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Despite the known association of chronic cardiovascular diseases and more severe courses of COVID-19, little is known about individual risk perception of patients with a history of acute myocardial infarction (AMI) and resulting preventive behaviours. In May 2020, a postal survey was conducted, including 150 patients with previous AMI from the myocardial infarction registry Augsburg. The study objective was to assess COVID-19 knowledge, individual risk perception, worries, infection likelihood and preventive behaviours in this patient cohort. From the 100 respondents, 69.7% perceived themselves to be at high risk of developing a severe course of COVID-19. There was a significant positive correlation between dangerousness assessment and knowledge on COVID-19. Despite a majority (70%) of patients rating their susceptibility for an infection as moderate to very high, the individual likelihood of being infected was rated at only 3%. Almost 70% of patients with previous MI classified themselves at high risk for a severe course of COVID-19 infection. As seen in other risk groups as well, the availability of valuable information sources as well as the support in individual risk reduction strategies and psychological coping mechanisms are mandatory, especially since higher knowledge correlates with dangerousness assessment and might lead to better compliance with preventive behaviours. [ABSTRACT FROM AUTHOR]

Background/Objectives: Only few epidemiologic studies examined sleep characteristics in relation to dietary behaviour. Our aim was to analyse associations of sleep duration, midpoint of sleep and sleep quality with dietary intake among the Bavarian population. Subjects/Methods: Within the cross-sectional Bavarian Food Consumption Survey II, 1050 subjects aged 13-81 years were recruited. Dietary intake was assessed with three 24-h dietary recalls by telephone (EPIC-Soft). In our study, 814 participants aged 18 years or older, who completed at least two 24-h dietary recalls and who had complete and plausible information on sleep characteristics were analysed. Dietary intake was described by the consumption of main food groups, energy-proving nutrients and energy intake. Sleep was measured by the Pittsburgh Sleep Quality Index Questionnaire, from which categories of self-reported usual sleep duration in half-h-steps per night, midpoint of sleep and overall sleep quality were derived. Results: Sleep duration was associated with intake of non-alcoholic beverages (P Conclusions: Our findings demonstrate only specific associations between sleep characteristics and dietary intake, and mainly sleep duration was associated with beverage intake., Author(s): C Kleiser [sup.1] [sup.2] , N Wawro [sup.1] [sup.2] , M Stelmach-Mardas [sup.3] , H Boeing [sup.3] , K Gedrich [sup.4] , H Himmerich [sup.5] , J Linseisen [sup.1] [...]

BACKGROUND/OBJECTIVES: The aim of this systematic review and meta-analysis was to assess the effect of season on food intake from selected food groups and on energy intake in adults. SUBJECTS/METHODS: The search process was based on selecting publications listed in the following: Medline, Scopus, Web of Science, Embase and Agris. Food frequency questionnaires, 24-h dietary recalls and food records as methods for assessment of dietary intake were used to assess changes in the consumption of 11 food groups and of energy intake across seasons. A meta-analysis was performed. RESULTS: Twenty-six studies were included. Articles were divided into those reporting data on four seasons (winter, spring, summer and autumn) or on two seasons (pre-and post-harvest). Four of the studies could be utilized for meta-analysis describing changes in food consumption across four season scheme: from winter to spring fruits decreased, whereas vegetables, eggs and alcoholic beverages increased; from spring to summer vegetable consumption further increased and cereals decreased; from summer to autumn fruits and cereals increased and vegetables, meat, eggs and alcoholic beverages decreased; from autumn to winter cereals decreased. A significant association was also found between energy intake and season, for 13 studies reporting energy intake across four seasons (favors winter) and for eight studies across pre- and post-harvest seasons (favors post-harvest). CONCLUSIONS: The winter or the post-harvest season is associated with increased energy intake. The intake of fruits, vegetables, eggs, meat, cereals and alcoholic beverages is following a seasonal consumption pattern and at least for these foods season is determinant of intake. European Journal of Clinical Nutrition (2016) 70, 700-708; doi:10.1038/ejcn.2015.224; published online 13 January 2016, INTRODUCTION A seasonal food can be defined as 'food that is outdoor grown or produced during the natural growing/production period for the country or region where it is produced. It [...]

We examined the association of baseline serum 25-hydroxyvitamin D (25(OH)D) with change in weight and total body fat in a cohort of community-dwelling older adults from Southern Germany. A total of 735 participants of the population-based KORA-Age Study (2009-2012), aged 65-90 years, were followed for 2.9 [+ or -]0.1 years. Body fat was assessed with bioelectrical impedance analysis. Linear and multinomial logistic models, adjusted for baseline covariables, were used to examine the association of 25(OH)D with percentage weight and body fat change during follow-up. 25(OH)D levels were not associated with overall weight change or body fat loss. Higher 25(OH)D levels were associated with a lower likelihood of having gained > 3% of body fat in women but not in men. As we cannot exclude residual confounding by outdoor physical activity and diet, our results are not sufficient to support a causal role of 25(OH)D in the etiology of obesity in Caucasian older adults. doi:10.1038/ejcn.2015.89; published online 22 July 2015, INTRODUCTION In older adults, obesity is associated with severe health consequences. (1) As weight loss, however, is only restrictively recommended to this age group, as it may have adverse effects [...]

