Public Institution NicolaeTestemitanu State University of Medicine and Pharmacy of [602711]

Ministry of Health of the Republic of Moldova
Public Institution “NicolaeTestemitanu” State University of Medicine and Pharmacy of
the Republic of Moldova
FACULTY OF MEDICINE N2
Department of Hygiene
DIPLOMA THESIS
Student: [anonimizat], group 1640
Scientific advisorAlexei Chirlici:,
Chisinau, 2015
CONTENT
Introduction………………………………………………………………………..…3
Chapter 1
1

Global and regional food consumption patterns and trends…………….……………6
1.1.Developments in the availability of dietary energy…………………..……………..6
1.2Availability and changes in consumption of dietary fat…………………. …………10
1.3Availability and changes in consumption of animal products………….…………..14
1.4 Availability and consumption of fish…………………………………………….16
1.5 Availability and consumption of fruits and vegetables………………………….19
1.6 Future trends in demand, food availability and consumption…………………..21
1.7 Health problems associated with food consumption……………………………25
Chapter 2
MATERIAL AND METHODS………………………………………………………29
Chapter 3
Personal results and discussions……………………………………………………….30
Chapter 4
Conclusions and recommendations
Conclusions………………………………………………………………………37
Recommendations………………………………………………………………..38
References…………………………………………………………………….……….39
Introduction
Promoting healthy diets and lifestyles to reduce the global burden of no communicable
diseases requires a multispectral approach involving the various relevant sectors in
societies. The agriculture and food sector figures prominently in this enterprise and must
be given due importance in any consideration of the promotion of healthy diets for
individuals and population groups. Food strategies must not merely be directed at
2

ensuring food security for all, but must also achieve the consumption of adequate
quantities of safe and good quality foods that together make up a healthy diet. Any
recommendation to that effect will have implications for all components in the food
chain. It is therefore useful at this juncture to examine trends in consumption patterns
worldwide and deliberate on the potential of the food and agriculture sector to meet the
demands and challenges posed by this report.
Economic development is normally accompanied by improvements in a country’s food
supply and the gradual elimination of dietary deficiencies, thus improving the overall
nutritional status of the country’s population. Furthermore, it also brings about
qualitative changes in the production, processing, distribution and marketing of food.
Increasing urbanization will also have consequences for the dietary patterns and
lifestyles of individuals, not all of which are positive. Changes in diets, patterns of work
and leisure – often referred to as the “nutrition transition” – are already contributing to
the causal factors underlying no communicable diseases even in the poorest countries.
Moreover, the pace of these changes seems to be accelerating, especially in the low-
income and middle-income countries.
The dietary changes that characterize the “nutrition transition” include both quantitative
and qualitative changes in the diet. The adverse dietary changes include shifts in the
structure of the diet towards a higher energy density diet with a greater role for fat and
added sugars in foods, greater saturated fat intake (mostly from animal sources), reduced
intakes of complex carbohydrates and dietary fiber, and reduced fruit and vegetable
intakes (1). These dietary changes are compounded by lifestyle changes that reflect
reduced physical activity at work and during leisure time ( 2). At the same time, however,
poor countries continue to face food shortages and nutrient inadequacies.
Diets evolve over time, being influenced by many factors and complex interactions.
Income, prices, individual preferences and beliefs, cultural traditions, as well as
3

geographical, environmental, social and economic factors all interact in a complex
manner to shape dietary consumption patterns. Data on the national availability of the
main food commodities provide a valuable insight into diets and their evolution over
time. FAO produces annual Food Balance Sheets which provide national data on food
availability (for almost all commodities and for nearly all countries). Food Balance
Sheets give a complete picture of supply (including production, imports, stock changes
and exports) and utilization (including final demand in the form of food use and
industrial non-food use, intermediate demand such as animal feed and seed use, and
waste) by commodity. From these data, the average per capita supply of macronutrients
(i.e. energy, protein, fats) can be derived for all food commodities. Although such
average per capita supplies are derived from national data, they may not correspond to
actual per capita availability, which is determined by many other factors such as
inequality in access to food. Likewise, these data refer to “average food available for
consumption”, which, for a number of reasons (for example, waste at the household
level), is not equal to average food intake or average food consumption. In the remainder
of this chapter, therefore, the terms “food consumption” or “food intake” should be read
as “food available for consumption”.
Actual food availability may vary by region, socioeconomic level and season. Certain
difficulties are encountered when estimating trade, production and stock changes on an
annual scale. Hence three-year averages are calculated in order to reduce errors. The
FAO statistical database (FAOSTAT), being based on national data, does not provide
information on the distribution of food within countries, or within communities and
households.
Research purpose
4

Hygienic evaluation of effective consumption of foods in Israel and Republic of
Moldova and the recommendation for improving the consumption of foods in both
countries.
Research objectives
1.Analysis of bibliographical sources concerning consumption of foods and
energetic values of daily diets in different countries.
2.Studying and hygienic evaluation of effective consumption of food – stuffs in
Israel
3.Studying and hygienic evaluation of effective consumption of food – stuffs in
Republic of Moldova.
4.Analysis of bibliographical sources concerning consumption of foods in Israel and
Republic of Moldova.
5.Developmentof recommendations concerning the rationalization of food
consumption directed to prevention of non-communicable diseases.
Chapter 1
1.1 Developments in the availability of dietary energy
Food consumption expressed in kilocalories (kcal) per capita per day is a key variable
used for measuring and evaluating the evolution of the global and regional food
situation. A more appropriate term for this variable would be “national average apparent
food consumption” since the data come from national Food Balance Sheets rather than
5

