The incidence of cancer overall in Mediterranean countries is lower than in Scandinavian countries, the United Kingdom, and the United States. This is mostly accounted for by the lower incidence among Mediterranean countries of cancer of the large bowel, breast, endometrium, and prostate. These forms of cancer have been linked to dietary factors, particularly low consumption of vegetables and fruit, and to a certain extent, high consumption of meat. The traditional Mediterranean diet is characterized by high consumption of foods of plant origin, relatively low consumption of red meat, and high consumption of olive oil, which in several studies has been reported to be more beneficial against cancer than other forms of added lipids. By taking into account the established or presumed nutritional causation of major forms of cancer and the composition of the traditional Mediterranean diet, estimates can be derived concerning the fraction of cancer occurrence in highly developed Western countries that could be attributed to their diets in comparison with the healthy traditional Mediterranean diet. Although estimates can only be crude, it can be calculated that up to 25% of the incidence of colorectal cancer, approximately 15% of the incidence of breast cancer, and approximately 10% of the incidence of prostate, pancreas, and endometrial cancer could be prevented if the populations of highly developed Western countries could shift to the traditional healthy Mediterranean diet.
Energy-generating nutrients and total energy were computed and analytically determined for four widely used foods in Greece (mousaka, bean soup, infant food, and feta cheese), as well as for the individual food items necessary for their preparation. Standard procedures were used for chemical analyses, whereas computed values were generated through the Unilever Dietary Analysis Program--UNIDAP (Barrow et al., 1988) on the basis of the British food composition tables. Pesticides and pesticide residues were also determined in the studied samples. A very good agreement was noted with respect to the nutrient composition of the four prepared foods, whereas the agreement was somewhat weaker for the individual food items used for the preparation of the composite foods. It is concluded that the UNIDAP program generates reliable nutrient composition data for composite foods and for time integrated dietary intakes in Greece. The concentrations of several of the determined pesticides were towards the higher end of the spectrum of levels reported in the literature. This project has demonstrated the value of collaboration between academic institutions, industry, and state laboratories towards the development and validation of food composition databases.
OBJECTIVE: To evaluate the consumption of added fats and oils across the European centres and countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). DESIGN AND SETTING: 24-Hour dietary recalls were collected by means of standardised computer-guided interviews in 27 redefined EPIC centres across 10 European countries. SUBJECTS: From an initial number of 36 900 subjects, single dietary recalls from 22 924 women and 13 031 men in the age range of 35-74 years were included. RESULTS: Mean daily intake of added fats and oils varied between 16.2 g (Varese, Italy) and 41.1 g (MalmÃ¶, Sweden) in women and between 24.7 g (Ragusa, Italy) and 66.0 g (Potsdam, Germany) in men. Total mean lipid intake by consumption of added fats and oils, including those used for sauce preparation, ranged between 18.3 (Norway) and 37.2 g day-1 (Greece) in women and 28.4 (Heidelberg, Germany) and 51.2 g day-1 (Greece) in men. The Mediterranean EPIC centres with high olive oil consumption combined with low animal fat intake contrasted with the central and northern European centres where fewer vegetable oils, more animal fats and a high proportion of margarine were consumed. The consumption of added fats and oils of animal origin was highest in the German EPIC centres, followed by the French. The contribution of added fats and oils to total energy intake ranged from 8% in Norway to 22% in Greece. CONCLUSIONS: The results demonstrate a high variation in dietary intake of added fats and oils in EPIC, providing a good opportunity to elucidate the role of dietary fats in cancer aetiology.
OBJECTIVE: To identify, quantify and depict variation of food habits in Europe, using data from the DAFNE (DAta Food NEtworking) databank. SETTING: Household budget survey data of 12 European countries, namely Belgium, Germany, Greece, Hungary, Ireland, Italy, Luxembourg, Norway, Poland, Portugal, Spain and the United Kingdom, around 1990. RESULTS: Data from the DAFNE databank are presented in simple pictorial presentations, which reveal considerable disparities in food habits. Furthermore, there appears to be nutritional variation within countries by socio-demographic groups, defined by their residence and educational level. The distribution patterns of food availability provide insights into the determinants of food preferences, as conditioned by current forces. CONCLUSION: The factors influencing consumer choice are many and varied. Thus, in order to promote healthy eating, it is essential to identify the food habits of the target population. In this context, information derived from household budget surveys, used in the development of the DAFNE databank, could be very important.
