Diversity of dietary patterns observed in the European Prospective Investigation into Cancer and Nutrition (EPIC) project

Abstract

Objective: To describe the diversity in dietary patterns existing across centres/regions participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). Design and setting: Single 24-hour dietary recall measurements were obtained by means of standardised face-to-face interviews using the EPIC-SOFT software. These have been used to present a graphic multi-dimensional comparison of the adjusted mean consumption of 22 food groups. Subjects: In total, 35 955 men and women, aged 35-74 years, participating in the EPIC nested calibration study. Results: Although wide differences were observed across centres, the countries participating in EPIC are characterised by specific dietary patterns. Overall, Italy and Greece have a dietary pattern characterised by plant foods (except potatoes) and a lower consumption of animal and processed foods, compared with the other EPIC countries. France and particularly Spain have more heterogeneous dietary patterns, with a relatively high consumption of both plant foods and animal products. Apart from characteristics specific to vegetarian groups, the UK 'health-conscious' group shares with the UK general population a relatively high consumption of tea, sauces, cakes, soft drinks (women), margarine and butter. In contrast, the diet in the Nordic countries, The Netherlands, Germany and the UK general population is relatively high in potatoes and animal, processed and sweetened/refined foods, with proportions varying across countries/centres. In these countries, consumption of vegetables and fruit is similar to, or below, the overall EPIC means, and is low for legumes and vegetable oils. Overall, dietary patterns were similar for men and women, although there were large gender differences for certain food groups. Conclusions: There are considerable differences in food group consumption and dietary patterns among the EPIC study populations. This large heterogeneity should be an advantage when investigating the relationship between diet and cancer and formulating new aetiological hypotheses related to dietary patterns and disease. Of all the environmental exposures diet is a universal exposure, comprising a complex mixture of different compounds that varies over time, space and according to a number of historical, ethnic, religious, agricultural, socioeconomic and psychological factors, at the individual and population levels 1 . The lack of unbiased dietary methods and the difficulty of measuring long-term individual cumulative dietary exposure, when measurements are obtained at fixed point(s) in time of the subject's life, are important methodological limitations for estimating diet accurately as an exposure 2,3 . These drawbacks may partly explain the lack of consistency in estimates of the association between diet and disease, particularly with regard to cancer 4 , and the attenuation in relative risk estimates of the actual relationship between diet and the outcome diseases due to random errors in dietary measurements 5 -7 . Another emerging possible ...

Compliance with the European and national nutritional objectives in a Mediterranean population

“…Our results suggest that a decrease in saturated fat should be recommended in the Catalan population. However, the 12% of energy derived from SFA found in the present study is still lower than the percentage found in other European populations (Slimani et al, 2002;Capita and Alonso-Calleja, 2003;Waijers et al, 2006) even in the Mediterranean region (FerroLuzzi et al, 2002).…”

Coffee, tea and decaffeinated coffee in relation to hepatocellular carcinoma in a European population: Multicentre, prospective cohort study

“…11 In some centres, additional information on caffeinated and decaffeinated coffee consumption was obtained [Germany, Greece, Italy (except Ragusa and Naples), Netherlands, and United Kingdom]. Information on tea consumption was not available in Norway.…”

Consumption of sweet beverages and type 2 diabetes incidence in European adults: results from EPIC-InterAct

“…This resulted in a final sample size of 11,684 type 2 diabetes cases and a subcohort of 15,374 (including 730 of the diabetes cases).…”

“…In addition, the diversity of dietary patterns in Europe leads to a wide variation in sweet beverage consumption across different countries, with a clear north-south gradient (i.e. higher consumption in northern than in southern European countries) [13,15].…”