title: Meal patterns across ten European countries - results from the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study.
abstract: To characterize meal patterns across ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study.
  
  
  
  Cross-sectional study utilizing dietary data collected through a standardized 24 h diet recall during 1995-2000. Eleven predefined intake occasions across a 24 h period were assessed during the interview. In the present descriptive report, meal patterns were analysed in terms of daily number of intake occasions, the proportion reporting each intake occasion and the energy contributions from each intake occasion.
  
  
  
  Twenty-seven centres across ten European countries.
  
  
  
  Women (64 %) and men (36 %) aged 35-74 years (n 36 020).
  
  
  
  Pronounced differences in meal patterns emerged both across centres within the same country and across different countries, with a trend for fewer intake occasions per day in Mediterranean countries compared with central and northern Europe. Differences were also found for daily energy intake provided by lunch, with 38-43 % for women and 41-45 % for men within Mediterranean countries compared with 16-27 % for women and 20-26 % for men in central and northern European countries. Likewise, a south-north gradient was found for daily energy intake from snacks, with 13-20 % (women) and 10-17 % (men) in Mediterranean countries compared with 24-34 % (women) and 23-35 % (men) in central/northern Europe.
  
  
  
  We found distinct differences in meal patterns with marked diversity for intake frequency and lunch and snack consumption between Mediterranean and central/northern European countries. Monitoring of meal patterns across various cultures and populations could provide critical context to the research efforts to characterize relationships between dietary intake and health.
authors.affiliation: 1Department of Internal Medicine and Clinical Nutrition,The Sahlgrenska Academy,University of Gothenburg,Box 459,SE-405 30,Gothenburg,Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Huseinovic
authors.affiliation: 1Department of Internal Medicine and Clinical Nutrition,The Sahlgrenska Academy,University of Gothenburg,Box 459,SE-405 30,Gothenburg,Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Winkvist
authors.affiliation: 3Dietary Exposure Assessment Group,International Agency for Research on Cancer,Lyon,France.
authors.forename: N
authors.initials: N
authors.lastname: Slimani
authors.affiliation: 3Dietary Exposure Assessment Group,International Agency for Research on Cancer,Lyon,France.
authors.forename: M K
authors.initials: MK
authors.lastname: Park
authors.affiliation: 3Dietary Exposure Assessment Group,International Agency for Research on Cancer,Lyon,France.
authors.forename: H
authors.initials: H
authors.lastname: Freisling
authors.affiliation: 4Department of Epidemiology,German Institute of Human Nutrition,Nuthetal,Germany.
authors.forename: H
authors.initials: H
authors.lastname: Boeing
authors.affiliation: 5Unit of Nutrition and Cancer,Cancer Epidemiology Research Programme,Catalan Institute of Oncology (ICO-IDIBELL),Barcelona,Spain.
authors.forename: G
authors.initials: G
authors.lastname: Buckland
authors.affiliation: 4Department of Epidemiology,German Institute of Human Nutrition,Nuthetal,Germany.
authors.forename: L
authors.initials: L
authors.lastname: Schwingshackl
authors.affiliation: 6Department of Community Medicine, Faculty of Health Sciences,University of Tromsø,The Arctic University of Norway,Tromsø,Norway.
authors.forename: E
authors.initials: E
authors.lastname: Weiderpass
authors.affiliation: 10Danish Cancer Society Research Center,Copenhagen,Denmark.
authors.forename: A L
authors.initials: AL
authors.lastname: Rostgaard-Hansen
authors.affiliation: 10Danish Cancer Society Research Center,Copenhagen,Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Tjønneland
authors.affiliation: 11Université Paris-Saclay,Université Paris-Sud,UVSQ,CESP,INSERM,Villejuif,France.
authors.forename: A
authors.initials: A
authors.lastname: Affret
authors.affiliation: 11Université Paris-Saclay,Université Paris-Sud,UVSQ,CESP,INSERM,Villejuif,France.
authors.forename: M C
authors.initials: MC
authors.lastname: Boutron-Ruault
authors.affiliation: 11Université Paris-Saclay,Université Paris-Sud,UVSQ,CESP,INSERM,Villejuif,France.
authors.forename: G
authors.initials: G
authors.lastname: Fagherazzi
authors.affiliation: 13German Cancer Research Center (DKFZ),Division of Cancer Epidemiology,Heidelberg,Germany.
authors.forename: V
authors.initials: V
authors.lastname: Katzke
authors.affiliation: 13German Cancer Research Center (DKFZ),Division of Cancer Epidemiology,Heidelberg,Germany.
authors.forename: T
authors.initials: T
authors.lastname: Kühn
authors.affiliation: 14Hellenic Health Foundation,Athens,Greece.
authors.forename: A
authors.initials: A
authors.lastname: Naska
authors.affiliation: 14Hellenic Health Foundation,Athens,Greece.
authors.forename: P
authors.initials: P
authors.lastname: Orfanos
authors.affiliation: 14Hellenic Health Foundation,Athens,Greece.
