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Nutrition Reports of the DGE

Nutrition Reports

The Nutrition Report of the German Nutrition Society provides the latest data on the nutritional situation and present nutritional problems in Germany.

Background Information

In 1968, the government of the Federal Republic of Germany (FRG) commissioned the German Nutrition Society (DGE) to prepare a report concerning the nutritional status of the German population. This Nutrition Report was well received when it was submitted in June of 1969 because for the first time it provided a wide-ranging overview of data that were available about nutrition in the FRG. As a result, the government decided to commission the DGE to prepare a comparable report every 4 years. In addition to an analysis of the nutritional situation in the FRG the Nutrition Reports from 1972 to 2000 contained reviews of important aspects covering current topics in nutrition. Moreover, they include the results of primary studies on relevant topics, which are specifically conducted for the Nutrition Reports and implemented by external researchers. These studies are funded by the Federal Ministry of Agriculture, Food and Regional Identity.

The Nutrition Reports provoked considerable interest both within and outside Germany.

The Nutrition Reports are an important information source for those responsible for nutrition and health policy, as well as for food manufacturers, the public, nutritionists, dietitians and the media.

The following Nutrition Reports provide most recent statistical data of the nutritional situation in Germany which are supplemented by overviews, analyses and reviews of studies on present nutritional problems including evaluations.

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15th DGE-Nutrition Report 2024

15th DGE-Nutrition Report 2024

The 15th Nutrition Report published by the German Nutrition Society in 2024. Full version available in German.

Chapters

Kurt Gedrich

ZIEL – Institute for Food & Health, Working Group on Public Health Nutrition, Technical University of Munich, Freising-Weihenstephan

Abstract

Introduction: Food Balance Sheets (FBS) have been providing data on the nutritional situation in Germany for decades. However, since these statistics primarily capture information on production in the agricultural sector and the food industry, their data are not directly comparable with intake data from epidemiological studies. Nonetheless, under certain assumptions, FBS still provide a valuable basis for trend analyses of food consumption in Germany.

Methodology: Consumption trends (since 2012) were examined using linear or segmented regression analyses, depending on the available data.

The evaluation of food consumption from a public health perspective was based on published food-health relations. This approach allowed for the establishment of a link between food consumption and disability-adjusted life years (DALYs) and the estimation of theoretical minimum risk exposure levels (TMREL) for the consumption of specific food groups.

For the evaluation of food consumption from environmental and climate protection perspectives, FBS data were merged with a database on the environmental impacts of food consumption, investigating diet-related greenhouse gas emissions as well as land and freshwater use.

Results: Since 2012, there has been an increase in the consumption of wheat flour, pasta, rice, potato products, vegetables in general, particularly tomatoes, carrots, and red beets, as well as fresh legumes, berries, and shell fruits, lemons, pasta filata cheese, and hard, semi-hard, and soft cheeses. Additionally, there has been a rise in the consumption of coffee, black tea, herbal/fruit infusions, and frozen foods, particularly pizza and baked goods, as well as ready-made meals (excluding pizza), potato products, and frozen vegetables.

During the same time period, the consumption of the following products has decreased: rye flour, fresh potatoes, bread and bakery products, peaches and apricots, grapes, imported citrus products, sweets, particularly chocolate products and hard/soft caramels, as well as milk and dairy products, especially drinking milk, yogurt, cream, and condensed milk products. Moreover, the consumption of cream cheese, pork, beef, and veal (since 2016), soft drinks, vegetable and fruit juices and nectars, mineral water, beer, table wine, sparkling wine, spirits, and thus overall alcohol has declined.

In contrast, the consumption of corn, cucumbers, onions, leafy and stem vegetables, fruit in general, dried fruits and tropical fruits, particularly oranges, clementines, grapefruits, and other citrus fruits, as well as bananas, processed cheese, and processed cheese preparations, has remained largely stable.

Conclusion: Compared to the TMREL, vegetable consumption is substantially too low. The same applies to the consumption of whole grain products, fruits and nuts, legumes, dairy products, and fish. Conversely, the consumption of soft drinks, refined grains, eggs, red meat, and meat products is too high. Overall, from a health perspective, the consumption of vegetables, red meat, and meat products is developing in a desirable direction, while trends in the consumption of fruit, dairy products, and soft drinks are driving further away from the respective TMREL.

When considering FBS from environmental and climate protection perspectives, the outstanding importance of animal products becomes evident. These are associated with about three-quarters of diet-related greenhouse gas emissions and about two-thirds of diet-related land and freshwater use. The share of dairy products, including butter, cheese, and fresh milk products, has increased since 2000, while the share of red meat has decreased.

Overall, increasing the consumption of grains as well as fruits (including nuts), and vegetables (including legumes) brings both health as well as environmental and climate benefits. The same applies to reducing the consumption of red meat.

Key messages

  • Despite certain methodological limitations, Food Balance Sheets provide a valuable foundation for trend analyses on food consumption in Germany.
  • From a public health perspective, the consumption of vegetables, red meat, and meat products is moving in a desirable direction. However, the opposite is true for the consumption of fruits, dairy products, and soft drinks.
  • From the standpoint of environmental and climate protection, animal products play a crucial role. They are responsible for about three-quarters of diet-related greenhouse gas emissions and about two-thirds of the corresponding land and freshwater use.
  • Overall, an increase in the consumption of grains, fruits (including nuts), and vegetables (including legumes), alongside a decrease in the consumption of red meat, bring both health benefits and advantages from an environmental and climate policy perspective.

Jakob Linseisen1,2, Florian Rohm1, Nina Wawro1,3, Melanie Senger4, Martin Kussmann4, Sebastian Gimpfl5, Kurt Gedrich5

1 Chair of Epidemiology, University of Augsburg, Augsburg

2 Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Munich

3 Institute of Epidemiology, Helmholtz Munich, Neuherberg

4 Competence Centre for Nutrition, Bavarian State Research Centre for Agriculture, Freising

5 ZIEL - Institute for Food & Health, Working Group on Public Health Nutrition, Technical University of Munich, Freising-Weihenstephan

Abstract

Introduction: During the SARS-CoV-2 pandemic, the household net income might have been affected by impaired working times, unemployment and increasing inflation, which might impact the habitual diet. The present study addressed this question by using data from a recently conducted food consumption survey.

