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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References
Ahlström S, Gmel G, Mäkelä P, Näsänen J (2005). Drinking contexts in European countries. In: K Bloomfield, A Allamani, F Beck, K Helmersson Bergmark, L Csemy, I. Eisenbach-Stangl et al. (eds). Gender, Culture and Alcohol Problems: A Multi-national Study. Project Final Report. Charité Campus Benjamin Franklin: Berlin. pp 73–86.
Brustad M, Skeie G, Braaten T, Slimani N, Lund E (2003). Comparison of telephone vs face-to-face interviews in the assessment of dietary intake by the 24 h recall EPIC SOFT program—the Norwegian calibration study. Eur J Clin Nutr 57, 107–113.
Colditz GA, Giovannucci E, Rimm EB, Stampfer MJ, Rosner B, Speizer FE et al. (1991). Alcohol intake in relation to diet and obesity in women and men. Am J Clin Nutr 54, 49–55.
Corrao G, Rubbiati L, Bagnardi V, Zambon A, Poikolainen K (2000). Alcohol and coronary heart disease: a meta-analysis. Addiction 95, 1505–1523.
Cummins RO, Shaper AG, Walker M, Wale CJ (1981). Smoking and drinking by middle-aged British men: effects of social class and town of residence. Br Med J (Clin Res Ed) 283, 1497–1502.
D'Avanzo B, La Vecchia C, Braga C, Franceschi S, Negri E, Parpinel M (1997). Nutrient intake according to education, smoking, and alcohol in Italian women. Nutr Cancer 28, 46–51.
Dallongeville J, Marecaux N, Ducimetiere P, Ferrieres J, Arveiler D, Bingham A et al. (1998). Influence of alcohol consumption and various beverages on waist girth and waist-to-hip ratio in a sample of French men and women. Int J Obes Relat Metab Disord 22, 1178–1183.
Droomers M, Schrijvers CT, Stronks K, van de MD, Mackenbach JP (1999). Educational differences in excessive alcohol consumption: the role of psychosocial and material stressors. Prev Med 29, 1–10.
Ferrari P, Kaaks R, Fahey MT, Slimani N, Day NE, Pera G et al. (2004). Within- and between-cohort variation in measured macronutrient intakes, taking account of measurement errors, in the European Prospective Investigation into Cancer and Nutrition study. Am J Epidemiol 160, 814–822.
Fisher M, Gordon T (1985). The relation of drinking and smoking habits to diet: the Lipid Research Clinics Prevalence Study. Am J Clin Nutr 41, 623–630.
Gronbaek M (2007). Confounders of the relation between type of alcohol and cardiovascular disease. Ann Epidemiol 17, S13–S15.
Gruchow HW, Sobocinski KA, Barboriak JJ, Scheller JG (1985). Alcohol consumption, nutrient intake and relative body weight among US adults. Am J Clin Nutr 42, 289–295.
Haftenberger M, Lahmann PH, Panico S, Gonzalez CA, Seidell JC, Boeing H et al. (2002a). Overweight, obesity and fat distribution in 50- to 64-year-old participants in the European Prospective Investigation into Cancer and Nutrition (EPIC). Public Health Nutr 5 (Suppl), S1147–S1162.
Haftenberger M, Schuit AJ, Tormo MJ, Boeing H, Wareham N, Bueno-de-Mesquita HB et al. (2002b). Physical activity of subjects aged 50-64 years involved in the European Prospective Investigation into Cancer and Nutrition (EPIC). Public Health Nutr 5 (Suppl), S1163–S1176.
Hebert JR, Kabat GC (1991). Implications for cancer epidemiology of differences in dietary intake associated with alcohol consumption. Nutr Cancer 15, 107–119.
Hulshof KF, Lowik MR, Kok FJ, Wedel M, Brants HA, Hermus RJ et al. (1991). Diet and other life-style factors in high and low socio-economic groups (Dutch Nutrition Surveillance System). Eur J Clin Nutr 45, 441–450.
Jones BR, Barrett-Connor E, Criqui MH, Holdbrook MJ (1982). A community study of calorie and nutrient intake in drinkers and nondrinkers of alcohol. Am J Clin Nutr 35, 135–139.
Kaye SA, Folsom AR, Prineas RJ, Potter JD, Gapstur SM (1990). The association of body fat distribution with lifestyle and reproductive factors in a population study of postmenopausal women. Int J Obes 14, 583–591.
Knibbe RA, Drop MJ, Van Reek MJ, Saenger G (1985). The development of alcohol consumption in the Netherlands: 1958-1981. Br J Addict 80, 411–419.
Knupfer G (1989). The prevalence in various social groups of eight different drinking patterns, from abstaining to frequent drunkenness: analysis of 10 US surveys combined. Br J Addict 84, 1305–1318.
La Vecchia C, Negri E, Franceschi S, Parazzini F, Decarli A (1992). Differences in dietary intake with smoking, alcohol, and education. Nutr Cancer 17, 297–304.
