (north of France) as compared to Haute-Garonne (south of France). However, the "healthy" food habits of southern Europe have also changed, thus resulting in negative developments regarding cardio-vascular diseases, as well as cancers — the main causes of premature deaths.

      These and other health problems related to our food habits are costing society huge sums of money. In Germany, the cost of nutrition-dependant diseases in 1988 was estimated to be 42 000 million Deutschmarks. For Scotland alone, the savings of a 50% reduction in cardio-vascular diseases, as achieved in certain countries already, has been calculated at £300 million per year.

      Better information and education of consumers and all persons working in the agro-food sector on relations between food, eating habits and health, could drastically improve public health by giving individuals a possibility to select a healthy diet. The adoption of nutritional policies would be an important step in achieving better public health records. Enhanced international co-operation, in particular with regard to research, must be favoured in this context.

I. Draft recommendation

1.       The Assembly is aware of the considerable benefits to public health that improvements in diet could bring.

2.       It therefore welcomes and acknowledges the work of member states' governments, the World Health Organisation, the European Union, the European Consumers' Organisation and the Council of Europe in this field.

3.       It believes that consumers, producers, distributors and the food industry have a common long-term interest in promoting nutritional goals in relevant policy areas, such as health, consumers, research, education, food and agriculture.

4.       Consequently, the Assembly recommends that the Committee of Ministers:

i.       include in its intergovernmental work programme, in particular with regard to eastern Europe, activities which would promote public health by improving consumers eating habits, diet and food safety. Such activities should include work carried out within the framework of the Partial Agreement in the Social and Public Health field (in the domain of products having direct or indirect repercussions on the human food chain) in order to harmonise legislation, regulations and methods governing, on the one hand, the control of quality, efficiency and innocuousness of products and, on the other hand, the use without danger of toxic products which are harmful to health;

ii.       invite governments of member states and the European Union:

      a.       to adopt nutritional policies while paying due attention to the needs of different population groups (age, diabetes, etc.);

      b.       to integrate such measures into other policy fields, such as food and agriculture, health, consumer policy, research and education;

      c.       to give more emphasis to research into all aspects of the relationship between diet and health and the safety of food, and to work for more international co-operation and consensus between experts at national and international level in this field;

      d.       to improve school education on the importance of a balanced and healthy diet for human health;

      e.       to promote the production of healthy food through co-operation between producers, consumers and the food industry;

      f.       to organise information campaigns on issues of importance for consumers' choice of a healthy diet;

      g.       to implement nutrition labelling, in line with Assembly Recommendation 1142 (1991) on the labelling of quality food products;

      h.       to upgrade education and training of all professionals and other staff in the food sector (producers, distributors, retailers, the food industry, etc.);

      i.       to make a special effort to assist agricultural producers in taking advantage of, and adapting to, new priorities in nutrition and food quality and new production tasks;

      j.       to work for improvements in the setting, implementation and control of food hygiene standards.

II. Explanatory memorandum

by Mr ALEXANDER

Contents

Introduction       5

Food and its socio-economic environment       7

Decreasing health spending — a new political priority       7

Which prospects for health diets?       8

Health foods and functional foods       9

Preventive nutrition       10

Food security       11

And the consumer?       12

Europe and food       12

Towards a nutrition policy       14

Agricultural producers       14

Conclusion       15

Introduction

      The Regional Office for Europe of the World Health Organisation (WHO) published in 1988 a study on healthy nutrition with the sub-title: "Preventing nutrition-related diseases in Europe" (WHO Regional Publications, European Series, No. 24). The principal author of this booklet, Professor Philip James writes in his executive summary that "in Europe as a whole, about half the premature deaths in men and women below the age of 65 years result from diseases to which diet makes an important contribution. Coronary heart disease, stroke, many kinds of cancer, oral disease, anaemia, goitre, cirrhosis of the liver, diabetes, gall stones, obesity, high blood pressure and bone disease in the elderly have a huge effect on medical services. These conditions should be considered preventable, even if the precise way in which dietary deficiencies or excesses lead to them remains obscure. An analysis of the dietary factors involved suggests that a common set of nutrient goals can be developed as desirable national health goals for the people of Europe". Details of these goals are given in the publication.

      The United Kingdom's Consumers' Association published in 1992 an analysis of one hundred authoritative scientific reports on food, nutrition and public health appearing between 1961 and 1991 ("Food and Health: The Experts Agree").