BACKGROUND/OBJECTIVES: The validity of dietary assessment in large-scale cohort studies has been questioned. Combining data sources for the estimation of usual intake in a blended approach may enhance the validity of dietary measurement. Our objective was to develop a web-based 24-h food list for Germany to identify foods consumed during the previous 24 h and to evaluate the performance of the new questionnaire in a feasibility study. SUBJECTS/METHODS: Available data from the German National Nutrition Survey II were used to develop a finite list of food items. A total of 508 individuals were invited to fill in the 24-h food list via the Internet up to three times during a 3-6-month time period. In addition, participants were asked to evaluate the questionnaire using a brief online evaluation form. RESULTS: In total, 246 food items were identified for the 24-h food list, reflecting > 75% variation in intake of 27 nutrients and four major food groups. Among the individuals invited, 64% participated in the feasibility study. Of these, 100%, 85% and 68% of participants completed the 24-h food list one, two or three times, respectively. The average time needed to complete the questionnaire was 9 min, and its acceptability by participants was rated as high. CONCLUSIONS: The 24-h food list represents a promising new dietary assessment tool that can be used as part of a blended approach combining multiple data sources for valid estimation of usual dietary intake in large-scale cohort studies. European Journal of Clinical Nutrition (2014) 68, 324-329; doi:10.1038/ejcn.2013.274; published online 8 January 2014 Keywords: nutritional epidemiology; dietary assessment; statistical modelling Keywords: nutritional epidemiology; dietary assessment; statistical modelling, INTRODUCTION The valid estimation of long-term dietary intake in large-scale cohort studies represents a methodological challenge. Food frequency questionnaires (FFQs) have long been the instrument of choice. However, FFQs measure [...]

Objectives: Within the European Prospective Investigation into Cancer and Nutrition (EPIC) study, the performance of 24-h dietary recall (24-HDR) measurements as reference measurements in a linear regression calibration model is evaluated critically at the individual (within-centre) and aggregate (between-centre) levels by using unbiased estimates of urinary measurements of nitrogen and potassium intakes. Methods: Between 1995 and 1999, 1072 study subjects (59% women) from 12 EPIC centres volunteered to collect 24-h urine samples. Log-transformed questionnaire, 24-HDR and urinary measurements of nitrogen and potassium intakes were analysed in a multivariate measurement error model to estimate the validity of coefficients and error correlations in self-reported dietary measurements. In parallel, correlations between means of 24-HDR and urinary measurements were computed. Linear regression calibration models were used to estimate the regression dilution (attenuation) factors. Results: After adjustment for sex, centre, age, body mass index and height, the validity coefficients for 24-HDRs were 0.285 (95% confidence interval: 0.194, 0.367) and 0.371 (0.291, 0.446) for nitrogen and potassium intakes, respectively. The attenuation factors estimated in a linear regression calibration model were 0.368 (0.228, 0.508) for nitrogen and 0.500 (0.361, 0.639) for potassium intakes; only the former was different from the estimate obtained using urinary measurements in the measurement error model. The aggregate-level correlation coefficients between means of urinary and 24-HDR measurements were 0.838 (0.637, 0.932) and 0.756 (0.481, 0.895) for nitrogen and potassium intakes, respectively. Conclusions: This study suggests that 24-HDRs can be used as reference measurements at the individual and aggregate levels for potassium intake, whereas, for nitrogen intake, good performance is observed for between-centre calibration, but some limitations are apparent at the individual level. Keywords: measurement errors; urinary measurements; EPIC; 24-h dietary recall; EPIC-SOFT doi: 10.1038/ejcn.2009.80, Introduction The accuracy of dietary assessment instruments used in nutritional epidemiology studies, that is, questionnaires such as food frequency questionnaires or dietary histories, has been repeatedly questioned (Freedman et al., [...]