authors.forename: A
authors.initials: A
authors.lastname: Trichopoulou
authors.affiliation: 16Epidemiology and Prevention Unit,Department of Preventive and Predictive Medicine,Fondazione IRCCS Istituto Nazionale dei Tumori,Milan,Italy.
authors.forename: V
authors.initials: V
authors.lastname: Pala
authors.affiliation: 17Molecular and Nutritional Epidemiology Unit,Cancer Research and Prevention Institute - ISPO,Florence,Italy.
authors.forename: D
authors.initials: D
authors.lastname: Palli
authors.affiliation: 18Unit of Epidemiology,Regional Health Service ASL TO3,Grugliasco (TO),Italy.
authors.forename: F
authors.initials: F
authors.lastname: Ricceri
authors.affiliation: 20Azienda Ospedaliera Universitaria (AOU) Federico II,Naples,Italy.
authors.forename: M
authors.initials: M
authors.lastname: Santucci de Magistris
authors.affiliation: 21Cancer Registry and Histopathology Unit,'Civic - M.P. Arezzo' Hospital,ASP Ragusa,Ragusa,Italy.
authors.forename: R
authors.initials: R
authors.lastname: Tumino
authors.affiliation: 22Norwegian Food Safety Authority,Head Office,Oslo,Norway.
authors.forename: D
authors.initials: D
authors.lastname: Engeset
authors.affiliation: 6Department of Community Medicine, Faculty of Health Sciences,University of Tromsø,The Arctic University of Norway,Tromsø,Norway.
authors.forename: T
authors.initials: T
authors.lastname: Enget
authors.affiliation: 6Department of Community Medicine, Faculty of Health Sciences,University of Tromsø,The Arctic University of Norway,Tromsø,Norway.
authors.forename: G
authors.initials: G
authors.lastname: Skeie
authors.affiliation: 23Navarra Public Health Institute,Pamplona,Spain.
authors.forename: A
authors.initials: A
authors.lastname: Barricarte
authors.affiliation: 5Unit of Nutrition and Cancer,Cancer Epidemiology Research Programme,Catalan Institute of Oncology (ICO-IDIBELL),Barcelona,Spain.
authors.forename: C B
authors.initials: CB
authors.lastname: Bonet
authors.affiliation: 25CIBER Epidemiology and Public Health (CIBERESP),Madrid,Spain.
authors.forename: M D
authors.initials: MD
authors.lastname: Chirlaque
authors.affiliation: 25CIBER Epidemiology and Public Health (CIBERESP),Madrid,Spain.
authors.forename: P
authors.initials: P
authors.lastname: Amiano
authors.affiliation: 29Public Health Directorate,Asturias,Spain.
authors.forename: J R
authors.initials: JR
authors.lastname: Quirós
authors.affiliation: 25CIBER Epidemiology and Public Health (CIBERESP),Madrid,Spain.
authors.forename: M J
authors.initials: MJ
authors.lastname: Sánchez
authors.affiliation: 31Department of Clinical Sciences in Malmö,Lund University,Lund,Sweden.
authors.forename: J A
authors.initials: JA
authors.lastname: Dias
authors.affiliation: 31Department of Clinical Sciences in Malmö,Lund University,Lund,Sweden.
authors.forename: I
authors.initials: I
authors.lastname: Drake
authors.affiliation: 2Department of Public Health and Clinical Medicine,Nutritional Research,Umeå University,Umeå,Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Wennberg
authors.affiliation: 32Centre for Nutrition,Prevention and Health Services,National Institute for Public Health and the Environment (RIVM),Bilthoven,The Netherlands.
authors.forename: Jma
authors.initials: J
authors.lastname: Boer
authors.affiliation: 32Centre for Nutrition,Prevention and Health Services,National Institute for Public Health and the Environment (RIVM),Bilthoven,The Netherlands.
authors.forename: M C
authors.initials: MC
authors.lastname: Ocké
authors.affiliation: 32Centre for Nutrition,Prevention and Health Services,National Institute for Public Health and the Environment (RIVM),Bilthoven,The Netherlands.
authors.forename: Wmm
authors.initials: W
authors.lastname: Verschuren
authors.affiliation: 34Department of Epidemiology and Biostatistics,School of Public Health,Imperial College London,London,UK.
authors.forename: C
authors.initials: C
authors.lastname: Lassale
authors.affiliation: 35Cancer Epidemiology Unit,Nuffield Department of Population Health,University of Oxford,Oxford,UK.
authors.forename: A
authors.initials: A
authors.lastname: Perez-Cornago
authors.affiliation: 34Department of Epidemiology and Biostatistics,School of Public Health,Imperial College London,London,UK.
authors.forename: E
authors.initials: E
authors.lastname: Riboli
authors.affiliation: 34Department of Epidemiology and Biostatistics,School of Public Health,Imperial College London,London,UK.
authors.forename: H
authors.initials: H
authors.lastname: Ward
authors.affiliation: 1Department of Internal Medicine and Clinical Nutrition,The Sahlgrenska Academy,University of Gothenburg,Box 459,SE-405 30,Gothenburg,Sweden.
authors.forename: H Bertéus
authors.initials: HB
authors.lastname: Forslund
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004032:Diet; D004034:Diet Surveys; D002149:Energy Intake; D005060:Europe; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D062407:Meals; D008875:Middle Aged; D011446:Prospective Studies; D062410:Snacks
keywords: 24 h dietary recall; EPIC; Energy intake; Intake frequency; Intake occasion; Meal patterns; Meals; Snacks; Standardization