REPORT OF STATISTICS ON FOOD HABITS FROM THE

MALTESE FIRST NATIONAL HEALTH INTERVIEW

SURVEY (HIS)

Comparison of Results with Recommendations of the

United Kingdom Food Standards Agency (FSA)

DEPARTMENT OF HEALTH INFORMATION

Public Health Medicine Trainee

Dr. Marvic Sammut M.D., M.Sc. Public Health, DCH
September 2006
 REPORT OF STATISTICS ON FOOD HABITS FROM THE MALTESE FIRST
NATIONAL HEALTH INTERVIEW SURVEY (HIS)

Comparison of Results with Recommendations of the United Kingdom (UK)

Food Standards Agency (FSA)

Introduction

The Department of Health Information (DHI) is the government organisation within the
Health Division responsible for national health information. The DHI uses health
information to provide various health statistics such as obstetric, mortality and cancer
statistics among others.

It is to be noted however, that these statistics do not provide health information about
health conditions or health habits that do not necessitate admission to hospital or lead to
death. Health Interview Surveys (HIS) are used as a tool to overcome this paucity and
provide valuable information about a nation’s health status and habits, which would
otherwise not be obtained from routinely collected information. The information obtained
from HIS would in turn provide data for planning health prevention and health care
services that would be evidence-based. Malta’s first HIS was carried out in 2002.

Food Habits – The First HIS

There were thirteen questions in the section on Food Habits in the first HIS – questions
number 94 to 106. These amounted to 7.39% of the total number of questions in the HIS.

Analysis of HIS Food Habits section Results

The Statistical Programme for Social Scientists (SPSS) and Microsoft Excel programme
were both used for analysis of the HIS data. The results were presented in numerical form
in the HIS Summary Statistics publication. The results of the Food Habits section were
analysed further and presented in graphical form too. They are presented and interpreted
in this report.

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Comparison of Results with Recommendations from the United Kingdom
Food Standards Agency

The United Kingdom Food Standards Agency (UK FSA) recommends eight tips for
eating well (http://www.eatwell.gov.uk/healthydiet/8tips/?view=printerfriendly). The
recommendations from these tips for eating well were compared to the results of
corresponding questions from the Food Habits section of the HIS, in order to gain a
clearer perspective of how healthy the eating habits of the Maltese Islands population
were in 2002 (See Annex 2, Questions number 94 to 96, and questions number 98 to
106).

1. First Tip for Eating Well – Base your Meals on Starchy Foods

The UK FSA recommends that starchy foods such as bread, cereals, rice, pasta and
potatoes should constitute about one third of the food we eat. It also recommends that
wholegrain varieties of starchy foods should be chosen whenever possible.

The results of the consumption of cereals, rice/pasta, fried potatoes and other potato
products showed that 28.05% of the interviewees consumed cereals on 3 or more days a
week, 29.68% rice or pasta, 10.09% fried potatoes and 32.43% other potato products.
(See Annex 2, question 103a, e, j and k).

The HIS results showed that Maltese bread was the type of bread most commonly eaten
with a range of 0 to 19 slices per day (mean – 2.2), whilst brown bread was the least type
of bread eaten (range – 0-12, mean – 0.5). (See Annex 2, Question 99)

These results indicated that the overall consumption of starchy foods on 3 or more days
was still low, as was the consumption of brown bread which was the least common type
of bread eaten.

Consumption of Starchy Foods apart from Bread by Gender

The results of the consumption of cereals, rice/pasta, fried potatoes and other potato
products were then analysed according to gender and mean number of years of education.
The frequency distribution of the consumption for these starchy foods was similar for
males and females (See Annex 1, Graph 1 and Graph 2).

The greatest group of interviewees for cereal consumption (58.11%) fell in the “never”
group for both genders with an upward trend seen with increasing age group. The upward
trend was steeper for women than for men. The second highest group was in the 6-7 days
(i.e. daily) frequency consumption of cereals. An upward trend with increasing age group
is noted in men whilst there is a practically equal distribution in all age groups in women.

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The greatest group of interviewees for frequency of consumption of rice/pasta (65.16%)
was found to be in the 1-2 days a week range. This was followed by the 3-5 days range
group. This distribution was seen for both men and women, although the distribution
among age groups was similar in both frequency groups in women, whilst there was an
upward trend with increasing age group in the 1-2 days group and a downward trend with
increasing age group in the 3-5 days group (See Annex 1, Graph 3 and Graph 4).

The highest number of interviewees for consumption of fried potatoes (48.50%) was
found to be in the “never” group, with an upward trend of consumption with increasing
age group in both men and women. The second highest group of interviewees was found
in the 1-2 days group, although the number of interviewees was bigger for men. A
downward trend with increasing age group was seen in both genders (See Annex 1,Graph
5 and Graph 6).

With both men and women other potato products were consumed most frequently on 1-
2 days a week (55.46%) and less frequently on 3-5 days a week. The frequency
distribution was very similar in all age groups in both genders (See Annex 1, Graph 7 and
Graph 8).

Consumption of Starchy Foods apart from Bread by Mean number of Years in Education

When the results of consumption of these four groups of starchy foods were analysed by
the mean number of years in education, it was found that cereals were consumed on 6-7
days per week by interviewees who had had the highest mean number of years in
education, although there was little if any statistically significant difference between the
frequency distribution groups (See Annex 1, Graph 9).

The interviewees with the highest mean number of years in education replied that they
consumed rice/pasta on 3-5 days a week (See Annex 1, Graph 10).

The group of interviewees with the highest mean number of years in education for the
consumption of fried potatoes was found to be in the “never” group, with a downward
trend noted with increasing frequency of consumption (See Annex 1, Graph 11). In the
consumption of other potato products the mean number of years in education was seen
to be highest for the 6-7 days per week consumption frequency. However this was closely
followed by the “never” group. The confidence intervals for both groups were however
wide indicating the lower significance of these results. It is also to be noted that there was
a decrease in the mean number of years in education with increasing frequency of
consumption of other potato products between the “never” group and the 3-5 days group
(See Annex 1, Graph 12).

The results of the consumption of starchy foods, apart from bread, according to the mean
number of years in education indicated that persons with a higher number of years in
education were more amenable and tended to comply more with health promotion
messages for healthier dietary habits. This could be due to the following main reasons.

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 • Education possibly exposes persons with a higher number of years in education
more frequently to healthy promotion messages.
• Education also increases the number of ways of access of the various forms of
health promotion messages, such as in written form and via internet.
• Education might also increase the understanding of the benefits of adopting
healthy eating habits.
• Education probably increases the chances of one having a better-paid job hence
providing a better economic situation with the possibility of purchasing healthier
foods which often prove to be more expensive than less healthy varieties.

As seen further on, these reasons also tend to apply for various foods.

2. Second Tip for Eating Well – Eat Lots of Fruit and Vegetables

Although there is an increased awareness about eating lots of fruit and vegetables, the
UK FSA states that most people are still not eating enough of these foods. The
recommended amount is of at least five (5) portions of fruit and vegetables every day.
These portions could be chosen from fresh, dried, frozen, tinned or juiced fruits and/or
vegetables.

Consumption of Vegetables and Fruit by Gender

The results of the first HIS yielded interesting results with regard to the consumption of
vegetables and fruit.

