Journal Mobile Options
Table of Contents
Vol. 47, No. 1, 2003
Issue release date: January–February 2003
Ann Nutr Metab 2003;47:37–46

Quantity and Quality of Dietary Fat, Carbohydrate, and Fiber Intake in the German EPIC Cohorts

Linseisen J. · Schulze M.B. · Saadatian-Elahi M. · Kroke A. · Miller A.B. · Boeing H.
aDivision of Clinical Epidemiology, German Cancer Research Center, Heidelberg, bDepartment of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany; cUnit of Nutrition and Cancer, International Agency for Research on Cancer, Lyon, France

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Aim: This evaluation aims to describe the quantity and quality of dietary fat, carbohydrate and fiber intake in both German cohorts participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods: Estimates are based on standardized computer-guided 24-hour dietary recalls from 1,078 women and 1,013 men in Heidelberg and 898 women and 1,032 men in Potsdam. In a subsample, plasma phospholipid (PL) fatty acids were analyzed as well. Results: Adjusted mean dietary intake estimates demonstrated that the contribution of fat as well as n–6 and n–3 polyunsaturated fatty acids (PUFA) to the total daily energy intake was higher in both women and men of EPIC-Potsdam compared to EPIC-Heidelberg. Surprisingly, the dietary n–6/n–3 PUFA ratio was lower in the Potsdam cohort. These results were confirmed by means of the PL fatty acid pattern. Besides the higher contribution of polysaccharides to total energy intake in EPIC-Heidelberg, women of the Heidelberg cohort revealed a significantly lower contribution of mono- and disaccharides (sucrose) to total energy intake. Although total fiber intake data were similar in both cohorts, analysis by food groups showed differences in dietary fiber intake originating from the food groups cereals, fruits and potatoes. Conclusion: The results demonstrate distinct differences in the dietary fat, carbohydrate and fiber intake between both German EPIC cohorts, which contribute to the exposure variation in the whole of EPIC.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Simopoulos AP: Fatty acids; in Goldberg I (ed): Functional Foods. Designer Foods, Pharmafoods, Nutraceuticals. New York, Chapman & Hall, 1998, pp 355–392.
  2. Saris WHM, Asp NGL, Björck I, Blaak E, Bornet F, Brouns F, Frayn KN, Fürst P, Riccardi G, Roberfroid M, Vogel M: Functional food science and substrate metabolism. Br J Nutr 1998;80(suppl 1):S47–S75.
  3. Deckelbaum RJ, Calder PC: Lipids in health and disease: Quantity, quality, and more. Curr Opin Clin Nutr Metab Care 2000;3:93–94.

