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Dietary polyphenol intake in Europe: the European Prospective Investigation into Cancer and Nutrition (EPIC) study

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Abstract

Background/Objectives

Polyphenols are plant secondary metabolites with a large variability in their chemical structure and dietary occurrence that have been associated with some protective effects against several chronic diseases. To date, limited data exist on intake of polyphenols in populations. The current cross-sectional analysis aimed at estimating dietary intakes of all currently known individual polyphenols and total intake per class and subclass, and to identify their main food sources in the European Prospective Investigation into Cancer and Nutrition cohort.

Methods

Dietary data at baseline were collected using a standardized 24-h dietary recall software administered to 36,037 adult subjects. Dietary data were linked with Phenol-Explorer, a database with data on 502 individual polyphenols in 452 foods and data on polyphenol losses due to cooking and food processing.

Results

Mean total polyphenol intake was the highest in Aarhus—Denmark (1786 mg/day in men and 1626 mg/day in women) and the lowest in Greece (744 mg/day in men and 584 mg/day in women). When dividing the subjects into three regions, the highest intake of total polyphenols was observed in the UK health-conscious group, followed by non-Mediterranean (non-MED) and MED countries. The main polyphenol contributors were phenolic acids (52.5–56.9 %), except in men from MED countries and in the UK health-conscious group where they were flavonoids (49.1–61.7 %). Coffee, tea, and fruits were the most important food sources of total polyphenols. A total of 437 different individual polyphenols were consumed, including 94 consumed at a level >1 mg/day. The most abundant ones were the caffeoylquinic acids and the proanthocyanidin oligomers and polymers.

Conclusion

This study describes the large number of dietary individual polyphenols consumed and the high variability of their intakes between European populations, particularly between MED and non-MED countries.

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Abbreviations

24-HDR:

24-h dietary recall

EPIC:

European Prospective Investigation into Cancer and Nutrition

MED:

Mediterranean

s.e.:

Standard error

SU.VI.MAX:

SUpplémentation en VItamines et Minéraux AntioXydants

USDA:

US Department of Agriculture

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Acknowledgments

This study was supported by the Institut National du Cancer, Paris (INCa Grants 2011-105), and the Wereld Kanker Onderzoek Fonds (WCRF NL 2012/604). The EPIC study was supported by the European Commission: Public Health and Consumer Protection Directorate 1993–2004, Research Directorate-General 2005; the French National Cancer Institute (L’Institut National du Cancer; INCA) (Grant Number 2009-139); Ligue contre le Cancer; the Institut Gustave Roussy; the Mutuelle Générale de l’Education Nationale; the Institut National de la Santé et de la Recherche Médicale (INSERM); the German Cancer Aid; the German Cancer Research Center (DKFZ); the German Federal Ministry of Education and Research; the Danish Cancer Society; The Danish Council for Strategic Research; Health Research Fund (FIS) of the Spanish Ministry of Health (RTICC (DR06/0020/0091); the participating regional governments from Asturias, Andalucía, Murcia, Navarra and Vasco Country and the Catalan Institute of Oncology of Spain; Cancer Research UK; Medical Research Council, UK; the Stroke Association, UK; British Heart Foundation; Department of Health, UK; Food Standards Agency, UK; the Wellcome Trust, UK; the Hellenic Health Foundation (Greece); Italian Association for Research on Cancer; Compagnia San Paolo, Italy; Dutch Ministry of Public Health, Welfare and Sports; Dutch Ministry of Health; Dutch Prevention Funds; LK Research Funds; Dutch ZON (Zorg Onderzoek Nederland); World Cancer Research Fund (WCRF); Statistics Netherlands (the Netherlands); Swedish Cancer Society; Swedish Scientific Council; Regional Government of Skane, The County Council of Västerbotten, Sweden; Nordforsk—Centre of Excellence programme; some authors are partners of ECNIS, a network of excellence of the 6th Framework Program of the European Commission.

Conflict of interest

Raul Zamora-Ros, Viktoria Knaze, Joseph A. Rothwell, Bertrand Hémon, Aurelie Moskal, Kim Overvad, Anne Tjønneland, Cecilie Kyrø, Guy Fagherazzi, Marie-Christine Boutron-Ruault, Marina Touillaud, Verena Katzke, Tilman Kühn, Heiner Boeing, Jana Förster, Antonia Trichopoulou, Elissavet Valanou, Eleni Peppa, Domenico Palli, Claudia Agnoli, Fulvio Ricceri, Rosario Tumino, Maria Santucci de Magistris, Petra H.M. Peeters, H. Bas Bueno-de-Mesquita, Dagrun Engeset, Guri Skeie, Anette Hjartåker, Virginia Menéndez, Antonio Agudo, Esther Molina-Montes, José María Huerta, Aurelio Barricarte, Pilar Amiano, Emily Sonestedt, Lena Maria Nilsson, Rikard Landberg, Timothy J. Key, Kay-Thee Khaw, Nicholas J. Wareham, Yunxia Lu, Nadia Slimani, Isabelle Romieu, Elio Riboli, Augustin Scalbert have no conflict of interest.