Methodology: The 3rd Bavarian Food Consumption Survey (BVS III) was designed as a diet survey representative of adults in Bavaria: between 2021 and 2023, repeated 24-hour diet recalls were collected by phone using the software GloboDiet©. The net equivalent income was calculated using information on net household income and household composition and classified as low, medium and high income. Overall, data of 449 men and 576 women were included in this analysis. The Kruskall-Wallis test was used to test for differences across income groups. When a food group or a nutrient showed a significant test result, multi-variable regression models were used for further analysis.

Results: Among 1 025 study participants, 119 men and 160 women lived in a household with low income, and 60 men and 82 women had a high income. With few exceptions, differences in the mean intake of food or nutrients across income groups were small and not statistically significant. On average, women and men in the high-income group consumed less red meat and more meat and milk alternatives but differences between income groups were non-significant. In multivariable-adjusted linear regression analyses, significant associations were identified between household net income and the consumption of grain products (inverse) and soups/sauces. Regarding nutrient intake, a significantly higher consumption of salt (NaCl) among people with low income was identified; this could be partly due to a significantly higher consumption of (salt-rich) convenience products from the food group soups/sauces.

Conclusion: Only a few differences in food and nutrient intake by household income were identified. Persons with low income consumed more grain products, more soups/sauces, and revealed a higher salt intake. The latter is judged unfavourable in terms of prevention and treatment of hypertension and hypertension-related diseases. In all income groups, a distinct gap between average consumption and food-based dietary guidelines of the German Nutrition Society (DGE) was observed; this included the food groups fruit, vegetables, legumes, nuts, whole grains as well as fresh and processed meat.

Key messages

  • In a recent cross-sectional study with a representative study design, household net income was investigated as a predictor of food consumption or nutrient intake.
  • Neither meat consumption nor consumption of fruit and vegetables were significantly different between income groups.
  • Men and women with low net income consumed a significantly higher amount of grain products, especially bread. This observation did not refer to whole-grain products as dietary fibre intakes did not differ.
  • Persons with a low income consumed more soups/sauces, possibly providing a high convenience level and a high salt content.
  • Mean salt (NaCl) intake significantly decreased with increasing income.
  • Except for salt intake, mean intakes of vitamins and minerals were not significantly different between income groups.
  • In all income groups, the current mean food consumption differs distinctly from the food-based dietary guidelines of the German Nutrition Society (DGE); this refers to a series of food groups, including fruit and vegetables, legumes, nuts, grain products and especially whole-grain products, and fresh and processed meat.

Christina Holzapfel1, Hans Hauner2

1 Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, Fulda

2 Institute for Nutritional Medicine, Else Kröner Fresenius Centre for Nutritional Medicine, Technical University of Munich, TUM University Hospital, Freising

Abstract

Introduction: The worldwide epidemic of overweight, including obesity, is also a big challenge in Germany. This is relevant, because overweight and obesity are main causes for several nutrition related diseases, which are associated with social and economic consequences. Mainly, a long-term positive energy balance caused by a sedentary lifestyle and energy dense food leads to overweight.

Methodology: Based on current data and study results the frequency, development, as well as different aspects of the health importance of overweight and obesity in different stages of life will be presented. For this purpose, available data from large national samples and from further regional and group-specific studies are used.

Results: For pregnant women data from the Bundesauswertung Geburtshilfe show a continuous increase of the prevalence of overweight at the beginning of pregnancy. The rate of newborns with an increased weight at birth of ≥ 4 000 g is 10 % and did not change over the last years. For children and adolescents there are no new representative data available. The current data from the KiGGS wave II show high prevalences of overweight. In adults the prevalence of overweight increases with age. More men than women – across all age groups – have overweight. Between the age of 18 and 65 years the total prevalence of overweight (body mass index (BMI) ≥ 25 kg/m²) is 60,8 % for men and 37,7 % for women (data from the Mikrozensus 2021). In the age group over 65 years the prevalence of overweight is decreasing.

Conclusion: The prevalence of overweight shows that all age groups of the population in Germany are affected. Obesity is a problem of the whole society with multifactorial causes and consequences for health, society, and economy. Especially persons with low socioeconomic status and migration background are affected. A portfolio of prevention measures is necessary to reduce the risk of the development of obesity and its associated diseases. It is also the need to reduce the consequences for the health care system. Here, lifestyle factors like nutrition and physical activity play a central role.

Key messages

  • Overweight including obesity is present in all age groups and increased in specific groups, especially during the COVID-19 pandemic.
  • Overweight including obesity before pregnancy and an excessive weight gain during pregnancy are associated with negative consequences for pregnancy, birth complications and long-term health for mother and child. Effective prevention measures are necessary.
  • In all age groups overweight is associated with socioeconomic status. Persons with a low socioeconomic status are more affected by overweight and have therefore an increased risk for the development of co-morbidities like type 2 diabetes, hypertension or coronary heart disease.
  • Children and adolescents with migration background are more often affected by overweight than children and adolescents without migration background. There is no difference in adults.
  • A portfolio of preventive measures (environmental prevention) is necessary, to tackle the prevalence of overweight and obesity.
  • Interdisciplinary (nutrition) research is needed, to understand the complexity of the development and prevention of overweight including obesity and to implement specific approaches to tackle it.

Anja Simmet1, Romy Schleicher2, Michael Teut2, Janine Ehret1, Gerrit Hummel1, Andreas Bschaden1, Michaela Heinrich-Rohr3, Nanette Ströbele-Benschop1

1 Institute of Nutritional Medicine, Department of Nutritional Psychology, University of Hohenheim, Stuttgart

2 Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Berlin

3 Department of Social Work, DHSH University of Applied Sciences, Kiel

Abstract

Introduction: In 2022, around 12.2 million people, in particular children, single parents, and families with three or more children, were at risk of poverty in Germany.

Aspects of nutrition and health within this population group have not been adequately reflected in previous studies. The study MEGA_kids aims to provide a comprehensive view of the health and nutrition situation of persons living in households at risk of poverty with children.

