Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Dietary fat intake in the European Prospective Investigation into Cancer and Nutrition: results from the 24-h dietary recalls

European Journal of Clinical Nutrition volume 63, pages S61–S80 (2009)Cite this article

Abstract

Objectives:

This paper describes the dietary intake of total fat, saturated (SFA), monounsaturated (MUFA) and polyunsaturated fatty acids (PUFA) and cholesterol of participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) in 27 centres across 10 countries.

Methods:

Between 1995 and 2000, a stratified random sample of 36 034 participants (age range 35–74 years) completed a standardized 24-h dietary recall, assessed by means of the computer software EPIC-SOFT. Lipid intake data were calculated using a standardized nutrient database.

Results:

On average, the contribution of fat to total energy intake was ⩾34% of energy intake (%en) in women and ⩾36%en in men for most EPIC centres, except for the British, Dutch and most Italian cohorts. Total fat (>40%en) and MUFA intakes (21%en, mainly from olive oil) were highest in Greece. Except for the Greek, Spanish and Italian centres, the average MUFA intake ranged between 10 and 13%en, with a high proportion derived from animal sources. SFA intake in women and men was lowest in the Greek, Spanish, Italian and UK cohorts with an average of ⩽13%en (down to 9%en), and highest in the Swedish centres (16%en). The mean PUFA intake was in the range of 4–8%en, being highest in the UK health-conscious cohort. The average cholesterol intake across EPIC varied from 140 to 384 mg/d in women and 215–583 mg/d in men.

Conclusions:

The presented data show differences and similarities in lipid intake across the European EPIC cohorts and also show differences in food sources of dietary lipids.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  • Bingham SA, Day N (2006). Commentary. Fat and breast cancer: time to re-evaluate both methods and results? Int J Epidemiol 35, 1022–1024.

    Article  Google Scholar 

  • Boeing H, Korfmann A, Bergmann MM (1999). Recruitment procedures of EPIC-Germany. Ann Nutr Metab 43, 205–215.

    Article  CAS  Google Scholar 

  • Boynton A, Neuhouser ML, Sorensen B, McTiernan A, Ulrich CM (2008). Predictors of diet quality among overweight and obese postmenopausal women. J Am Diet Assoc 108, 125–130.

    Article  Google Scholar 

  • Brunner EJ, Rees K, Ward K, Burke M, Thorogood M (2007). Dietary advice for reducing cardiovascular risk. Cochrane Database Syst Rev (online) Issue 4, Article no. CD002128.

  • Brustad M, Skeie G, Braaten T, Slimani N, Lund E (2003). Comparison of telephone vs face-to-face interviews in the assessment of dietary intake by the 24 h recall EPIC SOFT program--the Norwegian calibration study. Eur J Clin Nutr 57, 107–113.

    Article  CAS  Google Scholar 

  • Chajès V, Thiébaut AC, Rotival M, Gauthier E, Maillard V, Boutron-Ruault MC et al. (2008). Association between serum trans-monounsaturated fatty acids and breast cancer risk in the E3N-EPIC Study. Am J Epidemiol 167, 1312–1320.

    Article  Google Scholar 

  • Department of Health (1991). Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. Report on Health and Social Subjects 41 HMSO: London.

  • DGE (Deutsche Gesellschaft für Ernährung) (2000). Referenzwerte für die Nährstoffzufuhr. Umschau Braus GmbH: Frankfurt am Main.

  • Elmadfa I, Weichselbaum E (eds). (2005). European Nutrition and Health Report 2004. Forum of Nutrition, vol. 58, Karger: Basel.

    Book  Google Scholar 

  • EURODIET (2000). Nutrition and Diet for Healthy Lifestyles in Europe. Science and Policy Implications. Core report (http://ec.europa.eu/health/ph_determinants/life_style/nutrition/report01_en.pdf), co-ordinated by the University of Crete, School of Medicine.

  • Ferrari P, Kaaks R, Fahey MT, Slimani N, Day NE, Pera G et al. (2004). Within- and between-cohort variation in measured macronutrient intakes, taking account of measurement errors, in the European Prospective Investigation into Cancer and Nutrition study. Am J Epidemiol 160, 814–822.

