Biomarker-based evaluation of two 24-h recalls for comparing usual fish, fruit and vegetable intakes across European centers in the EFCOVAL Study.

BACKGROUND/OBJECTIVES: A standardized methodology is important to enable consistent monitoring of dietary intake across European countries. For this reason, we evaluated the comparability of the assessment of usual food intake collected with two non-consecutive computerized 24-h dietary recalls (24-HDRs) and a food propensity questionnaire (FPQ) among five European centers. SUBJECTS/METHODS: Two 24-HDRs using EPIC-Soft (the software developed to conduct 24-HDRs in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study) were performed to determine fish, fruit and vegetable (FV) consumed by 600 adults in Belgium (BE), the Czech Republic (CZ), France (FR), the Netherlands (NL) and Norway (NO) in a validation study. An FPQ was used to identify non-consumers. Information from the 24-HDRs and FPQ were used to estimate individual usual food intake by the Multiple Source Method (MSM). Blood samples were drawn to determine fatty acids in phospholipids and serum carotenoids as biomarkers of fish, and FV intake, respectively. RESULTS: The pooled correlation between usual fish intake and eicosapentaenoic acid plus docosahexaenoic acid in phospholipids was 0.19 in men and 0.31 in women (P for heterogeneity >0.50) and center-specific correlations ranged between 0.08 (CZ) and 0.28 (BE and NO) in men, and between 0.19 (BE) and 0.55 (FR) in women. For usual FV intake, the pooled correlation with serum carotenoids was 0.31 in men and 0.40 in women (P for heterogeneity >0.10); the center-specific correlations varied between 0.07 (NO) and 0.52 (FR) in men, and between 0.25 (NL) and 0.45 (NO) in women. CONCLUSION: Two standardized 24-HDRs using EPIC-Soft and an FPQ appeared to be appropriate to rank individuals according to their fish and FV intake in a comparable way among five European centers.

Potential and requirements for a standardized pan-European food consumption survey using the EPIC-Soft software.

BACKGROUND/OBJECTIVES: To describe the strengths, limitations and requirements of using EPIC-Soft software (the software developed to conduct 24-h dietary recalls in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study) in pan-European food consumption surveys, and to discuss potentials and barriers for a harmonized pan-European food consumption survey. SUBJECTS/METHODS: The paper is based on the experiences in the 'European Food Consumption and Validation' Project, which included updating six existing and preparing one new country-specific EPIC-Soft version, applying EPIC-Soft in validation and feasibility studies, and estimating the intake of nutrients and flavoring substances. The experiences were discussed in the September 2009 workshop 'Pan-European Food Consumption Surveys--for Standardized and Comparable Transnational Data Collection'. RESULTS: EPIC-Soft is suitable for detailed and standardized food consumption data collection in pan-European food consumption surveys. A thorough preparation of all aspects of the food consumption survey is important for the quality and efficiency during data collection and processing. The preparation and data-handling phase of working with EPIC-Soft is labor intensive and requires trained, motivated and qualified personnel. CONCLUSIONS: Given the suitability of EPIC-Soft as standardized dietary assessment tool in European dietary monitoring, the proposed strategy toward a pan-European food consumption survey is to prepare well, to allow flexibility in national extensions and to start with a limited number of countries that are interested.