      Dr John Beishon, chief executive of the UK Consumers' Association, writes in his preface to this book that "food and health are two of the most important areas of concern for consumers ... The food we eat is vital to life, but eating meals can and should be a pleasurable experience, as well as providing the essential nutrients. Yet as a nation we have distressingly high levels of avoidable diseases commonly associated with diet and much of the food we eat is tasteless, lacking in nutrients and unwholesome. The food industry is large and powerful. It spends millions of pounds promoting its products, often with little regard for their value in providing balanced, nutritious and healthy diets. Consumers are bombarded with advice about their health and are subjected to extravagant claims about the healthiness of this or that product or diet, mainly from those with vested interests in selling consumers their products."

      It was against this background that the Assembly decided to analyse the political consequences of the increased knowledge regarding diet and health.

      In order to prepare its report, the Committee on Agriculture first invited several European experts to sit on a panel for a Hearing on Diet and Health, Purity of Foodstuffs and Information to Consumers which took place in Paris on 30 April 1993. Members of this panel were:

      —Mr       Georges Bories, Director of Research, INRA (National Institute for Agronomic Research), Toulouse;—

      —Mr       E. Boutrif, Senior Officer, Food Quality and Standards Service, Food Policy and Nutrition Division, FAO;—

      —Mr       Patrice Collignon, RED (Rurality, Environment, Development);—

      —Mr       s Virginia Graham, Head of Communications of the European Consumers' Organisation (BEUC);—

      —Mr       Serge Michels, Food Officer of the French Consumers' Organisation;—

      —Mr       Gérard Pascal, Director of the National Centre for Studies and Recommendations on Nutrition and Food (CNERNA), Paris;—

      —Mr       Kees de Winter, Food Officer at BEUC;—

      —Mr       Heinrich Wohlmeyer, Director, Austrian Union for Agricultural Research (ÖVAF), Vienna.Th

      This hearing resulted in a memorandum which was discussed by the committee on 3 November 1993 in the presence of Dr Elisabeth Helsing, Officer for Nutrition of the Regional Office for Europe of the World Health Organisation (WHO). Dr Helsing on this occasion presented some illustrations of nutrition and health in Europe as well as WHO's nutrition action plan for the 1990s and an outline for a comprehensive food and nutrition policy. The information was worked into a preliminary draft report which was presented to a hearing on food and health, organised jointly with the European Consumers Organisation in the French National Assembly on 14 March 1994.

      Your Rapporteur wishes to express his gratitude to the French parliamentary delegation to the Council of Europe, for its help in organising this hearing. The expert panel, on this occasion consisted of:

      —Mr       Egon Gaerner, Head of Unit, General Directorate III (Industry), European Commission;—

      —Mr       s Elisabeth Helsing, Advisor for Nutrition, World Health Organisation, Regional Office for Europe;—

      —Mr       Jürg Lüthy, Head of Nutrition Department, Swiss Federal Office for Public Health, representing the Committee of Experts on the Health Control of Foodstuff of the Council of Europe;—

      —Mr       s Katerina Osancova, research worker, National Institute of Public Health of the Czech Republic;—

      —Mr       Gérard Pascal, Director, French National Centre for Studies and Recommendations on Nutrition and Food, (CNERNA), President of the Scientific Committee for Food of the European Commission;—

      —Mr       Kees de Winter, Food Officer, European Consumers' Organisation. Ot

      Other experts and representatives of organisations competent in the field under discussion also contributed to the success of this hearing.

      Your Rapporteur wishes to express the committee's gratitude to all these experts for the invaluable expertise they provided in the preparation of this report.

      In drawing up the present report, he has also benefited from the UK Consumers' Association's excellent report "Food and Health: the Experts Agree", referred to above.

Food and its socio-economic environment

      In many European countries the agro-food sector is the largest economic sector. In France, for example, it represents 16% of all industrial activities and the food industry in the United Kingdom employs half a million people.

      Seven food products out of ten are industrial products. In the United States of America some 15 000 new products are launched every year. Industries, producer organisations and retailers are all actively involved in promoting their products thus influencing the consumer's choice of diet. The development of brand names (Coca Cola, Nescafé, etc.) can be more important to a manufacturer than any other aspect of the food product. This explains the relatively huge sums allocated to marketing in the sector.