Methodology: MEGA_kids is a mixed-methods cross-sectional study consisting of four modules combining quantitative and qualitative methods. The first module BERNA applied self-administered questionnaires to assess, e.g. the individual’s diet, household food insecurity and the subjective health status among adults and children aged between 1 and 17 years living in households at risk of poverty. To estimate households’ expenditures on food purchases, cash receipts were collected over a period of two weeks. For the second module, IDEE, a semi-structured interview guide was used to identify factors influencing food security and nutritional quality from the perspective of adults living in households at risk of poverty with children. The third module, BEA, applied two World Cafés and one focus group and explored ideas of tailored support measures for a healthy diet from the perspective of adults living in households at risk of poverty with children. Finally, the fourth module, KENNER, surveyed parents from households with children at risk of poverty using an online survey tool on their knowledge, use and evaluation of nutrition-related prevention offers and measures. For reasons of clarity, the results of this module are not presented in this chapter.

Results: Children and parents of 498 households participated in BERNA, 16 and 25 parents took part in IDEE and BEA, respectively. Nearly 46 % of the parents participating in BERNA had been living in Germany for less than a year at the time the data was collected. Overall, 22.4 % of participating households experienced moderate or severe food insecurity in the 30 days prior to the survey; there was a significant relationship between food insecurity and the self-reported presence of a mental illness in the participating parent (OR 3.68, p = 0.002). A total of 68.9 % of parents suffered from social food insecurity. The median of the amount of consumed meat and sausage products and the median of energy consumed through low-nutrient, energy-dense foods were higher than recommended among children, adolescents, and adults. Of all food products, households spent the most money for these two food groups over the two weeks. In contrast, the participants consumed less fruit, vegetables, fish and cereal products than recommended.

Participants of the two qualitative studies IDEE and BEA cited high food prices as the biggest challenge to a health-promoting diet. Strategies for meeting nutritional needs included purchasing price reduced foods, cutbacks in other areas of life, and sacrificing food quality, quantity, and variety. To ensure a health-promoting diet with a low household budget, environmental changes such as cheaper prices for healthy food, were suggested.

Conclusion: Possible preventive measures to reduce food insecurity, to reduce the consumption of meat and sausage products and nutrient-poor, energy-dense foods and to promote the consumption of plant-based foods among children, adolescents and parents from households at risk-of-poverty are exemplified and the need for an overall political effort is emphasized.

Key messages

  • Using an innovative mixed-method approach, MEGA_kids offers a unique picture of the nutritional and health situation of families at risk of poverty.
  • More than four out of ten participating household heads had been living in Germany for less than a year at the time the data was collected.
  • Food insecurity was highly prevalent among participating households and shows a significant association with mental illness of the household-heading parent.
  • A low household budget restricted the food-related participation of many participants in social life.
  • Significantly more children/adolescents and parents, who had lived in Germany for at least one year at the time of data collection, were affected by obesity than recently migrated children/adolescents and parents.
  • The participants primarily suggested structural environmental change measures to facilitate access to health-promoting foods and meals.

Hannelore Daniel1, Britta Renner2, Theresa Maria Ting3, Jessica Tauer3, Anette Buyken4, Jakob Linseisen5,6 for the Working Group Personalised Nutrition of the German Nutrition Society (DGE)

1 Ex. Chair of Nutritional Physiology, Technical University of Munich, Freising, Germany

2 Chair of Psychological Diagnostics & Health Psychology, University of Constance, Constance

3 German Nutrition Society (DGE), Bonn

4 Chair of Public Health Nutrition, University of Paderborn, Paderborn

5 Chair of Epidemiology, University of Augsburg, Augsburg

6 Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Munich

Abstract

Personalized nutrition (PE) as a research domain, but also with commercial applications, was established around 20 years ago following the presentations of the blueprint of the human genome. It subsequently was understood primarily as nutrition, intended to meet the genetic predisposition of individuals. In the meantime, extensive studies on the variability of the human genome and also of the gut microbiome have shown that an extremely large number of gene variants and other determinants underlie the diet-related diseases. The variability of the gut microbiome is also immense and remains largely unexplained. It is often argued that much more biological parameters need to be incorporated to increase the quality and precision. These are then obtained from platform technologies for the representation of the transcriptome, proteome and metabolome. Future studies need to show to what extent the integration of these parameters generates indeed an added value. The key question, however, is whether such PE approaches will effectively promote sustained changes in dietary behaviour and lifestyle. The results of available scientific studies provide as a fairly consistent finding that personalization per se shows a benefit over generic recommendations, but that the inclusion of biomedical parameters (of any kind) generates little or no added benefit.


It thus appeared necessary to focus more on psychosocial determinants of diet-related behaviours and their modification. In its interdisciplinary constellation, the DGE working group therefore developed an adaptive behaviour change system (APNAS) that integrates data on the food environment, as well as individual resources and capabilities, to support decision-making in all diet- and lifestyle-related processes, aligned with self-defined goals. Biomedical parameters no longer play a prominent role in this concept. The new PE system leverages digital tools to gather relevant data on the individual’s living situation and diet-related behaviour, supporting users through bidirectional communication while constantly optimizing the system. However, this requires as well databases (e.g. with recipes and food composition) and algorithms to derive recommendations, along with a high level of data and privacy protection. Chatbots or avatars, tailored to the individual's abilities and skills (e.g., in language and comprehension), may be used to communicate with the user. Such a system could, for the first time, effectively reach target groups that would benefit the most from this type of personalized support and advice. In addition to health aspects, also other parameters, such as environmental protection, animal welfare or fairness may also be embedded in decision-making processes in an individualized form. Since chatbots and avatars – once generated – can be used many times and the content can be created immediately and in any language by means of artificial intelligence, such systems not only offer wide application, but are also very cost-effective.

Key messages

  • Previous concepts of PE were mainly based on biomedical parameters (genotype, microbiome signature, etc.) to provide personalized supplements, ready-made menus or services in the form of dietary and lifestyle recommendations. However, these approaches have hardly been able to document any benefit in scientific testing based on measurable health indicators or in changing eating patterns. Moreover, due to their cost, they are reserved only for privileged groups and have thus little relevance in terms of public health.
  • There was therefore a growing need for a revision of the current PE-concepts with a much stronger focus on behaviour and behavioural modification as the guiding principle; biomedical variables play herein only a minor role. Embedded in a circular system of recording and decision-making aids, the focus is on the individual in his specific material and social food environment as well as the its resources at the moment of decision-making.
  • Digital tools and artificial intelligence now offer the opportunity to develop completely new approaches to PE. They use available parameters from an individual’s dietary behaviour (when and where something is consumed) as well as constantly growing databases with information on the nutrient and energy content as well as health and sustainability indicators of individual foods or menus. Algorithms generate advice along predefined goals, using chatbots or personalized avatars. Embedded into the digital environment, services are offered to the individual in any place and in real time within a feedback loop as a self-learning system. Such a system has the potential to develop to a companion helping individuals to follow a healthier and more sustainable diet.