Author information

Authors and Affiliations

  1. Biomarker Group, Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), 150, cours Albert Thomas, 69372, Lyon Cedex 08, France

    Raul Zamora-Ros, Viktoria Knaze, Joseph A. Rothwell, Bertrand Hémon, Aurelie Moskal, Cecilie Kyrø, Nadia Slimani, Isabelle Romieu & Augustin Scalbert

  2. Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark

    Kim Overvad

  3. Danish Cancer Society Research Center, Copenhagen, Denmark

    Anne Tjønneland & Cecilie Kyrø

  4. U1018, Nutrition, Hormones and Women’s Health Team, Inserm, Centre for Research in Epidemiology and Population Health (CESP), Villejuif, France

    Guy Fagherazzi, Marie-Christine Boutron-Ruault & Marina Touillaud

  5. UMRS 1018, Paris South University, Villejuif, France

    Guy Fagherazzi, Marie-Christine Boutron-Ruault & Marina Touillaud

  6. Institut Gustave Roussy, 94805, Villejuif, France

    Guy Fagherazzi, Marie-Christine Boutron-Ruault & Marina Touillaud

  7. Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany

    Verena Katzke & Tilman Kühn

  8. Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany

    Heiner Boeing & Jana Förster

  9. Hellenic Health Foundation, Athens, Greece

    Antonia Trichopoulou, Elissavet Valanou & Eleni Peppa

  10. Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece

    Antonia Trichopoulou

  11. Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Florence, Italy

    Domenico Palli

  12. Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Claudia Agnoli

  13. Center for Cancer Prevention (CPO-Piemonte), and Human Genetic Foundation (HuGeF), Turin, Italy

    Fulvio Ricceri

  14. Cancer Registry and Histopathology Unit, “Civic M.P. Arezzo” Hospital, ASP Ragusa, Italy

    Rosario Tumino

  15. Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy

    Maria Santucci de Magistris

  16. Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands

    Petra H. M. Peeters

  17. School of Public Health, Imperial College London, London, UK

    Petra H. M. Peeters, H. Bas Bueno-de-Mesquita, Yunxia Lu & Elio Riboli

  18. Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands

    H. Bas Bueno-de-Mesquita

  19. Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands

    H. Bas Bueno-de-Mesquita

  20. Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

    H. Bas Bueno-de-Mesquita

  21. Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway

    Dagrun Engeset & Guri Skeie

  22. Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway

    Anette Hjartåker

  23. Public Health Directorate, Asturias, Spain

    Virginia Menéndez

  24. Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Barcelona, Spain

    Antonio Agudo

  25. Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs, Granada, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain

    Esther Molina-Montes

  26. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain

    Esther Molina-Montes, José María Huerta, Aurelio Barricarte & Pilar Amiano

  27. Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain

    José María Huerta

  28. Navarre Public Health Institute, Pamplona, Spain

    Aurelio Barricarte

  29. Public Health Department of Gipuzkoa, BioDonostia Research Institute, Health Department of Basque Region, San Sebastián, Spain

    Pilar Amiano

  30. Department of Clinical Sciences, Lund University, Malmö, Sweden

    Emily Sonestedt

  31. Department of Nutritional Research, Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

    Lena Maria Nilsson

  32. Arcum, Arctic Research Centre at Umeå University, Umeå, Sweden

    Lena Maria Nilsson

  33. Department of Food Science, Uppsala BioCentre, Swedish University of Agricultural Sciences, Uppsala, Sweden

    Rikard Landberg

  34. Nutritional Epidemiology Unit, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

    Rikard Landberg

  35. Cancer Epidemiology Unit, University of Oxford, Oxford, UK

    Timothy J. Key

  36. Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK

    Kay-Thee Khaw

  37. MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge University, Cambridge, UK

    Nicholas J. Wareham

Authors
  1. Raul Zamora-Ros
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  2. Viktoria Knaze
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  3. Joseph A. Rothwell
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  4. Bertrand Hémon
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  5. Aurelie Moskal
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  6. Kim Overvad
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  7. Anne Tjønneland
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  8. Cecilie Kyrø
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  9. Guy Fagherazzi
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  10. Marie-Christine Boutron-Ruault
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  11. Marina Touillaud
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  12. Verena Katzke
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  13. Tilman Kühn
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  14. Heiner Boeing
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  16. Antonia Trichopoulou
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  17. Elissavet Valanou
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  18. Eleni Peppa
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  19. Domenico Palli
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  20. Claudia Agnoli
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  21. Fulvio Ricceri
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  22. Rosario Tumino
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  23. Maria Santucci de Magistris
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  24. Petra H. M. Peeters
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  25. H. Bas Bueno-de-Mesquita
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  26. Dagrun Engeset
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  28. Anette Hjartåker
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  29. Virginia Menéndez
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  30. Antonio Agudo
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  33. Aurelio Barricarte
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  34. Pilar Amiano
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  35. Emily Sonestedt
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  36. Lena Maria Nilsson
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  37. Rikard Landberg
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  38. Timothy J. Key
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  39. Kay-Thee Khaw
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  40. Nicholas J. Wareham
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  41. Yunxia Lu
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  42. Nadia Slimani
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  43. Isabelle Romieu
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  44. Elio Riboli
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  45. Augustin Scalbert
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Corresponding author

Correspondence to Augustin Scalbert.

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Zamora-Ros, R., Knaze, V., Rothwell, J.A. et al. Dietary polyphenol intake in Europe: the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Eur J Nutr 55, 1359–1375 (2016). https://doi.org/10.1007/s00394-015-0950-x

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