      The availability of too many products (often almost identical in content but with a different presentation) in too many retail outlets with an impressive total selling surface has led to consumer confusion. Any one will agree that purchasing decisions are often based on hunches, sales pitches, brand reputation, or sheer fatigue rather than on a genuine awareness of value. These poorly founded decisions, made by millions of people every day of the year, profoundly influence the moral, social and economic world around us. Indeed, Mr James H. Schneider in a recent article in the Futurist claims that the inefficiency resulting from consumer confusion today may be costing the United States economy as much as one thousand million United States dollars per year. Not included in this figure are frustration, lost time and may be even poor health resulting from making an ill-informed purchase. It is possible that many good products are not even produced because consumers have no feasible way of distinguishing the superior from the average.

      Professor Jeoffrey Canon, in his introduction to the book "Food and Health: the Experts Agree" writes that "throughout the world industrialisation has come to include the displacement of traditional agricultural systems and distinctive national cuisines, and the introduction of meat, milk and dairy products as everyday foods, together with fatty, sugary manufactured foods and drinks". During the 1970s it was generally accepted among experts that fatty, sugary food was a cause of obesity, which increased the risk of high blood pressure, diabetes and heart attacks. In the 1970s the United Kingdom alone registered 200 000 deaths per year caused by heart disease. Food, nutrition and health suddenly became a subject of intense public interest, and the food industry responded with low fat and low calorie products. Modern life has also changed our eating patterns. The development of so called fast-foods has reduced both the diversity of the diet, eating time and the social well-being related to a meal.

Decreasing health spending — a new political priority

      OECD data from 1991 reveal that France spent 9,1% of its Gross Domestic Product (GDP) on health and was closely followed by Germany which spent 8,5% of its GDP. The United Kingdom for the same year spent 6,6% of its GDP equivalent to 855 ecus per person per year. This can be compared to health spending in 1970 which was 4,5% for the United Kingdom, 5,8% for France and 5,9% for Germany.

      The causes of this development are many. Amongst these are the fact that an ageing population needs more health care, technological development has made health services more expensive and the access to health services has been improved.

      The increasing costs have forced most governments in Europe to review health spending and the medical services they provide. The most important factor in reducing costs would be to drastically reduce accidents and to improve the health of the population at large. If a better diet adapted to individual needs would achieve improved health, then cost reductions would automatically follow, but it would be difficult to quantify the costs of developing a chronic disease and dying at an early age because food labels provide such poor nutritional information.

      The health situation in Europe, for which the diet plays a role, can be characterised as most alarming for central and eastern Europe, good but with variations among countries in southern Europe (the increasing "industrial" eating habits, rich in fat and sugar, have lead to increased premature mortality rates: 50% for cardio-vascular diseases in Spain, between 1970 and 1985), and relatively bad but improving in northern Europe. Hungary and Bulgaria, for example, have reported mortality rates from diseases of the circulatory system in 1990 four times higher than in France (and increasing from 1960). Premature mortality rates linked to cerebro-vascular diseases are about three times higher in Bulgaria and Hungary than in the United Kingdom, whereas these rates were of the same order in 1960 (30-40 per 100 000). 1990 death rates from ischaemic heart disease were more than twice the European average in Latvia, Estonia, Lithuania and Russia. Mrs Osancova told the hearing on food and health that the problem of a too rich and salty diet (high levels of sugar and saturated fats) had caused severe health problems in the Czech and Slovak Republics.

      The meeting with Dr Helsing also established that as much as half of cancers not caused by pollution could be related to the diet. It is worth mentioning in this context that the mortality from cancer in the period 1985-89 was almost double in Lille (north of France) as compared to Haute Garonne (south of France).

      Some attempts have been made to calculate the costs of diet-related health sufferings. In Scotland, according to a report published by the Scottish Home and Health Department on prevention of coronary heart disease, it is noted that even a 10% reduction in cardio-vascular diseases would save £60 million per year in costs to the tax payers of the National Health Service, and in output lost through certified incapacity to work. The savings of a 50% reduction, as achieved in the United States of America for the period 1970-85, would be £300 million per year. The nutrition report of 1988 for the Federal Republic of Germany estimates the costs of nutrition-dependent diseases (including dental disease) at almost 42 000 million Deutschmarks, which represents some 27% of the total costs for all diseases. A report on potential savings from improved diet for the United States of America also includes IQ gains for children.

Which prospects for health diets?

