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Contribution of highly industrially processed foods to the nutrient intakes and patterns of middle-aged populations in the European Prospective Investigation into Cancer and Nutrition study

Abstract

Objectives:

To describe the contribution of highly processed foods to total diet, nutrient intakes and patterns among 27 redefined centres in the 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC).

Methods:

Single 24-hour dietary recalls were collected from 36 034 individuals (aged 35–74 years) using a standardized computerized interview programme (EPIC-SOFT). Centre-specific mean food intakes (g/day) were computed according to their degree of food processing (that is, highly, moderately and non-processed foods) using a specifically designed classification system. The contribution (%) of highly processed foods to the centre mean intakes of diet and 26 nutrients (including energy) was estimated using a standardized nutrient database (ENDB). The effect of different possible confounders was also investigated.

Results:

Highly processed foods were an important source of the nutrients considered, contributing between 61% (Spain) and 78–79% (the Netherlands and Germany) of mean energy intakes. Only two nutrients, β-carotene (34–46%) and vitamin C (28–36%), had a contribution from highly processed foods below 50% in Nordic countries, in Germany, the Netherlands and the United Kingdom, whereas for the other nutrients, the contribution varied from 50 to 91% (excluding alcohol). In southern countries (Greece, Spain, Italy and France), the overall contribution of highly processed foods to nutrient intakes was lower and consisted largely of staple or basic foods (for example, bread, pasta/rice, milk, vegetable oils), whereas highly processed foods such as crisp bread, breakfast cereals, margarine and other commercial foods contributed more in Nordic and central European centres.

Conclusions:

Highly industrially processed foods dominate diets and nutrient patterns in Nordic and central European countries. The greater variations observed within southern countries may reflect both a larger contribution of non/moderately processed staple foods along with a move from traditional to more industrialized dietary patterns.

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Acknowledgements

The work described in this paper 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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Correspondence to N Slimani.

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Guarantor: N Slimani.Contributors: NS initiated and wrote this paper, taking into account comments from all co-authors, and was the overall coordinator of this project and of the EPIC Nutrient DataBase (ENDB) project. CB carried out the statistical analysis and preparation of tables and figures. GD was in charge of recoding dietary data according to the project-specific food reclassification, under the supervision of NS and DATS. DATS acted as an external expert on food chemistry and helped with the reclassification according to food processing methods. NS, GD, DATS, CB, VC, MMEvB, MCBR, AMcT, SG, JVK, IH, PA and MJ were members of the writing group and gave input on statistical analysis, drafting of the article and interpretation of results. MCBR, AMcT, SG, JVK, PA, PZ, AT, EW, GJ, SR, AKI, AB, LR, MT, MN, AM, FC, MCO, YTvdS, BB, CL, MB, AH, AT, AMJ and SB were local EPIC collaborators involved in collecting data, checking the project-specific food reclassification and 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 article and approved the final version.

Appendix

Appendix

Table A1

Table a1 Summary of the terminology and definitions of the classification used for industrially and commercially processed foods and ingredientsa

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Slimani, N., Deharveng, G., Southgate, D. et al. Contribution of highly industrially processed foods to the nutrient intakes and patterns of middle-aged populations in the European Prospective Investigation into Cancer and Nutrition study. Eur J Clin Nutr 63 (Suppl 4), S206–S225 (2009). https://doi.org/10.1038/ejcn.2009.82

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  • DOI: https://doi.org/10.1038/ejcn.2009.82

Keywords

  • 24-h dietary recall
  • standardisation
  • processed foods
  • industrial foods
  • nutrient patterns
  • EPIC-SOFT

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