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Food sources of carbohydrates in a European cohort of adults

  • E Wirfält (a1), A McTaggart (a2), V Pala (a3), B Gullberg (a4), G Frasca (a5), S Panico (a6), HB Bueno-de-Mesquita (a7), PHM Peeters (a8), D Engeset (a9), G Skeie (a9), MD Chirlaque (a10), P Amiano (a11), E Lundin (a12), A Mulligan (a2), EA Spencer (a13), K Overvad (a14), A Tjønneland (a15), F Clavel-Chapelon (a16), J Linseisen (a17), U Nöthlings (a18), E Polychronopoulos (a19), K Georga (a20), UR Charrondière (a21) and N Slimani (a21)...



To describe the average consumption of carbohydrate-providing food groups among study centres of the European Prospective Investigation into Cancer and Nutrition (EPIC).


Of the 27 redefined EPIC study centres, 19 contributed subjects of both genders and eight centres female participants only (men, n=13 031; women, n=22924, after exclusion of subjects under 35 and over 74 years of age from the original 36 900 total). Dietary data were obtained using the 24-hour recall methodology using the EPIC-SOFT software. The major sources of dietary carbohydrate were identified, and 16 food groups were examined.


The 10 food groups contributing most carbohydrate were bread; fruit; milk and milk products; sweet buns, cakes and pies; potato; sugar and jam; pasta and rice; vegetables and legumes; crispbread; and fruit and vegetable juices. Consumption of fruits as well as vegetables and legumes was higher in southern compared with northern centres, while soft drinks consumption was higher in the north. Italian centres had high pasta and rice consumption, but breakfast cereal, potato, and sweet buns, cakes and pies were higher in northern centres. In Sweden, lower bread consumption was balanced with a higher consumption of crispbread, and with sweet buns, cakes and pies. Overall, men consumed higher amounts of vegetables and legumes, bread, soft drinks, potatoes, pasta and rice, breakfast cereal and sugar and jam than women, but fruit consumption appeared more frequent in women.


The study supports the established idea that carbohydrate-rich foods chosen in northern Europe are different from those in the Mediterranean region. When comparing and interpreting diet–disease relationships across populations, researchers need to consider all types of foods.