      The two most frequent health troubles related to ageing are coronary diseases and cancer. Some nutritionists, as we have seen, have long argued that a reduction of fats in the diet would reduce the risk of heart attacks since it would reduce the concentration of a molecule called cholesterol in the blood. Many cancerologists, on the other hand, have kept quiet in this debate since some of them believe that cholesterol can protect against cancer. To complicate matters, cholesterol is not floating free in our blood but is associated with other molecules. It can be loosely packed (LDCh) or more densely (HDCh) packed. (HDCh) is bringing cholesterol to the liver for transformation, whereas (LDCh) transporting cholesterol from the liver, can cause deposits to be formed in the blood vessels. However, this depends not only on the cholesterol concentration but also on the associated molecules and minerals. WHO, as well as the United Kingdom study already cited, underline that a broad agreement exists among experts that a poor diet and physical inactivity (as well as smoking) are important factors in the development of a variety of disorders which lead to substantial morbidity and mortality. A fatty, sugary diet is particularly harmful.

      It should be stressed that the most important building blocks in the human body are proteins and lipids (fats and oils). The body cannot do without these. Advice on nutrition should therefore be clearly age-related: a fact that probably deserves increased attention. It seems to be important to have a balance of saturated and unsaturated lipids and the diet should not be too rich in proteins. Certain oils in fact play an essential role for the nervous transmissions and thus for the functioning of the brain. This is the case for linoleic and alpha-linoleic acids and their derivatives which can be found in some vegetable oils such as nuts and soya. Another example of nutrition-related health trouble is blindness which can result from a deficiency of vitamin A. Deficiencies or excesses of vitamins, minerals, lipids or proteins may lead to health problems.

      Linus Pauling, the double Nobel Prize winner, has advocated that the use of vitamin C could prevent diseases. There is increasing evidence that beta-carothen (provitamin A) and vitamin C can play a preventive role regarding cancer, whereas the role of vitamin E is uncertain — it may be positive as well as negative — depending on the circumstances. In relation to thrombosis, however, an addition of vitamin E seems to reduce the risk.

      Minerals play a most important role for our health and well-being. Iron is needed for the production and functioning of the haemoglobin, calcium is a major building block in the bone structure, and magnesium plays an important role for the functioning of our muscles, including that of the heart. A fair amount of fibres are also important for the functioning of the digestive system and its bio-flora (micro-organisms, bacteria in the intestine).

      The variety of ingredients in our food is enormous. The examples above are among the most well-known, but there are many mechanisms still insufficiently known or completely unknown. The role of vitamins C and E and of selenium as anti-oxidants for the ageing process is one relatively new field of research.

      The many complex interactions between diet and health demands a considerable research effort with a view to improving our knowledge and understanding of these processes. This knowledge in turn must be communicated to consumers and included in school curricula. The different branches of the food production, distribution and processing industry should also receive an upgrading of their knowledge.

Health foods and functional foods

      The knowledge linking nutrition to health has for a long time been used by the food industry, retailers and agricultural producers to promote their products. The promotion of low calorie products is one example, but there are an increasingly large number of products affirming their content of different vitamins or minerals to claim an added health-related value, (without any mention in most cases of daily intake standards). Mr Canon in his analysis, referred to above, claims that there is a general agreement among nutritional experts that disease-specific diets are not necessary. He goes on to say that "a diet rich in whole grain cereals, vegetables and fruits, and low in fats, sugar and salt, helps prevent a whole spectrum of diseases. The best diet to reduce the risk of heart attacks is the best diet to protect against obesity, diabetes, common cancers and other western diseases, and is also the best diet to promote general good health." However, many medical experts and part of the food/pharmaceutical industry advocate a more individual approach as a supplementary step. Health food is not only a generally healthy diet, but the diet could also be monitored to reach specific preventive or curative health goals. It should be added that certain disease-related diets might not be healthy from an overall point of view.

      A general trend in favour of "natural products" has seen the rapid expansion of organically grown foodstuffs meaning that no chemicals including synthetic fertiliser have been used in their production or in their processing. This group of products is claimed to be healthier because it does not contain toxic residues from any added chemicals. The local environment (closeness to a major polluter) may, however, considerably modify this image which is the reason why certain producer-regions (certain mountain regions or remotely situated regions) claim the advantages of their pure foodstuffs. Mr Gaerner, during the hearing on 14 March 1994, stressed that normal impurities and accepted food additives played a minor role for human health compared with that of foodstuffs themselves.

