Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-23T06:13:04.169Z Has data issue: false hasContentIssue false
  • English
  • Français

Dietary patterns among older Europeans: the EPIC-Elderly study

Published online by Cambridge University Press:  08 March 2007

Christina Bamia ,
Philippos Orfanos ,
Pietro Ferrari ,
Kim Overvad ,
Heidi H. Hundborg ,
Anne Tjønneland ,
Anja Olsen ,
Emmanuelle Kesse ,
Marie-Christine Boutron-Ruault  and
Françoise Clavel-Chapelon
...Show all authors
Christina Bamia
Affiliation:
Department of Hygiene and Epidemiology, University of Athens Medical School, M. Asias 75, Athens 11527, Greece
Philippos Orfanos
Affiliation:
Department of Hygiene and Epidemiology, University of Athens Medical School, M. Asias 75, Athens 11527, Greece
Pietro Ferrari
Affiliation:
International Agency for Research on Cancer (IARC-WHO), Lyon Cedex 08, France
Kim Overvad
Affiliation:
Department of Clinical Epidemiology, Aalborg Hospital, Aarhus University Hospital, Denmark
Heidi H. Hundborg
Affiliation:
Department of Clinical Epidemiology, Aarhus University Hospital, Denmark
Anne Tjønneland
Affiliation:
Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
Anja Olsen
Affiliation:
Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
Emmanuelle Kesse
Affiliation:
Equipe E3N-EPIC, INSERM, Institut Gustave Roussy, Villejuif Cedex, Paris, France
Marie-Christine Boutron-Ruault
Affiliation:
Institut Scientifique et Technique de l'Alimentation et de la Nutrition, INSERM U557, CNAM 5, Paris, France
Françoise Clavel-Chapelon
Affiliation:
Equipe E3N-EPIC, INSERM, Institut Gustave Roussy, Villejuif Cedex, Paris, France
Gabriele Nagel
Affiliation:
Division of Clinical Epidemiology, German Cancer Research Center, Heidelberg, Germany
Paolo Boffetta
Affiliation:
International Agency for Research on Cancer (IARC-WHO), Lyon Cedex 08, France Division of Clinical Epidemiology, German Cancer Research Center, Heidelberg, Germany
Heiner Boeing
Affiliation:
Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany
Kurt Hoffmann
Affiliation:
Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany
Dimitrios Trichopoulos
Affiliation:
Department of Hygiene and Epidemiology, University of Athens Medical School, M. Asias 75, Athens 11527, Greece Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
Nikos Baibas
Affiliation:
Department of Hygiene and Epidemiology, University of Athens Medical School, M. Asias 75, Athens 11527, Greece
Theodora Psaltopoulou
Affiliation:
Department of Hygiene and Epidemiology, University of Athens Medical School, M. Asias 75, Athens 11527, Greece
Teresa Norat
Affiliation:
International Agency for Research on Cancer (IARC-WHO), Lyon Cedex 08, France
Nadia Slimani
Affiliation:
International Agency for Research on Cancer (IARC-WHO), Lyon Cedex 08, France
Domenico Palli
Affiliation:
Molecular and Nutritional Epidemiology Unit CSPO-Scientific Institute of Tuscany, Florence, Italy
Vittorio Krogh
Affiliation:
Epidemiology Unit, National Cancer Institute, Milan, Italy
Salvatore Panico
Affiliation:
Dipartimento di Medicina Clinica e Sperimentale Federico II University Naples, Italy
Rosario Tumino
Affiliation:
Cancer Registry, Azienda Ospedaliera "Civile M.P. Arezzo", Ragusa, Italy
Carlotta Sacerdote
Affiliation:
Unit of Cancer Epidemiology, Department of Biomedical Sciences and Human Oncology, University of Turin, Turin, Italy
H. B. Bueno-de-Mesquita
Affiliation:
Centre for Nutrition and Health, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
Marga C. Ocké
Affiliation:
Centre for Nutrition and Health, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