from food consumption surveys. Analysis of FAOSTAT data shows that dietary energy
measured in kcals per capita per day has been steadily increasing on a worldwide basis;
availability of calories per capita from the mid-1960s to the late 1990s increased
globally by approximately 450 kcal per capita per day and by over 600 kcal per capita
per day in developing countries (see Table 1). This change has not, however, been equal
across regions. The per capita supply of calories has remained almost stagnant in sub-
Saharan Africa and has recently fallen in the countries in economic transition. In
contrast, the per capita supply of energy has risen dramatically in East Asia (by almost
1000 kcal per capita per day, mainly in China) and in the Near East/North Africa region
(by over 700 kcal per capita per day).
Table 1. Global and regional per capita food consumption (kcal per capita per day)
Region 1964 –
19661974 –
19761984 –
19861997 –
199920152030
World 235824352655280329403050
Developing countries 205421522450268128502980
Near East and North Africa 229025912953300630903170
Sub-Saharan Africa* 205820792057219523602540
Latin America and the
Caribbean239325462689282429803140
East Asia 195721052559292130603190
South Asia 201719862205240327002900
Industrialized countries 294730653206338034403500
Transition countries 322233853379290630603180
*Excludes South Africa.
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Source: reproduced, with minor editorial amendments from reference 3 with the
permission of the publisher.
In short, it would appear that the world has made significant progress in raising food
consumption per person. The increase in the world average consumption would have
been higher but for the declines in the transition economies that occurred in the 1990s. It
is generally agreed, however, that those declines are likely to revert in the near future.
The growth in food consumption has been accompanied by significant structural
changes and a shift in diet away from staples such as roots and tubers towards more
livestock products and vegetable oils ( 4). Table 1 shows that current energy intakes
range from 2681 kcal per capita per day in developing countries, to 2906 kcal per capita
per day in transition countries and 3380 kcal per capita per day in industrialized
countries. Data shown in Table 2 suggest that per capita energy supply has declined from
both animal and vegetable sources in the countries in economic transition, while it has
increased in the developing and industrialized countries.
Table 2. Vegetable and animal sources of energy in the diet (kcal per capita per day)
Region1967 – 19691977 – 19791987 – 19891997 – 1999
TVATVATVATVA
Developing countries 20591898161225420701842490224824226812344337
Transition countries 32872507780340025078933396245594129062235671
Industrialized countries 30032132871311222069063283233395033802437943
T, total kcal; V , kcal of vegetable origin; A, kcal of animal origin (including fish
products).
Source: FAOSTAT, 2003.
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Similar trends are evident for protein availability; this has increased in both developing
and industrialized countries but decreased in the transition countries. Although the
global supply of protein has been increasing, the distribution of the increase in the
protein supply is unequal. The per capita supply of vegetable protein is slightly higher in
developing countries, while the supply of animal protein is three times higher in
industrialized countries.
Globally, the share of dietary energy supplied by cereals appears to have remained
relatively stable over time, representing about 50% of dietary energy supply. Recently,
however, subtle changes appear to be taking place (see Fig. 1). A closer analysis of the
dietary energy intake shows a decrease in developing countries, where the share of
energy derived from cereals has fallen from 60% to 54% in a period of only 10 years.
Much of this downwards trend is attributable to cereals, particularly wheat and rice,
becoming less preferred foods in middle-income countries such as Brazil and China, a
pattern likely to continue over the next 30 years or so. Fig. 2 shows the structural
changes in the diet of developing countries over the past 30-40 years and FAO’s
projections to the year 2030 ( 3).
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Fig. 1. The share of dietary energy derived from cereals
Source: adapted from reference 4 with the permission of the publisher. WHO 03.19
Fig. 2. Calories from major commodities in developing countries
Source: reproduced from reference 3 with the permission of the publisher. WHO 03.20
1.2 Availability and changes in consumption of dietary fat
The increase in the quantity and quality of the fats consumed in the diet is an important
feature of nutrition transition reflected in the national diets of countries. There are large
variations across the regions of the world in the amount of total fats (i.e. fats in foods,
plus added fats and oils) available for human consumption. The lowest quantities
consumed are recorded in Africa, while the highest consumption occurs in parts of North
America and Europe. The important point is that there has been a remarkable increase in
the intake of dietary fats over the past three decades (see Table 3) and that this increase
has taken place practically everywhere except in Africa, where consumption levels have
stagnated. The per capita supply of fat from animal foods has increased, respectively, by
14 and 4 g per capita in developing and industrialized countries, while there has been a
decrease of 9 g per capita in transition countries.
9

Table 3. Trends in the dietary supply of fat
RegionSupply of fat (g per capita per day)
1967 –
19691977 –
19791987 –
19891997 –
1999Change between 1967 –
1969 and 1997 – 1999
World 5357677320
North Africa 4458656420
Sub-Saharan Africa*414341454
North America 11712513814326
Latin America and the
Caribbean5465737925
China 2427487955
East and South-East
Asia2832445224
South Asia 2932394516
European Community 11712814314831
Eastern Europe 9011111610414
Near East 5162737019
Oceania 10210211311311
Source: FAOSTAT, 2003.
The increase in dietary fat supply worldwide exceeds the increase in dietary protein
supply. The average global supply of fat has increased by 20 g per capita per day since
1967-1969. This increase in availability has been most pronounced in the Americas, East
Asia, and the European Community. The proportion of energy contributed by dietary
10