      A new development, particularly successful in Japan, has been the inclusion of ingredients with a specific function in traditional or new food products or beverages. One example is the addition of casein-phosphor-peptide, a molecule which facilitates the uptake of minerals in the intestine. Another example is the introduction of a new drink containing vitamins, caffeine and nicotine which claims to combat fatigue. Yet another product claims beneficial functions for the micro-organisms in the intestine and some products have included well-known extracts from medical plants to claim specific added functional values. The experience of adding Fluorine to water or that of using Fluorine pills to combat caries can be mentioned as a successful experiment in the European context.

      Worldwide there is an immense tradition of using plants or plant ingredients to achieve certain health benefits. Their use in the food industry is under way. The European market for these products has been estimated to reach 150 000 million ecus by 1995. Such uses must however be carefully controlled to avoid any adverse effect.

Preventive nutrition

      The concept of "preventive nutrition" implies the selection of a diet which would diminish health risks, in particular those linked to ageing, cardio-vascular diseases, certain cancers, etc. It has been pointed out above that depending on the disease in question the views of specialists may vary considerably as to the "healthiness" of a foodstuff or category of foods. There is a general agreement that the traditional Mediterranean diet is a healthy diet, whereas the typical "industrialised" northern European diet (rich in sugar, proteins and saturated fats) is unhealthy. The former has proved to reduce health risks. The expert panels at the committee's two hearings stressed the importance of considering the organism in its totality and not as a simple addition of functions.

      A comprehensive understanding of a foodstuff's nutritional value is still lacking and the communication, through labelling and other means, of what is known is far from satisfactory. A nutritional policy for the agro-food sector is in its initial stage. Food prices, for example, are still related to volumes or weights rather than to nutritional value and a systematic nutritional labelling has only started in a few countries. The example of milk illustrates this point. Its price is related to volume, fat and protein content (useful nutrients for children). Its content of certain minerals, vitamins and other molecules which also have important nutritive values are not considered in price terms. Its relative "purity" with regard to toxic residues has also been disregarded in pricing policy. A policy which encourages maximum productivity is bad for food quality as well as for the environment.

      A nutritional policy would require a comprehensive listing of food ingredients and their qualities in relation to health, but presented to the consumer in an understandable manner. The consumer as well as professionals of the agro-food sector, including retailers, would need additional education on nutritional aspects of food. Food education should also be strengthened at school level. Much more interdisciplinary research is needed in this area for real and incontestable progress to be made.

Food security

      The two most important factors for food safety are hygiene and the presence of toxic products. Hygiene norms are set for the production of milk, for slaughter houses and for other production or processing operations. The toxicological control has to be very severe and acceptable concentration limits for different ingredients and contaminants should be set at a European level on the basis of the recommendations (general guidelines, positive lists, analytical methods advocated) arising from the toxicological evaluations carried out within the framework of the work of the European Commission or of the Council of Europe's Partial Agreement in the Social and Public Health field (health control of foodstuff). The FAO/WHO Codex Alimentarius is not functioning satisfactorily because too many countries have to agree on standards and norms, thus to a certain extent reducing standards to the lowest common denominator.

      The committee hearing on 30 April 1993 revealed that there had been an increase in complaints from consumers regarding their allergic reactions to certain food ingredients. In Europe, health reactions to tropical products had also been registered. Mould or mushrooms or fungi can also intoxicate food products. Residues of pesticides or other additives used in food production and processing should be carefully controlled. Particular problems have arisen when such products were accepted outside Europe but not in Europe, for example in the case of certain growth hormones. The processing of food, for example, grilling, could in itself lead to the transformation of molecules into toxic products. Food processing has therefore to be carefully monitored in order to avoid such unwanted effects. Our environment is however "impure" and we are surrounded by toxic substances. The elimination of all biological agents (bacteria, etc.) might therefore have rather negative effects on our overall resistance to health aggressions. Much more emphasis must be given to education and information on the overall aspects of food security.

And the consumer?