Objectives: To describe the intake of vitamins thiamine (B1), riboflavin (B2), B6 (pyridoxine), B12 (cobalamine) and C (ascorbic acid) and their food sources among 27 centres in 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods: Between 1995 and 2000, 36 034 persons aged between 35 and 74 years were administered a standardized 24-h dietary recall using a computerized interview software programme (EPIC-SOFT). Intakes of the four B vitamins and vitamin C were estimated using the standardized EPIC Nutrient Database (ENDB). Mean intakes were adjusted for age and weighted by season and day of recall. Results: Intake of B vitamins did not vary considerably between centres, except in the UK health-conscious cohort, in which substantially higher intakes of thiamine and lower intakes of vitamin B12 were reported compared with other centres. Overall, meat was the most important contributor to the B vitamins in all centres except in the UK health-conscious group. Vitamin C showed a clear geographical gradient, with higher intakes in the southern centres as compared with the northern ones; this was more pronounced in men than in women. Vegetables and fruits were major contributors to vitamin C in all centres, but juices and potatoes were also important sources in the northern centres. Conclusions: This study showed no major differences across centres in the mean intakes of B vitamins (thiamine, riboflavin, B6, B12), whereas a tendency towards a north-south gradient was observed for vitamin C. doi: 10.1038/ejcn.2009.78 Keywords: water-soluble vitamins; 24-h dietary recall; standardization; ENDB; EPIC; Europe, Introduction The B vitamins, together with vitamin C, constitute the water-soluble group of vitamins. Classic syndromes caused by a deficiency of water-soluble vitamins, such as scurvy (vitamin C) and beriberi [...]

Background/objectives: Adequate mineral intake is important for the maintenance of bone health, cellular function and general metabolism, and possibly in the aetiology of cancer and other chronic diseases. This study aimed at investigating variation in intakes of selected minerals across 10 European countries participating in the EPIC (European Prospective Investigation into Cancer and Nutrition) study. Methods: Nutrient intakes for 36 034 subjects, aged between 35 and 74 years, in 27 centres were obtained using standardized 24-h dietary recall software (EPIC-SOFT). Mean intakes of calcium, phosphorus, magnesium, iron and potassium were calculated by centre and weighted by season and day of the week and were also stratified by age group. The contribution of food groups to total nutrient intake was calculated. Results: There was clear geographical variability in intakes, with differences ranging from 35% for magnesium to 90% for iron in men and 36% for potassium to 75% for calcium in women, and a twofold difference in sources of haem iron (meat and fish). There was a geographical gradient in iron intake, with higher intakes in Southern than in Northern Europe and also around a twofold north-south gradient in the contribution of fruits and vegetables to potassium intake. Compared with reference intakes, the majority of age groups and centres had intakes above the recommended levels. Dairy foods and products contributed the most to calcium and phosphorus intake in almost all centres. Cereals and cereal products contributed the most to magnesium and iron intakes, except in Greece and Germany. Conclusions: Intakes of minerals vary substantially throughout Europe, with some geographical variability in their food sources. doi: 10.1038/ejcn.2009.77 Keywords: calcium; phosphorus; magnesium; iron; potassium; EPIC, Introduction Minerals are essential nutrients, and adequate intakes are important not only for the maintenance of bone health but also for cellular function and general metabolism. Aspects of mineral metabolism [...]

Background/objectives: Europe has the highest level of alcohol consumption in the world. As drinking patterns are important determinants of the beneficial and harmful effects of alcohol consumption, we investigated alcohol consumption in relation to nutrient intake, place of consumption, education and body weight in a sample of adults from 10 European countries. Methods: A 24-h dietary recall interview was conducted on 13 025 men and 23 009 women, aged 35-74 years, from 27 centres participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Means and standard errors of alcohol consumption, adjusted for age, were calculated, stratified by gender and centre. Results: In many centres, higher level drinkers (males consuming >24 g of ethanol/day, equivalent to 42 standard drinks and females consuming >12 g of ethanol/day equivalent to >1 standard drink) obtained more energy from fat and protein and less from sugar than did abstainers. The proportion of energy from starch tended to be higher for male and lower for female higher level drinkers than for abstainers. Female higher level drinkers had a lower body mass index than did abstainers, whereas male higher level drinkers generally weighed more. Male higher level drinkers were less educated than abstainers in Mediterranean countries, but were more educated elsewhere. Female higher level drinkers were usually more educated than were abstainers. Outside the home, consumption (both genders) tended to be at friends' homes, particularly among men in Northern and Central Europe, and in bars in Spain. Conclusions: This study reveals clear geographical differences in drinking habits across Europe, and shows that the characteristics of different alcohol consumption categories also vary. doi: 10.1038/ejcn.2009.76 Keywords: Alcohol; EPIC; 24-h dietary recall; EPIC-Soft; ENDB, Introduction Europe has the highest level of alcohol consumption in the world (Rehm et al., 2003a). Studies on drinking patterns across Europe, in terms of place of consumption, types of [...]