There was an almost equal distribution in the frequency of consumption of vegetables in

the categories of 1-2 days, 3-5 days and 6-7 days a week. This was seen in both men and
women, although it is to be noted that the group of male interviewees in the 3-5 days
group was greater than the male groups for the 1-2 days and the 6-7 days consumption,
when compared to the female distribution. It is also interesting to note that, in both men
and women, there was a downward trend in the consumption of vegetables with
increasing age group of interviewees in the 1-2 days consumption group, and an upward
trend with increasing age group in consumption on a daily basis.

The interviewees who “never’ consume vegetables constituted the smallest group in both
genders, although it is to be noted that the male 15-24 age group who never consumed
vegetables was greater than the equivalent female age group (See Annex 1, Graph 13 and
Graph 14).

The results of the HIS show a sharp contrast between the consumption of fresh and dried
fruits. The greatest number of interviewees for the consumption of fresh fruit falls in the
6-7 days group for both genders (See Annex 1, Graph 15 and Graph 16), whilst the
greatest number of interviewees for the consumption of dried fruit for both men and
women fall in the “never” group (See Annex 1, Graph 17 and Graph 18). The results also

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showed that both male and female younger age groups, 15-24 years and 25-44 years,
tended to consume less fresh fruit than the older age groups (See Annex 1, Graph 15 and
Graph 16).

Consumption of Vegetables and Fruit by Mean Number of Years in Education

When the HIS results were analysed by the mean number of years in education an
increase in the mean number of years in education with increasing frequency of
consumption of vegetables and fresh fruit was noted (See Annex 1, Graph 19 and Graph
20). This increase in the mean number of years in education with increasing frequency of
dried fruit consumption was also seen between the “never” graph bar to the 3-5 days
graph bar. There was then a slight decrease in the mean number of years in education for
the consumption of dried fruit on a 6-7 day a week basis, although this mean number of
years was still greater than the number for the “never” and the 1-2 days group of
interviewees (See Annex 1, Graph 21).

3. Third Tip for Eating Well – Eat More Fish

The recommendations of the UK FSA for fish consumption are of at least two portions of
fish per week, including one portion of oily fish (examples of oily fish are salmon, fresh
tuna, mackerel, sardines and herring). Women of childbearing age are advised to have a
maximum of two portions of oily fish per week (one portion is about 140g). Other adults
are advised to have not more than four portions of oily fish per week.

Persons who regularly eat a lot of fish should try to vary the types of fish eaten as much
as possible. One can choose from fresh, frozen, canned or smoked fish. It is important to
remember, however, that canned and smoked fish can be high in salt.

Consumption of Fish by Gender

The HIS results showed that there was a very similar distribution in the frequency of fish
consumption in men and women (See Annex 1, Graph 22 and Graph 23 and Annex 2,
question 103 g.). The greatest number of interviewees fell in the 1-2 days per week
group. This was closely followed by the “never” group in both genders. Interestingly a
downward trend in fish consumption was noted with increasing age group in the “never”
category, which was matched by an upward trend with increasing age group in the 1-2
days per week fish consumption category. It is also to be noted that in both genders there
was an upward trend for fish consumption with increasing age group up to 74 years, in
the 3-5 days category.

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Consumption of Fish by Mean number of Years in Education

Graph 24 in Annex 1 showed that there was no statistically significant difference in mean
years in education between fish consumption on 1-2 days, 3-5 days and 6-7 days.

There was however a statistically significant lower difference in the mean number of
years in education in the group of interviewees who never consumed fish. This lower
mean number of years in education in interviewees who never consumed fish might
reflect the economic situation of these interviewees or/and the decreased exposure to
health promotion messages or a lesser understanding of health promotion messages and
of the health benefits of eating fish.

4. Fourth Tip for Eating Well – Cut Down on Saturated Fat and Sugar

Fats

The recommendation from the UK FSA with regard to fat consumption is that we need
some fats in our diet. What is important is that the fatty foods eaten are rich in
unsaturated fats and not in saturated fats. Foods that are high in saturated fats include
meat with visible fat, cakes, hard cheese, butter, cream and coconut oil. On the other hand
foods that are rich in unsaturated fats include vegetable oils including olive oil, reduced-
fat butter spread, nuts and seeds.

Packed foods give the amount of fat or even for saturated fat or “saturates” on the label.
The UK FSA gives the following values per 100g of food as a guide to knowing whether
a food contains a lot or a little fat.

• There is a lot of fat if the food contains 20g of fat or more per 100g of food or 5g
saturates or more per 100g of food.
• There is a little fat if the food contains 3g of fat or less per 100g of food or 1g of
saturates or less per 100g of food.

Consumption of Chicken/ Rabbit, Meat and Meat Products

Comparison of the results of the HIS for consumption of chicken/rabbit, meat and meat
products showed that the highest percentage for consumption was for chicken/rabbit at
71.84% on 1-2 days per week. This was followed by the percentage for meat
consumption of 62.02% on 1-2 days per week. Meat products were consumed by 33.76%
of the interviewees on 1-2 days a week.

Consumption of Chicken/ Rabbit, Meat and Meat Products by Gender

Analysis of the results for consumption of these foods by gender showed that the
consumption of chicken/rabbit and meat was highest on 1-2 days a week for both genders

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The consumption of chicken/rabbit was very similar for all age groups at all frequencies
(See Annex 1, Graph 25, Graph 26, Graph 27 and Graph 28).

It was noted that men tended to consume more meat on 1-2 days a week as they grew
older, whilst a downward trend was noted with increasing age group in the consumption
of meat by men on 3-5 days a week Consumption of meat by women on 1-2 days per
week was similar across all age groups, whilst the younger female age groups (15-64
years) were seen to have a greater number of interviewees who consumed meat on 3-5
days per week.

It is also interesting to note that the highest number of interviewees who said that they
never consumed meat was found to be in the older age group for both genders (75+ for
males and 64+ for females (See Annex 1, Graphs 27 and 28)). This could reflect the
economic situation of this age group throughout their life.

The consumption of meat products was seen to have a more uniform distribution
throughout all frequencies when compared to chicken/rabbit and meat consumption (See
Annex 1, Graph 29 and Graph 30).

Meat product consumption in men was seen to be highest on 1-2 days a week, although
consumption on 3-5 days and on 6-7 days was higher than for the same frequencies for
chicken/rabbit and meat consumption. One notes an upward trend with increasing age
group for the 1-2 day frequency and also for the “never” category. On the other hand
there was a downward trend with increasing age group in meat product consumption on
3-5 days and 6-7 days a week.

The distribution of meat product consumption in females was seen to be similar in

amount in the “never” and the 1-2 days per week categories. The distribution of
interviewees who consume meat products on 1-2 days and on 3-5 days a week was seen
to be similar across all age groups. There was a mild upward trend with increasing age
group in the “never” group, whilst a mild downward trend was seen with increasing age
group in the 6-7 days consumption category.

Consumption of Chicken/Rabbit, Meat and Meat Products by Mean Number of Years in

Education

The HIS results showed that there was no statistically significant difference between the
consumption of chicken/rabbit by the mean number of years in education in the “never”,
1-2 days and 3-5 days per week categories. The mean number of years in education for
the 6-7 days a week category was lower, but was not statistically significant, the
confidence interval being wide. (See Annex 1, Graph 31).

