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ObjectiveTo describe fruit and vegetable intake of 11-year-old children in ten European countries and compare it with current dietary guidelines.DesignCross-sectional survey. Intake was assessed using a previously validated questionnaire containing a pre-coded 24 h recall and an FFQ which were completed in the classroom. Portion sizes were calculated using a standardized protocol.SettingSurveys were performed in schools regionally selected in eight countries and nationally representative in two countries.SubjectsA total of 8158 children from 236 schools across Europe participating in the PRO GREENS project.ResultsThe total mean consumption of fruit and vegetables was between 220 and 345 g/d in the ten participating countries. Mean intakes did not reach the WHO population goal of ≥400 g/d in any of the participating countries. Girls had a significantly higher intake of total fruit and vegetables than boys in five of the countries (Sweden, Finland, Iceland, Bulgaria and Slovenia). Mean total fruit intake ranged between 114 and 240 g/d and vegetable intake between 73 and 141 g/d. When using the level ≥400 g/d as a cut-off, only 23·5 % (13·8–37·0 %) of the studied children, depending on country and gender, met the WHO recommendation (fruit juice excluded).ConclusionsFruit and vegetable consumption was below recommended levels among the schoolchildren in all countries and vegetable intake was lower than fruit intake. The survey shows that there is a need for promotional activities to improve fruit and vegetable consumption in this age group. [ABSTRACT FROM AUTHOR]

Background/objectives:Longitudinal studies investigating dietary patterns (DPs) and their association with childhood overweight/obesity are lacking in Europe. We identified DPs and investigated their association with overweight/obesity and changes in body mass index (BMI) in a cohort of European children.Subjects/methods:Children aged 2-10 from eight European countries were recruited in 2007-2008. Food frequency questionnaires were collected from 14 989 children. BMI and BMI z-scores were derived from height and weight and were used to identify overweight/obese children. After 2 years (mean), anthropometric measurements were repeated in 9427 children. Principal component analysis was used to identify DPs. Simplified DPs (SDPs) were derived from DPs. Adjusted odds ratios (ORs) for overweight/obesity with increasing DP intake were estimated using multilevel logistic regression. Associations of BMI change with DP and SDP were assessed by multilevel mixed regression. Models were adjusted for baseline BMI, age, sex, physical activity and family income.Results:Four DPs were identified that explained 25% of food intake variance: snacking, sweet and fat, vegetables and wholemeal, and protein and water. After 2 years, 849(9%) children became overweight/obese. Children in the highest vegetables and wholemeal tertile had lower risk of becoming overweight/obese (OR: 0.69, 95% confidence intervals (CIs): 0.54-0.88). Children in the highest SDP tertile of vegetables and wholemeal had similarly lower risk of becoming overweight/obese (OR: 0.64, 95% CIs: 0.51-0.82), and their BMI increased by 0.7 kg/m2 over the study period-significantly less than the increase in the lowest tertile (0.84 kg/m2).Conclusions:Our findings suggest that promoting a diet rich in vegetables and wholemeal cereals may counteract overweight/obesity in children. [ABSTRACT FROM AUTHOR]

Cancer is one of the major causes of death in western countries. Fruit and vegetable consumption may reduce the risk of cancers of the oropharynx, oesophagus, lung, stomach and colorectum. We investigated the potential effect of interventions aimed at increasing the intake of fruits and vegetables to the recommended level (500g/d) on future cancer incidence in Europe. Data on cancer incidence and daily intake of fruit and vegetables were compiled for France, Germany, The Netherlands, Spain and Sweden. We also performed a meta-analysis of European observational studies to arrive at a quantitative estimate on the association between fruit and vegetable intake and cancer risk. Predictions on the future cancer incidence were modelled using PREVENT 3.01. Our study predicted 212,000 fruit- and vegetable-related cancer cases in these countries in 2050, out of which 398 (0.19%) might be prevented if the 500g/d fruit and vegetable intake were achieved in the aforementioned countries. The largest absolute impact was observed for lung cancer with 257 (out of 136,517) preventable cases if the intervention was successfully implemented. Sweden would benefit the most from intervention to increase fruit and vegetable consumption with a 2% reduction in expected cases. Increasing fruit and vegetable consumption has a small impact on reducing the burden of cancer in Europe. Health impact assessment tools such as PREVENT can provide the basis for decision making in chronic disease prevention. [Copyright &y& Elsevier]

