Table 1 Summary of all studies identified to assess saturated fat: design, population studied, and dietary assessment instruments used and details of validation and/or reproducibility. Studies were selected to be included in this review based on the following two criteria: (1) the instrument was tested for validity and (2) the instrument was used in more than two countries simultaneously which represent a range of European regions
Authors/Study | Population | Countries | Instrument(s) | Macronutrient intake | Tested for validity | > 2 countries/country range |
|---|---|---|---|---|---|---|
Bondia-Pons et al. [35] | Adults/Men Age range not reported (n = 160) | 5 (Denmark, Finland Germany, Italy, Spain) | 3-day record | SFA (% energy) was calculated by converting food consumption into corresponding nutrient intake using validated nutrition software from each country Other macronutrients (% energy): Protein, Carbohydrates, Fat, MUFA, PUFA | X | |
Adults 35–70 years (n = 519,978) | 10 (Denmark, England, France, Germany, Greece, Italy, the Netherlands, Norway, Spain, Sweden) | FFQa 24-HDR | SFA (g/day) was calculated from 24-HDR data using EPIC Nutrient DataBase (ENDB) created to aid cross-country harmonisation of data [73] Other macronutrients: Total Fat, MUFA, PUFA Origin of fat: animal, plant, unknown/mixed F&V intake [23] SSBs intake [74] | X [63] Belgium, the Czech Republic, France, the Netherlands and Norway | X | |
Esteve et al. [40] | Adults/Controls Age range not reported (n = 2736) | 4 (France, Italy, Spain, Switzerland) | FFQ | SFA (g/day) was calculated using an ad hoc food-composition table compiled by INSERM on the basis of those published by McCance and Widdowson and revised by Paul and Southgate Other macronutrients: Protein (Total / Animal / Vegetable), Carbohydrates, Fibers, Total lipids, MUFA, PUFA | X | |
Adults/Elderly 70+ years (n = 453) | 2 (Greece, Sweden) | FFQ | SFA (g/day) was calculated using validated nutrition software (NUTTAB 1995), which is based on Australian FCTs modified to include additional Greek dishes and Swedish foods Other macronutrients: MUFA, PUFA, Carbohydrate, Protein Food sources: Olives, Olive oil, Other oil, Butter, Margarine [As Swedish data did not have a separate oil/fats food group because they were included in various recipes/dishes, they were unable to identify the quantity of oil/fat used in dishes in order to generate this food group and thus excluded the Swedish data when analysing fat intake] | |||
Adults (n = 5562) 17–79 years | 7 (Ireland, the Netherlands Spain, Greece, UK, Poland, Germany) | FFQ (Web-based) | SFA (% total energy), SFA (g) Nutritional composition and portion sizes were calculated from the 2008–2010 National Adult Nutrition Survey (NANS) database [43] Other macronutrients: MUFA, PUFA, Carbohydrates, Protein F&V intake [23] SSBs intake [74] | UK Comparison with EPIC-Norfolk FFQ using a sample of 117 participants [43] Reproducibility tested using test-retest (n = 100) on 2 occasions 4 weeks apart [42] Validated using a 4-day weighed food record [42] | X | |
HAPIEE [45] | Adults (n = 28,947) | 3 (Russia, Poland, Czech Republic) | FFQ | Saturated fat (g/day). McCance and Widdowson’s FCD Other macronutrients (g/day): Total carbohydrate, Protein, Total fat, PUFA, Trans fat Food sources: Animal fats and oils | X [75] UK Based on the Whitehall II questionnaire. Validated against a 7-day diet diary and biomarkers of nutrient intake by Brunner et al. [75] Assessed by energy-adjusted correlations, mean or median differences, and exact level of agreement. | |
Adults 26–65 years (n = 802) | 3 (Belgium, England, Italy) | FFQ | Total saturated lipids (% kcal/day) was calculated using Nutrition Analysis of FFQ (NAF), a computer programme used to convert the questionnaire dietary data into frequencies of consumption and average daily quantities of foods (energy and nutrients consumed). NAF was linked to the McCance FCT, the Italian FCT for Epidemiological studies, and the Dutch NEVO and Flemish-Belgian Nubel FCTs SF sub-types: myristic (C14), plamitic (C16), stearic (C18), arachidic (C20) Other macronutrients: unsaturated fats Food sources (food product groups used in dietary pattern analysis) (g/day): Starches, Cabbages and root vegetables, Leafy vegetables and tomatoes, Fruit and fruit or vegetable juices, Dairies, Cheese, Pasta and rice, Red meat and processed products, White meat and products, Fishes, Mollusks, Vegetable oils, Olive oil, Nuts and pizza, Sweets and sugars, Snacks, Chocolate coffee and tea, Mayonnaise, Alcoholic drinks | X [31] Belgium. UK and Netherlands FFQ validated as part of the EPIC study. Belgian FFQ was validated by Van Dongen et al. [31] | X | |