Graph 32 showed a statistically significant downward trend in the mean number of years
in education with increasing frequency of meat consumption (See Annex 2, Graph 32). A
similar downward trend in mean number of years in education was seen with increasing

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frequency of consumption of meat products. However this trend was not statistically
significant, as the confidence intervals were wide (See Annex 2, Graph 33).

Consumption of Cheese by Gender

The interviewees taking part in the HIS were asked about the consumption of cheese and
of low-fat cheese.

The results showed that the most even distribution of cheese or low-fat cheese across the
various frequencies was for consumption of cheese by men (See Annex 1, Graph 34,
Graph 35, Graph 36 and Graph 37). The greatest number of interviewees were found to
be in the “never” and the 1-2 days per week category for both genders. A downward
trend with increasing age group was seen in the 3-5 days per week frequency although
the trend for women was milder than that for men. The 6-7 day distribution in males also
decreased with increasing age, whilst the distribution for females was very even among
all age groups.

The consumption of low-fat cheese varies in pattern between males and females. There
was a downward trend with increasing age group in the male “never” category whilst an
upward trend was seen with increasing male age group in the 1-2 days per week group. In
women the distribution for these two frequency categories was similar, although the
trends were not as sharp in variation with increasing age group. There was a practically
even distribution between age groups in the 3-5 days and the 6-7 days frequencies for
men, whilst these frequencies of low-fat cheese consumption showed a downward
distribution in the 3-5 days a week group and an upward trend in the 6-7 days per week
group.

Consumption of Cheese and Low-fat cheese by Mean Years in Education

Although Graph 38 and Graph 39 showed that the highest mean number of years in
education for the consumption of cheese was in the 6-7 days per week category, and in
the 3-5 days a week and the 6-7 days a week category for the low-fat cheese
consumption, these results were not statistically significant, the confidence intervals
being wide (See Annex 1, Graph 38 and Graph 39).

The Type of Oil or Fat Used in Food Preparation and on Bread

In the HIS this dietary practice was investigated by asking the following two questions

• What kind of oil or fat is used most often for food preparation at home?
• What kind of oil or fat do you use on bread most often? (See Annex 1, questions
94 and 95 for percentage results of these two questions).

The results of these questions showed a contrast between the oil/fat most commonly used
in food preparation which is “other vegetable oils” other than olive oil, and that used on

9
bread which is olive oil (See Annex 2 for percentage results and Annex 1 for Graph 40
and Graph 41). The interviewees who fell in the other categories of oil/fat used in food
preparation were very low. On the other hand the interviewees used a greater variety of
oil/fat on bread. It is interesting to note that the percentage of interviewees who use olive
oil for food preparation decreases with increasing age group, whilst the use of other
vegetable oils increases with increasing age group.

Graph 41 shows a similar downward trend with the use of olive oil with increasing age
group, as with the type oil or fat used most often for food preparation. It is noted that
there was an upward trend with the use of other vegetable oils and low fat margarine with
increasing age groups.

The following points of observation can be drawn from the percentage results of question
94 (See Annex 2) and those in Graph 40 and Graph 41 (See Annex 1).

• The results in Graph 40 indicate that the greater use of olive oil in the 25-44 year
age group might have coincided with the concurrent increase in awareness in
recent years of the health benefits of using olive oil. The fact that other vegetable
oils use was greatest in the 65-74 age group reflects the greater number of years
that has passed since the health benefits of these oils started to be promoted.
These results might also indicate that once a person adopts a healthy practice, it
might be difficult to change it to a healthier practice.

• The fact that the greatest number of interviewees mostly used olive oil, other
vegetable oils or low fat margarine also indicates that health promotion measures
directed towards the use of healthier oils do have a measurable impact on the
population.

• The fact that younger age groups used olive oil whilst the older age groups tended
to use other vegetable oils or low fat margarine might have also reflected the
economic situation of the persons within those age groups.

The Types of Oil/Fat Used in Food Preparation and on Bread

Graph 42 (See Annex 1) showed that the interviewees who used olive oil in cooking
rather than other vegetable oils spent a greater mean number of years in education. This
difference was statistically significant. There was no statistically significant difference
between the use of ordinary margarine and low fat margarine.

Graph 43 (See Annex 1) showed that the graph bar with the highest mean number of
years in education was for the use of ordinary margarine on bread. The next lower mean
number of years in education was for the use of low fat margarine on bread. The mean
number of years in education for use of olive oil, and butter or product consisting mainly
of butter, on bread was slightly lower. The bars for these two products were equal in size.
There was a statistically significant difference between the use of olive oil, and butter or
product consisting mainly of butter, and other vegetable oils.

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The results in Graphs 42 and 43 might indicate that persons who had a higher mean
number of years in education might have had a greater exposure to and were more open
to health promotion measures and to changes towards healthier dietary practices. These
results might also indicate that persons who had spent more years in education might
have better paid jobs and thus be in a better economic situation.

The results also point to the tradition of using margarine or butter on bread more
commonly than using olive oil or other vegetable oils, by persons with higher mean
number of years in education.

Lard appeared to be used by persons with the lowest mean number of years in education,
although the confidence interval for the bars was very wide. The number of interviewees
who fell in this category in both questions was very small (0.12% in question 94 and
0.07% in question 95), (See Annex 2).

Sugar

The UK FSA states that most people are eating too many foods which contain added
sugar, such as sweets, cakes, biscuits and soft drinks. Apart from having a high calorific
value resulting in a tendency to gain weight, having sugary foods and drinks too often
could cause tooth decay, especially if taken in between meals.

In order to know if a food is high in added sugar, one needs to look at the ingredient
label. The ingredient present in the highest amount is always listed first. Added sugar can
be present in different forms of sugar such as sucrose, glucose, corn syrup and honey.
Sugars might also be presented under the figure of “Carbohydrates (of which sugars)”. If
the figure shown is only for total “Carbohydrates”, and not “Carbohydrates (of which
sugars)”, this means that the figure also includes carbohydrates from starchy foods.

The UK FSA gives the following values per 100g of food as a guide to knowing whether
a food contains a lot or a little sugar.

• There is a lot of sugar if the food contains 10g sugars or more per 100g of food.

• There is a little sugar if the food contains 2g of sugars or less per 100g of food.

Consumption of Sugar in Coffee, Tea or other Hot Beverages

Question 98 (See Annex 2), showed that the mean value for the number of teaspoonfuls
of granulated sugar or sugar cubes added to one cup of coffee, tea or another hot
beverage is low, 0.6 for coffee, 0.5 for tea and 0.1 for “other hot beverages”. The range
for the number of teaspoonfuls of sugar or sugar cubes added to all types of beverages
was that of 0 to 4.

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Consumption of Sweets and Sweet Pastries by Gender

The distribution of the interviewees by frequency of sweet consumption was similar for
both genders (See Annex 1, Graph 44 and Graph 45). The greatest number of
interviewees fell in the “never” category for both men and women, where an upward
trend was noted with increasing age group. It is interesting to note that the next highest
number of interviewees was found in the 1-2 days per week and the 6-7 days per week
categories in both genders. The distribution of interviewees in the 1-2 days a week
category was similar across all age groups for both males and females, whilst one notes a
downward trend with increasing age groups in the 6-7 days a week category, again for
both genders. One notes however that males in the 15-24 age group consumed more
sweets than females of the same age group.