    External Resources

  4. Law M: Dietary fat and adult diseases and the implications for childhood nutrition: An epidemiologic approach. Am J Clin Nutr 2000;72(suppl):1291S–1296S.
  5. Hooper L, Summerbell CD, Higgins JPT, Thompson RL, Capps NE, Smith GD, Riemersma RA, Ebrahim S: Dietary fat intake and prevention of cardiovascular disease: Systematic review. BMJ 2001;322:757–763.
  6. Rose DP: Dietary fatty acids and cancer. Am J Clin Nutr 1997;66(suppl):998S–1003S.
  7. Krauss RM, Eckel RH, Howard B, Appel LJ, Daniels SR, Deckelbaum RJ, Erdman JW, Kris-Etherton P, Goldberg IJ, Kotchen TA, Lichtenstein AH, Mitch WE, Mullis R, Robinson K, Wylie-Rosett J, Jeor SS, Suttie J, Tribble DL, Bazzarre TL: AHA dietary guidelines. Revision 2000: A statement for healthcare professionals from the Nutrition Committee of the American Heart Association. Circulation 2000;102:2284–2299.
  8. Deutsche Gesellschaft für Ernährung: Referenzwerte für die Nährstoffzufuhr. Frankfurt am Main, Umschau/Braus, 2000.
  9. Rivellese AA, Annuzzi G: Dietary fat versus carbohydrate in obesity and insulin resistance. Curr Opin Clin Nutr Metab Care 2000;3:117–120.
  10. Fuchs CS, Giovannucci EL, Colditz GA, Hunter DJ, Stampfer MJ, Rosner B, Speizer FE, Willett WC: Dietary fiber and the risk of colorectal cancer and adenoma in women. N Engl J Med 1999;340:169–176.
  11. Alberts DS, Martinez ME, Roe DJ, Guillen-Rodriguez JM, Marshall JR, von Leeuwen JB, Reid ME, Ritenbaugh C, Vargas PA, Bhattacharyya AB, Earnest DL, Sampliner RE, The Phoenix Colon Cancer Prevention Physicians’ Network: Lack of effect of a high-fiber cereal supplement on the recurrence of colorectal adenomas. N Engl J Med 2000;342:1156–1162.
  12. Schatzkin A, Lanza E, Corle D, Lance P, Iber F, Caan B, Shike M, Weissfeld J, Burt R, Cooper MR, Kikendall JW, Cahill J, The Polyp Prevention Trial Study Group: Lack of effect of a low-fat, high-fiber diet on the recurrence of colorectal adenomas. N Engl J Med 2000;342:1149–1155.
  13. Ferguson LR, Harris PJ: The study of antigenotoxic effects of dietary fibre is lost in a confused concept. Mutat Res 2000;447:319–322.
  14. Schneemann BO: Building scientific consensus: The importance of dietary fiber. Am J Clin Nutr 1999;69:1.
  15. Ha MA, Jarvis MC, Mann JI: A definition for dietary fiber. Eur J Clin Nutr 2000;54:861–864.
  16. Boeing H, Wahrendorf J, Becker N: EPIC-Germany – A source for studies into diet and risk of chronic diseases. Ann Nutr Metab 1999;43:195–204.
  17. Riboli E: The European Prospective Investigation into Cancer and Nutrition (EPIC): Plans and progress. J Nutr 2001;131:170S–175S.
  18. Schulze MB, Brandstetter BR, Kroke A, Wahrendorf J, Boeing H: Quantitative food intake in the EPIC-Germany cohorts. Ann Nutr Metab 1999;43:235–245.
  19. Schulze MB, Linseisen J, Kroke A, Boeing H: Macronutrient, vitamin, and mineral intakes in the EPIC-Germany cohorts. Ann Nutr Metab 2001;45:181–189.
  20. Kaaks R, Riboli E: Validation and calibration of dietary intake measurements in the EPIC project: Methodological considerations. European Prospective Investigation into Cancer and Nutrition. Int J Epidemiol 1997;26(suppl 1):S15–S25.
  21. Voss S, Charrondière UR, Slimani N, Kroke A, Riboli E, Wahrendorf J, Boeing H: EPIC-SOFT a European computer program for 24-hour dietary protocols. Z Ernährungswiss 1998;37:227–233.
  22. Slimani N, Deharveng G, Charrondière RU, van Kappel AL, Ocke MC, Welch A, Lagiou A, van Liere M, Agudo A, Pala V, Brandstetter B, Andren C, Stripp C, van Staveren WA, Riboli E: Structure of the standardized computerized 24-hour diet recall interview used as reference method in the 22 centers participating in the EPIC project. European Prospective Investigation into Cancer and Nutrition. Comput Methods Programs Biomed 1999;58:251–266.

    External Resources

  23. Slimani N, Ferrari P, Ocké M, Welch A, Boeing H, van Liere M, Pala V, Amiano P, Lagiou A, Mattisson I, Stripp C, Engeset D, Charrondière R, Buzzard M, van Staveren W, Riboli E: Standardization of the 24-hour diet recall calibration method used in the European Prospective Investigation into Cancer and Nutrition (EPIC): General concepts and preliminary results. Eur J Clin Nutr 2000;54:900–917.