fats exceeds 30% in the industrialized regions, and in nearly all other regions this share
is increasing.
The fat-to-energy ratio (FER) is defined as the percentage of energy derived from fat in
the total supply of energy (in kcal). Country-specific analysis of FAO data for 1988-
1990 (5) found a range for the FER of 7-46%. A total of 19 countries fell below the
minimum recommendation of 15% dietary energy supply from fat, the majority of these
being in sub-Saharan Africa and the remainder in South Asia. In contrast, 24 countries
were above the maximum recommendation of 35%, the majority of these countries
being in North America and Western Europe. It is useful to note that limitations of the
Food Balance Sheet data may contribute much of this variation in the FER between
countries. For instance, in countries such as Malaysia with abundant availability of
vegetable oils at low prices, Food Balance Sheet data may not reflect real consumption
at the individual household level.
Rising incomes in the developing world have also led to an increase in the availability
and consumption of energy-dense high-fat diets. Food balance data can be used to
examine the shift in the proportion of energy from fat over time and its relationship to
increasing incomes ( 6).
In 1961-1963, a diet providing 20% of energy from fat was associated only with
countries having at least a per capita gross national product of US$ 1475. By 1990,
however, even poor countries having a gross national product of only US$ 750 per
capita had access to a similar diet comprising 20% of energy from fat. (Both values of
gross national product are given in 1993 US$.) This change was mainly the result of an
increase in the consumption of vegetable fats by poor countries, with smaller increases
occurred in middle-income and high-income countries. By 1990, vegetable fats
accounted for a greater proportion of dietary energy than animal fats for countries in the
lowest per capita income category. Changes in edible vegetable oil supply, in prices and
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in consumption equally affected rich and poor countries, although the net impact was
relatively much greater in low-income countries. An equally large and important shift in
the proportion of energy from added sugars in the diets of low-income countries was
also a feature of the nutrition transition ( 1).
Examinations of the purchasing habits of people, aimed at understanding the relationship
between level of education or income and the different amounts or types of commodities
purchased at different times were also revealing. Research conducted in China shows
that there have been profound shifts in purchasing practices in relation to income over
the past decade. These analyses show how extra income in China affects poor people
and rich people in a differential manner, enhancing the fat intake of the poor more than
that of the rich ( 7).
A variable proportion of these fat calories are provided by saturated fatty acids. Only in
the two of the most affluent regions (i.e. in parts of North America and Europe) is the
intake of saturated fat at or above 10% of energy intake level. In other less affluent
regions, the proportion of dietary energy contributed by saturated fatty acids is lower,
ranging from 5% to 8%, and generally not changing much over time. National dietary
surveys conducted in some countries confirm these data. The ratio of dietary fat from
animal sources to total fat is a key indicator, since foods from animal sources are high in
saturated fat. Data sets used to calculate country-specific FERs can also be used to
calculate proportions of animal fat in total fat. Such analysis indicated that the
proportion of animal fat in total fat was lower than 10% in some countries (Democratic
Republic of Congo, Mozambique, Nigeria, Sao Tome and Principe, and Sierra Leone),
while it is above 75% in some other countries (Denmark, Finland, Hungary, Mongolia,
Poland and Uruguay). These findings are not strictly divided along economic lines, as
not all of the countries in the high range represent the most affluent countries. Country-
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specific food availability and cultural dietary preferences and norms to some extent
determine these patterns.
The types of edible oils used in developing countries are also changing with the
increasing use of hardened margarines (rich in trans fatty acids) that do not need to be
refrigerated. Palm oil is becoming an increasingly important edible oil in the diets of
much of South-East Asia and is likely to be a major source in the coming years.
Currently, palm oil consumption is low and the FER ranges between 15% and 18%. At
this low level of consumption, the saturated fatty acid content of the diet comprises only
4% to 8%. Potential developments in the edible oil sector could affect all stages of the
oil production process from plant breeding to processing methods, including the
blending of oils aimed at producing edible oils that have a healthy fatty acid
composition.
Olive oil is an important edible oil consumed largely in the Mediterranean region. Its
production has been driven by rising demand, which has increasingly shifted olive
cultivation from traditional farms to more intensive forms of cultivation. There is some
concern that the intensive cultivation of olives may have adverse environmental impacts,
such as soil erosion and desertification ( 8). However, agricultural production methods
are being developed to ensure less harmful impacts on the environment.
1.3 Availability and changes in consumption of animal products
There has been an increasing pressure on the livestock sector to meet the growing
demand for high-value animal protein. The world’s livestock sector is growing at an
unprecedented rate and the driving force behind this enormous surge is a combination of
population growth, rising incomes and urbanization. Annual meat production is
projected to increase from 218 million tonnes in 1997-1999 to 376 million tonnes by
2030.
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There is a strong positive relationship between the level of income and the consumption
of animal protein, with the consumption of meat, milk and eggs increasing at the
expense of staple foods. Because of the recent steep decline in prices, developing
countries are embarking on higher meat consumption at much lower levels of gross
domestic product than the industrialized countries did some 20-30 years ago.
Urbanization is a major driving force influencing global demand for livestock products.
Urbanization stimulates improvements in infrastructure, including cold chains, which
permit trade in perishable goods. Compared with the less diversified diets of the rural
communities, city dwellers have a varied diet rich in animal proteins and fats, and
characterized by higher consumption of meat, poultry, milk and other dairy products.
Table 4 shows trends in per capita consumption of livestock products in different regions
and country groups. There has been a remarkable increase in the consumption of animal
products in countries such as Brazil and China, although the levels are still well below
the levels of consumption in North American and most other industrialized countries.
As diets become richer and more diverse, the high-value protein that the livestock sector
offers improves the nutrition of the vast majority of the world. Livestock products not
only provide high-value protein but are also important sources of a wide range of
essential micronutrients, in particular minerals such as iron and zinc, and vitamins such
as vitamin A. For the large majority of people in the world, particularly in developing
countries, livestock products remain a desired food for nutritional value and taste.
Excessive consumption of animal products in some countries and social classes can,
however, lead to excessive intakes of fat.
Table 4. Per capita consumption of livestock products
Region Meat (kg per year) Milk (kg per year)
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1964 –
19661997 –
199920301964 –
19661997 –
19992030
World 24.236.445.373.978.189.5
Developing countries 10.225.536.728.044.665.8
Near East and North Africa 11.921.235.068.672.389.9
Sub-Saharan Africaa9.99.413.428.529.133.8
Latin America and the
Caribbean31.753.876.680.1110.2139.8
East Asia 8.737.758.53.610.017.8
South Asia 3.95.311.737.067.5106.9
Industrialized countries 61.588.2100.1185.5212.2221.0
Transition countries 42.546.260.7156.6159.1178.7
a Excludes South Africa.
Source: Adapted from reference 4 with the permission of the publisher.
The growing demand for livestock products is likely to have an undesirable impact on
the environment. For example, there will be more large-scale, industrial production,
often located close to urban centers, which brings with it a range of environmental and
public health risks. Attempts have been made to estimate the environmental impact of
industrial livestock production. For instance, it has been estimated that the number of
people fed in a year per hectare ranges from 22 for potatoes and 19 for rice to 1 and 2,
respectively, for beef and lamb ( 9). The low energy conversion ratio from feed to meat is
another concern, since some of the cereal grain food produced is diverted to livestock
production. Likewise, land and water requirements for meat production are likely to
become a major concern, as the increasing demand for animal products results in more
intensive livestock production systems ( 10).
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1.4 Availability and consumption of fish
Despite fluctuations in supply and demand caused by the changing state of fisheries
resources, the economic climate and environmental conditions, fisheries, including
aquaculture, have traditionally been, and remain an important source of food,
employment and revenue in many countries and communities ( 11). After the remarkable
increase in both marine and inland capture of fish during the 1950s and 1960s, world
fisheries production has leveled off since the 1970s. This leveling off of the total catch
follows the general trend of most of the world’s fishing areas, which have apparently
reached their maximum potential for fisheries production, with the majority of stocks
being fully exploited. It is therefore very unlikely that substantial increases in total catch
will be obtained in the future. In contrast, aquaculture production has followed the
opposite path. Starting from an insignificant total production, inland and marine
aquaculture production has been growing at a remarkable rate, offsetting part of the
reduction in the ocean catch of fish.
The total food fish supply and hence consumption has been growing at a rate of 3.6%
per year since 1961, while the world’s population has been expanding at 1.8% per year.
The proteins derived from fish, crustaceans and molluscs account for between 13.8%
and 16.5% of the animal protein intake of the human population. The average apparent
per capita consumption increased from about 9 kg per year in the early 1960s to 16 kg in
1997. The per capita availability of fish and fishery products has therefore nearly
doubled in 40 years, outpacing population growth.
As well as income-related variations, the role of fish in nutrition shows marked
continental, regional and national differences. In industrialized countries, where diets
generally contain a more diversified range of animal proteins, a rise in per capita
provision from 19.7 kg to 27.7 kg seems to have occurred. This represents a growth rate
close to 1% per year. In this group of countries, fish contributed an increasing share of
16