The distribution of interviewees between the different frequency categories for sweet
pastry consumption was similar for both males and females (See Annex 1, Graph 46 and
Graph 47). It is to be noted that sweet pastry consumption on 1-2 days and 6-7 days per
week was however higher than that for the same frequencies of sweet consumption. A
mild downward trend was noted in the female 1-2 days per week frequency category. In
males the highest number of interviewees in the 1-2 days per week frequency fell in the
15-24 age group, whilst the distribution among the other age groups was similar. Again
an upward trend with increasing age group was noted in the “never” category. It is
interesting to note that there was a higher consumption of sweet pastries in the 25-74
female age group than in the corresponding male age range.

Consumption of Sweets and Sweet Pastries by Mean Number of Years in Education

Consumption of sweets by mean number of years in education showed an upward trend

in the mean number of years between the “never” category and the 1-2 days and the 3-5
days per week categories. The mean number of years for the 6-7 days per week
consumption of sweets was however statistically significantly lower than the mean
number of years for the 1-2 days and the 3-5 days categories (See Annex 1, Graph 50).

It is interesting to note that for the consumption of sweet pastries, the mean number of
years in education was significantly lower for the “never” category than for all the other
categories, for which a similar mean number of years was found (See Annex 1, Graph
51).

It appears that education does not have such a positive impact on people when it comes to
consumption of sweets and sweet pastries.

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Consumption of Sugared Soft Drinks by Gender

The HIS results showed a contrast between males and females in the consumption of
sugared soft drinks. Although the highest number of interviewees fell in the “never”
category for both genders, the number was higher for females than for males. Also the
upward trend seen in males was very sharp as compared to the slope of the upward trend
seen in female sugared drinks consumption (See Annex 1, Graph 48 and Graph 49)

The next highest number of interviewees fell in the 6-7 days per week category for both
males and females. However males in the 15-64 age range drank significantly more
sugared soft drinks than females on 6-7 days per week frequency.

Consumption of Sugared Soft Drinks by Mean Number of Years in Education

In contrast to the consumption of sweets and sweet pastries by the mean number of years
in education, the lowest mean number of years in education for the consumption of
sugared soft drinks was found to be for the 6-7 days frequency consumption. This value
was found to be statistically significantly lower than the values for the other consumption
frequencies for sugared soft drinks (See Annex 2, Graph 52).

5. Fifth Tip for Eating Well – Try to eat less salt – no more than 6g a day

The UK FSA states that 75% of the salt in our diet is derived from processed food such as
breakfast cereals, soups and biscuits and ready-made meals. Therefore one could be
eating too much salt without realising it.

The UK FSA gives the following values per 100g of food as a guide to knowing whether
a food contains a lot or a little salt. It is also important to know that salt is often listed as
sodium on food labels. Salt = sodium x 2.5

• There is a lot of salt if the food contains 1.25g salt or more, or 0.5g sodium or
more per 100g of food.
• There is a little salt if the food contains 0.25g of salt or less, or 0.1g sodium or
less per 100g of food.

Consumption of Salt in Cooking and at Table

Consumption of salt in cooking and at table was enquired into by asking the following
two questions.

• Is salt added to your meals during cooking (excluding cubes)?

• Do you add salt to your meals at table? (See Annex 2, questions number 100 and
101).

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The percentages of question 100 (See Annex 1, question 100) showed that almost half of
the interviewees added salt to their meals during cooking (47%). Interestingly this was
followed by those interviewees who either never added salt or used a low salt alternative
(34.84%). The percentage for those who used salt only occasionally was 16.28%.

The results of question 101 (See Annex 2, question 101) showed an inversion of the
results as compared to question 100.The interviewees who replied that they never added
salt or used a low salt alternative with their meals at table were 58.90% whilst those who
almost always added salt to their meals at table amounted to 23.73%. The percentage for
those who only occasionally added salt to their meals at table (17.20%) was similar to the
percentage of interviewees who only occasionally added salt to their cooking (16.28%).

Graph 53 (See Annex 1) showed that the mean number of years in education for those
interviewees who almost always used salt in cooking was statistically significantly lower
than the other practices enquired about in this question.

Graph 54 shows the mean number of years in education by use of salt at table. There was
no statistical difference between the mean number of years in education for the different
practices in salt use with meals at table.

6. Sixth Tip for Eating Well – Get Active and Try to be a Healthy Weight

The recommendation for this tip for eating well from the UK FSA is that one should be
neither overweight nor underweight.

If persons are worried about their weight they should seek advice from their General
Practitioner (GP) or from a dietitian. If the need is only for loss of a little weight then the
following three practices should be helpful.

• One must only eat as much food as one needs depending on one’s lifestyle.
• One must choose to eat healthy food such as low-fat and low-sugar food, and eat
lots of fruit, vegetables and wholegrain foods.
• One must be more active

It is advised that in order to reach a healthy weight and maintain it one must change one’s
lifestyle gradually, aiming to lose 0.5 to 1 kg per week until the recommended weight for
one’s height is reached.

The questions within the section for dietary habits in the HIS that correspond to this sixth
tip are questions 104 and 106 (See Annex 2). The questions asked were the following.

Q 104. Have you changed your eating habits in the past 3 years?
Q 105. What was the main reason for changing your eating habits?
Q 106. Who advised you to change your eating habits?

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Q 104. Have you changed your eating habits in the past 3 years?

The interviewees who said that they had changed their eating habits over the past 3 years
amounted to 26.85% of the total interviewees. 73.01% had not changed their eating
habits. It however cannot be assumed that the interviewees who did not change their
eating habits were eating an unhealthy diet. It might be that they already had healthy
dietary practices.

The analysis of the results of question 104 by gender and age group are shown in Graph
55 (See Annex 1). It is noted that in all age groups more females changed their eating
habits over the previous 3 years as compared to males. There was however a downward
trend with increasing age group in the number of interviewees who changed their eating
habits. This could be understood as the greater difficulty one has as one gets older, to
change dietary habits that one has practiced for several years.

Graph 56 (See Annex 1) clearly shows that the interviewees with a higher mean number
of years in education were more likely to change their eating habits. As mentioned in
previous questions this could be due to the greater exposure and accessibility to health
promotion messages, the greater understanding of the health benefits in adopting healthy
eating practices, and their economic situation.

Q 105. What was the main reason for changing your eating habits?

Unfortunately the great majority of interviewees (72.75%) did not answer this question
(See Annex 2). 10.19% changed their eating habits “to live more healthy” and 8.15% did
so “to lose or gain weight”.

Analysis of these results by mean number of years in education showed that the one
category with a lower mean number of years as compared with the other categories was
that of “because of a disease or health problem”. There was a statistically significant
difference between this category and “to lose or gain weight”, “to live more healthy” and
“for some other reason” (See Annex 1, Graph 57).

Again this picture indicates that the interviewees who had a higher mean number of years
in education had a greater understanding of the benefits of a healthy diet while they
presumably were still healthy, as compared to the interviewees with a lower mean
number of years who changed their eating habits because of a disease or a health
problem.

Q 106. Who advised you to change your eating habits?

The analysis of these results was presented as percentage values (See Annex 2,
question106). The highest percentage of interviewees (18.96%) said that they had
changed their eating habits out of their own accord. The next highest groups of

15
interviewees changed their eating habits after being advised to do so by a doctor (7.22%)
or by a family member (5.37%).