Mortality statistics from the WHO database covering the period 1960 to 1990 have provided intriguing evidence that something unusual has been affecting in a beneficial way the health of the Mediterranean population. In recent papers, which evaluated the evidence accumulated over the last three decades, it was concluded that the traditional Mediterranean diet meets several important criteria for a healthy diet. Direct evidence in support of the beneficial properties of the Mediterranean diet has also become available. These data were derived from three studies, which have used a diet score, devised a priori on the basis of eight desirable key features of the traditional common diet in the Mediterranean region. The conclusion of these studies is that a diet that adheres to the principles of the traditional Mediterranean one is associated with longer survival. The Greek version of the Mediterranean diet is dominated by the consumption of olive oil and by high consumption of vegetables and fruits. Antioxidants represent a common element in these foods and an antioxidant action provides a plausible explanation for the apparent benefits. Wild edible greens frequently eaten in rural Greece in the form of salads and pies contain very high quantities of flavonoids-- considerably higher than those found in red wine or black tea. While there is no direct evidence that these antioxidants are central to the benefits of the Mediterranean Diet, indirect evidence from epidemiological data and the increasing understanding of their mechanisms of action suggest that antioxidants may play a major role.
OBJECTIVE: To describe physical activity of participants in the European Prospective Investigation into Cancer and Nutrition (EPIC). DESIGN: A cross-sectional analysis of baseline data of a European prospective cohort study. SUBJECTS: This analysis was restricted to participants in the age group 50-64 years, which was represented in all EPIC centres. It involved 236 386 participants from 25 centres in nine countries. In each EPIC centre, physical activity was assessed by standardised and validated questions. Frequency distribution of type of professional activity and participation in non-professional activities, and age-adjusted means, medians and percentiles of time dedicated to non-professional activities are presented for men and women from each centre. RESULTS: Professional activity was most frequently classified as sedentary or standing in all centres. There was a wide variation regarding participation in different types of non-professional activities and time dedicated to these activities across EPIC centres. Over 80% of all EPIC participants engaged in walking, while less than 50% of the subjects participated in sport. Total time dedicated to recreational activities was highest among the Dutch participants and lowest among men from MalmÃ¶ (Sweden) and women from Naples (Italy). In all centres, total time dedicated to recreational activity in the summer was higher than in the winter. Women from southern Europe spent the most time on housekeeping. CONCLUSIONS: There is a considerable variation of physical activity across EPIC centres. This variation was especially evident for recreational activities in both men and women.
OBJECTIVE: To compare individualised household budget survey (HBS) data with food consumption values derived from individual nutrition surveys (INSs). SETTING: Four European countries: Belgium, 1980-85 and 1987-88; Greece, 1993-94; Norway, 1992-94; and the United Kingdom, 1985-88. DESIGN: Household budget survey data were individualised with non-parametric models. Individual nutrition survey data were converted into 'HBS-like' estimates, with the application of recipe-based calculations and yield factors for weight changes during food preparation. To correct for over- and underreporting or recording in both surveys, quantities (in g day(-1)) of 14 principal food groups were expressed as fractions of total food quantity (in g day(-1)). For each food group, INS and HBS-derived mean values were calculated for 24 research units, jointly defined by country (four countries involved), gender (male, female) and age (younger, middle-aged and older). Pearson correlation coefficients were calculated and correlation diagrams were drawn. CONCLUSION: The results of this preliminary analysis show that there is value in the nutritional information derived from HBSs. However, additional and more sophisticated work is required, in order to derive reliable point and interval estimates of individual food consumption based on HBS data.