The European Prospective Investigation into Cancer and Nutrition (EPIC) is an ongoing multi-centre prospective cohort study designed to investigate the relationship between nutrition and cancer, with the potential for studying other diseases as well. The study currently includes 519 978 participants (366 521 women and 153 457 men, mostly aged 35-70 years) in 23 centres located in 10 European countries, to be followed for cancer incidence and cause-specific mortality for several decades. At enrolment, which took place between 1992 and 2000 at each of the different centres, information was collected through a non-dietary questionnaire on lifestyle variables and through a dietary questionnaire addressing usual diet. Anthropometric measurements were performed and blood samples taken, from which plasma, serum, red cells and buffy coat fractions were separated and aliquoted for long-term storage, mostly in liquid nitrogen. To calibrate dietary measurements, a standardised, computer-assisted 24-hour dietary recall was implemented at each centre on stratified random samples of the participants, for a total of 36 900 subjects. EPIC represents the largest single resource available today world-wide for prospective investigations on the aetiology of cancers (and other diseases) that can integrate questionnaire data on lifestyle and diet, biomarkers of diet and of endogenous metabolism (e.g. hormones and growth factors) and genetic polymorphisms. First results of case-control studies nested within the cohort are expected early in 2003. The present paper provides a description of the EPIC study, with the aim of simplifying reference to it in future papers reporting substantive or methodological studies carried out in the EPIC cohort.
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,
Securing accurate measurements of dietary intake across populations is challenging. Of the methods, self-reported 24-h recalls are often used in low-income countries (LICs) because they are quick, culturally sensitive, do not require high cognitive ability, and provide quantitative data on both foods and nutrients. Measuring intakes via 24-h recalls involves ) collecting data on food intakes,) the appropriate use of relevant food-composition data for calculating nutrient intakes, and ) statistically converting observed intakes to "usual intakes" for evaluating nutrient adequacy or relations between foods and nutrients and health outcomes. Like all dietary methods, 24-h recalls are subject to random errors that lower the precision and systematic errors that can reduce accuracy at each stage of the measurement protocol. Research has identified the potential sources of measurement errors in 24-h recall protocols and emphasized that sources of random error can be reduced by incorporating standardized quality-control procedures and collecting more than one 24-h recall per person, with the number depending on the study objective. Careful design of the initial 24-h recall protocol can take into account potential sources of systematic error, such as day of the week, season, age, etc. Other sources of systematic error (e.g., energy underreporting) can best be detected by including a reference measure (e.g., doubly labeled water to measure energy expenditure). Alternatively, 24-h recall intakes of energy can be compared with same-day weighed intakes. Nevertheless, very few studies in LICs have assessed the validity of 24-h recalls in their study settings or adopted recommended standardized protocols to mitigate random errors. Hence, efforts should be made to improve the assessment, analysis, and interpretation of self-reported 24-h recall data for population studies in LICs. Accurate and precise dietary intake data at the national level can play an essential role in informing food, nutrition, and agricultural policies; food fortification planning; and compliance to food-based dietary guidelines.
and Sweden. They were compared from the point view of availability, de®nition, analytical methods, and mode of expression of the nutrients of interest for EPIC, and it was seen that most of the nutrients in the tables are analysed and expressed in a compatible way. For some nutrients, however, common methods and de®nitions (folate, dietary ®bre), or modes of expression (energy, protein, carbohydrates, carotenes, vitamin A and E) have not yet been agreed upon, so values are not comparable. For vitamin C a wide range of values are found due to the high natural variation in foods. For compiled tables, an additional problem is the use of several sources which may mean that the nutritional values are not comparable within the same table; and these values cannot be converted if the source is not stated. In addition, some tables were compiled using food composition values produced over 20 years ago with outdated analytical methods. In view of the inconsistent values for some nutrients and due to the large amount of foods reported within EPIC, it was concluded that standardised food composition tables have to be developed for the nine European countries involved in EPIC in order to provide comparable nutrient intake data.
A comprehensive review is presented of the nutrient composition for buffalo, mare, and dromedary camel milks at the level of breed, and species-level data for yak, mithun, musk ox, donkey, Bactrian camel, llama, alpaca, reindeer and moose milks. Average values of nutrients were calculated and compared. Interspecies values (g 100 g⁻¹) were 0.7-16.1 for total fat, 1.6-10.5 for protein, 2.6-6.6 for lactose, and 67.9-90.8 for water. Reindeer and moose milks had the highest fat and protein concentrations and the lowest lactose contents. Mare and donkey milks had the lowest protein and fat contents, in addition to showing the most appropriate fatty acid profile for human nutrition. Dromedary camel milk was most similar to cow milk in proximate composition. Moose milk was the richest in minerals, having values as high as 358 mg 100 g⁻¹ for calcium, 158 mg 100 g⁻¹ for sodium and 150 mg 100 g⁻¹ for phosphorus. Interbreed differences of 4 g 100 g⁻¹ were observed in total fat in buffalo, yak, mare and dromedary camel milks. Large interbreed differences were also present in the mineral contents in mare, buffalo and dromedary camel milks. By bringing together these compositional data, we hope to usefully widen the biodiversity knowledge base, which may contribute to the conservation and sustainable use of milk from underutilized dairy breeds and species, and to improved food and nutrition security, particularly in developing countries.
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