7. Seventh Tip for Eating Well – Drink Plenty of Water

The daily amount of water that should be drunk, as recommended by the UK FSA is that
of 6 to 8 glasses (1.2 litres). When the weather is warm or when one is carrying out
physical exercise, more water should be drunk. The results obtained from the questions in
the Food Habits section regarding the consumption of coffee, tea, other beverages and
milk are also included in this section.

Consumption of Water by Gender

Analysis of water consumption by different frequencies for both men and women
together showed that 67.76% of the interviewees drank water on 6-7 days per week. (See
Annex 2, question 103 t.).

Analysis of the results by gender showed a similar distribution in the consumption of

water in men and women with the greatest number of male and female interviewees
falling in the 6-7 days per week frequency. A downward trend with increasing age group
could be noted in this frequency group for both males and females. The group of
interviewees in the male 1-2 days per week category was slightly greater than the female
group and these was also a mild upward trend with increasing age group (See Annex 1,
Graph 58 and Graph 59).

Consumption of Water by Mean Number of Years in Education

The results of consumption of water by mean number of years in education are depicted
in Graph 60 (See Annex 1). There was a clear increase in the mean number of years with
increasing frequency of consumption of water from the “never” category through to the
6-7 days per week category. This again reflects the influence that education has on a
person understanding the health benefits of drinking water.

Consumption of Coffee, Tea or other Hot Beverages

The interviewees were also asked how many cups of coffee, tea or other hot beverages
they drank every day. (See Annex 2, question 97). The mean value for coffee and tea
drinking was the same at 2.2 cups per day. The number range of coffee cups drank per
day was 0 to 18 cups, whilst that for tea drinking was 0 to 16 cups. The range for “other
hot beverages” was 0 to 20 with a mean value of 0.2 cups for “other hot beverages”.

Consumption of Milk

The results of this question (See Annex 2, question 96) showed that fresh milk was the
type of milk most often drank by the interviewees (46.06%). This was followed by

16
skimmed milk (31.12%) and then by the group of persons who did not drink milk
(9.58%). Evaporated milk was the milk next most often used (7.47%).

The greatest male group of interviewees drank fresh milk, whilst the next bigger group
drank skimmed milk (See Annex 1, Graph 61). The groups of female interviewees who
drank fresh milk and those who drank skimmed milk were very similar in size (See
Annex 1, Graph 62).

Graph 61 (See Annex 1), depicting the consumption of milk by men showed a decrease in
the use of fresh milk with increasing age group, whilst an increase was seen in the use of
skimmed milk and evaporated or light/very light evaporated milk with increasing age
group.

The increase in the use of skimmed milk with increasing age group in men might indicate
an increased awareness and adoption of healthy diet habits. It is to be noted, however,
that the term “skimmed milk” was not divided into the categories of fresh skimmed milk
or powdered skimmed milk. However if the skimmed milk used was powdered skimmed
milk, apart from a healthier habit adoption, it might indicate the practicality of powdered
milk lasting longer and hence one not needing to buy milk every few days.

The other types of milk most often used by men were evaporated milk and light/very
light evaporated milk. Apart from these being a matter of taste, the use of these types of
milk might again indicate the practicality of the storage and availability of these types of
milk for much longer than fresh milk. Here again there was an increase in the use of these
types of milk with increasing age groups, possibly as more men chose or found
themselves living on their own.

Graph 62 (See Annex 1), showed the type of milk most often used by women. There was
a contrast in the frequency and distribution of the use of fresh milk and skimmed milk by
women as compared to men. As seen in graph 62 the use of fresh milk in the 15-24 and
25-44 year age group was high as compared to the use of skimmed milk or other types of
milk. The use of fresh milk by female interviewees in the 45-64 and the 65-74 age groups
was relatively lower as compared to the other age groups. However, it is to be noted that
there was a mirroring increase in the use of skimmed milk in these same age groups.

It would be interesting to carry out a study to investigate whether this sudden change in
use of fresh milk to skimmed milk at the 45-64 age group occurred concurrently with the
menopausal age range and the concurrent increase in the incidence of non insulin
dependent diabetes (NIDDM), hypercholesteroleamia and ischaemic heart disease (IHD).

Graph 62 also showed an upward trend in the use of evaporated and light/very light
evaporated milk with increasing age group in women. It is to be noted that evaporated
milk was more commonly used in the 75+ age group than was light/very light evaporated
milk. This difference was statistically significant. The group of women who did not drink
milk was smaller than the men’s group.

17
Graph 63 (See Annex 1) showed that the type of milk most commonly used by the
interviewees with the highest mean number of years in education was skimmed milk.
This was followed by fresh milk. There was a statistically significant difference between
these two graph bars. Interestingly the graph bar with the next highest mean number of
years in education was that for “I do not drink milk”. This was followed by light/very
light evaporated milk and then evaporated milk. The highest statistically significant
difference was seen between the graph bar for skimmed milk and evaporated milk.

Graph 63 clearly shows that education has an influence on the type of milk used as a
healthy dietary habit.

8. Eighth Tip for Eating Well – Don’t Skip Breakfast

The UK FSA stresses the importance of having breakfast as it gives the energy required
for the daily activities. It also helps to control one’s weight, probably because when
breakfast is missed there is a greater possibility for one to feel hungry before lunch and
snack on foods that are rich in fats and sugars.

There was no corresponding question to this Eating Well tip in the HIS. However this tip
for eating well has been included in this report to present the complete list of the UK FSA
recommended Tips for Eating Well.

Summary of Results

The following is a summary of the results obtained from the Food Habits section in the
first HIS.

• Starchy Foods - The overall consumption of starchy foods on 3 or more days was
found to be still low, among interviewees, as was the consumption of brown bread
which was the least common type of bread eaten. The results of the consumption
of starchy foods, apart from bread, according to the mean number of years in
education indicated that persons with a higher number of years in education ate a
greater amount of starchy foods.

• Vegetables and Fruit - There was an almost equal distribution in the frequency of
consumption of vegetables by both men and women on one or more days a week.
63.05% of interviewees consumed fresh fruit every day. The greatest number of
interviewees for both genders was found to be in the 6-7 days per week group.
Analysis of the results by the mean number of years in education showed an
increase in the mean number of years with increasing frequency of consumption
of vegetables and fresh fruit.

• Fish - There was a very similar distribution in the frequency of fish consumption
in men and women, the greatest number of interviewees being in the 1-2 days per
week consumption category. An upward trend with increasing age group in this

18
 frequency category was also noted. There was no statistically significant
difference in mean years in education between fish consumption on 1-2 days or
more. There was however a statistically significant lower difference in the mean
number of years in education in the group of interviewees who never consumed
fish.

• Fats

• Chicken/Rabbit, Meat and Meat Products - The results for consumption of these
foods by gender showed that the consumption of chicken/rabbit and meat was
highest on 1-2 days a week for both genders. The consumption of chicken/rabbit
was very similar for all age groups at all frequencies. Meat products were found
to be consumed more frequently. There was no statistically significant difference
between the consumption of chicken/rabbit by the mean number of years in
education. A statistically significant downward trend in the mean number of years
in education with increasing frequency of meat consumption was found. There
was a similar downward trend with meat product consumption, which however
was not statistically significant.

• Cheese and Low-Fat Cheese – The greatest number of interviewees consumed

cheese or/and low-fat cheese on 2 or less days a week. Interviewees with a lower
mean number of years in education tended to consume more cheese. However the
differences in mean number of years were not statistically significant.

