EPIC is among the largest cohort studies, with approximately 475,000 study participants, on the etiological influence of diet and chronic diseases. During a 4-year recruitment period, two German EPIC centers, located in Heidelberg and Potsdam, aimed to recruit a total of 60,000 study participants from the local populations. The recruitment process was based on addresses from general population registries and started 4–5 weeks in advance with an initial invitation by mail to the basic examination for this study. Subjects not responding within 2 weeks were reminded. In Potsdam, this was done by mail and telephone, and in Heidelberg by telephone. During the recruitment phase, from 1994 to 1998, 53,162 subjects in total were examined for the cohort studies in Heidelberg (n = 25,546) and Potsdam (n = 27,616). The participation rate, compared to the invited number of subjects, was 22.7% in Potsdam and 38.3% in Heidelberg, with a considerable variation by municipality and gender. A comparison with data from the National Health Survey 1991/1992 revealed that the cohort populations were of higher socio-economic status and were healthier than the source population. We concluded that the selective participation would help to ensure high maintenance of the cohort during active follow-up. Selective participation does not harm etiological conclusions because disease associations are derived internally as relative risk. The relative risk estimates can be used to calculate population-attributable risk and preventable proportion, based on exposure prevalence derived by surveys and other studies.
In the baseline assessment of the two EPIC-Germany cohorts Heidelberg and Potsdam, dietary information was obtained with an identical food frequency questionnaire (FFQ). The optically readable FFQ was designed to assess the usual food and nutrient intake of individuals during the past 12 months. The present analysis was based on dietary data from 25,212 participants in Heidelberg (11,776 men, 13,436 women) and 26,270 participants in Potsdam (10,249 men, 16,021 women). This paper presents the first results of a descriptive dietary analysis on a food group level based on 16 food groups and selected subgroups. Each of these food groups and subgroups was divided into quintiles, and the age-adjusted mean intake for each quintile was calculated. The comparison of dietary habits between the two cohorts, as well as the comparison between men and women within each cohort showed clear differences both in the quintiles of most food groups as well as in the range between the lowest and highest quintile. Except for the food groups non-alcoholic and alcoholic beverages, sugar and confectionery, sauces, and soups, men and women participating in Potsdam reported higher intakes of all the other food groups. The amount of food intake was generally lower in women than in men, with the exception of vegetables, fruit, dairy products, and non-alcoholic beverages. Further differences between the study centers were observed regarding the use of cooking fat for meat and vegetable preparation. In conclusion, the dietary variation, e.g. the exposure variation, was increased by recruiting two geographically distinct cohorts, instead of only one, in Germany.
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