Petra H. Peeters
Affiliation:
Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
Caroline T. van Rossum
Affiliation:
Centre for Nutrition and Health, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
José-Ramón Quirós
Affiliation:
Dirección General de Salud Pública, Consejería de Salud y Servicios Sanitarios de Asturias, Oviedo, Spain
Maria-José Sánchez
Affiliation:
Andalusian School of Public Health, Granada Cancer Registry, Granada, Spain
Carmen Navarro
Affiliation:
Epidemiology Department, Murcia Health Council, Murcia, Spain
Aurelio Barricarte
Affiliation:
Public Health Institute, Navarra, Spain
Miren Dorronsoro
Affiliation:
Public Health Division of Gipuzkoa, Health Department of Basque Country, San Sebastian, Spain
Göran Berglund
Affiliation:
Department of Medicine, Surgery and Orthopaedics, Lund University, Malmö, Sweden
Elisabet Wirfält
Affiliation:
Department of Medicine, Surgery and Orthopaedics, Lund University, Malmö, Sweden
Göran Hallmans
Affiliation:
Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden
Ingegerd Johansson
Affiliation:
Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden
Sheila Bingham
Affiliation:
MRC Dunn Human Nutrition Unit, Cambridge, UK
Kay-Tee Khaw
Affiliation:
Institute of Public Health, University of Cambridge, Cambridge, UK
Elizabeth A. Spencer
Affiliation:
Cancer Research UK Epidemiology Unit, University of Oxford, Oxford, UK
Andrew W. Roddam
Affiliation:
Cancer Research UK Epidemiology Unit, University of Oxford, Oxford, UK
Elio Riboli
Affiliation:
International Agency for Research on Cancer (IARC-WHO), Lyon Cedex 08, France
Antonia Trichopoulou*
Affiliation:
Department of Hygiene and Epidemiology, University of Athens Medical School, M. Asias 75, Athens 11527, Greece
*
*Corresponding author: Professor Antonia Trichopoulou, fax +30 210 746 2079, email antonia@nut.uoa.gr
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Overall dietary patterns have been associated with health and longevity. We used principal component (PC) and cluster analyses to identify the prevailing dietary patterns of 99 744 participants, aged 60 years or older, living in nine European countries and participating in the European Prospective Investigation into Cancer and Nutrition (EPIC-Elderly cohort) and to examine their socio-demographic and lifestyle correlates. Two PC were identified: PC1 reflects a ‘vegetable-based’ diet with an emphasis on foods of plant origin, rice, pasta and other grain rather than on margarine, potatoes and non-alcoholic beverages. PC2 indicates a ‘sweet- and fat-dominated’ diet with a preference for sweets, added fat and dairy products but not meat, alcohol, bread and eggs. PC1 was associated with a younger age, a higher level of education, physical activity, a higher BMI, a lower waist:hip ratio and never and past smoking. PC2 was associated with older age, less education, never having smoked, a lower BMI and waist:hip ratio and lower levels of physical activity. Elderly individuals in southern Europe scored positively on PC1 and about zero on PC2, whereas the elderly in northern Europe scored negatively on PC1 and variably on PC2. The results of cluster analysis were compatible with the indicated dietary patterns. ‘Vegetable-based’ and a ‘sweet- and fat-dominated’ diets are prevalent among the elderly across Europe, and there is a north–south gradient regarding their dietary choices. Our study contributes to the identification of groups of elderly who are likely to have different prospects for long-term disease occurrence and survival.

