Lessons from the European Prospective Investigation into Cancer and Nutrition (EPIC) Study for the Development of Cross-Country Nutritional Epidemiologic Research in East Asia.

Abstract

The European Prospective Investigation into Cancer and Nutrition (EPIC) study is a prospective cohort study with about 520,000 study participants enrolled from 23 centers in 10 western European countries (Greece, Spain, Italy, France, Germany, Netherlands, United Kingdom, Denmark, Sweden, and Norway). This study is unique in that food frequency questionnaire-based dietary assessment methods are tailored to different eating habits in different countries, while maximum efforts were made for standardization of the food composition database and dietary intake calculations. Such an international collaboration project has not been conducted in East Asian countries, where dietary habits are considerably different from those in European and other countries. Accurate assessment of dietary intake in Asian countries is particularly challenging, as Asian diets are generally complex, consisting of many variations of compsite and mixed dishes. Nevertheless, these large variations in dietary habits warrant thorough investigation into the association between dietary factors and chronic diseases within each country. On the other hand, with technological advancement, more and more large-scale prospective cohort studies have used repeated measurements of dietary intake based on a more detailed dietary assessment method, such as multiple-day dietary records, which have not been incorporated in EPIC. Here, the author briefly summarizes the experiences and considerations in the conduct of EPIC as well as the current situation of dietary habits and research methodology in East Asian countries, and then discusses the importance of the development of cross-country nutritional epidemiologic research in East Asia in the near future.