Objective: The relationship of socio-economic status and vegetable consumption is examined in nine European countries. The aim is to analyse whether the pattern of socio-economic variation with regard to vegetable consumption is similar in all studied countries with high v. low vegetable availability and affordability, and whether education has an independent effect on vegetable consumption once the effects of other socio-economic factors have been taken into account. Design: The data for the study were obtained from national surveys conducted in Finland, Denmark, Germany, Estonia, Latvia, Lithuania, France, Italy and Spain, in 1998 or later. These surveys included data on the frequency of use of vegetables. Food Balance Sheets indicated that the availability of vegetables was best in the Mediterranean countries. The prices of vegetables were lowest in the Mediterranean countries and Germany. Results: Educational level was positively associated with vegetable consumption in the Nordic and Baltic countries. In the Mediterranean countries, education was not directly associated with the use of vegetables but, after adjusting for place of residence and occupation, it was found that those with a lower educational level consumed vegetables slightly more often. Manual workers consumed vegetables less often than non-manual workers, but otherwise there was no systematic association with occupation. Conclusions: The Mediterranean countries did not show a positive association between educational level and vegetable consumption. The positive association found in the Northern European countries is linked to the lower availability and affordability of vegetables there and their everyday cooking habits with no long-standing cultural tradition of using vegetables. [ABSTRACT FROM AUTHOR]

Abstract: The European Prospective Investigation into Cancer and Nutrition (EPIC) was specifically designed to investigate the relationship between diet and cancer, with the aims of making a significant contribution to the accumulated scientific knowledge, trying to overcoming limitations of previous study. We present the most relevant results obtained so far for the most frequent cancer sites. EPIC is a multicenter prospective study carried out in 23 centers from 10 European countries: Denmark, France, Germany, Greece, Italy, the Netherlands, Norway, Spain, Sweden, and the United Kingdom, including 519,978 subjects (366,521 women and 153,457 men), most aged 35–70 years. Consumption of fruit is negatively associated with cancer of the lung but probably not with prostate cancer and breast cancer. Consumption of vegetables, mainly onion and garlic, probably reduces the risk of the intestinal stomach cancer but probably is not associated with cancer of the lung, prostate, and breast cancer. Consumption of red and processed meat is positively associated with colorectal cancer and with non-cardia stomach cancer in those infected by Helicobacter pylori. Fish intake is negatively associated with colorectal cancer risk. High alcohol intake increases the risk of breast cancer. These first results from the EPIC study on main food groups and most frequent tumors have made a significant contribution to the already accumulated evidence and, in combination with data from other prospective studies, provide the scientific knowledge for appropriate public health strategies aimed at reducing the global cancer burden. [ABSTRACT FROM AUTHOR]

Objective:The aim in this study was to assess the association between individual plasma carotenoid levels (α-carotene, β-carotene, lycopene, β-cryptoxanthin, lutein, zeaxanthin) and fruit and vegetable intakes recorded by a calibrated food questionnaire (FQ) and 24-h dietary recall records (24HDR) in nine different European countries with diverse populations and widely varying intakes of plant foods.Design:A stratified random subsample of 3089 men and women from nine countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC), who had provided blood samples and dietary and other lifestyle information between 1992 and 2000, were included.Results:β-Cryptoxanthin was most strongly correlated with total fruits (FQ r=0.52, 24HDR r=0.39), lycopene with tomato and tomato products (FQ r=0.38, 24HDR r=0.25), and α-carotene with intake of root vegetables (r=0.39) and of total carrots (r=0.38) for FQ only. Based on diet measured by FQ and adjusting for possible confounding by body mass index (BMI), age, gender, smoking status, alcohol intake, and energy intake, the strongest predictors of individual plasma carotenoid levels were fruits (R partial 2=17.2%) for β-cryptoxanthin, total carrots (R partial 2=13.4%) and root vegetables (R partial 2=13.3%) for α-carotene, and tomato products (R partial 2=13.8%) for lycopene. For 24HDR, the highest R partial 2 was for fruits in relation to β-cryptoxanthin (7.9%).Conclusions:Intakes of specific fruits and vegetables as measured by food questionnaires are good predictors of certain individual plasma carotenoid levels in our multicentre European study. At individual subject levels, FQ measurements of fruits, root vegetables and carrots, and tomato products are, respectively, good predictors of β-cryptoxanthin, α-carotene, and lycopene in plasma.European Journal of Clinical Nutrition (2005) 59, 1387–1396. doi:10.1038/sj.ejcn.1602252; published online 14 September 2005 [ABSTRACT FROM AUTHOR]