Adults 18–64 years (n = 1379) | 2 (Northern Ireland, Republic of Ireland) | 7-day record | SFA (g/day), SFA (% energy), and % contribution of the major food groups to SFA, were calculated by analysing food using WISP, which used the McCance and Widdowson’s Composition of Foods 5th Edition, and also included additional data (including analysis of recipes of composite dishes, manufacturer’s data on Irish foods and new products). Other macronutrients (g): Protein, Fat, Carbohydrate, Total sugars Food sources (contribution to daily fat intake): Meat and meat products. Butter spreading fats and oils, Biscuit cakes pastries and puddings, Milk and yoghurt, Potatoes and potato products, Sugars preserves confectionary and savoury snacks, Vegetables and vegetable dishes including pulses, Breads and rolls, Cheese, Eggs and egg dishes, Fish and fish dishes, Flours grains starches rice pasta and savouries, Soups sauces and miscellaneous foods, Creams ice-creams and chilled desserts | |||
Parfitt et al. [48] | Adults/Students 18–32 years (n = 48) | 2 (England, Italy) | 5 or 7-day record | SF (% of total fat) was calculated by converting food consumption into corresponding nutrient intake with validated nutrition software from each country: England: Salford Microdiet version 7, a computer software based on and updated from McCance and Widdowson’s FCTs,Italy: Foodometer, computer software, using data from the Italian National Institute of Nutrition Other macronutrients: MUFA, PUFA | ||
Adults 30–70 years > 154,000 men and women in the PURE study on a whole. | 3 European. 4 LIC: Zimbabwe, Bangladesh, India, and Pakistan; 10 MIC: South Africa, Brazil, Argentina, Colombia, Chile, Poland, China, Malaysia, Iran, and Turkey; and 3 HIC: Canada, Sweden, and UAE. | FFQ | SFA (g/day) was calculated from the Polish version of the FFQ using a master international nutrient database which has been created primarily based on the United States Department of Agriculture (Washington, D.C.) FCD and modified appropriately with reference to local FCT, and supplemented with recipes of locally eaten mixed dishes Other macronutrients: Protein, Fat, Carbohydrate, MUFA, PUFA | X [49] Poland. To validate the shortened FFQ, a convenience sample (n = 146) of the PURE study participants in an urban (n = 73) and rural (n = 73) setting were recruited. The FFQ administered twice, approx. 1 year apart. | X | |
Adults/Men 40–59 years at enrolment 70–89 years at 30 year follow up [50] (n ≈ 11,500) | 7 (Finland, Greece, Italy, Japan, The Netherlands, USA, Yugoslavia) | Cross-check dietary history method | SF (g) were calculated for each cohort using information obtained from buying food products representing the average daily intake in a cohort and analysing for composition of SF [51] SF (% energy) was calculated using computerised versions of local food tables [50] Other macronutrients: Protein (% energy), MUFA (% energy), PUFA (% energy), Carbohydrate (% energy), Fibre (g/1000 kcal) F&V intake [23] | Tested for reproducibility only. [64] The reproducibility of food intake was investigated in repeated surveys carried out three and 12 months after the initial survey, by Bloemberg et al. [64] | X | |
Adults/Elderly (n ≈ 2600) 70–75 years | 12 (Belgium, Denmark, France, Greece, Hungary, Italy, Netherlands, Norway, Poland, Portugal, Spain, Switzerland) | Modified dietary history method comprising a 3-day estimated record and meal-based frequency checklist | SFA (% energy) Foods were translated into nutrients by using country-specific food-composition tables [52] Other macronutrients: PUFA, Protein, Fibre F&V intake [23] SSBs intake [74] | X [65] Validated against a 3-day weighed record [65]. | X | |