Scientific publications 

Martin Liehr, Tanja Schubert, Nikolas Roh, Paulina Hudec, Leandra Kripylo

Federal Ministry of Food and Agriculture (BMEL), Berlin         

Abstract

"Front-of-Pack Nutrition Label" (FOPNL) are nutritional policy measures designed to support consumers with nutritionally advantageous food choices. In various European countries, FOPNL therefore belong to the repertoire for nutritional policy measures. The use of FOPNL within the European Union is currently not harmonised, which is why the food policies of European countries follow different approaches to FOPNL. Since November 2019, the Nutri-Score has been part of the Federal Government's food policy. The five-step colour-letter-combination is intended to provide consumers with additional orientation when choosing food by facilitating the comparison of the nutrient composition within a product group. The current article provides an overview of the current status of work on the Nutri-Score, including its past implementation as an FOPNL for Germany as well as its future development.

Key messages

  • The Nutri-Score is an integral part of the German nutrition policy with the aim to simplify the comparability of foods for the consumer, in terms of their nutritional composition.
  • European food labelling legislation does not yet provide the option for the mandatory use of Front-of-Pack Nutrition Label (FOPNL), which is why the EU member states can only issue a recommendation for an FOPNL.
  • A legislative proposal announced by the EU Commission for an EU-wide harmonised mandatory FOPNL has been welcomed by a large number of European countries, but not yet been submitted.
  • Together with other European countries, the Federal Ministry of Food and Agriculture, coordinates the Nutri-Score on behalf of Germany in the European context with the aim of ensuring a harmonised and practicable roll-out and establishing the Nutri-Score at European level.
  • Part of the international cooperation is a panel of experts whose independent scientists have developed an advanced Nutri-Score algorithm.

Jakob Linseisen1, Volker Böhm2, Janine Bröder3, Johanna Conrad3, Ralf Greiner4, Bettina Hieronimus5, Marina Liaskos5, Jörg Meier6, Sabine Rohrmann7, Sascha Rohn8 for the Working Group of (Ultra) Processed Foods of the German Nutrition Society

1 Chair of Epidemiology, University of Augsburg, Augsburg

2 Institute of Nutritional Sciences, Friedrich Schiller University Jena, Jena

3 German Nutrition Society (DGE), Bonn

4 Institute of Food Technology and Bioprocess Engineering, Max Rubner Institute (MRI), Karlsruhe

5 Institute of Physiology and Biochemistry of Nutrition, Max Rubner Institute (MRI), Karlsruhe

6 Faculty of Agriculture and Food Sciences, Neubrandenburg University of Applied Sciences, Neubrandenburg

7 Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich,

8 Institute of Food Technology and Food Chemistry, Technische Universität Berlin, Berlin

No abstract and key messages available

Diana Behsnilian1, Janine Bröder2, Jessica Tauer2, Esther Mayer-Miebach1

1 Institute of Food Technology and Bioprocess Engineering, Max Rubner Institute (MRI), Karlsruhe

2 German Nutrition Society (DGE), Bonn

Abstract

A dietary pattern with a high proportion of highly processed food, also called ultra-processed food, is postulated to be a risk factor for a variety of diet-related diseases such as obesity, cardiovascular disease, and type 2 diabetes. In recent years, different classification systems were developed for assessing the relationship between the consumption of processed, and in particular ultra-processed foods, and diet-related diseases. Foods are grouped in categories according to their levels of processing. Common categories are (i) unprocessed, (ii) minimally processed, (iii) processed, and (iv) highly or ultra-processed. These classification systems can be used to estimate the proportion of ultra-processed foods in the diet.

In the first part of the chapter, processing methods, their areas of application as well as their impact on the food raw materials are described. In the second part, food classification systems based on the processing levels which are commonly used in nutritional studies are described and compared. The systems differ in their objectives and focus. This explains the reported difficulties when applying them for food classification. Moreover, these differences cause strong limitations in comparability of the results when used to evaluate the correlations between ultra-processed food and diet-related diseases.

The quality of processed foods and their physiological effects are largely determined by (i) the effect of processing methods applied to the food raw materials as well as (ii) the type and amount of ingredients used. However, in all but one classification system (SIGA classification), the criteria for describing the levels of processing predominantly focus on processing objectives and convenience levels. The impact which processing methods have on the raw materials is considered, if at all, secondarily. Furthermore, the ingredients, including additives, are evaluated in different degrees of accuracy by the classifications systems. Merely the SIGA classification clearly defines evaluation criteria for sugar, fat and salt contents, the processing level of ingredients, including additives, and the content of certain additives.

At present, there is no scientific consensus on consistent, objective and unambiguous criteria for describing different processing levels. Therefore, the scientific community strongly recommends the development of a practice-oriented, differentiated and generally valid food classification system according to the processing level.

Key messages

  • Since 2009, food classification systems based on the processing level have been developed for assessing the impact of ultra-processed food on human health in scientific studies. The classification systems (IRAC-EPIC, IFIC, UNC, NOVA, and SIGA) differ – sometimes significantly – regarding to their underlying definition of processing levels and the criteria applied for categorization. The outcomes of the nutrition studies hence depend on the applied classification system and are comparable to a limited extent only.
  • While the international Food and Agriculture Organization (FAO) called for standardization already in 2015, no universally valid classification criteria have been agreed upon to date. Based on a 2019 FAO report on the NOVA classification system, this system is most commonly used in nutritional epidemiological studies. During the production of processed products, the native structure and components of the raw food materials are modified by the applied processing methods and the ingredients added as part of formulations. The SIGA-system – as a further development of the NOVA-system – uniquely allows for reporting the contributions of processing methods and recipes separately when assessing the health effects of processed foods.
  • None of the current classification systems is suitable for adequately assessing important processing objectives such as food security or the climate-friendly and environmentally- friendly utilization of resources.
  • To increase the understanding and evidence on the effects of processing methods and ingredients on the development of diet-related diseases, systematic and interdisciplinary research is needed. This research should also address further possible impact factors of food processing and formulation (including energy density, food structure/matrix, process contaminants, additives).

