Skip to main content

Eating out of home and its correlates in 10 European countries. The European Prospective Investigation into Cancer and Nutrition (EPIC) study

  • Philippos Orfanos (a1), Androniki Naska (a1), Dimitrios Trichopoulos (a2), Nadia Slimani (a3), Pietro Ferrari (a3), Marit van Bakel (a3), Genevieve Deharveng (a3), Kim Overvad (a4), Anne Tjønneland (a5), Jytte Halkjær (a5), Maria Santucci de Magistris (a6), Rosario Tumino (a7), Valeria Pala (a8), Carlotta Sacerdote (a9), Giovanna Masala (a10), Guri Skeie (a11), Dagrun Engeset (a11), Eiliv Lund (a11), Paula Jakszyn (a12), Aurelio Barricarte (a13), Maria-Dolores Chirlaque (a14), Carmen Martinez-Garcia (a15), Pilar Amiano (a16), J Ramon Quirós (a17), Sheila Bingham (a18), Ailsa Welch (a18), Elizabeth A Spencer (a19), Timothy J Key (a19), Sabine Rohrmann (a20), Jakob Linseisen (a20), Jennifer Ray (a21), Heiner Boeing (a21), Petra H Peeters (a22), H Bas Bueno-de-Mesquita (a23), Marga Ocke (a23), Ingegerd Johansson (a24), Gerd Johansson (a25), Göran Berglund (a26), Jonas Manjer (a26), Marie-Christine Boutron-Ruault (a27), Mathilde Touvier (a27), Françoise Clavel-Chapelon (a27) and Antonia Trichopoulou (a1)...

To compare the average out-of-home (OH) consumption of foods and beverages, as well as energy intake, among populations from 10 European countries and to describe the characteristics of substantial OH eaters, as defined for the purpose of the present study, in comparison to other individuals.


Cross-sectional study. Dietary data were collected through single 24-hour dietary recalls, in which the place of consumption was recorded. For the present study, substantial OH eaters were defined as those who consumed more than 25% of total daily energy intake at locations other than the household premises. Mean dietary intakes and the proportion of substantial OH eaters are presented by food group and country. Logistic regression analyses were used to estimate the odds of being a substantial OH eater in comparison to not being one, using mutually adjusted possible non-dietary determinants.


Ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC).


The subjects were 34 270 individuals, 12 537 men and 21 733 women, aged 35–74 years.


The fraction of energy intake during OH eating was generally higher in northern European countries than in the southern ones. Among the food and beverage groups, those selectively consumed outside the home were coffee/tea/waters and sweets and, to a lesser extent, cereals, meats, added lipids and vegetables. Substantial OH eating was positively associated with energy intake and inversely associated with age and physical activity. Substantial OH eating was less common among the less educated compared with the more educated, and more common during weekdays in central and north Europe and during the weekend in south Europe.


Eating outside the home was associated with sedentary lifestyle and increased energy intake; it was more common among the young and concerned in particular coffee/tea/waters and sweets.