    Article  Google Scholar 

  • Ferrari P, Slimani N, Ciampi A, Trichopoulou A, Naska A, Lauria C et al. (2002). Evaluation of under- and overreporting of energy intake in the 24-h diet recalls in the European Prospective Investigation into Cancer and Nutrition (EPIC). Public Health Nutr 5 (Suppl), S1329–S1345.

    Article  Google Scholar 

  • Food and Nutrition Board, Institute of Medicine (2005). Macronutrients and healthful diets. In: Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. The National Academies Press: Washington DC, pp 769–879.

  • Giskes K, Lenthe Fv F, Brug HJ, Mackenbach J (2004). Dietary intakes of adults in the Netherlands by childhood and adulthood socioeconomic position. Eur J Clin Nutr 58, 871–880.

    Article  CAS  Google Scholar 

  • Grundy SM (2007). Cardiovascular and metabolic risk factors: how can we improve outcomes in the high-risk patient? Am J Med 120 (Suppl 1), S3–S8.

    Article  Google Scholar 

  • Haftenberger M, Lahmann PH, Panico S, Gonzalez CA, Seidell JC, Boeing H et al. (2002a). Overweight, obesity and fat distribution in 50- to 64-year-old participants in the European Prospective Investigation into Cancer and Nutrition (EPIC). Public Health Nutr 5 (Suppl), S1147–S1162.

    Article  Google Scholar 

  • Haftenberger M, Schuit AJ, Tormo MJ, Boeing H, Wareham N, Bueno-de-Mesquita HB et al. (2002b). Physical activity of subjects aged 50–64 years involved in the European Prospective Investigation into Cancer and Nutrition (EPIC). Public Health Nutr 5 (Suppl), S1163–S1176.

    Article  Google Scholar 

  • Helsing E (1993). Trends in fat consumption in Europe and their influence on the Mediterranean diet. Eur J Clin Nutr 47 (Suppl 1), S4–S12.

    PubMed  Google Scholar 

  • Hjartåker A, Lagiou A, Slimani N, Lund E, Chirlaque MD, Vasilopoulou E et al. (2002). Consumption of dairy products in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort: data from 35 955 24-h dietary recalls in 10 European countries. Public Health Nutr 5 (6B), 1259–1271.

    Article  Google Scholar 

  • Howard BV, Manson JE, Stefanick ML, Beresford SA, Frank G, Jones B et al. (2006). Low-fat dietary pattern and weight change over 7 years. The women's health initiative dietary modification trial. J Am Med Assoc 295, 39–49.

    Article  CAS  Google Scholar 

  • Kaaks R, Plummer M, Riboli E, Esteve J, van Staveren W (1994). Adjustment for bias due to errors in exposure assessments in multicenter cohort studies on diet and cancer: a calibration approach. Am J Clin Nutr 59 (Suppl), S245–S250.

    Article  Google Scholar 

  • Kaaks R, Riboli E, van Staveren W (1995). Calibration of dietary intake measurements in prospective cohort studies. Am J Epidemiol 142, 548–556.

    Article  CAS  Google Scholar 

  • Lallukka T, Laaksonen M, Rahkonen O, Roos E, Lahelma E (2007). Multiple socio-economic circumstances and healthy food habits. Eur J Clin Nutr 61, 701–710.

    Article  CAS  Google Scholar 

  • Linseisen J, Bergström E, Gafá L, Gonzalez C, Thiébaut A, Trichopoulou A et al. (2002a). Consumption of added fats and oils in the European Prospective Investigation into Cancer and Nutrition (EPIC) centres across 10 European countries as assessed by 24-h recalls. Public Health Nutr 5 (6B), 1227–1242.

    Article  CAS  Google Scholar 

  • Linseisen J, Kesse E, Slimani N, Bueno-de-Mesquita HB, Ocké MC, Skeie G et al. (2002b). Meat consumption in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts—results from the 24-h dietary recalls. Public Health Nutr 5 (6B), 1243–1258.

    Article  CAS  Google Scholar 

  • Linseisen J, Schulze MB, Kroke A, Boeing H, Miller AB (2003). Quantity and quality of dietary fat, carbohydrate, and fiber intake in the German EPIC cohorts. Ann Nutr Metab 47, 37–46.

