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  • Original Article
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Eating out of home: energy, macro- and micronutrient intakes in 10 European countries. The European Prospective Investigation into Cancer and Nutrition

European Journal of Clinical Nutrition volume 63, pages S239–S262 (2009)Cite this article

Abstract

Objectives:

To assess the contribution of out-of-home (OH) energy and nutrient intake to total dietary intake, and to compare out- versus in-home nutrient patterns among 27 centres in 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

Methods:

Between 1995 and 2000, 36 034 participants aged between 35–74 years completed a standardized 24-h dietary recall using a software programme (EPIC-Soft) that recorded the place of food/drink consumption. Eating OH was defined as the consumption of foods and beverages anywhere other than in household premises, irrespective of the place of purchase/preparation. Nutrient intakes were estimated using a standardized nutrient database. Mean intakes were adjusted for age and weighted by season and day of recall.

Results:

Among women, OH eating contributed more to total fat intake than to intakes of protein and carbohydrates. Among both genders, and particularly in southern Europe, OH eating contributed more to sugar and starch intakes and less to total fibre intake. The contribution of OH eating was also lower for calcium and vitamin C intakes. The composition of diet at home was different from that consumed out of home in southern countries, but was relatively similar in the north.

Conclusions:

In northern Europe, OH and in-home eating are homogeneous, whereas southern Europeans consider OH eating as a distinctive occasion. In most centres, women selected more fat-rich items when eating out.

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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 their assistance with editing and Kimberley Bouckaert and Heinz Freisling for technical assistance.

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Author notes

  1. S Bingham: The author is deceased.

Authors and Affiliations

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

    P Orfanos, A Naska, A Trichopoulou, V Stratigakou & E Oikonomou

  2. Hellenic Health Foundation, Athens, Greece

    A Trichopoulou

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

    S Grioni

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

    J M A Boer & E M Niekerk

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

    M M E van Bakel, G Deharveng & N Slimani

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

    U Ericson

  7. Division of Cancer Epidemiology, German Cancer Research Centre (DKFZ), Heidelberg, Germany

    S Rohrmann

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

    H Boeing

  9. Public Health and Participation Directorate, Health and Health Care Services Council, Asturias, Spain

    L Rodríguez

  10. Institute of Public Health of Navarra, Pamplona and CIBER Epidemiología y Salud Pública (CIBERESP), Spain,

    E Ardanaz

  11. Institute for Scientific Interchange Foundation, Turin, Italy

    C Sacerdote

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

    M C Giurdanella

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

    P H M Peeters

  14. Department of Surgery, Malmö University Hospital, Malmö, Sweden

    J Manjer

  15. Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden

    B van Guelpen

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

    G Skeie & D Engeset

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

    J Halkjær

  18. Institute of Preventive Medicine, Copenhagen, Denmark

    A M Jensen

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

    A McTaggart & S Bingham

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

    F Crowe

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

    M Touvier & M Niravong

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

    M Touvier

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

    E Riboli

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

    S Bingham

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  1. P Orfanos
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  2. A Naska
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  25. V Stratigakou
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  26. E Oikonomou
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  27. M Touvier
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  29. E Riboli
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Corresponding author

Correspondence to P Orfanos.

Additional information

Guarantor: A Trichopoulou.Contributors: PO was the coordinator for the analyses conducted in this paper and for drafting the article. NS was the overall coordinator of this project and of the EPIC nutritional databases (ENDB) project. AN, AT, SG, JMA-B, MvB and UE, as members of the working group on ‘Eating out and nutrient intakes’, gave input on statistical analyses, interpretation of results and drafting of the article. The other co-authors were local EPIC collaborators involved in data collection and documentation and in 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 A1a, Table A1b

Table Fully-adjusteda mean daily micronutrient intake (mg) at home (AHb) and out of home (OHc) and fraction of intake out of home (fraction OHd) among men by centre ordered from south to north
Full size table

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Orfanos, P., Naska, A., Trichopoulou, A. et al. Eating out of home: energy, macro- and micronutrient intakes in 10 European countries. The European Prospective Investigation into Cancer and Nutrition. Eur J Clin Nutr 63 (Suppl 4), S239–S262 (2009). https://doi.org/10.1038/ejcn.2009.84

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