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Intake of total, animal and plant proteins, and their food sources in 10 countries in the European Prospective Investigation into Cancer and Nutrition

European Journal of Clinical Nutrition volume 63, pages S16–S36 (2009)Cite this article

Abstract

Objective:

To describe dietary protein intakes and their food sources among 27 redefined centres in 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC).

Methods:

Between 1995 and 2000, 36 034 persons, aged between 35 and 74 years, were administered a standardized 24-h dietary recall (24-HDR) using a computerized interview software programme (EPIC-SOFT). Intakes (g/day) of total, animal and plant proteins were estimated using the standardized EPIC Nutrient Database (ENDB). Mean intakes were adjusted for age, and weighted by season and day of recall.

Results:

Mean total and animal protein intakes were highest in the Spanish centres among men, and in the Spanish and French centres among women; the lowest mean intakes were observed in the UK health-conscious group, in Greek men and women, and in women in Potsdam. Intake of plant protein was highest among the UK health-conscious group, followed by some of the Italian centres and Murcia, whereas Sweden and Potsdam had the lowest intake. Cereals contributed to the highest proportion of plant protein in all centres. The combined intake of legumes, vegetables and fruit contributed to a greater proportion of plant protein in the southern than in the northern centres. Total meat intake (with some heterogeneity across subtypes of meat) was, with few exceptions, the most important contributor to animal protein in all centres, followed by dairy and fish products.

Conclusions:

This study shows that intake of protein, especially of animal origin, differs across the 10 European countries, and also shows some differences in food sources of protein across Europe.

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Acknowledgements

This study 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. A A Welch

    Present address: 22Current address: School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK.,

  2. J Linseisen

    Present address: 23Current address: Institute of Epidemiology, Helmholtz Centre Munich, Neuherberg, Germany.,

  3. P Ferrari

    Present address: 24Current address: Data Collection and Exposure Unit (DATEX), European Food Safety Authority, Parma, Italy.,

  4. S Bingham: The author is deceased.

Authors and Affiliations

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

    J Halkjær, A Olsen & A Tjønneland

  2. Department of Cardiology, Center for Cardiovascular Research, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark

    L J Bjerregaard

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

    G Deharveng, P Ferrari & N Slimani

  4. 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

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

    F L Crowe

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

    E Wirfält

  7. Department of Nutritional Research, University of Umeå, Umeå, Sweden

    V Hellstrom

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

    M Niravong & M Touvier

  9. AFSSA (French Food Safety Agency), DERNS/PASER, Maisons-Alfort, France

    M Touvier

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

    J Linseisen

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

    A Steffen

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

    M C Ocké

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

    P H M Peeters

  14. Epidemiology Department, Murcia Health Council, Murcia and CIBER Epidemiología y Salud Pública (CIBERESP), Spain

    M D Chirlaque

  15. Public Health Department of Guipuzkoa, Basque Government, San Sebastian and CIBER Epidemiología y Salud Pública (CIBERESP), Spain

    N Larrañaga

  16. Cancer Registry and Environmental Epidemiology Division, National Cancer Institute of Milan, Milano, Italy

    P Contiero

  17. Cancer Registry, Azienda Ospedaliera ‘Civile - MP Arezzo’, Ragusa, Italy

    G Frasca

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

    D Engeset & E Lund

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

    G Misirli & M Kosti

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

    E Riboli

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

    S Bingham

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  1. J Halkjær
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Corresponding author

Correspondence to J Halkjær.

Additional information

Guarantor: Dr J Halkjær.

Contributors: JH carried out the statistical analysis, prepared the tables and figures and wrote the paper, taking into account comments from all co-authors. NS was the overall coordinator of this project and of the EPIC nutritional databases (ENDB) project. JH, AO, LJB and GD were members of the ‘protein working group’ and gave input on statistical analyses, drafting of the manuscript and interpretation of results. The other co-authors were local EPIC collaborators involved in the collection of data, and in documenting, compiling and evaluating the subset of their national nutrient databases used in the ENDB. ER is the overall coordinator of the EPIC study. All co-authors provided comments and suggestions on the manuscript and approved the final version.

Appendix

Appendix

Tables A1, A2, A3 and A4

Table a1 Fully adjusteda mean daily intake of total protein by centre ordered from south to north, gender and age group
Full size table
Table a2 Fully adjusteda mean daily intake of animal protein by centre ordered from south to north, gender and age group
Full size table
Table a3 Fully adjusteda mean daily intake of plant protein by centre ordered from south to north, gender and age group
Full size table
Table a4 Fully adjusteda mean daily intake of protein of unknown source by centre ordered from south to north, gender and age group
Full size table

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Halkjær, J., Olsen, A., Bjerregaard, L. et al. Intake of total, animal and plant proteins, and their food sources in 10 countries in the European Prospective Investigation into Cancer and Nutrition. Eur J Clin Nutr 63 (Suppl 4), S16–S36 (2009). https://doi.org/10.1038/ejcn.2009.73

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