    Article  CAS  Google Scholar 

  • Mead A, Atkinson G, Albin D, Alphey D, Baic S, Boyd O et al. (2006). Dietetic guidelines on food and nutrition in the secondary prevention of cardiovascular disease—evidence from systematic reviews of randomized controlled trials (second update, January 2006). J Hum Nutr Diet 19, 401–419.

    Article  CAS  Google Scholar 

  • Riboli E, Hunt KJ, Slimani N, Ferrari P, Norat T, Fahey M et al. (2002). European Prospective Investigation into Cancer and Nutrition (EPIC): study populations and data collection. Public Health Nutr 5 (Suppl), S1113–S1124.

    Article  Google Scholar 

  • Riboli E, Kaaks R (1997). The EPIC Project: rationale and study design. Int J Epidemiol 26 (Suppl 1), S6–S14.

    Article  Google Scholar 

  • Saadatian-Elahi M, Slimani N, Chajès V, Jenab M, Goudable J, Biessy C et al. (2009). Plasma phospholipid fatty acid profiles and their association with food intakes: results from a cross-sectional study within the European Prospective Investigation into Cancer and Nutrition (EPIC). Am J Clin Nutr 89, 331–346.

    Article  CAS  Google Scholar 

  • Sandström B, Lyhne N, Pedersen JI, Aro A, Thorsdottir I, Becker W (1996). Nordic Nutrition Recommendations 1996. Scand J Nutr/ Näringsforskning 40, 161–165.

    Google Scholar 

  • Slimani N, Deharveng G, Charrondiere RU, van Kappel AL, Ocke MC, Welch A et al. (1999). Structure of the standardized computerized 24-h diet recall interview used as reference method in the 22 centers participating in the EPIC project. European Prospective Investigation into Cancer and Nutrition. Comput Methods Programs Biomed 58, 251–266.

    Article  CAS  Google Scholar 

  • Slimani N, Deharveng G, Unwin I, Southgate DA, Vignat J, Skeie G et al. (2007). The EPIC nutrient database project (ENDB): a first attempt to standardize nutrient databases across the 10 European countries participating in the EPIC study. Eur J Clin Nutr 61, 1037–1056.

    Article  CAS  Google Scholar 

  • Slimani N, Fahey M, Welch AA, Wirfalt E, Stripp C, Bergstrom E et al. (2002b). Diversity of dietary patterns observed in the European Prospective Investigation into Cancer and Nutrition (EPIC) project. Public Health Nutr 5 (Suppl), S1311–S1328.

    Article  Google Scholar 

  • Slimani N, Ferrari P, Ocke M, Welch A, Boeing H, Liere M et al. (2000). Standardization of the 24-h diet recall calibration method used in the European Prospective Investigation into Cancer and Nutrition (EPIC): general concepts and preliminary results. Eur J Clin Nutr 54, 900–917.

    Article  CAS  Google Scholar 

  • Slimani N, Kaaks R, Ferrari P, Casagrande C, Clavel-Chapelon F, Lotze G et al. (2002a). European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study: rationale, design and population characteristics. Public Health Nutr 5 (Suppl), S1125–S1145.

    Article  Google Scholar 

  • Spiegelman D (2004). Commentary: correlated errors and energy adjustment-where are the data? Int J Epidemiol 33, 1387–1388.

    Article  Google Scholar 

  • Thiébaut AC, Kipnis V, Chang SC, Subar AF, Thompson FE, Rosenberg PS et al. (2007). Dietary fat and postmenopausal invasive breast cancer in the National Institutes of Health-AARP Diet and Health Study cohort. J Natl Cancer Inst 99, 451–462.

    Article  Google Scholar 

  • WCRF/AICR (2007). Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective. World Cancer Research Fund/American Institute for Cancer Research: Washington DC.

  • Welch AA, Lund E, Amiano P, Dorronsoro M, Brustad M, Kumle M et al. (2002). Variability of fish consumption within the 10 European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Public Health Nutr 5 (Suppl), S1273–S1285.

    Article  Google Scholar 

  • WHO/FAO (2003). Diet, Nutrition and the Prevention of Chronic Diseases (Report of a Joint WHO/FAO Expert Consultation). WHO Technical Report Series 916 World Health Organization: Geneva.

  • Willett W (1998). Nutritional Epidemiology, 2nd edn. Oxford University Press: New York.