total protein intake until 1989 (accounting for between 6.5% and 8.5%), but since then
its importance has gradually declined and, in 1997, its percentage contribution was back
to the level prevailing in the mid-1980s. In the early 1960s, per capita fish supply in
low-income food-deficit countries was, on average, only 30% of that of the richest
countries. This gap has been gradually reduced, such that in 1997, average fish
consumption in these countries was 70% of that of the more affluent economies. Despite
the relatively low consumption by weight in low-income food-deficit countries, the
contribution of fish to total animal protein intake is considerable (nearly 20%). Over the
past four decades, however, the share of fish proteins in animal proteins has declined
slightly, because of faster growth in the consumption of other animal products.
Currently, two-thirds of the total food fish supply is obtained from capture fisheries in
marine and inland waters, while the remaining one third is derived from aquaculture.
The contribution of inland and marine capture fisheries to per capita food supply has
stabilized, around 10 kg per capita in the period 1984-1998. Any recent increases in per
capita availability have, therefore, been obtained from aquaculture production, from
both traditional rural aquaculture and intensive commercial aquaculture of high-value
species.
Fish contributes up to 180 kcal per capita per day, but reaches such high levels only in a
few countries where there is a lack of alternative protein foods grown locally or where
there is a strong preference for fish (examples are Iceland, Japan and some small island
states). More typically, fish provides about 20-30 kcal per capita per day. Fish proteins
are essential in the diet of some densely populated countries where the total protein
intake level is low, and are very important in the diets of many other countries.
Worldwide, about a billion people rely on fish as their main source of animal proteins.
Dependence on fish is usually higher in coastal than in inland areas. About 20% of the
17

world’s population derives at least one-fifth of its animal protein intake from fish, and
some small island states depend almost exclusively on fish.
Recommending the increased consumption of fish is another area where the feasibility
of dietary recommendations needs to be balanced against concerns for sustainability of
marine stocks and the potential depletion of this important marine source of high quality
nutritious food. Added to this is the concern that a significant proportion of the world
fish catch is transformed into fish meal and used as animal feed in industrial livestock
production and thus is not available for human consumption.
1.5 Availability and consumption of fruits and vegetables
Consumption of fruits and vegetables plays a vital role in providing a diversified and
nutritious diet. Allow consumption of fruits and vegetables in many regions of the
developing world is, however, a persistent phenomenon, confirmed by the findings of
food consumption surveys. Nationally representative surveys in India ( 12), for example,
indicate a steady level of consumption of only 120-140 g per capita per day, with about
another 100 g per capita coming from roots and tubers, and some 40 g per capita from
pulses. This may not be true for urban populations in India, who have rising incomes
and greater access to a diverse and varied diet. In contrast, in China, – a country that is
undergoing rapid economic growth and transition – the amount of fruits and vegetables
consumed has increased to 369 g per capita per day by 1992.
At present, only a small and negligible minority of the world’s population consumes the
generally recommended high average intake of fruits and vegetables. In 1998, only 6 of
the 14 WHO regions had an availability of fruits and vegetables equal to or greater than
the earlier recommended intake of 400 g per capita per day. The relatively favorable
situation in 1998 appears to have evolved from a markedly less favorable position in
previous years, as evidenced by the great increase in vegetable availability recorded
18

