Public Health Nutrition

Research Article

Consumption of vegetables, fruit and other plant foods in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts from 10 European countries

A Agudoa1 c1, N Slimania2, MC Ockéa3, A Naskaa4, AB Millera5, A Krokea6, C Bamiaa4, D Karalisa4, P Vineisa7, D Pallia8, HB Bueno-de-Mesquitaa3, PHM Peetersa9, D Engeseta10, A Hjartåkera11, C Navarroa12, C Martínez Garciaa13, P Wallströma14, JX Zhanga15, AA Welcha16, E Spencera17, C Strippa18, K Overvada19, F Clavel-Chapelona20, C Casagrandea2 and E Ribolia2

a1 Department of Epidemiology, Catalan Institute of Oncology (ICO), 08907 L'Hospitalet de Llobregat, Barcelona, Spain

a2 International Agency for Research on Cancer, Lyon, France

a3 National Institute for Public Health and the Environment, Bilthoven, The Netherlands

a4 School of Medicine, University of Athens, Greece

a5 German Cancer Research Centre, Heidelberg, Germany

a6 German Institute of Human Nutrition, Postdam-Rehbrücke, Germany

a7 Cancer Epidemiology Unit, University of Turin, Italy

a8 Molecular and Nutritional Epidemiology Unit, CSPO, Scientific Institute of Tuscany, Florence, Italy

a9 Julius Center for General Practice and Patient Oriented Research, University of Utrecht, The Netherlands

a10 Institute of Community Medicine, University of Tromsø, Norway

a11 Institute for Basic Medical Sciences, Oslo, Norway

a12 Department of Epidemiology, Health Council of Murcia, Spain

a13 Andalusian School of Public Health, Granada, Spain

a14 Department of Medicine, Lund University, Malmö University Hospital, Sweden

a15 Nutritional Research, Department of Public Health and Clinical Medicine, University of Umeå, Sweden

a16 Institute of Public Health, School of Clinical Medicine, University of Cambridge, UK

a17 Cancer Research UK, Epidemiology Unit, University of Oxford, UK

a18 Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark

a19 Institute of Epidemiology and Social Medicine, University of Aarhus, Denmark

a20 INSERM, U521, Institute Gustave Roussy, Villejuif, France


Objective: To describe and compare the consumption of the main groups and sub-groups of vegetables and fruits (V&F) in men and women from the centres participating in the European Prospective Investigation into Cancer and Nutrition (EPIC).

Design: Cross-sectional analysis. Dietary intake was assessed by means of a 24-hour dietary recall using computerised interview software and standardised procedures. Crude and adjusted means were computed for the main groups and sub-groups of V&F by centre, separately for men and women. Adjusted means by season, day of the week and age were estimated using weights and covariance analysis.

Setting: Twenty-seven centres in 10 European countries participating in the EPIC project.

Subjects: In total, 35 955 subjects (13 031 men and 22 924 women), aged 35–74 years, randomly selected from each EPIC cohort.

Results: The centres from southern countries had the highest consumption of V&F, while the lowest intake was seen in The Netherlands and Scandinavia for both genders. These differences were more evident for fruits, particularly citrus. However, slightly different patterns arose for some sub-groups of vegetables, such as root vegetables and cabbage. Adjustment for body mass index, physical activity, smoking habits and education did not substantially modify the mean intakes of vegetables and fruits.

Conclusions: Total vegetable and fruit intake follows a south–north gradient in both genders, whereas for several sub-groups of vegetables a different geographic distribution exists. Differences in mean intake of V&F by centre were not explained by lifestyle factors associated with V&F intake.


c1 *Corresponding author: Email