Van Diepen et al. [54] | Adults/Students Age range not reported (n = 185) | 2 (Greece, the Netherlands) | 24-HDR | SFA (% energy) was calculated using ‘Food Processor 7.40, a computer software of which had the addition of Greek and Dutch recipes. It used estimated levels of intake Other macronutrients: MUFA, PUFA, Fibre, Protein, Carbohydrates | ||
Van Oostrom et al. [55] | Adults 20–55 years (n = 94) | 2 (The Netherlands, Spain) | 3-day record | SF (g) and SF (% energy) were calculated using validated nutrition software from each country: The Netherlands: Dutch Nutrient Database Spain: Nutrition tables for Spain. Other macronutrients: Total fat, MUFA, PUFA, Carbohydrates, Protein | ||
WHO-MONICA EC/MONICA Project optional nutrition study [33, 56] | Adults 45–64 years (n = 7226) | 9 (Northern Ireland (Belfast), UK (Cardiff), Denmark, Finland, Belgium, Germany, France, Italy, Spain) 4 (Sub-study comprising of Germany, Finland, France and Northern Ireland) 2 (Sub study comprising of France and Northern Ireland) | 3-day and 7-day records | Food consumption was converted into corresponding nutrient intake using validated nutrition software from each country [76];SFA (g) were calculated by Evans et al... [56];SFA (% energy) was calculated by Winkler et al. [76] using local FCT from the 4 countries Other macronutrients: PUFA, MUFA, Carbohydrates, Protein | X | |
ZENITH [57] | Adults/Elderly 55–87 years (n = 387) | 3 (France, Italy, Northern Ireland) | 4-day recall method | SFA (g/day) was calculated using food consumption data were converted into energy, macro- and micronutrients using relevant FCTs for each country. For foods and nutrients not available in the FCTs, these were assigned the compositions of similar foods derived from other databanks Other macronutrients: Total fat, MUFA, PUFA, Carbohydrates, Fibre, Protein | X | |
Adolescents 12–17 years (n = 3000) | 9 (Austria, Belgium, France, Germany, Greece, Hungary, Italy, Sweden, Spain) | 24-HDR | SFA (% of total fat) was calculated by using the German Food Code and Nutrient Data Base (Bundeslebensmittelschlussel, BLS, Version II.3.1) [59] Other macronutrients: Carbohydrates, Protein, Fat, PUFA, MUFA, Fibre Correlations between food groups and fatty acid intake (SFA, PUFA and MUFA) examined [59] F&V intake [23] SSBs intake [74] | 24-HDR evaluated by Vereecken et al. [58, 67] Intakes of energy and eight nutrient components calculated using different FCTs approaches were compared [66] | X | |
EYHS [60] | Children 9 years, 15 years (n = 2182) | 2 (Sweden, Estonia) | 24 HDR supplemented with a 2-day record | SF (% energy) was calculated using validated nutrition software from each country: Sweden: Nutrient intake data were analysed in Sweden using the Swedish FCD PC-kost (maintained by the Swedish National Food Administration), Estonia: The Finnish FCD Micro-Nutrica 2.0 (modified and translated into the Estonian language at Tallinn University of Technology, Department of Food Processing) Other macronutrients: Protein, Carbohydrate, Fat, MUFA, PUFA, Fibre | ||
Children (n = 16,864) 2–9 years [14,972 children proxies completed the FFQ. 14,863 recall interviews completed] | 8 (Belgium, Cyprus, Estonia, Germany Hungary, Italy, Spain, Sweden) | FFQ 24-HDR | Linking to country-specific FTCs, and using the SACINA data daily intake (g/day) of all food groups the ratio of unsaturated to saturated fats was calculated [61] F&V intake [23] SSBs intake [74] | SACINA is based on the YANA-C instrument validated as part of the HELENA study by Vereecken et al. [67] SACINA was validated by Börnhorst et al. [68] using the doubly labelled water technique The CEHQ-FFQ has been validated using 2 24-HDRs [71] The reproducibility of CEHQ-FFQ has been examined by Lanfer et al. [69], and the validity by Huybrechts et al. [70] | X | |
Piqueras et al. [62] | Children (n = 176) 4 years | 3 (Spain, Germany, Hungary) | FFQ | SF (g) and SF (% energy) were calculated using the program CESNID and the database used for the nutrient analysis was the 3rd edition of CESNIDs food tables | X [72] Sweden FFQ based on one used in MONICA which was validated by Johanasson et al. [72] | X |