Le Marchand L, Kolonel LN, Hankin JH, Yoshizawa CN (1989). Relationship of alcohol consumption to diet: a population-based study in Hawaii. Am J Clin Nutr 49, 567–572.
Leifman H (2008). A comparative analysis of drinking patterns in 6 EU countries in the year 2000. Contemp Drug Probl 29, 501–548.
Liu S, Serdula MK, Williamson DF, Mokdad AH, Byers T (1994). A prospective study of alcohol intake and change in body weight among US adults. Am J Epidemiol 140, 912–920.
Mannisto S, Uusitalo K, Roos E, Fogelholm M, Pietinen P (1997). Alcohol beverage drinking, diet and body mass index in a cross-sectional survey. Eur J Clin Nutr 51, 326–332.
Nuttens MC, Romon M, Ruidavets JB, Arveiler D, Ducimetiere P, Lecerf JM et al. (1992). Relationship between smoking and diet: the MONICA-France project. J Intern Med 231, 349–356.
Rehm J, Rehn N, Room R, Monteiro M, Gmel G, Jernigan D et al. (2003a). The global distribution of average volume of alcohol consumption and patterns of drinking. Eur Addict Res 9, 147–156.
Rehm J, Gmel G, Sempos CT, Trevisan M (2003b). Alcohol-related morbidity and mortality. Alcohol Res Health 27, 39–51.
Riboli E, Kaaks R (1997). The EPIC Project: rationale and study design. European Prospective Investigation into Cancer and Nutrition. Int J Epidemiol 26 (Suppl 1), S6–S14.
Riboli E, Hunt K, Slimani N, Ferrari P, Norat T, Fahey M et al. (2002). The EPIC study: study population and data collection. Public Health Nutr 5 (Suppl), S1113–S1124.
Ruidavets JB, Bataille V, Dallongeville J, Simon C, Bingham A, Amouyel P et al. (2004). Alcohol intake and diet in France, the prominent role of lifestyle. Eur Heart J 25, 1153–1162.
Sieri S, Agudo A, Kesse E, Klipstein-Grobusch K, San Jose B, Welch AA et al. (2002). Patterns of alcohol consumption in 10 European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) project. Public Health Nutr 5 (Suppl), S1287–S1296.
Slattery ML, McDonald A, Bild DE, Caan BJ, Hilner JE, Jacobs Jr DR et al. (1992). Associations of body fat and its distribution with dietary intake, physical activity, alcohol, and smoking in blacks and whites. Am J Clin Nutr 55, 943–949.
Slimani N, Ferrari P, Ocke M, Welch A, Boeing H, Liere M et al. (2000). Standardization of the 24-h diet recall calibration method used in the European prospective investigation into cancer and nutrition (EPIC): general concepts and preliminary results. Eur J Clin Nutr 54, 900–917.
Slimani N, Kaaks R, Ferrari P, Casagrande C, Clavel-Chapelon F, Lotze G et al. (2002). EPIC calibration study: rationale, design and population characteristics. Public Health Nutr 5 (Suppl), S1125–S1145.
Slimani N, Deharveng G, Unwin I, Southgate DA, Vignat J, Skeie G et al. (2007). The EPIC nutrient database project (ENDB): a first attempt to standardize nutrient databases across the 10 European countries participating in the EPIC study. Eur J Clin Nutr 61, 1037–1056.
Tejera J, Santolaria F, Gonzalez-Reimers E, Batista N, Jorge JA, Hernandez-Nieto L (1991). Alcoholic intake in a small rural village. Alcohol Alcohol 26, 361–366.
Thomson M, Fulton M, Elton RA, Brown S, Wood DA, Oliver MF (1988). Alcohol consumption and nutrient intake in middle-aged Scottish men. Am J Clin Nutr 47, 139–145.
Toniolo P, Riboli E, Cappa AP (1991). A community study of alcohol consumption and dietary habits in middle-aged Italian women. Int J Epidemiol 20, 663–670.
van Oers JA, Bongers IM, van de Goor LA, Garretsen HF (1999). Alcohol consumption, alcohol-related problems, problem drinking, and socioeconomic status. Alcohol Alcohol 34, 78–88.
Veenstra J, Schenkel JA, Erp-Baart AM, Brants HA, Hulshof KF, Kistemaker C et al. (1993). Alcohol consumption in relation to food intake and smoking habits in the Dutch National Food Consumption Survey. Eur J Clin Nutr 47, 482–489.
Williamson DF, Forman MR, Binkin NJ, Gentry EM, Remington PL, Trowbridge FL (1987). Alcohol and body weight in United States adults. Am J Public Health 77, 1324–1330.
Wilsgaard T, Jacobsen BK, Arnesen E (2005). Determining lifestyle correlates of body mass index using multilevel analyses: the Tromso Study, 1979-2001. Am J Epidemiol 162, 1179–1188.
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.
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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.
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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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