[A review of the nutritional management plans in the member states of the European Union].
Obesity has reached epidemiological proportions in Europe and the burden of diseases attributable to nutrition is substantial. Under the impetus of the World Health Organisation (WHO), member states have been urged to develop national action plans for nutrition and physical activity. This study describes what has been done in terms of nutrition policy at national level in the member states of the European Union right before its enlargement in 2004. It is a critical review of publicly available policy documents on nutrition and physical activity. The background idea was to assist the initiative of the Belgian food industry to play a proactive role in the development of a Belgian nutrition action plan. At the time of writing, in total six out of the fifteen EU member states namely Sweden, Finland, Denmark, France, the Netherlands and the United Kingdom, reported to have an operational national nutrition plan. By the end of the year 2004, another four countries are expected to have their plan finalised. In line with WHO guidelines, all nutrition plans in this study acknowledge the importance of a multidisciplinary approach and promote stakeholder involvement at some point. Most of the plans however, do not elaborate on their specific role and strategies that will be used to do so. It seems that stakeholder mobilisation is largely restricted to the implementation phases. All operational nutrition plans envisage reducing social disparities. Long-established vulnerable groups in society such as pregnant women, children and elderly are targeted. Considerable variability was observed for nutritional objectives and dietary recommendations between the different countries. Nutrition surveillance and monitoring activities seem to vary considerably between the different action plans. None of the countries except Denmark documents the theoretical foundations and development process of their nutritional surveillance system. National nutrition policy in Europe is clearly in a state of flux and the centre of gravity seems to move away from Scandinavia. Although the importance of nutritional surveillance, comprehensive approach to nutritional problems and stakeholder involvement is recognised by the action plans, the rationale, justification and mechanisms for it is vaguely described. Our findings call for increased efforts to strengthen the evidence base of public health nutrition policy. To achieve this however, systematic evaluations and proper reporting of which health and nutrition promotion strategies work in the different countries in the EU are urgently needed.