between 1990 and 1998 for most of the regions. In contrast, the availability of fruit
generally decreased between 1990 and 1998 in most regions of the world.
The increase in urbanization globally is another challenge. Increasing urbanization will
distance more people from primary food production, and in turn have a negative impact
on both the availability of a varied and nutritious diet with enough fruits and vegetables,
and the access of the urban poor to such a diet. Nevertheless, it may facilitate the
achievement of other goals, as those who can afford it can have better access to a diverse
and varied diet. Investment in periurban horticulture may provide an opportunity to
increase the availability and consumption of a healthy diet.
Global trends in the production and supply of vegetables indicate that the current
production and consumption vary widely among regions, as indicated in Table 5. It
should be noted that the production of wild and indigenous vegetables is not taken into
account in production statistics and might therefore be underestimated in consumption
statistics. In 2000, the global annual average per capita vegetable supply was 102 kg,
with the highest level in Asia (116 kg), and the lowest levels in South America (48 kg)
and Africa (52 kg). These figures also include the large amount of horticultural produce
that is consumed on the farm. Table 5 and Figure 3 illustrate the regional and temporal
variations in the per capita availability of vegetables per capita over the past few
decades.
Table 5. Supply of vegetables per capita, by region, 1979 and 2000 (kg per capita
per year)
Region 19792000
World 66.1101.9
Developed countries 107.4112.8
Developing countries 51.198.8
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Africa 45.452.1
North and Central America 88.798.3
South America 43.247.8
Asia 56.6116.2
Europe 110.9112.5
Oceania 71.898.7
Source: reproduced from reference 13 with the permission of the publisher.
Fig.3.Trends in the supply of vegetables per capita, by region, 1970-
2000
Source: reproduced from reference 13 the permission of the publisher.WHO 03.21
1.6 Future trends in demand, food availability and consumption
In recent years the growth rates of world agricultural production and crop yields have
slowed. This has raised fears that the world may not be able to grow enough food and
other commodities to ensure that future populations are adequately fed. However, the
20

slowdown has occurred not because of shortages of land or water but rather because
demand for agricultural products has also slowed. This is mainly because world
population growth rates have been declining since the late 1960s, and fairly high levels
of food consumption per person are now being reached in many countries, beyond which
further rises will be limited. It also true that a high share of the world’s population
remains in poverty and hence lacks the necessary income to translate its needs into
effective demand. As a result, the growth in world demand for agricultural products is
expected to fall from an average 2.2% per year over the past 30 years to an average
1.5% per year for the next 30 years. In developing countries the slowdown will be more
dramatic, from 3.7% per year to 2% per year, partly as a result of China having passed
the phase of rapid growth in its demand for food. Global food shortages are unlikely, but
serious problems already exist at national and local levels, and may worsen unless
focused efforts are made.
The annual growth rate of world demand for cereals has declined from 2.5% per year in
the 1970s and 1.9% per year in the 1980s to only 1% per year in the 1990s. Annual
cereal use per person (including animal feeds) peaked in the mid-1980s at 334 kg and
has since fallen to 317 kg. The decline is not a cause for alarm, it is largely the natural
result of slower population growth and shifts in human diets and animal feeds. During
the 1990s, however, the decline was accentuated by a number of temporary factors,
including serious economic recessions in the transition countries and in some East and
South-East Asian countries.
The growth rate in the demand for cereals is expected to rise again to 1.4% per year up
until 2015, slowing to 1.2% per year thereafter. In developing countries overall, cereal
production is not expected to keep pace with demand. The net cereal deficits of these
countries, which amounted to 103 million tonnes or 9% of consumption in 1997-1999,
could rise to 265 million tonnes by 2030, when they will be 14% of consumption. This
21

