Public Health Nutrition

Research Article

Variability of fish consumption within the 10 European countries participating in the European Investigation into Cancer and Nutrition (EPIC) study

AA Welcha1 c1, E Lunda2, P Amianoa3, M Dorronsoroa3, M Brustada2, M Kumlea2, M Rodrigueza4, C Lasherasa5, L Janzona6, J Janssona7, R Lubena1, EA Spencera8, K Overvada9, A Tjønnelanda10, F Clavel-Chapelona11, J Linseisena12, K Klipstein-Grobuscha13, V Benetoua14, X Zavitsanosa14, R Tuminoa15, R Galassoa16, HB Bueno-de-Mesquitaa17, MC Ockéa17, UR Charrondièrea18 and N Slimania18

a1 Strangeways Research Laboratory, Department of Public Health and Primary Care, University of Cambridge, Wort's Causeway, Cambridge CB1 8RN, UK

a2 Institute of Community Medicine, University of Tromsø, Norway

a3 Public Health Division of Gipuzkoa, Department of Health of the Basque Government, San Sebastian, Spain.

a4 Granada Cancer Registry, Andalusian School of Public Health, Granada, Spain

a5 Department of Functional Biology, Faculty of Medicine, University of Oviedo, Spain

a6 Department of Community Medicine, Malmö University Hospital, Sweden

a7 Reseach Centre for Endocrinology and Metabolism, Sahlgrenska University Hospital, Göteborg, Sweden

a8 Cancer Research UK, Epidemiology Unit, University of Oxford, UK

a9 Department of Epidemiology and Social Medicine, University of Aarhus, Denmark

a10 Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark

a11 INSERM, E3N–EPIC Group, Institute Gustave Roussy, Villejuif, France

a12 Division of Clinical Epidemiology, German Cancer Research Centre, Heidelberg, Germany

a13 Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany

a14 Department of Hygiene and Epidemiology, School of Medicine, University of Athens, Greece

a15 Cancer Registry, ‘Civile – M.P. Arezzo’ Hospital, Ragusa, Italy

a16 Institute of Internal Medicine and Metabolic Diseases, University of Naples, Italy

a17 Department of Chronic Diseases Epidemiology, National Institute for Public Health and the Environment, Bilthoven, The, Netherlands

a18 International Agency for Research on Cancer, Lyon, France


Objective: To describe and compare the consumption of total fish (marine foods) and the fish sub-groups – white fish, fatty fish, very fatty fish, fish products and crustacea, in participants from the European Investigation into Cancer and Nutrition (EPIC) study.

Design: Cross-sectional analysis of dietary intake using a computerised standardised 24-hour recall interview. Crude means, means and standard errors adjusted by age, season and day of the week were calculated, stratified by centre and gender.

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

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

Results: A six- to sevenfold variation in total fish consumption exists in women and men, between the lowest consumption in Germany and the highest in Spain. Overall, white fish represented 49% and 45% of the intake of total fish in women and men, respectively, with the greatest consumption in centres in Spain and Greece and the least in the German and Dutch centres. Consumption of fatty fish reflected that of total fish. However, the greatest intake of very fatty fish was in the coastal areas of northern Europe (Denmark, Sweden and Norway) and in Germany. Consumption of fish products was greater in northern than in southern Europe, with white fish products predominating in centres in France, Italy, Spain, The Netherlands and Norway. Intake of roe and roe products was low. The highest consumption of crustacea was found in the French, Spanish and Italian centres. The number of fish types consumed was greater in southern than in northern Europe. The greatest variability in consumption by day of the week was found in the countries with the lowest fish intake.

Conclusions: Throughout Europe, substantial geographic variation exists in total fish intake, fish sub-groups and the number of types consumed. Day-to-day variability in consumption is also high.


c1 *Corresponding author: Email