Meal patterns across ten European countries – results from the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study

Research output: Contribution to journalArticle


Objective: To characterize meal patterns across ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study. Design: 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. Setting: Twenty-seven centres across ten European countries. Subjects: Women (64 %) and men (36 %) aged 35–74 years (n 36 020). Results: 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. Conclusions: 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.


  • E. Huseinovic
  • A. Winkvist
  • N. Slimani
  • M. K. Park
  • H. Freisling
  • H. Boeing
  • G. Buckland
  • L. Schwingshackl
  • E. Weiderpass
  • A. L. Rostgaard-Hansen
  • A. Tjønneland
  • A. Affret
  • M. C. Boutron-Ruault
  • G. Fagherazzi
  • V. Katzke
  • T. Kühn
  • A. Naska
  • P. Orfanos
  • A. Trichopoulou
  • V. Pala
  • D. Palli
  • F. Ricceri
  • M. Santucci de Magistris
  • R. Tumino
  • D. Engeset
  • T. Enget
  • G. Skeie
  • A. Barricarte
  • C. B. Bonet
  • M. D. Chirlaque
  • P. Amiano
  • J. R. Quirós
  • M. J. Sánchez
  • M. Wennberg
  • JMA M A Boer
  • M. C. Ocké
  • WMM M M Verschuren
  • C. Lassale
  • A. Perez-Cornago
  • E. Riboli
  • H. Ward
  • H. Bertéus Forslund
External organisations
  • University of Gothenburg
  • Umeå University
  • International Agency for Research on Cancer, World Health Organization
  • German Institute of Human Nutrition
  • Catalan Institute of Oncology
  • Folkhälsan Research Center
  • Danish Cancer Society Research Center
  • Stabilite genetique et oncogenese
  • German Cancer Research Centre
  • National and Kapodistrian University of Athens
  • Istituto Nazionale dei Tumori
  • Cancer Research and Prevention Institute (ISPO)
  • University of Turin
  • University of Naples Federico II
  • Civic and M.P Arezzo Hospital
  • Norwegian Food Safety Authority
  • UiT The Arctic University of Norway, Tromsø
  • CIBER Epidemiology and Public Health (CIBERESP)
  • University of Murcia
  • Biodonostia Health Research Institute
  • Public Health Directorate
  • University of Granada
  • National Institute for Public Health and the Environment (RIVM)
  • University Medical Center Utrecht
  • Imperial College London
  • University of Oxford
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cancer and Oncology


  • 24 h dietary recall, Energy intake, EPIC, Intake frequency, Intake occasion, Meal patterns, Meals, Snacks, Standardization
Original languageEnglish
Pages (from-to)2769-2780
Number of pages12
JournalPublic Health Nutrition
Issue number15
Publication statusPublished - 2016 Oct
Publication categoryResearch