Janine Bröder1, Jessica Tauer1, Marina Liaskos2, Bettina Hieronimus2 for the Working Group of (Ultra) Processed Foods of the German Nutrition Society

1 German Nutrition Society (DGE), Bonn

2 Institute of Physiology and Biochemistry of Nutrition, Max Rubner Institute (MRI), Karlsruhe

Abstract

Introduction: A high proportion of ultra-processed foods (UPF) in the daily energy intake is considered an indicator of an energy-dense, nutrient-poor diet. Furthermore, it is hypothesised that a high intake of UPF increases the prevalence of chronic, non-communicable diseases. The objective of this systematic review is to summarise the current state of evidence on the relationship between UPF consumption and the following endpoints: a) overweight/obesity, b) hypertension, c) metabolic syndrome, d) type 2 diabetes (T2DM), e) cardiovascular diseases (CVD) and f) allergies.

Methodology: A systematic literature search was conducted for each endpoint in three scientific literature databases. The identified primary studies were then reviewed by two researchers on the basis of predefined inclusion criteria. To assess the methodological quality of the included primary studies, ROBINS-I was used to assess the risk of bias along seven domains.

Results: A total of 37 studies were included: 14 on overweight/obesity, five on hypertension, two on metabolic syndrome, five on T2DM, ten on CVD and one on allergies. For the endpoints overweight/obesity, hypertension, T2DM and CVD, a positive association between UPF consumption and the relative risk of these endpoints was found in adults. For the endpoints metabolic syndrome and allergies, the current available data is insufficient; for the endpoint overweight/obesity the data for children and adolescents was found to be heterogeneous and therefore inconclusive. Hence, no conclusions were drawn for these endpoints regarding the relationship with UPF consumption. With the exception of one study, all included studies used the NOVA classification for food categorisation by degree of processing. The analysis identified a moderate risk of bias in ten of the included studies, while 27 studies were found to have a high risk of bias.

Conclusion: The analysis revealed a risk-increasing association between UPF consumption and four of the investigated endpoints. However, the application of the NOVA classification system for categorising foods according to their degree of processing is associated with limitations. Further studies, especially intervention studies, are needed in order to gain a differentiated understanding of the underlying mechanisms associated with UPF consumption (e.g. energy density, food structure/matrix, process contaminants and additives) and the associated health risks.

Key messages

  • UPF include foods and beverages that have undergone extensive industrial processing of raw materials during the production process. These products often contain a considerable number of added ingredients, particularly additives (such as flavourings, preservatives, and colourings) and energy-rich ingredients (such as saturated fatty acids and sugar).
  • To review the current state of evidence on the relationship between UPF consumption and six endpoints, 37 studies were included in this systematic literature review.
  • A high intake of UPF is associated with an increased risk of overweight/obesity, hypertension, T2DM and CVD in adulthood.
  • No conclusion could be drawn for the endpoints metabolic syndrome and allergies due to insufficient data, as well as for overweight/obesity in children and adolescents, as data was found to be heterogeneous and therefore inconclusive.
  • Further studies, especially intervention studies, are needed to gain a differentiated understanding of the underlying mechanisms associated with UPF consumption and potential associated health risks.

Andreas Dötsch, Hanna Haidar, Judith Lauvai, Manuel Rodriguez Gomez, Manuela Rist, Marina Liaskos, Sandrine Louis, Victor Schmalle, Bettina Hieronimus

Institute of Physiology and Biochemistry of Nutrition, Max Rubner Institute (MRI), Karlsruhe

Abstracts

Proteins are essential for human nutrition, with approximately 60 % of dietary protein in Germany coming from animal sources. This dependency raises ecological, ethical, and health concerns. Therefore, novel alternative protein sources are gaining importance as they represent innovative technologies and products with the potential to address ecological, ethical, and health challenges.

The present report provides a narrative overview of novel alternative protein sources, including plant-based, microbial, and animal origins (insects and in-vitro meat), with a focus on their nutritional quality. In addition, it will outline chances and challenges of novel alternative protein sources as well as certain aspects of sustainability.

Plant-based substitutes are derived from various sources, including both traditionally consumed plants and plant species or parts not previously used for human consumption. These products, typically composed of multiple ingredients, often mimic the form, texture, and taste of animal-based foods.

Fermentation plays a central role in alternative protein production, with various types such as classical fermentation, biomass fermentation, and precision fermentation. Classical fermentation uses microorganisms to ferment raw materials, altering taste, texture, or nutritional properties. Biomass fermentation primarily involves microorganisms themselves as the main components of the products. Precision fermentation enables the specific production of diverse proteins and other ingredients using microorganisms.

Insects as food have a long cultural tradition in tropical regions of Africa, Asia, and Latin America, predominantly consisting of protein with a species-specific high-quality amino acid profile. However, utilizing insects for nutrition poses microbial and allergen risks.

In-vitro meat (lab-grown or "clean meat") is produced in the laboratory from cell cultures. While in-vitro meat production is not yet ready for large-scale production, further intensive development is required until the resulting meat is equivalent to traditional meat.

Regarding the overarching nutritional quality of novel alternative protein sources, it is noteworthy that protein quality varies based on source and product, with amino acid composition, digestibility, and bioavailability being crucial for its evaluation. Additionally, these protein sources provide nutrients such as minerals, vitamins, and bioactive compounds, such as fibres or secondary plant compounds, requiring consideration of content, digestibility, and bioavailability for nutritional assessment. Products may also contain contaminants or pose microbial risks, necessitating monitoring and minimization of these risks.

The products available to date exhibit a wide range in terms of raw materials, technologies, and nutritional quality. Novel alternative protein sources have the potential to be a nutritionally balanced alternative to traditional animal foods.

Key messages

  • Novel alternative protein sources encompass plant-based (edible as well as non-edible plant components), animal-based (insects, in-vitro meat), and microbial protein sources (algae, yeast, fungi, bacteria).
  • The nutritional quality varies significantly among these products and depends on the raw materials and processing methods employed.
  • The precise control of production conditions of many processes for the production of novel alternative protein sources offers the possibility to positively influence the nutrient composition of foods.
  • A conscious selection of foods is necessary, since there are novel alternative protein sources with favourable nutritional physiological properties as well as highly processed products, rich in salt and sugar.

