Public Health Nutrition

Research Article

Diversity of dietary patterns observed in the European Prospective Investigation into Cancer and Nutrition (EPIC) project

N Slimania1 c1, M Faheya1, A Welcha2, E Wirfälta3, C Strippa4, E Bergströma5, J Linseisena6, MB Schulzea7, C Bamiaa8, Y Chloptsiosa8, F Vegliaa9, S Panicoa10, HB Bueno-de-Mesquitaa11, MC Ockéa11, M Brustada12, E Lunda12, CA Gonzáleza13, A Barcosa14, G Berglunda3, A Winkvista5, A Mulligana2, P Applebya15, K Overvada16, A Tjønnelanda17, F Clavel-Chapelona18, E Kessea18, P Ferraria1, WA Van Staverena19 and E Ribolia1

a1 Unit of Nutrition and Cancer, International Agency for Research on Cancer, 150 cours Albert-Thomas, 69372 Lyon Cedex 08, France

a2 Institute of Public Health, University of Cambridge, UK

a3 Department of Medicine, Surgery and Orthopaedics, Lund University, University Hospital Malmö, Sweden

a4 Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark

a5 Epidemiology, Department of Public Health and Clinical Medicine, Umeå University, Sweden

a6 Division of Clinical Epidemiology, German Cancer Research Centre, Heidelberg, Germany

a7 German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany

a8 Department of Hygiene and Epidemiology, School of Medicine, University of Athens, Greece

a9 Institute for Scientific Interchange Foundation, Turin, Italy

a10 Department of Clinical and Experimental Medicine, University Federico II, Naples, Italy

a11 Department of Chronic Diseases Epidemiology, National Institute for Public Health and the Environment, Bilthoven, The Netherlands

a12 Institute of Community Medicine, University of Tromsø, Norway

a13 Department of Epidemiology, Catalan Institute of Oncology, Barcelona, Spain

a14 Service of Surveillance and Epidemiological Control, Institute of Public Health of Navarra, Pamplona, Spain

a15 Cancer Research UK, Epidemiology Unit, University of Oxford, UK

a16 Institute of Epidemiology and Social Medicine, University of Aarhus, Denmark

a17 17Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark

a18 INSERM, U521, Institute Gustave Roussy, Villejuif, France

a19 Department of Human Nutrition and Epidemiology, Wageningen Agricultural University, The Netherlands


Objective: To describe the diversity in dietary patterns existing across centres/regions participating in the European Prospective Investigation into Cancer and Nutrition (EPIC).

Design and setting: Single 24-hour dietary recall measurements were obtained by means of standardised face-to-face interviews using the EPIC-SOFT software. These have been used to present a graphic multi-dimensional comparison of the adjusted mean consumption of 22 food groups.

Subjects: In total, 35 955 men and women, aged 35–74 years, participating in the EPIC nested calibration study.

Results: Although wide differences were observed across centres, the countries participating in EPIC are characterised by specific dietary patterns. Overall, Italy and Greece have a dietary pattern characterised by plant foods (except potatoes) and a lower consumption of animal and processed foods, compared with the other EPIC countries. France and particularly Spain have more heterogeneous dietary patterns, with a relatively high consumption of both plant foods and animal products. Apart from characteristics specific to vegetarian groups, the UK ‘health-conscious’ group shares with the UK general population a relatively high consumption of tea, sauces, cakes, soft drinks (women), margarine and butter. In contrast, the diet in the Nordic countries, The Netherlands, Germany and the UK general population is relatively high in potatoes and animal, processed and sweetened/refined foods, with proportions varying across countries/centres. In these countries, consumption of vegetables and fruit is similar to, or below, the overall EPIC means, and is low for legumes and vegetable oils. Overall, dietary patterns were similar for men and women, although there were large gender differences for certain food groups.

Conclusions: There are considerable differences in food group consumption and dietary patterns among the EPIC study populations. This large heterogeneity should be an advantage when investigating the relationship between diet and cancer and formulating new aetiological hypotheses related to dietary patterns and disease.


c1 *Corresponding author: Email