Objectives: This paper describes the dietary intake of total fat, saturated (SFA), monounsaturated (MUFA) and polyunsaturated fatty acids (PUFA) and cholesterol of participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) in 27 centres across 10 countries. Methods: Between 1995 and 2000, a stratified random sample of 36 034 participants (age range 35-74 years) completed a standardized 24-h dietary recall, assessed by means of the computer software EPIC-SOFT. Lipid intake data were calculated using a standardized nutrient database. Results: On average, the contribution of fat to total energy intake was ≥ 34% of energy intake (%en) in women and ≥ 36%en in men for most EPIC centres, except for the British, Dutch and most Italian cohorts. Total fat (440%en) and MUFA intakes (21%en, mainly from olive oil) were highest in Greece. Except for the Greek, Spanish and Italian centres, the average MUFA intake ranged between 10 and 13%en, with a high proportion derived from animal sources. SFA intake in women and men was lowest in the Greek, Spanish, Italian and UK cohorts with an average of ≤ 13%en (down to 9%en), and highest in the Swedish centres (16%en). The mean PUFA intake was in the range of 4-8%en, being highest in the UK health-conscious cohort. The average cholesterol intake across EPIC varied from 140 to 384 mg/d in women and 215-583 mg/d in men. Conclusions: The presented data show differences and similarities in lipid intake across the European EPIC cohorts and also show differences in food sources of dietary lipids. doi: 10.1038/ejcn.2009.75 Keywords: EPIC; 24-h diet recalls; dietary intake; lipids; EPIC-Soft; ENDB, Introduction Diet has a major impact on modulating the risk and severity of a number of chronic diseases including obesity and obesity-related metabolic disorders, cardiovascular diseases and cancer. Among macronutrients, [...]

Objective: To describe dietary protein intakes and their food sources among 27 redefined centres in 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods: Between 1995 and 2000, 36 034 persons, aged between 35 and 74 years, were administered a standardized 24-h dietary recall (24-HDR) using a computerized interview software programme (EPIC-SOFT). Intakes (g/day) of total, animal and plant proteins were estimated using the standardized EPIC Nutrient Database (ENDB). Mean intakes were adjusted for age, and weighted by season and day of recall. Results: Mean total and animal protein intakes were highest in the Spanish centres among men, and in the Spanish and French centres among women; the lowest mean intakes were observed in the UK health-conscious group, in Greek men and women, and in women in Potsdam. Intake of plant protein was highest among the UK health-conscious group, followed by some of the Italian centres and Murcia, whereas Sweden and Potsdam had the lowest intake. Cereals contributed to the highest proportion of plant protein in all centres. The combined intake of legumes, vegetables and fruit contributed to a greater proportion of plant protein in the southern than in the northern centres. Total meat intake (with some heterogeneity across subtypes of meat) was, with few exceptions, the most important contributor to animal protein in all centres, followed by dairy and fish products. Conclusions: This study shows that intake of protein, especially of animal origin, differs across the 10 European countries, and also shows some differences in food sources of protein across Europe. doi: 10.1038/ejcn.2009.73 Keywords: total proteins; animal proteins; plant proteins; EPIC; 24-h dietary recall; ENDB, Introduction Dietary protein is an important macronutrient, contributing to around 15-20% of the total dietary energy intake in Western countries (CDC, 2004; Elmadfa and Weichselbaum, 2005). Protein, which contributes essential [...]

Objectives: To describe energy intake and its macronutrient and food sources among 27 regions in 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods: Between 1995 and 2000, 36034 subjects aged 35-74 years were administered a standardized 24-h dietary recall. Intakes of macronutrients (g/day) and energy (kcal/day) were estimated using standardized national nutrient databases. Mean intakes were weighted by season and day of the week and were adjusted for age, height and weight, after stratification by gender. Extreme low- and high-energy reporters were identified using Goldberg's cutoff points (ratio of energy intake and estimated basal metabolic rate 2.72), and their effects on macronutrient and energy intakes were studied. Results: Low-energy reporting was more prevalent in women than in men. The exclusion of extreme-energy reporters substantially lowered the EPIC-wide range in mean energy intake from 2196-2877 to 2309-2866 kcal among men. For women, these ranges were 1659-2070 and 1873-2108 kcal. There was no north-south gradient in energy intake or in the prevalence of low-energy reporting. In most centres, cereals and cereal products were the largest contributors to energy intake. The food groups meat, dairy products and fats and oils were also important energy sources. In many centres, the highest mean energy intakes were observed on Saturdays. Conclusions: These data highlight and quantify the variations and similarities in energy intake and sources of energy intake among 10 European countries. The prevalence of low-energy reporting indicates that the study of energy intake is hampered by the problem of underreporting. Keywords: energy intake; underreporting; dietary fat; 24-h dietary recall; Europe; EPIC-soft doi: 10.1038/ejcn.2009.72, Introduction Nowadays, in Europe, an enormously rich variety of foods is available on the market, and this very abundance, especially of energy-dense foods and drinks, is considered to be one [...]

The study aims to investigate whether general and abdominal adiposity is a contributory factor in increasing the risk of death in Europe. The results indicate that both general and abdominal adiposity are associated with a higher risk of death.