Alfonso Lampen

Federal Institute for Risk Assessment (BfR), Berlin

Abstract

The massive global input of plastic is causing relevant environmental problems worldwide. Among other things, it also has a negative impact on human food resources. Over time, macroplastics become microplastics and nanoplastics through abrasion and degradation. The possible effects of micro- and nanoplastics on humans have only recently become the focus of scientific attention, as new analytical detection techniques such as µRaman spectroscopy, µFTIR, stimulated RAMAN scattering (SRS microscopy) using algorithms and pyrolysis with gas chromatography coupled with mass spectrometry have made reliable detection possible. It has been shown that micro-/nanoplastics accumulate in the environment via the air and water and also enter food via the food chain. In addition to inhalation, there is a significant oral intake of micro- and nanoplastics with food. Microplastics and nanoplastics have been detected in mineral water from plastic bottles and traces of microplastics have also been found in tap water, so it can be assumed that they are ingested with food. Although the oral bioavailability of microplastics is low in humans due to the particle size and the effect of barriers in the intestine, the oral intake and bioavailability of nanoplastics appears very likely, as biological barriers can be overcome. The mechanisms of action of micro-/nanoplastics after oral uptake in the body are still poorly understood. Due to the barriers to oral intake, the risk for consumers with regard to orally ingested microplastics in the diet appears to be low. However, the health risks of nanoplastic material are to be classified as potentially relevant, as membranes are overcome and nanoplastics would therefore be bioavailable. However, there is a lack of reliable scientific data on this. New research approaches on uptake, molecular effects and exposure are necessary. Sustainability strategies should address the issue of micro-/nanoplastics more clearly in future in order to generate solutions to achieve the sustainability goals.

Key messages

  • Macroplastics become microplastics through abrasion and degradation.
  • Microplastics become nanoplastics through abrasion and degradation.
  • Micro- and nanoplastics pollute the environment and are found in the food chain.
  • Micro- and nanoplastics influence ecosystems and thus biodiversity.
  • Analytical advancements such as µFTIR and µRaman spectroscopy enable the collection of exposure data on microplastics in food.
  • Microplastics have been detected in mineral water bottles, especially in PET bottles.
  • Microplastics are present in tap water only in trace amounts.
  • Due to intestinal barriers, the oral bioavailability of microplastics in humans is low. However, the oral bioavailability of nanoplastics is reasonable.
  • The potential risks of nanoplastics are still completely unclear, but they may be relevant.
  • Sustainability strategies should address the issue of micro- and nanoplastics in the future.

Dorothee Volkert1, Hanna Maria Siebentritt1, Isabel Galicia Ernst1, Ulrike Bornschlegel1, Linda Weber1, Johann Ockenga3, Michael Hiesmayr2

1 Institute for Biomedicine of Ageing, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Nurenberg

2 Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna

3 Medical Clinic II, Klinikum Bremen-Mitte, Bremen

Abstracts

Analysing and evaluating the nutritional situation and quality of nutritional care in hospitals and nursing homes

Introduction: According to the 14th DGE Nutrition Report, based on previous analyses of the nutritionDay project, malnutrition is a relevant health problem in Germany and the structures and processes of nutritional care in hospitals and nursing homes are unsatisfactory. However, these data were not sufficient to derive specific measures for improvement. The aim of this part of the project was therefore to update the earlier analyses describing the nutritional situation. Furthermore, the quality of nutritional care in German hospitals and nursing homes was to be evaluated with the help of existing nutritionDay data and additional surveys.

Methodology: nutritionDay data from 2019–2022 on the nutritional situation were analysed descriptively in the same way as before and compared with updated results from 2018; variables characterising the quality of nutritional care were also analysed. In addition, aspects of nutritional care quality were discussed in four online dialogues with employees and managers from hospitals and nursing homes.

Results: During the reporting period, 14 % of the 1,755 participating patients were underweight, 24 % had an unintentional weight loss of more than 5 %, 9 % were categorised as malnourished by staff and 21 % were severely malnourished according to GLIM criteria. In the participating nursing homes, 23 % of the 2,864 residents were found to be underweight, 13 % had unintentional weight loss of more than 5 kg in the last year and 8 % were classified as malnourished by the nursing staff. On participating hospital wards, on average 8 of 12 analysed structural and process indicators to describe the quality of care were implemented. With a higher number of implemented quality indicators on the ward, nutritional care measures were taken more frequently.

The online dialogues revealed at the institutional level the need to create more awareness, resources and structures for good nutritional care in hospitals; in nursing homes, the focus was on the lack of nutritionists. At a political level, participants in hospitals felt that there was a particular lack of budget provision, standardised and appropriate catering rates and mandatory elements and certifications.

Conclusion: In order to sustainably improve the quality of nutrition and nutritional care in hospitals and nursing homes, financial and professional resources must be standardised and improved, and binding standards introduced. Political measures are essential in order to enable all institutions to implement good nutritional care and to eliminate the current deficits.

Cost-effectiveness of nutritional care in hospitals

Introduction: Malnutrition causes enormous costs for the healthcare system due to complications and secondary illnesses and the resulting longer length of hospitalisation. In this part of the project, the potential cost savings from a reduction in length of stay as a result of improved nutritional care were modelled.

Methodology: Using current nutritionDay data from Germany, differences in length of stay between patients with different amount eaten at lunch on nutritionDay were calculated by multivariable regression analysis. Assuming that 30 % of patients with a reduced amount eaten can achieve full consumption through improved nutritional care and thus reduce the length of stay accordingly, the potentially avoidable costs were calculated using statistical data from the German healthcare system.

Results: 3,055 patients were included in the analysis. The median length of stay was 6 days for patients who ate everything (39 %), 7 days if half (28 %), 8 days if a quarter (13 %) and 9 days if nothing was eaten despite permission (4 %). The assumed increase in the amount eaten corresponds to a reduction in the length of stay of 20 hospital days per 100 patients. With an average length of stay of 7.2 days in hospitals in Germany, this means a reduction of 2.7 % and, assuming costs of 560 euros per hospital day, corresponds to total costs of 969,807,535 euros per year.

Conclusion: Despite undoubtedly existing limitations, the analysis demonstrates an enormous cost saving potential of improved nutritional care through the impact on length of stay in German hospitals. In the future, a more precise estimation of the costs, taking into account also other causes of malnutrition-related costs and, in particular, a calculation of the cost balance would be desirable.