gap can be bridged by increased surpluses from traditional grain exporters, and by new
exports from the transition countries, which are expected to shift from being net
importers to being net exporters.
Oil crops have seen the fastest increase in area of any crop sector, expanding by 75
million hectares between the mid-1970s and the end of the 1990s, while cereal area fell
by 28 million hectares over the same period. Future per capita consumption of oil crops
is expected to rise more rapidly than that of cereals. These crops will account for 45 out
of every 100 extra kilocalories added to average diets in developing countries between
now and 2030.
There are three main sources of growth in crop production: expanding the land area,
increasing the frequency at which it is cropped (often through irrigation), and boosting
yields. It has been suggested that growth in crop production may be approaching the
ceiling of what is possible in respect of all three sources. A detailed examination of
production potentials does not support this view at the global level, although in some
countries, and even in whole regions, serious problems already exist and could deepen.
Diets in developing countries are changing as incomes rise. The share of staples, such as
cereals, roots and tubers, is declining, while that of meat, dairy products and oil crops is
rising. Between 1964-1966 and 1997-1999, per capita meat consumption in developing
countries rose by 150% and that of milk and dairy products by 60%. By 2030, per capita
consumption of livestock products could rise by a further 44%. Poultry consumption is
predicted to grow the fastest. Productivity improvements are likely to be a major source
of growth. Milk yields should improve, while breeding and improved management
should increase average carcass weights and off-take rates. This will allow increased
production with lower growth in animal numbers, and a corresponding slowdown in the
growth of environmental damage from grazing and animal wastes.
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In developing countries, demand is predicted to grow faster than production, resulting in
a growing trade deficit. In meat products this deficit will rise steeply, from 1.2 million
tonnes per year in 1997-1999 to 5.9 million tonnes per year in 2030 (despite growing
meat exports from Latin America), while in the case of milk and dairy products, the rise
will be less steep but still considerable, from 20 million tonnes per year in 1997-1999 to
39 million tonnes per year in 2030. An increasing share of livestock production will
probably come from industrial enterprises. In recent years, production from this sector
has grown twice as fast as that from more traditional mixed farming systems and more
than six times faster than that from grazing systems.
World fisheries production has kept ahead of population growth over the past three
decades. Total fish production has almost doubled, from 65 million tonnes in 1970 to
125 million tonnes in 1999, when the world average intake of fish, crustaceans and
molluscs reached 16.3 kg per person. By 2030, annual fish consumption is likely to rise
to some 150-160 million tonnes, or between 19-20 kg per person. This amount is
significantly lower than the potential demand, as environmental factors are expected to
limit supply. During the 1990s the marine catch levelled out at 80-85 million tonnes per
year, and by the turn of the century, three-quarters of ocean fish stocks were overfished,
depleted or exploited up to their maximum sustainable yield. Further growth in the
marine catch can only be modest.
Aquaculture compensated for this marine slowdown, doubling its share of world fish
production during the 1990s. It is expected to continue to grow rapidly, at rates of 5-7%
per year up to 2015. In all sectors of fishing it will be essential to pursue forms of
management conducive to sustainable exploitation, especially for resources under
common ownership or no ownership.
1.7 Health problems associated with food consumption
23

Diabetes
People suffering from diabetes must control their glycaemia, i.e. their blood glucose
concentration. The glycaemic index, which expresses the relative ability of different
foods to raise the level of glucose in blood, helps them to choose the sources of
carbohydrates that provide a low release of glucose after a meal. Among the numerous
starchy foods available, beans, and pulses in general, present the lowest glycaemic
index, which makes them a valuable source of energy for diabetic people. For example,
the glycaemic index of kidney beans does not exceed 27 (glucose=100), and those of
lentils and chickpeas, 28 and 33, respectively, whereas those of rice, whole meal bread
and baked potatoes reach 50, 77 and 85, respectively (Foster Powell& Brand-Miller,
1995). This advantage is not highlighted by diabetes associations. Rather, the latter
recommend, as does the AICR, choosing a diet containing plenty of grain products,
vegetables and fruit and to avoid sugary foods, fat, salt and alcohol (American Diabetes
Association, 2001; Diabetes UK, 2001a). On its ideal plate, Diabetes UK (2001b ) puts
beans and other pulses in the ‘protein’ group, together with meat and fish, and considers
bread, cereals and potatoes as starchy foods. The American Diabetes Association,
however, puts pulses in with the ‘grains, beans and starchy vegetables’ at the bottom of
its food pyramid but also presents them as a possible substitute for meat. It means that
people are advised to eat more grains and beans than any other foods. It is also
recommended that diabetic people eat more starches, whatever their origin. Foods
suggested to increase starch intake are grains and pulses, the latter in the form of soups
or salads. Glycaemic regulation is seldom mentioned.
Obesity
Overweight and obesity are a main concern for an increasing number of people in the
world, and are associated with the risk of a wide number of diseases and health
disorders. They have a multiple origin and the most obvious is certainly the amount of
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food eaten. The associations for overweight and obese people do not propose a list of
diets that help reduce body weight but rather inform them on the possible health
consequences, on how to change their life-style, etc. Therefore, advice on the advantage
of specific foods are not provided and pulses are scarcely mentioned. In one case,
people are advised to eat as their ancestors did, i.e. either as Stone-Age ancestors, who
consumed primarily plants such as nuts, grains, beans and fruits, or, more recently, as
early 20th-century ancestors, whose diet was based on carbohydrates (bread, beans) and
not on fat (Obesity.com, 2001). The Heart Information Network also mentions the bulk
properties of beans, which help increase fullness after the meal and are useful in weight-
reduction plans (Grieger, 2001a). Finally, most health organizations advise a lowering of
body weight and present the plant based food diet as the best way to success .
Coronary heart disease
Coronary heart disease (CHD) is, in most industrialized countries, one of the most
common single cause of death. There is strong evidence that nutritional factors
contribute to the etiology of the condition and that dietary modifi- cation, together with
life-style modification, are important in the treatment of patients (Mann &Truswell,
1999). A positive correlation has been established between CHD death rate and plasma
cholesterol level, and, among other things, the latter is due to too high a consumption of
saturated fat. On the other hand, a regular intake of beans, or any other pulse, may
contribute to lowering of the plasma cholesterol level (Anderson et al., 1984; Shutler et
al., 1989; Kingman, 1991). This positive effect of pulses is not mentioned by the
American Heart Association (2001a ) nor by the Vegetarian Resource Group (2001),
which suggests heart-healthy diets. As for cancer and diabetes, the new message is: ‘eat
more plant-based foods’, rather than ‘avoid saturated fat and cholesterol’. The basis of
the recommendations is a diet rich in fruits, vegetables, legumes (beans), whole grains,
low-fat dairy products, fish and lean meat (American Heart Association, 2001a). In the
25