• Oil or Fat - The results showed a contrast between the oil/fat most commonly
used in food preparation which is “other vegetable oils” other than olive oil, and
that used on bread which is olive oil. Here again the trend for interviewees with a
higher mean number of years in education to use a healthy option i.e. olive oil in
cooking is seen. However, surprisingly the highest mean number of years in
education for oil/fat use on bread was found to be for ordinary margarine.

• Sugar

• Teaspoons of Cubes of Sugar – The range of teaspoonfuls used in coffee, tea or

other hot beverages was 0-4. The highest mean value was for coffee at 0.6.

• Sweets and Sweet Pastries - The distribution of the interviewees by frequency of

sweet consumption was similar for both genders. The greatest number of
interviewees was found to be in the “never” category for both men and women,
where an upward trend was noted with increasing age group. Sweet pastry
consumption on 1-2 days and 6-7 days per week was found to be higher than that
for the same frequencies of sweet consumption. The distribution of interviewees
between the different frequency categories for sweet pastry consumption was
similar for both males and females.

The mean number of years in education increased with increasing frequency of

19
 sweet consumption, although the mean number of years for the 6-7 days was
statistically significantly lower.

It is interesting to note that for the consumption of sweet pastries, the mean
number of years in education was significantly lower for the “never” category
than for all the other categories, for which a higher and similar mean number of
years was found. It appears that education does not have such a positive impact on
people when it comes to consumption of sweets and sweet pastries.

• Sugared Soft Drinks - A contrast between males and females in the consumption
of sugared soft drinks was found. Although the highest number of interviewees
fell in the “never” category for both genders (57.36%), the number was higher for
females than for males. The next highest number of interviewees was found in the
“daily” category for both males and females (21.06%).

• Salt – Almost half of the interviewees replied that they added salt to their cooking
and about a third said that they never added salt, or used a low salt alternative.
Conversely just over half of the interviewees said that they never added salt or
used a low salt alternative at table, whilst a quarter of interviewees almost always
added salt to their meals at table. The mean number of years in education was
found to be statistically significantly lower for interviewees who almost always
added salt to their cooking, whilst there was no statistically significant difference
between the mean number of years in education for the different practices at table.

• Changes in Eating Habits – Almost a quarter of the interviewees had reported that
they had changed their eating habits over the previous three years, although a
downward trend with increasing age group was noted. It was found that in all age
groups more females than males had changed their eating habits. Interviewees
with a higher mean number of years in education were found to be more likely to
have changed their eating habits. The commonest reason given for this change
was to live a healthier life and people with more years in education were more
likely to do so for such reasons. Interviewees who changed their eating habits
because they had been found to have some disease or a health problem had a
lower mean number of years in education.

• Water – A similar distribution for water consumption for both genders was found
with the highest percentage being in the “daily” category (67.76%). An upward
trend in the mean number of years in education was found to be associated with
an increasing frequency in water consumption.

• Coffee, Tea and other Hot Beverages – Coffee and tea were the commonest
beverages drank among these three types of beverages, with a mean value of 2.2
cups equally for tea and coffee and a mean value of 0.2 cups for “other hot
beverages”.

20
 • Milk – The commonest type of milk consumed by both male and female
interviewees was fresh milk, followed by skimmed milk. It is to be noted,
however, that this question did not divide this category into different types of
skimmed milk e.g. fresh skimmed milk or powdered skimmed milk. In men a
downward trend with increasing age group was seen for consumption of fresh
milk, whilst an upward trend with increasing age group was found for skimmed
milk. In females the trend in distribution was not even. A contrast was seen in the
45-64 and the 65-74 age groups as compared to the other age groups. Whilst the
consumption in these two age groups was lower for fresh milk, the consumption
was higher for skimmed milk as compared to the other age groups. In keeping
with these results the highest mean number of years in education was found in
interviewees who consumed skimmed milk and fresh milk. The mean number of
years for interviewees who consumed evaporated milk was statistically
significantly lower.

Limitations

The following limitations were noted during formulation of this report on the first HIS
results.

1. The first HIS was carried out in 2002. Changes in the food habits of the
population on the Maltese Islands might have taken place since that time, so that
some results from this HIS might not be a reflection of the true current (2006)
dietary practices of our population.

2. Being the first HIS, there was not the possibility of comparing the results with
previous similar surveys. This would be possible when the results of future HIS
would be available.

3. A limitation of the questionnaire was that certain questions were not designed to
detect irregular and infrequent consumption of foods or drinks. This might have
favoured the reporting of the “never” category when the intake was occasional.

4. These first HIS results were compared to foreign (UK) recommended healthy
dietary practices. Comparison of the results to locally designed healthy dietary
recommendations would have rendered this analysis more realistic.

5. In question 103 e. and f. (See Annex 2) rice and pasta, and chicken and rabbit
respectively were grouped together into two categories. Considering the Maltese
diet, in which pasta and chicken are probably more frequently consumed than rice
and rabbit, it would have been interesting and more informative to look at the
consumption of rice, pasta, chicken and rabbit separately.

21
 6. In question 96 (See Annex 1), the “skimmed milk” category is not further sub-
divided into the fresh skimmed milk and the powdered skimmed milk.
Researching this pattern of use of skimmed milk might indicate practices
reflecting changes in dietary practices possibly resulting from life-style changes.

Recommendations

1. The HIS should be carried out on a regular basis, such as every three years. More
Public Health professionals, apart from those working within the DHI, could be
involved immediately after the HIS interviews have been completed, in order to
carry out timely analyses and reporting of the results.

2. A locally designed healthy diet policy should be implemented so that HIS results
could be analysed against a local background.

3. The results of the HIS should be used as evidence-based data in order to create
national policies for healthy eating and also for planning health promotion
measures and health services.

4. Future HIS should be designed to make comparison of their results and of the
results of other HIS possible.

Conclusion

The data of the First HIS carried out in 2002 yielded interesting results about the dietary
habits of the population of the Maltese Islands. A common trend that was observed for a
number of foods and food habits that were researched was that, the greatest number of
interviewees reported to be at either extremes of dietary practices e.g. either in the
“never” or “1-2 days a week” categories, or in the “6-7 days a week” (daily) category.
This “extremes-favouring” approach might reflect the way healthy dietary habits are
promoted or understood by the public. A modified approach whereby the public is
empowered to adopt a more balanced and moderating pattern could be considered in the
local scenario. However, as mentioned in the “Limitations” section, one has to keep in
mind that the questionnaire was not designed to detect irregular and infrequent
consumption of foods and drinks.

The Health Interview Survey therefore proves to be a valuable tool which provides
evidence-based data upon which evaluation and modification of the relevant current
health policies, health promotion programmes and health services could be carried out, in
order to keep in line with the ever-evolving life-styles of our society.

22
Acknowledgements

Acknowledgements go to Dr. Neville Calleja for his help and advice and to Dr. Miriam
Dalmas for her supervision and support. This report would not have been possible
without their invaluable and timely guidance.