Objective:The aim of this study was to assess the ability of a single 24-h dietary recall (24HDR) and food questionnaires (FQ) to predict plasma carotenoid levels at the ecological level by assessing the relationship between mean plasma carotenoid levels and mean intake of fruit and vegetables measured by 24HDR and FQ across 16 European regions.Design:A random subsample of 3089 subjects was included, stratified by age and gender. They provided blood samples and dietary information between 1992 and 2000 as part of the European Prospective Investigation into Cancer and Nutrition.Results:Using Spearman's correlation coefficients, the correlations between mean regional 24HDR fruit and vegetable variables and corresponding mean plasma carotenoid levels were generally higher than the correlations using FQ means. The highest correlation was between the 24HDR citrus fruit variable and beta-cryptoxanthin (r=0.90). For 24HDR, total fruits and vegetables were highly correlated with lutein, zeaxanthin, and beta-cryptoxanthin (r=0.83–0.87), while vegetables were more closely related with lutein (r=0.69) and zeaxanthin (r=0.68), and fruits correlated with zeaxanthin (r=0.87) and beta-cryptoxanthin (r=0.84). Root vegetables (r=0.81) and total carrots (r=0.71) were well correlated with alpha-carotene. In the multivariate models adjusting for age, body mass index, and season, and using observations of means stratified by sex and region, the association was generally higher for 24HDR compared to FQ.Conclusion:Mean regional intakes of fruits and vegetables in several European countries were closely correlated with corresponding mean plasma levels of individual carotenoids. Fruits and vegetables measured by 24HDR were generally better able to predict plasma carotenoids at the ecological level.European Journal of Clinical Nutrition (2005) 59, 1397–1408. doi:10.1038/sj.ejcn.1602253; published online 14 September 2005 [ABSTRACT FROM AUTHOR]

Context The intake of vegetables and fruits has been thought to protect against breast cancer. Most of the evidence comes from case-control studies, but a recent pooled analysis of the relatively few published cohort studies suggests no significantly reduced breast cancer risk is associated with vegetable and fruit consumption. Objective To examine the relation between total and specific vegetable and fruit intake and the incidence of breast cancer. Design, Setting, and Participants Prospective study of 285 526 women between the ages of 25 and 70 years, participating in the European Prospective Investigation Into Cancer and Nutrition (EPIC) study, recruited from 8 of the 10 participating European countries. Participants completed a dietary questionnaire in 1992-1998 and were followed up for incidence of cancer until 2002. Main Outcome Measures Relative risks for breast cancer by total and specific vegetable and fruit intake. Analyses were stratified by age at recruitment and study center. Relative risks were adjusted for established breast cancer risk factors. Results During 1 486 402 person-years (median duration of follow-up, 5.4 years), 3659 invasive incident breast cancer cases were reported. No significant associations between vegetable or fruit intake and breast cancer risk were observed. Relative risks for the highest vs the lowest quintile were 0.98 (95% confidence interval [CI], 0.84-1.14) for total vegetables, 1.09 (95% CI , 0.94-1.25) for total fruit, and 1.05 (95% CI , 0.92-1.20) for fruit and vegetable juices. For 6 specific vegetable subgroups no associations with breast cancer risk were observed either. Conclusion Although the period of follow-up is limited for now, the results suggest that total or specific vegetable and fruit intake is not associated with risk for breast cancer. [ABSTRACT FROM AUTHOR]