Keywords

Dietary patternsElderlyCohort study
Type
Research Article
Information
British Journal of Nutrition , Volume 94 , Issue 1 , July 2005 , pp. 100 - 113
Copyright
Copyright © The Nutrition Society 2005

References

Balder, HF, Virtanen, M, Brants, HA, et al. (2003) Common and country-specific dietary patterns in four European cohort studies. J Nutr 133, 4246–4251.CrossRefGoogle ScholarPubMed
Chatfield, C & Collins, AJ (1995) Introduction to Multivariate Analysis [Chatfield, C and Zidek, JV, editors]. London: Chapman & Hall.Google Scholar
Costacou, T, Bamia, C, Ferrari, P, Riboli, E, Trichopoulos, D & Trichopoulou, A (2003) Tracing the Mediterranean diet through principal components and cluster analyses in the Greek population. Eur J Clin Nutr 57, 1378–1385.CrossRefGoogle ScholarPubMed
de Groot, LC, Van Staveren, WA & Burema, J (1996) Survival beyond age 70 in relation to diet. Nutr Rev 54, 211–212.CrossRefGoogle ScholarPubMed
Euronut–SENECA (1991) Nutrition and the elderly in Europe. 1st European Congress on Nutrition and Health in the Elderly. The Netherlands, December 1991. Eur J Clin Nutr 45, Suppl. 31–196.Google Scholar
Fung, TT, Rimm, EB, Spiegelman, D, Rifai, N, Tofler, GH, Willett, WC & Hu, FB (2001a) Association between dietary patterns and plasma biomarkers of obesity and cardiovascular disease risk. Am J Clin Nut 73, 61–67.CrossRefGoogle ScholarPubMed
Fung, TT, Willett, WC, Stampfer, MJ, Manson, JA & Hu, FB (2001b) Dietary patterns and the risk of coronary heart disease in women. Arch Intern Med 161, 1857–1862.CrossRefGoogle ScholarPubMed
Haines, PS, Siega-Riz, AM & Popkin, BM (1999) The Diet Quality Index revised: a measurement instrument for populations. J Am Diet Assoc 99, 697–704.CrossRefGoogle ScholarPubMed
Haveman-Nies, A, de Groot, LP & Van Staveren, WA (1998) Snack patterns of older Europeans. J Am Diet Assoc 98, 1297–1302.CrossRefGoogle ScholarPubMed
Haveman-Nies, A, Tucker, KL, de Groot, LC, Wilson, PW & Van Staveren, WA (2001) Evaluation of dietary quality in relationship to nutritional and lifestyle factors in elderly people of the US Framingham Heart Study and the European SENECA study. Eur J Clin Nut 55, 870–880.CrossRefGoogle ScholarPubMed
Hu, FB, Rimm, E & Smith-Warner, SA (1999) Reproducibility and validity of dietary patterns assessed with a food-frequency questionnaire. Am J Clin Nutr 69, 243–249.CrossRefGoogle ScholarPubMed
Hu, FB, Rimm, EB, Stampfer, MJ, Ascherio, A, Spiegelman, D & Willett, WC (2000) Prospective study of major dietary patterns and risk of coronary heart disease in men. Am J Clin Nutr 72, 912–921.CrossRefGoogle ScholarPubMed
Hu, FB & Willett, WC (2002) Optimal diets for prevention of coronary heart disease. JAMA 288, 2569–2578.CrossRefGoogle ScholarPubMed
Huijbregts, PP, Feskens, EJ & Kromhout, D (1995) Dietary patterns and cardiovascular risk factors in elderly men: the Zutphen Elderly Study. Int J Epidemiol 24, 313–320.CrossRefGoogle ScholarPubMed
Huijbregts, P, Feskens, E, Rasanen, L, Fidanza, F, Nissinen, A, Menotti, A & Kromhout, D (1997) Dietary pattern and 20 year mortality in elderly men in Finland, Italy, and the Netherlands: longitudinal cohort study. BMJ 315, 13–17.CrossRefGoogle ScholarPubMed
Kant, AK, Schatzkin, A, Graubard, BI & Schairer, C (2000) A prospective study of diet quality and mortality in women. JAMA 283, 2109–2115.CrossRefGoogle ScholarPubMed
Kennedy, ET, Ohls, J, Carlson, S & Fleming, K (1995) The Healthy Eating Index: design and applications. J Am Diet Assoc 95, 1103–1108.CrossRefGoogle ScholarPubMed
Key, TJ, Schatzkin, A, Willett, WC, Allen, NE, Spencer, EA & Travis, RC (2004) Diet nutrition and the prevention of cancer. Publ Health Nutr 7, 187–200.CrossRefGoogle ScholarPubMed
Kumagai, S, Shibata, H, Watanabe, S, Suzuki, T & Haga, H (1999) Effect of food intake pattern on all-cause mortality in the community elderly: a 7-year longitudinal study. J Nutr Health Aging 3, 29–33.Google ScholarPubMed
Lin, H, Bermudez, OI & Tucker, KL (2003) Dietary patterns of Hispanic elders are associated with acculturation and obesity. Nutrition 133, 3651–3657.Google ScholarPubMed
McCann, SE, Weiner, J, Graham, S & Freudenheim, JL (2001) Is principal components analysis necessary to characterise dietary behaviour in studies of diet and disease? Publ Health Nutr 4, 903–908.CrossRefGoogle ScholarPubMed