Key messages

  • The latest analyses of nutritionDay data from Germany continue to show a high prevalence of malnutrition in hospital patients and nursing home residents.
  • The current results are largely similar to those from previous years; differences between the reporting periods are rather due to low participation rates, heterogeneity of the participating institutions and a lack of representativeness than to actual changes over time.
  • In German hospitals and nursing homes, a lack of nutritional expertise, documentation structures and firmly established nutritional care processes was observed.
  • The challenges of nutritional care in hospitals and nursing homes are in particular a lack of prioritisation of nutritional issues, a lack of time with a high workload and a lack of budget with increased costs.
  • In order to improve nutritional care in hospitals and nursing homes, an increase and standardisation of catering rates, training courses, mandatory nutritional therapy structures and processes and the expansion of interdisciplinary cooperation are considered particularly useful.
  • The length of stay in hospital was on average 3 days shorter for patients who ate all of their lunch on nutritionDay than for patients who did not eat anything.
  • Assuming that 30 % of patients with a reduced intake at lunch on nutritionDay would eat the entire meal through better nutritional care, this would reduce the length of stay for the German healthcare system by 2.7 %, resulting in potential cost savings of almost 1 billion euros per year.

Sabine Will, Claudia Meißner, Mario Meixner, Margot Dasbach, Wilfried Rozhon, Nora Brehme, Katja Kröller

Department of Agriculture, Ecotrophology and Landscape Development, Anhalt University of Applied Sciences, Bernburg

Abstract

Introduction: The importance of system catering is also growing steadily in Germany, and could contribute to the high prevalence of nutrition-related diseases due to the high energy and low nutrient density of the food on offer. Data on the supply and use of system catering in Germany has so far been limited, so this research project was dedicated to analysing and evaluating a sample of 14 selected restaurant chains in Germany.

Methodology: A nutritional-related assessment was carried out on the basis of the complete information provided by the companies on their websites about their standard food offerings. In addition, a mixture of qualitative and quantitative methods was used to record the usage behaviour of the target group of 16 to under 35-year-olds and to derive corresponding recommendations for action.

Results: All 14 companies offered both vegetarian and vegan products, although these hardly differed from the meat-based options in terms of energy and nutritional composition and were also chosen less frequently by the participants. The majority of the food combinations chosen by participants exceed the guideline values for energy, fat, sugar and salt recommended by the DGE. In a representative survey, the participants stated that they used system catering more frequently (30 %) than individual catering or communal catering, mainly due to the good accessibility and fast service. Motives relating to health or sustainability played a subordinate role in the choice of restaurant or food.

Conclusion: The results show that the range of system catering must be assessed as nutritionally critical. This is supported by the results on participants food selection and frequency of consumption. The consumer-related motives suggest that strategies deliberately geared towards health or sustainability are unlikely to be effective, while strategies geared towards price or affectively effective strategies can be assumed to be effective.

Key messages

  • The DGE/ÖGE-guidelines for the intake of energy, fat, salt and sugar were exceeded for the most frequently consumed products or product combinations, with vegetarian or vegan options hardly differing from those containing meat.
  • 30 % of 16- to under 35-year-olds state that they use system catering restaurants at least once a week and thus, according to their own statements, more frequently than individual restaurants or communal catering.
  • The most important reasons for using system catering restaurants were good accessibility, fast service and a standardized offer. Other activities (e.g. shopping, commuting to work) were usually the main reason for use.
  • The participants surveyed were primarily influenced by price and enjoyment-oriented strategies; strategies that emphasize health and sustainability aspects could even have the opposite effect.

Mareike Täger1, Linda Chalupová2, Silke Thiele1

1 ife Institute of Food Economics, Kiel

2 Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, Fulda

Abstract

Introduction: The type and amount of resources used to achieve a nutritionally balanced and more sustainable diet varies depending on the food production system (FPS) used. A comparative analysis of the sustainability of the FPS Cook & Serve (C&S), Cook & Hold (C&H), Cook & Chill (C&C) and Cook & Freeze (C&F) is not yet available. The aim of this project is therefore to evaluate the different FPS regarding sustainable production methods to derive recommendations for action for stakeholders in policy and practice.

Methodology: In a first step, FPS-relevant indicators were developed for the four sustainability dimensions analysed here: health, environment, social aspects, and costs. These indicators (e. g. energy consumption, nutrient losses) were then evaluated for each of the four FPS using the three methods of literature analysis, modelling, and/or surveys. As the indicators are measured in different units (e. g. kWh, euros), they were transformed using an index so that they could be directly compared in an evaluation matrix. In addition, the greenhouse gas emissions (GHGE) of the FPS were calculated. The evaluation matrix and the calculated GHGE formed the basis for the comparison of the FPS and the derivation of recommendations for action.

Results: The results show that different FPS proved to be particularly advantageous depending on the dimension and indicator considered. For example, C&S performed best in the health and social dimension for all indicators, while C&H performed best in the environmental and cost dimension (excluding investment as well as operating and work equipment g costs). Depending on the energy source, either C&H or C&S had the lowest GHGE.

Conclusion: The purpose of this study was to evaluate different FPS in terms of sustainable production. This evaluation can be used as an aid when deciding which FPS to choose. If all the indicators considered are weighted equally, C&S is the most favourable system. However, if, for example, energy efficiency is given a higher weighting, C&H performs better. A value-benefit analysis, in which the individual indicators are weighted according to the specific objectives and needs of a decision-maker, can be helpful in the decision-making process.

Key messages

  • Cook & Serve scored best throughout the sustainability dimensions of health and social issues.
  • Cook & Hold scored best in the environmental and cost dimensions (excluding investment, operating and work equipment costs).
  • Cook & Hold was found to have the lowest GHGE per meal based on the average electricity mix in Germany.
  • When using renewable energy sources such as hydro or wind power, Cook & Serve had the lowest GHGE per meal, followed by Cook & Freeze.
  • When the dimensions were equally weighted, Cook & Serve showed the most advantages. However, with a higher weighting of e.g. energy efficiency, Cook & Hold performed better.
  • The combination of different systems, e.g. Cook & Serve and Cook & Hold, could create synergies by complementing health, social and environmental benefits.
  • A value-benefit analysis, in which the individual indicators are weighted according to the specific objectives and needs of a decision-maker, can be helpful in the decision-making process.
  • Other constraints not considered here (e.g. lack of space, existing kitchen infrastructure) should also be taken into account when deciding on an FPS.