    Book  Google Scholar 

Download references

Acknowledgements

The work described in the paper was carried out with the financial support of the European Commission: Public Health and Consumer Protection Directorate 1993–2004; Research Directorate-General 2005; Ligue contre le Cancer (France); Société 3M (France); Mutuelle Générale de l’Education Nationale; Institut National de la Santé et de la Recherche Médicale (INSERM); Institut Gustave Roussy; German Cancer Aid; German Cancer Research Center; German Federal Ministry of Education and Research; Danish Cancer Society; Health Research Fund (FIS) of the Spanish Ministry of Health; Spanish Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra and the Catalan Institute of Oncology; and ISCIII RETIC (RD06/0020), Spain; Cancer Research UK; Medical Research Council, UK; the Stroke Association, UK; British Heart Foundation; Department of Health, UK; Food Standards Agency, UK; the Wellcome Trust, UK; Greek Ministry of Health; Hellenic Health Foundation; Italian Association for Research on Cancer; Italian National Research Council, Regione Sicilia (Sicilian government); Associazione Iblea per la Ricerca Epidemiologica—ONLUS (Hyblean association for epidemiological research, NPO); Dutch Ministry of Health, Welfare and Sport; Dutch Prevention Funds; LK Research Funds; Dutch ZON (Zorg Onderzoek Nederland); World Cancer Research Fund (WCRF); Swedish Cancer Society; Swedish Research Council; Regional Government of Skane and the County Council of Vasterbotten, Sweden; Norwegian Cancer Society; the Norwegian Research Council and the Norwegian Foundation for Health and Rehabilitation. We thank Sarah Somerville, Nicole Suty and Karima Abdedayem for assistance with editing and Kimberley Bouckaert and Heinz Freisling for technical assistance.

Author information

Author notes

  1. J Linseisen

    Present address: 27Current address: Institute of Epidemiology, Helmholtz Centre Munich, Neuherberg, Germany.,

  2. A A Welch

    Present address: 28Current address: School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK.,

  3. P Ferrari

    Present address: 29Current address: Data Collection and Exposure Unit (DATEX), European Food Safety Authority, Parma, Italy.,

  4. The author is deceased.

  5. AFSSA (French Food Safety Agency), DERNS/PASER, Maisons-Alfort, France

Authors and Affiliations

  1. Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany

    J Linseisen & R Kaaks

  2. Department of Public Health and Primary Care, MRC Centre for Nutritional Epidemiology in Cancer Prevention and Survival, University of Cambridge, Cambridge, UK

    A A Welch & S Bingham

  3. National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands

    M Ocké & H B Bueno-de-Mesquita

  4. Public Health Department of Gipuzkoa, Basque Government, San Sebastian and CIBER Epidemiología y Salud Pública (CIBERESP), Spain