    External Resources

  24. Klipstein-Grobusch K, Georg T, Boeing H: Interviewer variability in anthropometric measurements and estimates of body composition. Int J Epidemiol 1997;26:S174–S180.
  25. Schofield WN: Predicting basal metabolic rate, new standards and review of previous work. Hum Nutr Clin Nutr 1985;39(suppl 1):5–41.
  26. Chajes V, Hulten K, Van Kappel AL, Winkvist A, Kaaks R, Hallmans G, Lener P, Riboli E: Fatty-acid composition in serum phospholipids and rid of breast cancer: An incident case-control study in Sweden. Int J Cancer 1999;83:585–590.
  27. Statistisches Bundesamt: Statistisches Jahrbuch 1998. Wiesbaden, 1998.
  28. Willett W: Nutritional Epidemiology. New York, Oxford University Press, 1998.
  29. Voss S, Kroke A, Klipstein-Grobusch K, Boeing H: Is macronutrient composition of dietary intake data affected by underreporting? Results from the EPIC-Potsdam Study. European Prospective Investigation into Cancer and Nutrition. Eur J Clin Nutr 1998;52:119–126.
  30. Kroke A, Klipstein-Grobusch K, Voss S, Moseneder J, Thielecke F, Noack R, Boeing H: Validation of a self-administered food-frequency questionnaire administered in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study: Comparison of energy, protein, and macronutrient intakes estimated with the doubly labeled water, urinary nitrogen, and repeated 24-hour dietary recall methods. Am J Clin Nutr 1999;70:439–447.
  31. Mensink GB, Thamm M, Haas K: Nutrition in Germany 1998. Gesundheitswesen 1999;61(suppl 2):S200–S206.
  32. Winkler G, Brasche S, Heinrich J: Trends in food intake in adults from the city of Erfurt before and after the German reunification. Ann Nutr Metab 1997;41:283–290.
  33. Winkler G, Brasche S, Döring A, Heinrich J: Dietary intake of middle-aged men from an East and a West German city after the German reunification: Do differences still exist? Eur J Clin Nutr 1998;52:98–103.
  34. Heseker H, Adolf T, Eberhardt W, Hartmann S, Kübler W, Schneider R: Food intake and nutrient supply in Germany – Results of the VERA Study. Ernährung/Nutrition 1994;18:158–161.
  35. Thiel C, Heinemann L, Thai DM: Lebensmittelaufnahme und Nährstoffversorgung in den neuen und alten Bundesländern. Ernährungsumschau 1993;40:486–490.
  36. Thiel C, Heinemann L, Thai DM: The nutritional situation of the adult population in the new German federal states after the political changes of the early 1990s. Ernährungsforschung 1996;41:239–248.
  37. Hirsch T, Kempe G: Consumption of omega–3 and omega–6 fatty acids in former East and West Germany and changes in East Germany after the reunification. Respir Med 1999;93:213–216.
  38. Jaross W, Bergmann S, Wahrburg U, Schulte H, Assmann G: Dietary habits in Eastern Germany: Changes after reunification and their relation to CHD risk profiles (DRECAN). Rev Environ Health 1996;11:27–33.
  39. Bolte G, Frye C, Hölscher B, Meyer I, Wjst M, Heinrich J: Margarine consumption and allergy in children. Am J Res Crit Care Med 2001;163:277–279.
  40. Wolk A, Furuheim M, Vessby B: Fatty acid composition of adipose tissue and serum lipids are valid biological markers of dairy fat intake in men. J Nutr 2001;131:828–833.
  41. Ma J, Folsom AR, Shahar E, Eckfeldt JH: Plasma fatty acid composition as an indicator of habitual dietary fat intake in middle-aged adults. Am J Clin Nutr 1995;62:564–571.
  42. Horrobin DF, Ells K, Morse-Fisher N, Mankiu MS: Fatty acid distribution in plasma phospholipids in normal individuals from different geographical locations. J Nutr Med 1991;2:249–258.
  43. Phinney SD, Odin RS, Johnson SB, Holman RT: Reduced arachidonate in serum phospholipids and cholesteryl esters associated with vegetarian diets in humans. Am J Clin Nutr 1990;51:385–392.
  44. Bjerve KS, Brubakk AM, Fougner KJ, Johnsen H, Midthjell K, Vik T: Omega–3 fatty acids: Essential fatty acids with important biological effects, and serum phospholipid fatty acids as markers of dietary omega–3-fatty-acid intake. Am J Clin Nutr 1993;57(suppl):801S–806S.
  45. Anderson GH: Sugars and health: A review. Nutr Res 1997;17:1485–1498.
  46. Macdiarmid JI, Vail A, Cade JE, Blundell JE: The sugar-fat relationship revisited: Differences in consumption between men and women of varying BMI. Int J Obes 1998;22:1053–1061.
  47. Linseisen J, Gedrich K, Karg G, Wolfram G: Sucrose intake in Germany. Z Ernährungswiss 1998;37:303–314.
  48. Harris PJ, Ferguson LR: Dietary fibres may protect or enhance carcinogenesis. Mutat Res 1999;442:95–110.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50