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14th DGE-Nutrition Report 2020

The 14th Nutrition Report was published by the German Nutrition Society in 2020. It dealt with:

  • Nutritional situation in Germany
  • Nutrition in German hospitals and nursing homes based on data from the nutritionDay project
  • Data on breastfeeding and infant nutrition in Germany from the survey on breastfeeding and infant nutrition in Germany (SuSe II)
  • Vegetarian and vegan diets in children and adolescents in Germany (VeChi-Youth-Study)
  • Relationship between the consumption of vegetables, fruit and meat and the risk of diet-related diseases
  • Effects of vitamin D status on the prevention and treatment of selected extraskeletal diseases
  • Dietary factors and the incidence of neurodegenerative diseases
  • Gestational overweight at the initial pregnancy check-up

  • Trends in vegetable consumption 2007-2018

  • Vitamin B 12 status is adequate in the majority of the study participants

  • Critical levels in iodine status

  • Need for action in calcium intake

  • A high dietary fiber intake among vegan adolescents

  • Effects of vitamin D in seven extraskeletal diseases

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Archive

The 13th DGE-Nutrition Report 2016 dealt with:

  • Nutritional situation in Germany
  • Catering in nurseries
  • Catering in care homes for the elderly
  • Influence of food processing and meal preparation on food choice, nutrient intake, intake of additives and the body weight of children, adolescents and adults
  • Influence of diet in the prevention of nutrition-related diseases
  • Behavioural and conditional prevention of obesity

The 12th Nutrition Report 2012 dealt with:

  • Nutritional Situation in Germany
  • Nutritional Situation of Seniors with Need of Care in Private Homes in Germany (ErnSiPP Study)
  • Situation, Quality and Satisfaction with “Meals on Wheels”
  • Food Safety
  • Disease Prevention and Nutrition

The Nutrition Report 2008 dealt with:

  • Nutritional situation in Germany
  • Company canteens – An Assessment of the Current Situation in Germany
  • Nutrition of the Elderly in German Nursing Homes
  • Toxicological Aspects of Nutrition
  • Microbiological Aspects of Nutrition
  • Nutrition and 'Fetal Programming'
  • Disease Prevention and Nutrition

The Nutrition Report 2004 dealt with:

  • Nutritional situation in Germany
  • Toxicological aspects of nutrition
  • Microbiological aspects of nutrition
  • Vitamin and mineral content of vegetable food
  • Tumorigenesis – inhibiting and promoting nutritional factors
  • Nutritional influence on the intestinal flora
  • Influence of phytochemicals on health
  • Representation and effect of nutritional information on television
  • Enrichment of food and new products

The Nutrition Report 2000 dealt with:

  • The nutritional situation in the Federal Republic of Germany
  • Breastfeeding and infant nutrition in Germany
  • Nutritional situation in day-care centres: Study of the Nutritional Situation in Day-Care Centres
  • Eating habits and nutritional situation of children and adolescents
  • Nutrition of the elderly
  • Toxicological aspects of nutrition
  • Microbiological aspects of nutrition
  • Technological aspects of food processing
  • Nutritional influence on the intestinal flora
  • Prevention of diseases by wholesome diets

The Nutrition Report 1996 dealt with:

  • The nutritional situation in Germany
  • Institutional feeding in the new Federal Länder (former German Democratic Republic)
  • Iodine deficiency prophylaxis in Germany
  • Toxicological aspects of nutrition
  • Microbiological aspects of nutrition
  • Tumorigenesis – inhibiting and promoting effects of nutritional factors
  • Significance of phytochemicals for health
  • Malnutrition of geriatric patients
  • Novel food
  • Information provided on food labels as a factor influencing food choice

The 1992 Report dealt with:

  • Development of the nutritional situation in Germany
  • Toxicological and microbiological aspects of nutrition
  • Selected socio-cultural influences on the nutritional behaviour
  • Food allergies and food intolerance reactions
  • Tumorigenesis – inhibiting and promoting effects of nutritional factors
  • Iodine supply and iodine deficiency prophylaxis in Germany

The 1988 Nutrition Report dealt with:

  • Development of the nutritional situation in the Federal Republic of Germany
  • Toxicological and microbiological aspects of nutrition
  • Documentation Chernobyl
  • Food allergies and food intolerance reactions
  • Influence of federal measures on the nutritional behaviour
  • Influences on human food intake
  • Meals eaten away from home
  • Recommendations to meet nutrient and dietary energy requirements
  • Nutritional research in the Federal Republic of Germany

The 1980 Nutrition Report dealt with:

  • Development of the nutritional situation in the Federal Republic of Germany
  • Nutritional behaviour in the Federal Republic of Germany
  • Eating away from home (problem analysis with special regard to the main meal)
  • Relationship between nutrition research and health policy

In 1976 detailed information was presented in the following fields:

  • Food consumption and nutrient supply in the Federal Republic of Germany
  • The influence of nutrition on the health situation in the Federal Republic of Germany
  • Hygienic-toxicological and microbiological aspects of food
  • Communal feeding in the Federal Republic of Germany
  • Analysis of some selected samples of the influence of advertising on the nutritional behaviour
  • Psychological causes of poor nutritional behaviour

In addition to an analysis of the nutritional situation in the Federal Republic of Germany the Reports of 1972 to 2004 also contain reviews of studies on nutritional problems. The following subjects were dealt with in 1972:

  • Nutritional behaviour in the Federal Republic of Germany
  • Nutritional significance of processed food
  • Changes in food quality during storage, processing and packaging
  • Nutrition education at school
  • Nutrition science and nutrition research

The 1969 Nutrition Report dealt with the following subjects on 140 pages:

  • Production and consumption in the light of nutritional physiology
  • Relation between production and consumption of food produced in Germany
  • Population and consumer structure according to economic sectors
  • Relation between physiological consumer requirements and food prices
  • Food consumption and nutrient intake
  • Changes in nutrition in an industrial society
  • Evaluation according to nutritional physiology
  • Conclusions and future trends

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How to find

The Nutrition Reports provoked considerable interest both within and outside Germany.  From 1984 on, summaries of the Nutrition Reports have therefore been translated into English. Summaries are available as downloads for the Nutrition Reports 2000 and newer. Please contact us in case of interest in the older versions.

Full versions of the Nutrition Reports are only available in German:

The 15th DGE Nutrition Report as well as the DGE Nutrition Reports from 2004 to 2016 can be downloaded . The 14th DGE Nutrition Report can be purchased as a print copy via the DGE Media Service.