title: 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: OBJECTIVE
  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, beta-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.
authors.affiliation: Dietary Exposure Assessment Group, International Agency for Research on Cancer, Lyon, France. Slimani@iarc.fr
authors.forename: N
authors.initials: N
authors.lastname: Slimani
authors.forename: G
authors.initials: G
authors.lastname: Deharveng
authors.forename: D A T
authors.initials: DA
authors.lastname: Southgate
authors.forename: C
authors.initials: C
authors.lastname: Biessy
authors.forename: V
authors.initials: V
authors.lastname: Chajès
authors.forename: M M E
authors.initials: MM
authors.lastname: van Bakel
authors.forename: M C
authors.initials: MC
authors.lastname: Boutron-Ruault
authors.forename: A
authors.initials: A
authors.lastname: McTaggart
authors.forename: S
authors.initials: S
authors.lastname: Grioni
authors.forename: J
authors.initials: J
authors.lastname: Verkaik-Kloosterman
authors.forename: I
authors.initials: I
authors.lastname: Huybrechts
authors.forename: P
authors.initials: P
authors.lastname: Amiano
authors.forename: M
authors.initials: M
authors.lastname: Jenab
authors.forename: J
authors.initials: J
authors.lastname: Vignat
authors.forename: K
authors.initials: K
authors.lastname: Bouckaert
authors.forename: C
authors.initials: C
authors.lastname: Casagrande
authors.forename: P
authors.initials: P
authors.lastname: Ferrari
authors.forename: P
authors.initials: P
authors.lastname: Zourna
authors.forename: A
authors.initials: A
authors.lastname: Trichopoulou
authors.forename: E
authors.initials: E
authors.lastname: Wirfält
authors.forename: G
authors.initials: G
authors.lastname: Johansson
authors.forename: S
authors.initials: S
authors.lastname: Rohrmann
authors.forename: A-K
authors.initials: AK
authors.lastname: Illner
authors.forename: A
authors.initials: A
authors.lastname: Barricarte
authors.forename: L
authors.initials: L
authors.lastname: Rodríguez
authors.forename: M
authors.initials: M
authors.lastname: Touvier
authors.forename: M
authors.initials: M
authors.lastname: Niravong
authors.forename: A
authors.initials: A
authors.lastname: Mulligan
authors.forename: F
authors.initials: F
authors.lastname: Crowe
authors.forename: M C
authors.initials: MC
authors.lastname: Ocké
authors.forename: Y T
authors.initials: YT
authors.lastname: van der Schouw
authors.forename: B
authors.initials: B
authors.lastname: Bendinelli
authors.forename: C
authors.initials: C
authors.lastname: Lauria
authors.forename: M
authors.initials: M
authors.lastname: Brustad
authors.forename: A
authors.initials: A
authors.lastname: Hjartåker
authors.forename: A
authors.initials: A
authors.lastname: Tjønneland
authors.forename: A M
authors.initials: AM
authors.lastname: Jensen
authors.forename: E
authors.initials: E
authors.lastname: Riboli
authors.forename: S
authors.initials: S
authors.lastname: Bingham
mesh_terms: D000328:Adult; D000368:Aged; D001205:Ascorbic Acid / Q000008:administration & dosage; D004032:Diet / Q000706:statistics & numerical data*; D015930:Diet Records; D004034:Diet Surveys; D002149:Energy Intake; D005060:Europe; D057140:Fast Foods; D005260:Female; D005511:Food Handling; D005525:Food-Processing Industry; D006801:Humans; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage; D008875:Middle Aged; D011446:Prospective Studies; D019207:beta Carotene / Q000008:administration & dosage
chemical_list: D018977:Micronutrients; D019207:beta Carotene; D001205:Ascorbic Acid