McCullough, ML, Feskanich, D, Stampfer, MJ, Giovannucci, EL, Rimm, EB, Hu, FB, Spiegelman, D, Hunter, DJ, Colditz, GA & Willett, WC (2002) Diet quality and major chronic disease risk in men and women: moving toward improved dietary guidance. Am J Clin Nutr 76, 1261–1271.CrossRefGoogle ScholarPubMed
Mann, JI (2002) Diet and risk of coronary heart disease and type 2 diabetes. Lancet 360, 783–789.CrossRefGoogle ScholarPubMed
Martinez, ME, Marshall, JR & Sechrest, L (1998) Invited commentary: factor analysis and the search for objectivity. Am J Epidemiol 148, 17–19.CrossRefGoogle ScholarPubMed
Martinez-Gonzalez, MA, Fernandez-Jarne, ESerrano-Martinez, MMarti, A, Martinez, JA & Martin-Moreno, JM (2002) Mediterranean diet and reduction in the risk of a first acute myocardial infarction: an operational healthy dietary score. Eur J Nutr 41, 153–160.CrossRefGoogle ScholarPubMed
Osler, M, Heitmann, BL, Gerdes, LU, Jørgensen, LM & Schroll, M (2001) Dietary patterns and mortality in Danish men and women: a prospective observational study. Br J Nutr 85, 219–225.CrossRefGoogle ScholarPubMed
Patterson, RE, Haines, PS & Popkin, BM (1994) Diet quality index: capturing a multidimensional behavior. J Am Diet Assoc 94, 57–64.CrossRefGoogle ScholarPubMed
Prevost, AT, Whichelow, MJ & Cox, BD (1997) Longitudinal dietary changes between 1984–5 and 1991–2 in British adults: association with socio-demographic, lifestyle and health factors. Br J Nutr 78, 873–888.CrossRefGoogle ScholarPubMed
Riboli, E, Hunt, KJ, Slimani, N, et al. (2002) European Prospective Investigation into Cancer and Nutrition (EPIC): study populations and data collection. Pubc Health Nutr 5, 1113–1124.CrossRefGoogle Scholar
SAS Institute Inc (1999) SAS/STAT User's Guide, Version 8. Cary, NC: SAS Institute, Inc.Google Scholar
Schroll, K, Carbajal, A, Decarli, B, Martins, I, Grunenberger, F, Blauw, YH & de Groot, CP (1996) Food patterns of elderly Europeans. SENECA Investigators. Eur J Clin Nutr 50, Suppl. 2, S86–S100.Google ScholarPubMed
Schulze, MB, Hoffmann, K, Kroke, A & Boeing, H (2001) Dietary patterns and their association with food and nutrient intake in the Prospective Investigation into Cancer and Nutrition (EPIC)-Postdam Study. Br J Nutr 85, 363–373.CrossRefGoogle Scholar
Sieri, S, Krogh, V, Pala, V, Muti, P, Micheli, A, Evangelista, A, Tagliabue, G & Berrino, F (2004) Dietary patterns and risk of breast cancer in the ORDET cohort. Cancer Epidemiol Biomarkers Prev 13, 567–572.CrossRefGoogle ScholarPubMed
Slattery, ML, Boucher, KM, Caan, BJ, Potter, JD & Ma, KN (1998) Eating patterns and risk of colon cancer. Am J Epidemiol 148, 4–16.CrossRefGoogle ScholarPubMed
Slimani, N, Fahey, M, Welch, AA, et al. (2002) Diversity of dietary patterns observed in the European Prospective Investigation into Cancer and Nutrition (EPIC) project. Publ Health Nutr 5, 1311–1328.CrossRefGoogle ScholarPubMed
Slimani, N, Kaaks, R, Ferrari, P, et al. (2002) European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study: rationale, design and population characteristics. Publ Health Nutr 5, 1125–1145.CrossRefGoogle ScholarPubMed
Srinath, Reddy K & Katan, MB (2004) Diet, nutrition and the prevention of hypertension and cardiovascular diseases. Pubc Health Nutr 7, 167–186.Google Scholar
Stata Corporation (1999) Intercooled Stata 6.0 for Windows 98/95/NT. Texas: Stata Corporation.Google Scholar
Terry, P, Hu, FB, Hansen, H & Wolk, A (2001) Prospective study of major dietary patterns and colorectal cancer risk in women. Am J Epidemiol 154, 1143–1149.CrossRefGoogle ScholarPubMed
Trichopoulos, D & Lagiou, P (2001) Dietary patterns and mortality. Br J Nutr 85, 133–134.CrossRefGoogle ScholarPubMed
Trichopoulou, A, Costacou, T, Bamia, C & Trichopoulos, D (2003) Adherence to Mediterranean diet and survival in a Greek population. N Engl J Med 348, 2599–2608.CrossRefGoogle Scholar
Trichopoulou, A, Kouris-Blazos, A, Wahlqvist, ML, Gnardellis, C, Lagiou, P, Polychronopoulos, E, Vassilakou, T, Lipworth, L & Trichopoulas, D (1995) Diet and overall survival in elderly people. BMJ 311, 1457–1460.CrossRefGoogle ScholarPubMed
Tucker, KL, Dallal, GE & Rush, D (1992) Dietary patterns of elderly Boston-area residents defined by cluster analysis. J Am Diet Assoc 92, 1487–1491.CrossRefGoogle ScholarPubMed
Willett, WC (1998) Diet and coronary heart disease Nutritional Epidemiology 2nd ed., pp. 414–466 [Willett, WC, editor]. New York: Oxford University Press.Google Scholar