Meal patterns across 10 European countries – results from the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study

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 standardised 24-h diet recall during 1995-2000. Eleven predefined intake occasions across a 24-h period were assessed during the interview. In this 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 36020 women (64%) and men (36%) aged 35-74 years. 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/day in countries as compared to 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 to 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 to 24-34% (women) and 23-35% (men) in central/northern Europe. Conclusion 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.