      The committee was informed at the hearings that the most important criteria for consumers when choosing a foodstuff were taste, smell, texture, colour, etc. (that is organo-leptic properties), their safety (no health risks) and their nutritional quality. Is the consumer well guided by labelling, advertising and information in his choice of the most healthy diet in a supermarket filled with an increasing variety of attractively presented fresh or processed foodstuffs? A fresh salad, for example, has no indication of its nitrate content (which may be above recommended levels) nor whether it was produced in a glasshouse or in the open air, in the soil or in a nutritive solution, whether it was radiated or stored in CO₂ to increase conservation time, whether it has other valuable nutrients or other toxic residues, etc. Tomatoes have no indication of the relative liquid content (water) which of course influences taste, as well as price and nutritional value. Too many "experts" are also giving conflicting advice on the "best type of food for your health". Producers, agro-food industries and retailers are manipulating the organo-leptic presentation of their foodstuffs to increase sales. Appetite and hunger can be stimulated through images, smell or even sounds. Present-day technology allows producers to manipulate all three factors and create demand for their special products.

      In this jungle of information, consumers must have the right to receive better data on the foodstuffs they buy and in particular their contribution to a healthy diet. Claims made in food labelling should be verifiable. Nutritional education must be offered to consumers and should be included in school curricula. A good food education would result in improvements in our diet with resulting health benefits. This will also entail reduced health spending for society. It is therefore important that Council of Europe member states and the European Union start elaborating a nutrition policy aimed at, among other things, reducing food-related health risks and informing consumers of the benefits for their well-being and health that sound eating habits and a well composed diet could have. Agricultural policy, as well as labelling, advertising, food processing, storage and other agro-food related policies must be adapted to these goals. The food industry as well as agricultural producers and consumer organisations must be fully involved in the elaboration of a framework for such a new nutritional policy. The Assembly, in its Recommendation 1142 (1991) on the labelling of quality food products, has already put forward several proposals in line with such an initiative.

Europe and food

      The European Union, the European Free Trade Association and the new democracies of central and eastern Europe, as well as the Organisation for Economic Co-operation and Development are all involved in the process of opening up trade in food products in Europe and the world. A liberalisation of world trade in food has been negotiated within the framework of the General Agreement on Tariffs and Trade (GATT). Major issues in addition to the removal of trade barriers, are consumer safety, purity of foodstuffs, regulation of claims made in labelling and advertising, on additives and residues and on packaging. Needless to say, in Europe it is the European Union which is leading this work. It is not the aim of this report to make a comprehensive presentation of European Union legislation relating to food and food markets for which three directorates in the Commission are responsible. The directives drawn up by the European Commission can be vertical as well as horizontal. Some of them are not yet agreed upon. The principle of "subsidiarity" has introduced a new dimension to this work. The Commission has recently made a proposal for a "general food directive" which will integrate earlier directives. The idea has also been put forward to create a European food agency. However, Europe has still not an equivalent organisation to the Food and Drug Administration of the United States of America.

      Your Rapporteur feels it appropriate to make a few additional comments on the situation in countries of the former communist bloc. Following the introduction of reforms, all of these countries have experienced a significant reduction in the purchasing power of households. This has led to a dramatic reduction in the energy and nutrient content of their diets which could entail the risk of severe deficiencies among the socially vulnerable low-income groups. This has happened at a time when the same countries must upgrade their food regulations to meet western standards in order to be able to increase exports of foodstuffs and thus improve their economies.

      It would be in line with the Assembly's earlier recommendations on assistance to the populations of the former Soviet bloc and for the furthering of European integration to ask the Council of Europe member governments and the European Union to pay special attention to the need to improve diets, food safety and health conditions in central and eastern Europe. More emphasis should also be given to assistance aiming at bringing their food standards in line with west European levels. The committee's meeting in Poland (8-9 June 1993) clearly illustrated that food subsidies or their abolition can have a major impact on the possibility of feeding oneself correctly. The sudden deregulation of food prices and the dumping of certain western products on east European markets have led to a considerable level of malnutrition, in particular among the poor. Major changes in policies governing food markets should therefore be better monitored in order to avoid unnecessary hardship and negative effects on public health.