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1Freudenheim, JL, Krogh, V, D'Amicis, A, Scaccini, C, Sette, S, Ferro-Lucci, A, et al. Food sources of nutrients in the diet of elderly Italians: I. Macronutrients and lipids. Int. J. Epidemiol. 1993; 22: 855–68.
2World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR). Food, Nutrition and the Prevention of Cancer: A Global Perspective. Washington, DC: WCRF/AICR, 1997.
3Trichopoulou, A, Vasilopoulou, E. Nutritional composition and flavonoid content of edible wild greens and green pies: a potential rich source of antioxidant nutrients in the Mediterranean diet. Food Chem. 2000; 70: 319–23.
4Messina, MJ, Persky, V, Setchell, KDR, Barnes, S. Soy intake and cancer risk: a review of the in vitro and in vivo data. Nutr. Cancer 1994; 21: 113–31.
5Thompson, L, Robb, P, Serraino, M, Cheung, F. Mammalian lignan production from various foods. Nutr. Cancer 1991; 16: 4352.
6Adlercreutz, H. Phytoestrogens: epidemiology and a possible role in cancer protection. Environ. Health Perspect. 1995; 103: 103–12.
7Liljeberg, H, Björck, I. Effects of a low-glycemic index spaghetti meal on glucose tolerance and lipidemia at a subsequent meal in healthy subjects. Eur. J. Clin. Nutr. 2000; 54: 24–8.
8Liljeberg, H, Björck, I. Delayed gastric emptying rate may explain improved glycaemia in healthy subjects to a starchy meal with added vinegar. Eur. J. Clin. Nutr. 1998; 52: 368–71.
9Martin, L, Dumon, H, Lecannu, G, Champ, M. Potato and high-amylose maize starches are not equivalent producers of butyrate for the colonic mucosa. Br. J. Nutr. 2000; 84: 689–96.
10Salmeron, J, Manson, J-AE, Stampfer, MJ, Colditz, GA, Wing, AL, Willet, WC. Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. J. Am. Med. Assoc. 1997; 277: 472–7.
11Salmeron, J, Ascherio, A, Rimm, E, Colditz, G, Spiegelman, D, Jenkins, D, et al. Dietary fiber, glycemic load, and risk of NIDDM in men. Diabetes Care 1997; 20: 545–50.
12Agus, M, Swain, J, Larson, C, Eckert, E, Ludwig, D. Dietary composition and physiologic adaptations to energy restriction. Am. J. Clin. Nutr. 2000; 71: 901–7.
13Kaaks, R. Nutrition, hormones and breast cancer: is insulin the missing link? Cancer Causes Control 1996; 7: 605–25.
14La Vecchia, C, Negri, E, Decarli, A, Franceschi, S. Diabetes mellitus and colorectal cancer risk. Cancer Epidemiol. Biomark. Prev. 1997; 6: 1007–10.
15Kono, S, Honjo, S, Todoroki, I, Nishiwaki, M, Hamada, H, Nishikawa, H, et al. Glucose intolerance and adenomas of the sigmoid colon in Japanese men. Cancer Causes Control 1998; 9: 441–6.
16Hu, F, Manson, J, Liu, S, Hunter, D, Colditz, G, Michels, K, et al. Prospective study of adult onset diabetes mellitus (type 2) and risk of colorectal cancer in women. J. Natl. Cancer Inst. 1999; 91: 542–7.
17Nilsen, T, Vatten, L. Prospective study of colorectal cancer risk and physical activity, diabetes, blood glucose and BMI: exploring the hyperinsulinemia hypothesis. Br. J. Cancer 2001; 84: 417–22.
18Phillips, J, Muir, J, Birkett, A, Lu, Z, Jones, G, O'Dea, K, et al. Effect of resistant starch on fecal bulk and fermentation-dependent events in humans. Am. J. Clin. Nutr. 1995; 62: 121–30.
19Jenkins, D, Vuksan, V, Kendall, C, Wursch, P, Jeffcoat, R, Waring, S, et al. Physiological effects of resistant starches on fecal bulk, short chain fatty acids, blood lipids and glycemic index. J. Am. Coll. Nutr. 1998; 17: 609–16.
20Hylla, S, Gostner, A, Dusel, G, Anger, H, Bartram, H, Christl, S, et al. Effects of resistant starch on the colon in healthy volunteers: possible implications for cancer prevention. Am. J. Clin. Nutr. 1998; 67: 136–42.
21Hald, MT, Vogel, U, Dragsted, L, Loft, S, Wallin, H. Characterization of sugar-induced mutations in the cII gene in the colon of Big Blue rats. Paper presented at Danish Cancer Society Symposium, Nutrition and Cancer26–29 August 2001.
22Slattery, ML, Curtin, K, Anderson, K, Ma, KN, Edwards, S, Leppert, M, et al. Associations between dietary intake and Ki-ras mutations in colon tumors: a population-based study. Cancer Res. 2000; 60: 6935–41.