    P Amiano & M Dorronsoro

  5. Department of Preventive & Predictive Medicine, Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy

    C Agnoli

  6. Dietary Exposure Assessment Group, International Agency for Research on Cancer, Lyon, France

    P Ferrari, V Chajès & N Slimani

  7. Department of Clinical Sciences, Lund University, Malmö, Sweden

    E Sonestedt

  8. Institut Gustave Roussy, CNRS FRE 2939, Villejuif, France

    V Chajès

  9. Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany

    C Weikert

  10. Public Health and Participation Directorate, Health and Health Care Services Council, Asturias, Spain

    L Rodríguez

  11. Molecular and Nutritional Epidemiology Unit, ISPO, Florence, Italy

    I Ermini

  12. Department of Clinical and Experimental Medicine, University of Naples, Federico II, Naples

    A Mattiello

  13. Italy,

    A Mattiello

  14. Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands

    Y T van der Schouw

  15. Department of Surgery, Malmö University Hospital, Malmö, Sweden

    J Manjer

  16. Department of Nutritional Research, University of Umeå, Umeå, Sweden

    S Nilsson

  17. Lifestyle and Cancer Group, International Agency for Research on Cancer, Lyon, France

    M Jenab

  18. Institute of Community Medicine, University of Tromsø, Tromsø, Norway

    E Lund & M Brustad

  19. Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark

    J Halkjær

  20. Department of Clinical Epidemiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark

    M U Jakobsen

  21. University of Cambridge School of Clinical Medicine, Addenbrookes Hospital, Cambridge, UK

    K T Khaw

  22. Cancer Epidemiology Unit, University of Oxford, Oxford, UK

    F Crowe

  23. Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece

    C Georgila & G Misirli

  24. Inserm, ERI 20, Institut Gustave Roussy, Villejuif, France

    M Niravong & M Touvier

  25. Diet and Cancer Group, MRC Mitochondrial Biology Unit,, Cambridge, UK

    M Touvier & S Bingham

  26. Department of Epidemiology, Public Health and Primary Care, Imperial College, London, UK

    E Riboli

Authors
  1. J Linseisen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A A Welch
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M Ocké
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P Amiano
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. C Agnoli
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. P Ferrari
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. E Sonestedt
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. V Chajès
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. H B Bueno-de-Mesquita
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. R Kaaks
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. C Weikert
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. M Dorronsoro
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. L Rodríguez
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. I Ermini
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. A Mattiello
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Y T van der Schouw
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. J Manjer
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. S Nilsson
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. M Jenab
    View author publications

    You can also search for this author in PubMed Google Scholar

  20. E Lund
    View author publications

    You can also search for this author in PubMed Google Scholar

  21. M Brustad
    View author publications

    You can also search for this author in PubMed Google Scholar

  22. J Halkjær
    View author publications

    You can also search for this author in PubMed Google Scholar

  23. M U Jakobsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  24. K T Khaw
    View author publications

    You can also search for this author in PubMed Google Scholar

  25. F Crowe
    View author publications

    You can also search for this author in PubMed Google Scholar

  26. C Georgila
    View author publications

    You can also search for this author in PubMed Google Scholar

  27. G Misirli
    View author publications

    You can also search for this author in PubMed Google Scholar

  28. M Niravong
    View author publications

    You can also search for this author in PubMed Google Scholar

  29. M Touvier
    View author publications

    You can also search for this author in PubMed Google Scholar

  30. S Bingham
    View author publications

    You can also search for this author in PubMed Google Scholar

  31. E Riboli
    View author publications

    You can also search for this author in PubMed Google Scholar

  32. N Slimani
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J Linseisen.

Additional information

Guarantor: J Linseisen.

Contributors: JL carried out the statistical analyses, prepared the tables and figures, and wrote the paper, taking into account comments from all co-authors. NS was the overall coordinator of this project and the EPIC nutritional databases (ENDB) project. AW, MO, PA, CA, PF, ES, VC, and HB B-d-M were members of the ‘working group on fat intake’ and gave inputs on the statistical analysis, drafting of the paper and interpretation of the results. RK, CW, MD, LR, IE, AM, YTvdS, JM, SN, MJ, EL, MB, JH, MUJ, KTK, FC, CG, GM, MN, MT, SB were local EPIC collaborators involved in the collection of data and in documenting, compiling and evaluating the subset of their national nutrient databases used in the ENDB. ER is the overall coordinator of the EPIC study. All co-authors provided comments and suggestions on the paper and approved the final version.

Appendix

Appendix

Tables A1, A2, A3, A4 and A5

Table a1 Minimally adjusteda mean daily intake of total fat (g/d) by centre ordered from south to north, gender and age group
Full size table
Table a2 Minimally adjusteda mean daily intake of saturated fatty acids (g/d) by centre ordered from south to north, gender and age group
Full size table
Table a3 Minimally adjusteda mean daily intake of monounsaturated fatty acids (g/d) by centre ordered from south to north, gender and age group
Full size table
Table a4 Minimally adjusteda mean daily intake of polyunsaturated fatty acids (g/d) by centre ordered from south to north, gender and age group
Full size table
Table a5 Minimally adjusteda mean daily intake of cholesterol (mg/d) by centre ordered from south to north, gender and age group
Full size table

Rights and permissions

Reprints and permissions

About this article

Cite this article

Linseisen, J., Welch, A., Ocké, M. et al. Dietary fat intake in the European Prospective Investigation into Cancer and Nutrition: results from the 24-h dietary recalls. Eur J Clin Nutr 63 (Suppl 4), S61–S80 (2009). https://doi.org/10.1038/ejcn.2009.75

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ejcn.2009.75

Keywords

This article is cited by

Search

Advanced search

Quick links