Towards a nutrition policy

      WHO defines a nutrition policy as "an explicit governmental mandate to the food and health sectors to include health considerations into food supply policies and nutritional considerations into health policies". The Confederation of the Food and Drink Industries of the European Union presented at the hearing on 14 March 1994 its views on the development of a nutrition policy which objectives were stated as:

      —pr       ovision of a safe and varied food supply, in sufficient quantity;—

      —pr       ovision of information about those foods;—

      —nu       trition and health education.Th

      These three pillars of nutrition policy should then be supported by some or all of the following:

      —fo       rmulation of dietary advice/nutritional guidelines;—

      —su       rveillance of intake;—

      —av       ailability of nutritional data on foods;—

      —fo       od research and scientific development;—

      —ef       fective liaison between interest groups.Th

      The main objective of a nutrition policy must be to orient food production, distribution and consumption to take full account of nutritional priorities for the promotion of consumer health. This demands a series of actions at different levels. WHO recommends that nutrition policy objectives should be established on the basis of situation analysis and their implementation must be continuously surveyed. Nutrition policy must be allowed to influence and guide food supply as well as food quality and should play an important role in guiding food demand. Research has already proved a fundamental tool for the understanding of the complex interrelations between diet and health. This multidisciplinary effort must be continued and given increased resources because of the importance of this issue for the well-being of our society. Education and information must be a key element of a strategy to upgrade the knowledge among consumers, producers, retailers, distributors and the food industry of the main factors relating food and health.

      A nutrition labelling policy should be an integral element of a nutrition policy, and such a policy must take full account of cultural and regional differences.

Agricultural producers

      Agricultural policies in most European countries have excessively, for historical reasons, put the main emphasis on the quantity of food produced, disregarding to a certain extent quality, food traditions and the nutritional values of food. The result has been over-production, a decay of the countryside and severe health problems affecting large groups of the population. This costly and counter-productive policy must be revised. It is true that new elements have been introduced in agricultural policy in favour of nature conservation and rural development but nutritional aspects have not been sufficiently dealt with. The consequences for agricultural policies of introducing a nutrition policy may be many and would need to be thoroughly analysed in the presence of and involving all parties concerned. The introduction of a nutrition policy would also have impacts on other policy areas, such as health and consumer policies. It seems logic for a reform of agricultural policies in line with nutritional priorities that products corresponding to identified nutritional objectives should be awarded a higher price, thus motivating producers to implement necessary production changes. A new awareness of diet and health among consumers would most probably lead to a change in food demands and consumers may agree to place more emphasis on their health and to pay more for a quality diet. Food production could thus be increasingly guided by market forces while at the same time the economies of agricultural producers could be improved and health costs reduced.

      Cost benefit analysis of changing eating habits will motivate governments to favour healthy food habits and to invest in research, education and public information to this end.

Conclusion

      This report reiterates the close relationship between food and health and it attempts to show that correct nutrition can protect against or heal a number of diseases, prevent suffering, and result in a considerable reduction in health spending. Correct eating habits can also contribute to enhancing the well-being of consumers. The acquiring of new and better knowledge about the interactions between food, eating habits and health and the distribution of information on these relationships must be actively promoted.

      Your Rapporteur is therefore of the opinion that the Assembly could recommend to Council of Europe member governments and to the European Union that guidelines be established for a new nutrition policy and reforms be undertaken in other policy areas in order to comply with this new policy. This would particularly affect agricultural policies but also labelling, information and health policies. Information exchange in the agro-food sector must be fluid, easy and fast, and must ensure the greatest transparency all the way through to the consumer who assesses the product. Particular attention should be given to health claims of different foodstuffs. The agro-industrial sector and European consumers' organisations should be associated with the design, implementation and necessary control work related to these reforms. Increased emphasis should be given to international consultation — not least with regard to research and education/information.

      Reporting committee: Committee on Agriculture.

      Budgetary implications for the Assembly: none.

      Reference to committee: Doc. 6768 and Reference No. 1900 of 1 October 1993.

      Draft recommendation adopted unanimously by the committee on 12 April 1994.

      Members of the committee: MM. Scheer (Chairman), Sipos, van der Linden (Vice-Chairmen), Mrs Anttila, MM. Bernardini, Bühler, Mrs Burbiené, MM. de Carolis, Černý, Couveinhes, Deasy, Figel, Goerens, Granstedt, Gunnarsson, Hansen, Holte, Sir Ralph Howell, MM. Iuliano, Jeambrun, Kiratlioǧlu, Lanner, Lord Mackie of Benshie, MM. Mändmets, Mannino, Metelko, Michels, Ottenbourgh, Pirinski, Pizzo, Rodrigues, Roger, Roman, Seiler (Alternate: Berger), Smolarek, Jack Thompson, MM. Vella, Vrettos.

      N.B.       The names of those members present at the meeting are printed in italics.

      Secretary to the committee: Mr Lervik.