23Southgate, D. The role of dietary fibre in the diet. J. Roy. Soc. Health 1990; 110: 174176.
24Greenwald, P, Clifford, C, Milner, J. Diet and cancer prevention. Eur. J. Cancer 2001; 37: 948965.
25McCann, J. Obesity, cancer links prompts new recommendations. J. Natl. Cancer Inst. 2001; 93: 901902.
26Riboli, E, Kaaks, R. The EPIC Project: rationale and study design. Int. J. Epidemiol. 2001; 26: S6–S14.
27Slimani, N, Kaaks, R, Ferrari, P, Casagrande, C, Clavel, F, Lotze, G, et al. European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study: rationale, design and population characteristics. Public Health Nutr. 2002; 5(6B): 1125–45.
28Slimani, N, Ferrari, P, Ocké, M, Welch, A, Boeing, H, Liere, M, et al. Standardization of the 24-hour recall calibration method used in the European Prospective Investigation into Cancer and Nutrition (EPIC): general concepts and preliminary results. Eur. J. Clin. Nutr. 2000; 54: 900–17.
29Slimani, N, Deharveng, G, Charrondière, R, van Kappel, A, Ocké, M, Welch, A, et al. Structure of the standardized computerized 24-h diet recall interview used as reference method in the 22 centers participating in the EPIC project. European Prospective Investigation into Cancer and Nutrition. Comput. Meth. Programs Biomed. 1999; 58: 251–66.
30Deharveng, G, Charrondière, UR, Slimani, N, Southgate, DAT, Riboli, E. Comparisons of nutrients in the food composition tables available in the nine European countries participating in EPIC. Eur. J. Clin. Nutr. 1999; 53: 6079.
31Norusis, MJ. SPSS for Windows Professional Statistics, Release 6.0. Chicago, IL: SPSS Inc., 1993.
32Helsing, E. Trends in fat consumption in Europe and their influence on the Mediterranean diet. Eur. J. Clin. Nutr. 1993; 47: S4–12.
33Cruz, A. Dietary habits and nutritional status in adolescents over Europe – Southern Europe. Eur. J. Clin. Nutr. 2000; 54: S29–35.
34Kushi, L, Lenart, E, Willett, W. Health implications of Mediterranean diets in light of contemporary knowledge. 1. Plant foods and dairy products. Am. J. Clin. Nutr. 1995; 61: 1407S–15S.
35Kushi, L, Lenart, E, Willett, W. Health implications of Mediterranean diets in light of contemporary knowledge. 2. Meat, wine, fats, and oil. Am. J. Clin. Nutr. 1995; 61: 1416S–27S.
36Keys, A. Coronary heart disease in seven countries. Circulation 1970; 41(Suppl. 1): 1211.
37Trichopoulou, A, Vasilopoulou, E, Lagiou, A. Mediterranean diet and coronary heart disease: are antioxidants critical? Nutr. Rev. 1999; 57: 253–5.
38Tavani, A, LaVecchia, C. Fruit and vegetable consumption and cancer risk in a Mediterranean population. Am. J. Clin. Nutr. 1995; 61: 1374S–7S.
39Trichopoulou, A, Lagiou, P, Kuper, H, Trichopoulos, D. Cancer and Mediterranean dietary traditions. Cancer Epidemiol. Biomark. Prev. 2000; 9: 869–73.
40Steinmetz, K, Potter, J. Vegetables, fruits and cancer. I. Epidemiology. Cancer Causes Control 1991; 2: 325–57.
41Ness, AR, Powles, JW. Fruit and vegetables, and cardiovascular disease: a review. Int. J. Epidemiol. 1997; 26: 113.
42Law, M, Morris, J. By how much does fruit and vegetable consumption reduce the risk of ischaemic heart disease? Eur. J. Clin. Nutr. 1998; 52: 549–56.
43Serra-Majem, L, Ribas, L, Tresserras, R, Ngo, J, Salleras, J. How could changes in diet explain changes in coronary heart disease mortality in Spain? The Spanish paradox. Am. J. Clin. Nutr. 1995; 61: 1351S–9S.
44Holdsworth, M, Gerber, M, Haslam, C, Scali, J, Beardsworth, A, Avallone, M, et al. A comparison of dietary behaviour in Central England and a French Mediterranean region. Eur. J. Clin. Nutr. 2000; 54: 530–9.
45Roos, G, Prättälä, R. Disparities in Food Habits. Review of Research in 15 European Countries. Publications of the National Public Health Institute. FAIR-97-3096 Disparities Group (tasks 4 and 5) (B24). Helsinki, Finland: KTL–National Public Health Institute, 1999.