23
 ANNEX ONE

Graph 1. Consumption of cereals in men, by age group

90.00%

80.00%

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

Graph 2. Consumption of cereals in women, by age groups

90.00%

80.00%

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

24
 Graph 3. Consumption of rice/pasta in men, by age groups
80.00%

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

Graph 4. Consumption of rice/pasta in women, by age groups

80.00%

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

25
 Graph 5. Consumption of fried potatoes in men, by age groups
80.00%

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency
15 - 24 25 - 44 45 - 64 65 - 74 75+

Graph 6. Consumption of fried potatoes in women, by age groups

90.00%

80.00%

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

26
 Graph 7. Consumption of other potato products in men, by age groups
70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

Graph 8. Consumption of other potato products in women, by age groups

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

27
 Graph 9. Mean no of years by consumption of cereals

11.5

11

10.5

10

9.5

8.5

8
Never 1 - 2 days 3 - 5 days 6 - 7 days

Graph 10. Mean no of years in education by consumption of rice/pasta

11

10.5

10

9.5

8.5
Never 1 - 2 days 3 - 5 days 6 - 7 days

28
 Graph 11. Mean no of years in education by consumption of fried potatoes

10.5

10

9.5

8.5

7.5
Never 1 - 2 days 3 - 5 days 6 - 7 days

Graph 12. Mean no of years in education by consumption of other potato products

10.8

10.6

10.4

10.2

10

9.8

9.6

9.4

9.2

9
Never 1 - 2 days 3 - 5 days 6 - 7 days

29
 Graph 13. Consumption of Vegetables in men, by age groups
50.00%

45.00%

40.00%

35.00%

30.00%

25.00%

20.00%

15.00%

10.00%

5.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

Graph 14. Consumption of vegetables in women, by age groups

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

30
 Graph 15. Consumption of fresh fruit in men, by age groups
90.00%

80.00%

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

Graph 16. Consumption of fresh fruit in women, by age groups

90.00%

80.00%

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

31
 Graph 17. Consumption of dried fruits in men, by age groups

100.00%

90.00%

80.00%

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

Graph 18. Consumption of dried fruits in women, by age groups

100.00%

90.00%

80.00%

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

32
 Graph 19. Mean no of years in education by consumption of vegetables

12

10

0
Never 1 - 2 days 3 - 5 days 6 - 7 days

Graph 20. Mean no of years in education by consumption of fresh fruit

10.4

10.2

10

9.8

9.6

9.4

9.2

8.8

8.6
Never 1 - 2 days 3 - 5 days 6 - 7 days

33
 Graph 21. Mean no of years in education by consumption of dried fruit

14

12

10

0
Never 1 - 2 days 3 - 5 days 6 - 7 days

Graph 22. Consumption of fish in males, by age groups

80.00%

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

34
 Graph 23. Consumption of fish in women, by age groups
80.00%

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

Graph 24. Mean no of years in education by consumption of fish

12

10

0
Never 1 - 2 days 3 - 5 days 6 - 7 days

35
 Graph 25. Consumption of chicken/rabbit in men, by age groups
90.00%

80.00%

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

Graph 26. Consumption of chicken/rabbit in women, by age groups

90.00%

80.00%

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

36
 Graph 27. Consumption of meat in men, by age groups
80.00%

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

Graph 28. Consumption of meat by women, by age groups

80.00%

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

37
 Graph 29. Consumption of meat products in men, by age groups
60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

Graph 30. Consumption of meat products in women, by age groups

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

38
 Graph 31. Mean no of years in education by consumption of chicken/rabbit

11

10.5

10

9.5

8.5

7.5
Never 1 - 2 days 3 - 5 days 6 - 7 days

Graph 32. Mean no of years in education by consumption of meat

12

10

0
Never 1 - 2 days 3 - 5 days 6 - 7 days

39
 Graph 33. Mean no of years in education by consumption of meat products

10.4

10.2

10

9.8

9.6

9.4

9.2

9
Never 1 - 2 days 3 - 5 days 6 - 7 days

Graph 34. Consumption of cheese in men, by age groups

50.00%

45.00%

40.00%

35.00%

30.00%

25.00%

20.00%

15.00%

10.00%

5.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

40
 Graph 35. Consumption of cheese in women, by age groups
60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

Graph 36. Consumption of low-fat cheese in men, by age groups

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

41
 Graph 37. Consumption of low fat cheese in women, by age groups
60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

Graph 38. Mean no of years in education by consumption of cheese

10.6

10.4

10.2

10

9.8

9.6

9.4

9.2
Never 1 - 2 days 3 - 5 days 6 - 7 days

42
 Graph 39. Mean no of years in education by consumption of low-fat cheese

10.6

10.4

10.2

10

9.8

9.6

9.4

9.2
Never 1 - 2 days 3 - 5 days 6 - 7 days

Graph 40. Fat/oil most often used in food preparation

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Olive oil Other vegetable Ordinary Low fat margarine Butter or product Lard or other Other fats None
oils margarine consisting mainly animal fat
of butter

15 - 24 25 - 44 45 - 64 65 - 74 75+

43
 Graph 41. Fat/oil most often used on bread

45.0%

40.0%

35.0%

30.0%

25.0%

20.0%

15.0%

10.0%

5.0%

0.0%
Olive oil Other vegetable Ordinary Low fat margarine Butter or product Lard or other Other fats None
oils margarine consisting mainly animal fat
of butter

15 - 24 25 - 44 45 - 64 65 - 74 75+

Graph 42. Mean no. of years in education by fat/oil used in food preparation

14

12

10

0
Olive oil Other vegetable Ordinary Low fat margarine Butter or product Lard or other Other fats None
oils margarine consisting mainly animal fat
of butter

44
 Graph 43. Mean no. of years in education by fat/oil used on bread

14

12

10

0
Olive oil Other vegetable Ordinary Low fat margarine Butter or product Lard or other Other fats None
oils margarine consisting mainly animal fat
of butter

Graph 44. Consumption of sweets in men, by age groups

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

45
 Graph 45. Consumption of sweets in women, by age groups
70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

Graph 46. Consumption of sweet pastries in men, by age groups

50.00%

45.00%

40.00%

35.00%

30.00%

25.00%

20.00%

15.00%

10.00%

5.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

46
 Graph 47. Consumption of sweet pastries in women, by age groups
50.00%

45.00%

40.00%

35.00%

30.00%

25.00%

20.00%

15.00%

10.00%

5.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

Graph 48. Consumption of sugared soft drinks in men, by age groups

80.00%

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

47
 Graph 49. Consumption of sugared soft drinks in women, by age groups
90.00%

80.00%

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

Graph 50. Mean no of years in education by consumption of sweets

10.8

10.6

10.4

10.2

10

9.8

9.6

9.4

9.2

9
Never 1 - 2 days 3 - 5 days 6 - 7 days

48
 Graph 51. Mean no of years in education by consumption of sweet pastries
10.6

10.4

10.2

10

9.8

9.6

9.4

9.2

9
Never 1 - 2 days 3 - 5 days 6 - 7 days

Graph 52. Mean no of years in education by consumption of sugared soft drinks

11

10.5

10

9.5

8.5

8
Never 1 - 2 days 3 - 5 days 6 - 7 days

49
 Graph 53. Mean years in education by use of salt in cooking
12

10

0
Almost always Occasionally Never or low salt alternative I don't know

Graph 54. Mean no. of years in education by use of salt at the table
12

10

0
Almost always Occasionally Never or low salt alternative

50
 Graph 55. Changed eating habits within last 3 years
45.00%

40.00%

35.00%

30.00%

25.00%

20.00%

15.00%

10.00%

5.00%

0.00%
15 - 24 25 - 44 45 - 64 65 - 74 75+
Age Groups

Male Female

Graph 56. Mean no of years in education by changed eating habits in previous 3 yrs
11

