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Alcohol consumption patterns, diet and body weight in 10 European countries

European Journal of Clinical Nutrition volume 63, pages S81–S100 (2009)Cite this article

Abstract

Background/objectives:

Europe has the highest level of alcohol consumption in the world. As drinking patterns are important determinants of the beneficial and harmful effects of alcohol consumption, we investigated alcohol consumption in relation to nutrient intake, place of consumption, education and body weight in a sample of adults from 10 European countries.

Methods:

A 24-h dietary recall interview was conducted on 13 025 men and 23 009 women, aged 35–74 years, from 27 centres participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Means and standard errors of alcohol consumption, adjusted for age, were calculated, stratified by gender and centre.

Results:

In many centres, higher level drinkers (males consuming >24 g of ethanol/day, equivalent to >2 standard drinks and females consuming >12 g of ethanol/day equivalent to >1 standard drink) obtained more energy from fat and protein and less from sugar than did abstainers. The proportion of energy from starch tended to be higher for male and lower for female higher level drinkers than for abstainers. Female higher level drinkers had a lower body mass index than did abstainers, whereas male higher level drinkers generally weighed more. Male higher level drinkers were less educated than abstainers in Mediterranean countries, but were more educated elsewhere. Female higher level drinkers were usually more educated than were abstainers. Outside the home, consumption (both genders) tended to be at friends' homes, particularly among men in Northern and Central Europe, and in bars in Spain.

Conclusions:

This study reveals clear geographical differences in drinking habits across Europe, and shows that the characteristics of different alcohol consumption categories also vary.

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Acknowledgements

This work was carried out with the financial support of the European Commission: Public Health and Consumer Protection Directorate 1993–2004; Research Directorate-General 2005; Ligue contre le Cancer (France); Société 3M (France); Mutuelle Générale de l'Education Nationale; Institut National de la Santé et de la Recherche Médicale (INSERM); Institut Gustave Roussy; German Cancer Aid; German Cancer Research Center; German Federal Ministry of Education and Research; Danish Cancer Society; Health Research Fund (FIS) of the Spanish Ministry of Health; Spanish Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra and the Catalan Institute of Oncology; and ISCIII RETIC (RD06/0020), Spain; Cancer Research UK; Medical Research Council, UK; the Stroke Association, UK; British Heart Foundation; Department of Health, UK; Food Standards Agency, UK; the Wellcome Trust, UK; Greek Ministry of Health; Hellenic Health Foundation; Italian Association for Research on Cancer; Italian National Research Council, Regione Sicilia (Sicilian government); Associazione Iblea per la Ricerca Epidemiologica–ONLUS (Hyblean association for epidemiological research, NPO); Dutch Ministry of Health, Welfare and Sport; Dutch Prevention Funds; LK Research Funds; Dutch ZON (Zorg Onderzoek Nederland); World Cancer Research Fund (WCRF); Swedish Cancer Society; Swedish Research Council; Regional Government of Skane and the County Council of Vasterbotten, Sweden; Norwegian Cancer Society; the Norwegian Research Council; and the Norwegian Foundation for Health and Rehabilitation. We thank Sarah Somerville, Nicole Suty and Karima Abdedayem for assistance with editing and Kimberley Bouckaert and Heinz Freisling for technical assistance.

Author information

Author notes

  1. P Ferrari

    Present address: 25Current address: Data Collection and Exposure Unit (DATEX), European Food Safety Authority, Parma, Italy.,

  2. J Linseisen

    Present address: 26Current address: Institute of Epidemiology, Helmholtz Centre Munich, Neuherberg, Germany.,

  3. A A Welch

    Present address: 27Current address: School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK.,

  4. S Bingham: The author is deceased.

Authors and Affiliations

  1. Department of Preventive & Predictive Medicine, Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy

    S Sieri & V Krogh

  2. Molecular and Nutritional Epidemiology Unit, ISPO, Florence, Italy

    C Saieva

  3. Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands

    D E Grobbee & Y T van der Schouw

  4. Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany

    M Bergmann

  5. Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany

    S Rohrmann & J Linseisen

  6. Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark

    A Tjønneland & A Olsen

  7. Dietary Exposure Assessment Group, International Agency for Research on Cancer, Lyon, France

    P Ferrari & N Slimani

  8. Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece

    Y Chloptsios & V Dilis

  9. Lifestyle and Cancer Group, International Agency for Research on Cancer, Lyon, France

    M Jenab

  10. Department of Clinical Sciences, Lund University, Malmö, Sweden

    P Wallström

  11. Department of Odontology, Faculty of Medicine, University of Umeå, Umeå, Sweden

    I Johansson

  12. Epidemiology Department, Murcia Health Council, Murcia

    M D Chirlaque

  13. CIBER Epidemiología y Salud Pública (CIBERESP), Spain

    M D Chirlaque

  14. Andalusian School of Public Health, Granada

    M J Sanchez

  15. CIBER Epidemiología y Salud Pública (CIBERESP), Spain

    M J Sanchez

  16. Inserm, ERI 20, Institut Gustave Roussy, Villejuif, France

    M Niravong & F Clavel-Chapelon

  17. Department of Public Health and Primary Care, MRC Centre for Nutritional Epidemiology in Cancer Prevention and Survival, University of Cambridge, Cambridge, UK

    A A Welch & S Bingham

  18. Cancer Epidemiology Unit, University of Oxford, Oxford, UK

    N E Allen

  19. National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands

    H B Bueno-de-Mesquita

  20. Institute for Scientific Interchange Foundation, Turin, Italy

    C Sacerdote

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

    S Panico

  22. Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway

    C L Parr

  23. Institute of Community Medicine, University of Tromsø, Tromsø, Norway

    T Braaten

  24. Department of Clinical Epidemiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark

    M K Jensen

  25. Diet and Cancer Group, MRC Mitochondrial Biology Unit, Cambridge, UK

    S Bingham

  26. Department of Epidemiology, Public Health and Primary Care, Imperial College, London, UK

    E Riboli

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  1. S Sieri
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  2. V Krogh
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  28. M K Jensen
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  30. E Riboli
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  31. N Slimani
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Corresponding author

Correspondence to S Sieri.

Additional information

Guarantor: S Sieri. Contributors: The writing group leaders (SS, VK) conducted statistical analyses, prepared tables and figures, and wrote the paper, taking into account comments from all co-authors. NS was overall project coordinator of this project and of the EPIC nutrient database (ENDB) project. SS, VK, CS, DEG, SR, MB and PF were members of the writing group and gave input on statistical analyses, manuscript drafting and results interpretation. The other co-authors were local EPIC collaborators involved in the collection of dietary and other data, and contributed to the ENDB project. ER is the overall coordinator of EPIC. All co-authors provided comments and suggestions on the manuscript and approved the final version.

Appendix

Appendix

Table A1

Table a1 Fully adjusteda mean alcohol intake by centre ordered from south to north, gender and age group
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Sieri, S., Krogh, V., Saieva, C. et al. Alcohol consumption patterns, diet and body weight in 10 European countries. Eur J Clin Nutr 63 (Suppl 4), S81–S100 (2009). https://doi.org/10.1038/ejcn.2009.76

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