food guide pyramid for people at risk with CHD, beans are included in the bottom
portion, together with bread, cereals and starchy vegetables (American Heart
Association, 2001b) but not as a substitute for meat products. The Heart Information
Network, however, presents and explains the components of beans that help reduce
CHD or cancer risks. Beans are first presented as a source of soluble fibres that lower
blood levels of cholesterol, and a poor source of fats, especially saturated ones (Grieger,
2001a). Beans, together with peas, lentils and chickpeas, are also shown as the best
sources of folate, the vitamin that lowers the blood level of homocysteine. High levels of
homocysteine are associated with an increased risk of heart disease (Grieger, 2001a;
Newgent, 2001). They are also seen as a poor source of fat. Finally, Grieger (2001b )
presents beans as a valuable source of phytochemicals that are good for health. For
example, they contain saponins that knock out some kinds of tumors cells, particularly
lung and blood cancers. These phytochemicals also lower blood cholesterol by inhibiting
either cholesterol absorption or bile acid reabsorption. Isoflavones, found in chickpeas,
lower blood cholesterol and have antioxidant effects.
Cancer
In France, 36 % of registered cases of cancer are located at the level of the digestive
tract (de Puytorac, 2000). The American Institute for Cancer Research (AICR) estimates
that eating a healthy diet, plus staying physically active and maintaining a healthy
weight could cut the cancer risk by 30–40 % (American Institute for Cancer Research,
2001a). This association published a review based on more than 4500 research studies
that examined the relationship between dietary factors and 18 specific cancers
(American Institute for Cancer Research, 1997). The full report, entitled ‘Food,
Nutrition and the Prevention of Cancer: a Global Perspective’ suggested 15
recommendations that help reduce cancer risk. The first proposes: ‘choose
predominantly plant-based diets rich in a variety of vegetables and fruits, pulses
26

(legumes) and minimally processed starchy staple foods’. The fifth invites one to: ‘eat
600–800 g a day of a variety of cereals (grains), pulses (legumes), roots and tubers’. The
other recommendations concern the maintenance of weight, daily exercise, limitation of
alcohol, meat, salt, fatty foods, etc. It is remarkable that pulse consumption is mentioned
twice, including the first recommendation, making it a staple food in term of cancer
prevention. To popularize the concept of eating healthy, i.e. to prevent not only cancer
but also obesity and diabetes mellitus, the AICR proposes the ‘New American Plate’,
presented as a new approach to eating for better health and a model that emphasizes the
kinds of foods that can significantly reduce the risk of disease. Plant-based foods such as
vegetables, fruits, whole grains and beans should cover two-thirds (or more) of the plate.
Meat, fish, poultry or low-fat dairy should cover one-third, or less (American Institute
for Cancer Research, 2001b). Harvard University’s School of Public Health has also
published a report in which it concluded that much cancer is preventable, if people eat
more fruits and vegetables, more legumes and grains, less red meat, salt and saturated fat
(Cedar, 2001). Pulses are not presented as having any particular advantage, compared to
other plant foods, against cancer: they are low in fat and rich in dietary fibre. Dietary
fibre is not presented as a key factor for cancer prevention either, since recent studies
suggest that fibre alone does not protect against cancer. It is rather the plant material as a
whole, containing fibre, vitamins, minerals and phytochemicals, that works to lower the
cancer risk in many ways (American Institute for Cancer Research, 2001a).
Chapter 2
MATERIAL AND METHODS
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To study the consumption food in Israel and Republic of Moldova we took the statistic
data of consumption food in the period from 1992-2007 . to compare this obtained with
data from literature concerning the consumption level in Israel and with data
concerning the consumption in Republic of Moldova to see the differences between the
two Countries which has the high level and if it increase or decrease during this time
and to do a recommendation how to improve the level of consumption for health
condition and to decrease the health problem that associated with the consumption of
food in Israel and Republic of Moldova whether if it increase or decrease the
consumption level of food
a.The food consumption refers to the amount of food available for human
consumption as estimated by the FAO Food Balance Sheets. However the actual
food consumption may be lower than the quantity shown as food availability
depending on the magnitude of wastage and losses of food in the household, e.g.
during storage, in preparation and cooking, as plate-waste or quantities fed to
domestic animals and pets, thrown or given away.
b.Food consumption per person is the amount of food, in terms of quantity,
for each individual in the total population. Figures are shown for food groups.
c.This includes the quantity of each commodity and it's derived products,
available for human consumption, during the reference period. Food from milk
relates to the quantity of milk, as well as to the fresh milk equivalent of dairy
products.
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Chapter 3 Personal results and discussions
During the period from 1992 till 2007 the consumption of meat in Israel has seen an
increase by more than 100 g per person between the years, in 1992 the consumption
level was 163 g per person ,in 2007 was 275 g per person( fig.no.4) .
Fig. no. 4. Comparison of meat consumption
in Israel and in Republic of Moldova
In Republic of Moldova are among the few countries whose meat consumption levels
have remained relatively stable, but at low quantities. In the year of 1992 the
consumption level was 77 g/day or 46 kg /year. It must be remember, that the
29

recommended norm of meat during one year is 78 kg/person .The same level was in the
year of 2007(fig.no.1). In the year of 2011 the consumption level of meat was 38 kg/year
.
Fig. no. 5. Comparison of vegetables consumption
in Israel and in Republic of Moldova
The consumption of vegetables in Israel in the period from 1992-2002 has a little
decrease in the year 1992 the level of consumption was 504 g /day while in the year
2002 has increase by more than 100 g/day the consumption level was 629 g/day but
from period of 2002-2007 the level has a little decrease by almost 120 g/day the
consumption level in the year 2007 was 503 g /day per person . In Republic of Moldova
30

the consumption level in the years of 1992-2007 a stable with a little increase in the year
1992 the level was 246 g/day the increase almost by 50 g/day in the year 2007 the
consumption level of vegetables was 283 g/day .but in the year of 2011 the
consumption level of vegetables was 115 kg/year .
Fig. no. 6. Comparison of fish and seafood consumption
in Israel and in Republic of Moldova
31