46Adlercreutz, H. Epidemiology of phytoestrogens. Baillières Best Pract. Clin. Endocrinol. Metab. 1998; 12: 605–23.
47Gibson, S. Are high-fat, high-sugar foods and diets conducive to obesity? Int. J. Food Sci. Nutr. 1996; 47: 405–15.
48Macdiarmid, J, Cade, J, Blundell, J. High and low fat consumers, their macronutrient intake and body mass index: further analysis of the National Diet and Nutrition Survey of British Adults. Eur. J. Clin. Nutr. 1996; 50: 505–12.
49Macdiarmid, J, Vail, A, Cade, J, Blundell, J. The sugar–fat relationship revisited: differences in consumption between men and women of varying BMI. Int. J. Obes. Relat. Metab. Disord. 1998; 22: 1053–61.
50Boulton-Smith, C, Woodward, M. Dietary composition and fat to sugar ratios in relation to obesity. Int. J. Obes. Relat. Disord. 1994; 18: 820–8.
51Drewnowski, A, Henderson, S, Shore, A, Fischler, C, Preziosi, P, Hercberg, S. The fat–sucrose seesaw in relation to age and dietary variety of French adults. Obes. Res. 1997; 5: 511–8.
52Gudmand-Höyer, E, Skovberg, H. Disaccharide digestion and maldigestion. Scand. J. Gastroenterol. 1996; 31: 111–21.
53Suarez, F, Savaiano, D, Levitt, M. A comparison of symptoms after the consumption of milk or lactose-hydrolyzed milk by people with self-reported severe lactose intolerance. N. Engl. J. Med. 1995; 333: 14.
54Norkost 1997. Landsomfattende kostholdsundersökelse blant menn og kvinner i alderen 16–79. år. Rapport 2/1999. Oslo: Statens råd for ernaering og fysisk aktivitet, 1999.
55O'Doherty Jensen, K, Holm, L. Preferences, quantities and concerns: socio-cultural perspectives on the gendered consumption of foods. Eur. J. Clin. Nutr. 1999; 53: 351–9.
56Beer-Borst, S, Hercberg, S, Morabia, A, Bernstein, M, Galan, P, Galasso, R, et al. Dietary patterns in six European populations: results from EURALIM, a collaborative European data harmonization and information campaign. Eur. J. Clin. Nutr. 2000; 54: 253–62.
57Patterson, RE, Haines, PS, Popkin, BM. Health lifestyle patterns of US adults. Prev. Med. 1994; 23: 453–60.
58Johansson, L, Frost Andersen, L. Who eats 5 a day? Intake of fruits and vegetables among Norwegians in relation to gender and lifestyle. J. Am. Diet. Assoc. 1998; 98: 689–91.
59Irala-Estevez, J, Groth, M, Johansson, L, Oltersdorf, U, Prattala, R, Martinez-Gonzalez, M. A systematic review of socio-economic differences in food habits in Europe: consumption of fruit and vegetables. Eur. J. Clin. Nutr. 2000; 54: 706–14.
60Tjönneland, A, Grönbeck, M, Stripp, C, Overvad, K. Wine intake and diet in a random sample of 48763 Danish men and women. Am. J. Clin. Nutr. 1999; 69: 4954.
61Wallstrom, P, Wirfält, E, Janzon, L, Mattisson, I, Elmstahl, S, Johansson, U, et al. Fruit and vegetable consumption in relation to risk factors for cancer: a report from the Malmö Diet and Cancer Study. Public Health Nutr. 2000; 3: 263–71.
62Chatenoud, L, Negri, E, Vecchia, C, Volpato, O, Franceschi, S. Wine drinking and diet in Italy. Eur. J. Clin. Nutr. 2000; 54: 177–9.
63Roos, G, Johansson, L, Kasmel, A, Klumbiene, J, Prattala, R. Disparities in vegetable and fruit consumption: European cases from the north to the south. Public Health Nutr. 2001; 4: 3543.
64Agudo, A, Pera, G. Vegetable and fruit consumption associated with anthropometric, dietary and lifestyle factors in Spain. EPIC Group of Spain. European Prospective Investigation into Cancer. Public Health Nutr. 1991; 2: 263–71.
65Agudo, A, Amiano, P, Barcos, A, Barricarte, A, Beguiristain, JM, Chirlaque, MD, et al. Dietary intake of vegetables and fruits among adults in five regions of Spain. EPIC Group of Spain. European Prospective Investigation into Cancer and Nutrition. Eur. J. Clin. Nutr. 1991; 53: 174–80.
66Pala, V, Berrino, F, Vineis, P, Palli, D, Celentano, E, Tumino, R. How vegetables are eaten in Italian EPIC centres: still setting a good example? Paper presented at European Conference on Nutrition and Cancer21–24 June 2001.



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