10.8

10.6

10.4

10.2

10

9.8

9.6

9.4

9.2

9
Yes No

51
 Graph 57. Mean no of years in education by reason for changing eating habits
14

12

10

0
To lose or gain weight To maintain weight To live more healthy Because of a disease or For some other reason
health problem

Graph 58. Consumption of water in men, by age groups

80.00%

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

52
 Graph 59. Consumption of water in women, by age groups
90.00%

80.00%

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Never 1 - 2 days 3 - 5 days 6 - 7 days
Frequency

15 - 24 25 - 44 45 - 64 65 - 74 75+

Graph 60. Mean no of years in education by consumption of water

10.4

10.2

10

9.8

9.6

9.4

9.2

8.8

8.6

8.4
Never 1 - 2 days 3 - 5 days 6 - 7 days

53
 Graph 61. Type of milk used most often by men
80.00%

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Fresh milk Skimmed milk Evaporated milk Light/v. light evaporated milk I do not drink milk

15 - 24 25 - 44 45 - 64 65 - 74 75+

Graph 62. Type of milk most often used by women

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
Fresh milk Skimmed milk Evaporated milk Light/v. light evaporated milk I do not drink milk

15 - 24 25 - 44 45 - 64 65 - 74 75+

54
 Graph 63. Mean level of education by type of milk used

12

10

0
Fresh milk Skimmed milk Evaporated milk Light/ver light evaporated milk I do not drink milk

55
 ANNEX TWO

THE FIRST NATIONAL HEALTH INTERVIEW SURVEY (HIS)

SUMMARY STATISTICS

FOOD HABITS

94. What kind of oil or fat is used most often for food preparation at home?
(Preferably fill in ONE circle, at most two)
Olive oil 38.87%
Other vegetable oils 52.55%
Ordinary margarine 2.13%
Low fat margarine 3.44%
Butter or product consisting mainly of butter 0.96%
Lard or other animal fat 0.12%
Other fats 0.35%
None 6.00%
Not Applicable/No information 0.56%

95. What kind of oil or fat do you use on bread most often?
(Preferably fill in ONE circle, at most two)
Olive Oil 38.71%
Other vegetable oils 17.13%
Ordinary Margarine 6.47%
Low fat margarine 18.77%
Butter or product consisting mainly of butter 12.91%
Lard or other animal fat 0.07%
Other spreads 2.27%
None 7.52%
Not Applicable/No information 0.40%

96. What type of milk do you use most often?

(Preferably fill in ONE circle, at most two)
Fresh milk 46.06%
Skimmed milk 31.12%
Evaporated milk (tinned) 7.47%
Light/very light evaporated milk (tinned) 5.15%
I do not drink milk 9.58%
Not Applicable/No information 0.62%

56
97. How many cups of coffee or tea or other hot beverages do you drink every day?
(Please answer ALL questions)

a. Cups of coffee:

Mean Median Range Minimum Maximum SD

2.2 2.0 18 0 18 2.5

b. Cups of tea:

Mean Median Range Minimum Maximum SD

2.2 2.0 16 0 16 2.4

c. Cups of other hot beverages:

Mean Median Range Minimum Maximum SD

0.2 0 20 0 20 0.8

98. How many teaspoonfuls of granulated sugar or sugar cubes do you use
for one cup of coffee or tea or other hot beverage?
(Please answer ALL questions)

a. Cup of coffee:

Mean Median Range Minimum Maximum SD

0.6 0 4 0 4 0.8

b. Cup of tea:

Mean Median Range Minimum Maximum SD

0.5 0 4 0 4 0.8

c. Cup of other hot beverages:

Mean Median Range Minimum Maximum SD

0.1 0 4 0 4 0.4

57
99. How many slices or portions of bread do you usually eat per day?
(Please answer ALL questions)

a. Maltese bread:

Mean Median Range Minimum Maximum SD

2.2 2.0 19 0 19 2.2

b. White bread:

Mean Median Range Minimum Maximum SD

1.2 0 18 0 18 1.8

c. Brown bread:

Mean Median Range Minimum Maximum SD

0.5 0 12 0 12 1.3

100. Is salt added to your meals during cooking (excluding cubes)?

Almost always 47.00%
Occasionally 16.28%
Never (or low salt alternative) 34.84%
I don’t know 1.66%
Not Applicable/No information 0.22%

101. Do you add salt to your meals at table?

Almost always 23.73%
Occasionally 17.20%
Never (or low salt alternative) 58.90%
Not Applicable/No information 0.17%

102. What cooking methods are used at home?

(Barbecue = grilling; ‘Grillioso’ = baking/roasting)

Never Occasionally Often Always

a. Grilling 16.28% 45.62% 31.26% 5.65%
b. Frying 35.19% 52.72% 10.07% 1.12%
c. Steaming/Boiling 7.45% 33.06% 51.69% 6.91%
d. Baking/Roasting 2.95% 46.34% 47.35% 2.84%
e. Microwave 76.57% 12.21% 6.79% 2.51%

58
103. On how many days during the last week (7-day period) have you consumed the
following foods and drinks?
Never 1-2 days 3-5 days 6-7 days
a. cereals (cornflakes, etc.) 58.11% 13.33% 9.09% 18.96%
b. eggs 30.11% 54.08% 12.32% 3.12%
c. low fat cheese 39.74% 31.37% 15.28% 12.32%
d. cheese 35.36% 32.73% 16.94% 13.66%
e. rice/pasta 4.59% 65.16% 26.66% 3.02%
f. chicken/rabbit 12.18% 71.84% 13.89% 1.57%
g. fish 41.61% 51.76% 5.22% 0.87%
h. meat 14.15% 62.02% 21.09% 2.06%
i. meat products 27.25% 33.76% 22.54% 14.85%
j. fried potatoes (chips) 48.50% 40.51% 8.43% 1.66%
k. other potatoes 11.18% 55.46% 28.26% 4.17%
l. beans/pulses 39.85% 45.71% 11.01% 2.72%
m. vegetables 6.68% 27.60% 36.48% 28.75%
n. fresh fruit 8.43% 12.16% 15.07% 63.05%
o. dried/canned fruit 79.76% 11.90% 2.74% 3.33%
p. sweet pastries 31.21% 33.39% 15.96% 18.25%
(includes biscuits, cakes, fancy cakes, gateaux, etc.)
q. sweets 37.98% 26.22% 14.43% 20.17%
r. sugar free soft drinks 64.85% 10.68% 7.05% 15.70%
s. soft drinks 57.36% 12.35 % 7.73% 67.76%

104. Have you changed your eating habits in the past 3 years?
Yes 26.85%
No 73.01% Go to 107
Not Applicable/No information 0.14%

105. What was the main reason for changing your eating habits?
(Please fill in ONE circle only)

To lose or gain weight 8.15%

To maintain weight 0.87%
To live more healthy 10.19%
Because of a disease or health problem 4.57%
For some other reason 3.47%
Not Applicable/No information 72.75%
Please specify: ______________________________

106. Who advised you to change you your eating habits?

(Please answer ALL questions)
Yes
a. A doctor 7.22%
b. Other health care professional 3.21%
c. A dietician 1.59%
d. A family member 5.37%
e. Beautician 0.82%
f. Someone else 2.46%
g. Or was it of your own accord 18.96%