The consumption of fish and seafood in israel is very high and a corresponding jump in
its environmental impact the consumption level in years of 1992-2007 has been
gradually stable ,in 1992 the level was 61 g while in 2007 year was 57 g .In republic of
moldova the consumption level have a large increase , in the year of 1992 the level was
5 g/day while the year of 2007 the consumption level was 33 g/day that mean that the
consumption level of fish has increase more than 6 times .
fig no. 7. Comparison of eggs consumption
in Israel and in Republic of Moldova
32

The consumption of eggs has seen a large decrease in Israel during the years, the
consumption level in 1992 was 49 g/day while in 2007 the level was 24 g/day per person
that means the consumption level in Israel has decrease by almost a half between 1992-
2007 . While the consumption level in republic of Moldova between the years of 1992-
2007 has been gradually increase in the year 1992 the consumption level was 11 g/day
while in the year of 2007 has been 27 that mean the level was increase more than two
times between the years of 1992-2007 .In the year of 2011 the consumption level was
190 kg/year .
Fig. no. 8. Comparison of sugar consumption
in Israel and in Republic of Moldova
33

The sugar consumption in Israel during 1992 -2002 the consumption levels have
remained relatively stable but from 2002 till 2007 the sugar consumption per person has
decrease by almost a half from 127 g per person in 2002 till 71 g/day per person in 2007
.
The sugar consumption in Republic of Moldova the opposite from Israel between the
years 1992-2007 the consumption level of sugar and sweeteners has little increase from
78 g/day in the year 1992 till 108 g/day in 2007 .
Fig. no. 9. Comparison of fruits consumption
in Israel and in Republic of Moldova
34

The consumption of fruits in Israel between the years 1992- 2007 have been very high ,
the consumption level in 1992 was 427 g/day , in 2007 424/day that means that the
consumption level of fruits during the years have been stable .While in Republic of
Moldova the consumption level between the years of 1992-1997 has been the same 216
g /day with a little increase from 1997 to 2002 with 267 g/day but from the years 2002-
2007 has been a gradually decrease more than a half from 267g/day in 2002 till 123
g/day in 2007 . In 2011 the consumption level was 43kg/day.
Fig. no. 10. Comparison of milk consumption
in Israel and in Republic of Moldova
Between the years of 1992 and 2007 the consumption of milk in Israel have a little
decrease .in the year of 1992 the level was 587 g/day while in the year of 2007 the
35

consumption level was 493/day , that a decrease by almost 100 g during the period of
1992-2007. While in Republic of Moldova the opposite from Israel the consumption of
milk between the years of 1992-2007 was a little increase by almost 100 g/day the
consumption level in 1992 was 383 g/day per person while in the year of 2007 the level
was 449 g/day , in the year of 2011 the consumption level of milk was 170 kg/year.
Chapter 4.General conclusions and recommendations
Conclusions
1.The consumption of the majority of food-stuffs in Israel is higher than the level
of consumption in Republic of Moldova.
2.The most difference was established in consumption of food-stuffs of animal
origin, especially fish and fish products and consumption of fruits.
3.The majority of food-stuffs consumption in Republic of Moldova at low quantities
but during the years the consumption of food-stuffs in the Republic of Moldova
improved and had a large increase .
4.In 2011 Israel ranks third in the world in terms of vegetable consumption Israelis
also like their sweets, downing an average of 38.8 kilograms per person each year,
according to OECD figures. Here, too Israel ranks third.
36

5.The consumption level of milk and milk products in Israel and Republic of
Moldova is low.

Recommendations
1.Fifteen percent of Israel’s adult population is obese; roughly one out of two is
overweight. More than one out of five children aged 12-18 is overweight or obese
To prevent the obesity it is recommended to decrease the consumption of meat
and meat products
2.For Republic of Moldova it is recommended to increase the consumption of
different food-stuffs of animal origin especially, meat and meat products to
prevent anemia among young children and women; fish and fish products,
especially marine and oceanic to prevent the disease of thyroid gland.
3.For Republic of Moldova it is recommended to increase the consumption of fruits
to ensure the organism with vitamins.
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4.In 2011 Israel ranks third in the world in terms of sugar and sweets consumption it
is recommended to decrease the consumption to avoid health problems (obesity,
etc) and to have a healthy life.
5.For Israel and Republic of Moldova it is recommended to rise the consumption of
milk and milk products .
Bibliographic references
1. Economist Intelligence Unit
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3. FAO – Food and Agriculture Organization
4. FAO Food security Data by Food Groups/Items, June 2012
5. FAO Food security Data, September 2014
6. Global Food Security Index, 2013
7. Global Hunger Index, 2013
8. International Food Policy Research Institute
38

9. Israel’s Agriculture
10. Israel Dairy Board Facts and Figures
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and Agriculture Organization of the United Nations, 1994 (FAO Food and Nutrition .
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consumption-of-food-import
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20. Paull J. 2008 Organics Olympiad 2007—perspectives on the global state of organic
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Declaration
I hereby declare that the diploma thesis entitled " Hygienic evaluation of effective
consumption of foods In Israel and Republic of Moldova " is written by me and has not
been presented before at another college or institution of higher education in the country
or abroad. Also, I declare that all sources used, including the Internet sources, are
indicated in the paper, considering the rules for avoiding plagiarism: – all text fragments
are reproduced exactly, even the proper translations from other languages are written in
quotes and have detailed reference source; – paraphrasing in own words of text written
by other authors has detailed reference; – summary of the ideas of other authors has a
detailed reference to the original text.
Date
Name and surname of student Hamad Humeidi ____________
(Original signature)
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