Diet in the Italian Epic Cohorts: Presentation of Data and Methodological Issues

Abstract

One of the aims of the EPIC study is to produce accurate descriptions of the dietary habits of the participants recruited in the 27 EPIC centers of 10 European countries. To do this, different dietary assessment instruments were developed and applied to capture the wide range of diets characterizing the different European populations. Three different food frequency questionnaires were developed for Italy: one for the centers of Varese, Turin and Florence, one for Ragusa and one for Naples. These inquired about eating habits over the previous year and were completed by 46,839 Italian EPIC participants. Specially developed software analyzed the responses and linked them to food composition tables in order to provide a nutritional breakdown of individual and collective diets. A further aim of EPIC was to develop a method of rendering data from different dietary questionnaires comparable. To do this, dietary data were collected from a sample of about 8% of the Italian EPIC cohort, using a standardized computer-driven 24-hour dietary recall interview, and then compared with the dietary data collected by the questionnaires. This paper provides an extensive description of the technical features and performance of the food frequency questionnaires and the 24-hour recall interview, including a comparison of estimates of the intake of different food groups provided by the two instruments. From this comparison, the repeatability and reliability of consumption estimates was assessed, resulting in indications for improving data comparability. The paper also presents food frequency questionnaire estimates of the daily intake of foods and nutrients by center, sex and age group, as well as information on dietary habits such as place and time of intake, and food preparation and preservation methods as provided by the 24-hour recall interview. The picture that emerged is that Italian eating habits are undergoing marked changes, with a tendency to less healthy eating. Documentation of these changes in relation to age, sex and region provides an essential starting point for investigating the influence of diet on the development of cancer and other chronic diseases.

Food intake and risk of cutaneous melanoma in an Italian population

“…Moreover, recall bias is not a plausible explanation of the study findings, since diet is not generally regarded as a risk factor of melanoma by the general population. We detected an association between the consumption of vegetable oil (in our population mainly due to intake of corn oil and sunflower seed oil) and melanoma risk, and average consumption of vegetable oil was considerably greater in patients than in controls (4.94 vs 3.09 g/day in men and 4.75 vs 2.61 in women), though these intakes were within the range reported in the general Italian population (Pala et al, 2003). However, though this association appears to agree with the excess risk associated previously with linoleic acid intake in the study population, no association emerged between risk and other foods with high polyunsaturated fatty acid (PUFA) content, such as olive oil, processed meat, bread, cakes and related products, margarine, nuts and seed.…”

“…We examined a consecutive series of 59 newly diagnosed melanoma patients attending the Dermatologic Clinic of Modena University Hospital, provided that they resided in province and had recently been diagnosed with melanoma at an early clinical stage. Each patient was associated with a control through random selection among age-(75 years) and sexmatched Modena province residents.Apart from a dermatological examination, collection of anamnestic data and sampling of blood and toenails specimens, we obtained information from cases and controls regarding their normal diet through a self-administered semiquantitative food frequency questionnaire originally developed and validated within the European Prospective Investigation into Cancer and Nutrition (EPIC) program (Pisani et al, 1997(Pisani et al, , 2002Pala et al, 2003). This questionnaire was specifically designed for the central northern Italy and consisted of 248 questions concerning the frequency and the quantity of consumption of 188 items, and it was designed to ascertain in detail how much and what kind of foods had been consumed over the previous year, using illustrations of sample dishes of definite sizes or by reference to standard portion sizes.…”

White blood cell count, sex and age are major determinants of heterogeneity of platelet indices in an adult general population: results from the MOLI-SANI project

“…16 After the exclusion of subjects with incomplete questionnaires (n=188, 1%), or missing platelet count, plateletcrit, mean platelet volume and platelet distribution width values (n=926, 5%), and all subjects recruited in the Termoli center, because a different cell counter was used (n=5,107), 18,097 subjects were finally analyzed.…”

Total dietary antioxidant capacity and lung function in an Italian population: a favorable role in premenopausal/never smoker women

“…The NAF software (Nutritional Analysis of Food Frequency Questionnaires, National Cancer Institute, Milan, Italy) (Pala et al, 2003) was used to transform information about food composition into daily intake of food items, energy, macro-and micronutrients and TAC. Nutrient data for specific foods were obtained from the food composition database for epidemiological studies in Italy (Salvini et al, 1998) integrated with the TAC values of a number of foods representative of the average Italian diet, such as fruits, vegetables, oils, beverages, spices, dried fruits, sweets, cereals, pulses and nuts (Pellegrini et al, 2003(Pellegrini et al, , 2006.…”