Public Health Nutrition

Research Article

Patterns of alcohol consumption in 10 European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) project

S Sieria1 c1, A Agudoa2, E Kessea3, K Klipstein-Grobuscha4, B San-Joséa5, AA Welcha6, V Krogha1, R Lubena5, N Allena7, K Overvada8, A Tjønnelanda9, F Clavel-Chapelona3, A Thiébauta3, AB Millera10, H Boeinga4, M Kolyvaa5, C Saievaa11, E Celentanoa12, MC Ockéa13, PHM Peetersa14, M Brustada15, M Kumlea15, M Dorronsoroa16, A Fernandez Feitoa17, I Mattissona18, L Weinehalla19, E Ribolia20 and N Slimania20

a1 Epidemiology Unit, National Cancer Institute, Via Venezian 1, 20133 Milan, Italy

a2 Catalan Institute of Oncology, Barcelona, Spain

a3 Institute Gustave Roussy, Villejuif, France

a4 Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany

a5 University of Athens, Greece

a6 Institute of Public Health, University of Cambridge, UK

a7 Cancer Research UK, Epidemiology Unit, University of Oxford, UK

a8 Department of Epidemiology and Social Medicine, University of Aarhus, Denmark

a9 Institute of Cancer Epidemiology, Copenhagen, Denmark

a10 Division of Clinical Epidemiology, German Cancer Research Centre, Heidelberg, Germany

a11 Molecular and Nutritional Epidemiology Unit, CSPO, Scientific Institute of Tuscany, Florence, Italy

a12 Epidemiology Unit, National Cancer Institute, Naples, Italy

a13 Department for Chronic Diseases Epidemiology, National Institute for Public Health and the Environment, Bilthoven, The Netherlands

a14 Julius Center for General Practice and Patient Oriented Research, Utrecht, The Netherlands

a15 Institute of Community Medicine, University of Tromsø, Norway

a16 Public Health Division of Gipuzkoa, Department of Health of Basque Government, San Sebastian, Spain

a17 Public Health Directorate, Health Council and Health Services Asturias, Oviedo, Spain

a18 Department of Medicine, Surgery and Orthopaedics, Lund University, Malmö, Sweden

a19 Epidemiology and Nutritional Research, Department of Public Health and Clinical Medicine, Umeå University, Sweden

a20 International Agency for Research on Cancer, Lyon, France


bjective: The aim of this study was to compare the quantities of alcohol and types of alcoholic beverages consumed, and the timing of consumption, in centres participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). These centres, in 10 European countries, are characterised by widely differing drinking habits and frequencies of alcohol-related diseases.

Methods: We collected a single standardised 24-hour dietary recall per subject from a random sample of the EPIC cohort (36 900 persons initially and 35 955 after exclusion of subjects under 35 and over 74 years of age). This provided detailed information on the distribution of alcohol consumption during the day in relation to main meals, and was used to determine weekly consumption patterns. The crude and adjusted (by age, day of week and season) means of total ethanol consumption and consumption according to type of beverage were stratified by centre and sex.

Results: Sex was a strong determinant of drinking patterns in all 10 countries. The highest total alcohol consumption was observed in the Spanish centres (San Sebastian, 41.4 g day−1) for men and in Danish centres (Copenhagen, 20.9 g day−1) for women. The lowest total alcohol intake was in the Swedish centres (Umeå, 10.2 g day−1) in men and in Greek women (3.4 g day−1). Among men, the main contributor to total alcohol intake was wine in Mediterranean countries and beer in the Dutch, German, Swedish and Danish centres. In most centres, the main source of alcohol for women was wine except for Murcia (Spain), where it was beer. Alcohol consumption, particularly by women, increased markedly during the weekend in nearly all centres. The German, Dutch, UK (general population) and Danish centres were characterised by the highest percentages of alcohol consumption outside mealtimes.

Conclusions: The large variation in drinking patterns among the EPIC centres provides an opportunity to better understand the relationship between alcohol and alcohol-related diseases.


c1 *Corresponding author: Email