The European Prospective Investigation into Cancer and Nutrition (EPIC), which covers a large cohort of half a million men and women from 23 European centres in 10 Western European countries, was designed to study the relationship between diet and the risk of chronic diseases, particularly cancer. Information on usual individual dietary intake was assessed using different validated dietary assessment methods across participating countries. In order to adjust for possible systematic over-or underestimation in dietary intake measurements and correct for attenuation bias in relative risk estimates, a calibration approach was developed. This approach involved an additional dietary assessment common across study populations to re-express individual dietary intakes according to the same reference scale. A single 24-hour diet recall was therefore collected, as the EPIC reference calibration method, from a stratified random sample of 36 900 subjects from the entire EPIC cohort, using a software program (EPIC-SOFT) specifically designed to standardise the dietary measurements across study populations. This paper describes the design and populations of the calibration sub-studies set up in the EPIC centres. In addition, to assess whether the calibration sub-samples were representative of the entire group of EPIC cohorts, a series of subjects' characteristics known possibly to influence dietary intakes was compared in both population groups. This was the first time that calibration sub-studies had been set up in a large multi-centre European study. These studies showed that, despite certain inherent methodological and logistic constraints, a study design such as this one works relatively well in practice. The average response in the calibration study was 78.3% and ranged from 46.5% to 92.5%. The calibration population differed slightly from the overall cohort but the differences were small for most characteristics and centres. The overall results suggest that, after adjustment for age, dietary intakes estimated from calibration samples can reasonably be interpreted as representative of the main cohorts in most of the EPIC centres.
Objectives: There is epidemiologic evidence that the consumption of fried, grilled or barbecued meat and fish that are welldone or browned may be associated with an increased cancer risk. These high-temperature cooking methods are thought to be surrogates for mutagens and carcinogens produced in meat and fish, eg heterocyclic amines or polycyclic hydrocarbons. Since data on food cooking methods are scarce, the aim of this study was to describe the variation in meat and fish cooking methods in different parts of Europe. Design: Using a standardized 24 h recall from a sub-sample of the EPIC cohort (35 644 persons, 35 -75 y old), mean daily intake of meat and fish prepared by different cooking methods and the relative contribution of the cooking methods to the overall cooking of meat and fish was calculated. Results: Whereas frying was more often noted in northern Europe, roasting and stir frying were more often used in the south. Concerning high-temperature cooking methods, their frequency of application varies between 15% in the EPIC cohort of NorthItaly and 49% in the cohort of The Netherlands. Average consumption of fried, grilled and barbecued meat and fish ranges from a low of 12 g=day in the centres in southern Spain to a high of 91 g=day in northern Spain.
Quality control is an indispensable part of quality assurance in any study, intending to ensure high standards during data acquisition. The aim of this paper is to describe the measures of quality control undertaken in the German EPIC study centers and to present selected results of these procedures (EPIC = European Prospective Investigation into Cancer and Nutrition). For all data assessment tools applied in the German EPIC study, procedures were developed to monitor both the personnel as well as the technical instruments. These procedures combined quantitative and qualitative measurements of quality control. Interviewer performance was evaluated through direct observation and rated according to an evaluation score. Blood pressure and anthropometric measurements were both controlled through direct observation of measurement procedures as well as through periodical technical control of measurement devices. Blood sampling procedures were directly monitored and subsequent handling of the probes tightly recorded, including information on time sequence of work-up and room temperature. With these diverse control measurements and the obtained rating of assessment procedures a broad pool of information has been made available to support a critical evaluation of the data obtained in the EPIC study centers in Heidelberg and Potsdam.
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