Corresponding author
*Corresponding author: Email
Hide All
1Kant AK, Graubard BI. Eating out in America, 1987–2000: trends and nutritional correlates. Preventive Medicine 2004; 38 (2): 243249.
2Popkin BM, Haines PS, Siega-Riz AM. Dietary patterns and trends in the United States: the UNC-CH approach. Appetite 1999; 32 (1): 814.
3Guthrie JF, Lin BH, Frazao E. Role of food prepared away from home in the American diet, 1977–78 versus 1994–96: changes and consequences. Journal of Nutrition Education and Behavior 2002; 34 (3): 140150.
4Lin B, Frazao E, Guthrie J. Away-from-home Foods Increasingly Important to Quality of American Diet. Agriculture Information Bulletin No. 749. Washington, DC: US Department of Agriculture, Economic Research Service, 1999; 1–22.
5Nielsen SJ, Siega-Riz AM, Popkin BM. Trends in energy intake in US between 1977 and 1996: similar shifts seen across age groups. Obesity Research 2002; 10 (5): 370378.
6Nielsen SJ, Popkin BM. Patterns and trends in food portion sizes, 1977–1998. JAMA: Journal of the American Medical Association 2003; 289 (4): 450453.
7Jabs J, Devine CM. Time scarcity and food choices: an overview. Appetite 2006; 47 (2): 196204.
8Roos E, Sarlio-Lahteenkorva S, Lallukka T. Having lunch at a staff canteen is associated with recommended habits. Public Health Nutrition 2004; 7 (1): 5361.
9Burns C, Jackson M, Gibbons C, Stoney RM. Foods prepared outside the home: association with selected nutrients and body mass index in adult Australians. Public Health Nutrition 2002; 5 (3): 441448.
10Shrapnel BIS. Fast Food in Australia 1995. Sydney: Shrapnel BIS, 1995.
11Kearney JM, Hulshof KFAM, Gibney MJ. Eating patterns – temporal distribution, converging and diverging foods, meals eaten inside and outside of the home – implications for developing FBDG. Public Health Nutrition 2001; 4 (2B): 693698.
12Riboli E, Kaaks R. The EPIC project: rationale and study design. European Prospective Investigation into Cancer and Nutrition. International Journal of Epidemiology 1997; 26 (Suppl. 1): S614.
13Slimani N, Kaaks R, Ferrari P, Casagrnde C, Clavel-Chapelon F, Lotze G, et al. . European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study: rationale, design and population characteristics. Public Health Nutrition 2002; 5 (6B): 11251145.
14Slimani N, Deharveng G, Charrondiere R, van Kappel AL, Ocke MC, Welch A, et al. . Structure of the standardized computerized 24-h diet recall interview used as reference method in the 22 centers participating in the EPIC project. European Prospective Investigation into Cancer and Nutrition. Computer Methods and Programs in Biomedicine 1999; 58 (3): 251266.
15Slimani N, Deharveng G, Unwin I, Southgate DA, Vignat J, Skeie G, et al. . The EPIC Nutrient DataBase project (ENDB): a first attempt to standardise nutrient databases across 10 European countries participating in the EPIC study. European Journal of Clinical Nutrition 2007; in press.
16Charrondière UR, Vignat J, Møller A, Ireland J, Becker W, Church S, et al. . The European Nutrient Database (ENDB) for nutritional epidemiology. Journal of Food Composition and Analysis 2002; 15: 435451.
17Riboli E, Hunt KJ, Slimani N, Ferrari P, Norat T, Fahey M, et al. . European Prospective Investigation into Cancer and Nutrition (EPIC): study populations and data collection. Public Health Nutrition 2002; 5 (6B): 11131124.
18Haftenberger M, Schuit AJ, Tormo MJ, Boeing H, Wareham N, Bueno-de-Mesquita HB, et al. . Physical activity of subjects aged 50–64 years involved in the European Prospective Investigation into Cancer and Nutrition (EPIC). Public Health Nutrition 2002; 5 (6B): 11631177.
19James WPT, Schofield EC. Human Energy Requirements: A Manual for Planners and Nutritionists. Oxford: Oxford University Press, 1990.
20World Health Organization (WHO). Physical Status: The Use and Interpretation of Anthropometry. Report of a WHO Expert Committee. WHO Technical Report Series No. 854. Geneva: WHO, 1995.
21Gregory J, Foster K, Tyler H, Wiseman M. The Dietary and Nutritional Survey of British Adults. London: HMSO, 1990; 218–27.
22Agudo A, Slimani N, Ocké MC, Naska A, Miller AB, Kroke A, et al. . Consumption of vegetables, fruit and other plant foods in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts from 10 European countries. Public Health Nutrition 2002; 5 (6B): 11791196.
23Lutkepohl H. Introduction to Multiple Time Series Analysis. New York: Springer-Verlag, 1991; Chapter 4.
24Registar General for England and Wales. Occupational Mortality 1970–1972. OPCS Series DS No. 1. London: Her Majesty’s Stationery Office, 1978.
25Harnack LJ, Jeffery RW, Boutelle KN. Temporal trends in energy intake in the United States: an ecologic perspective. American Journal of Clinical Nutrition 2000; 71 (6): 14781484.
26Bell AC, Swinburn BA. What are the key food groups to target for preventing obesity and improving nutrition in schools? European Journal of Clinical Nutrition 2004; 58 (2): 258263.
27Le Francois P, Calamassi-Tran G, Hebel P, Renault C, Lebreton S, Volatier JL. Food and nutrient intake outside the home of 629 French people of fifteen years and over. European Journal of Clinical Nutrition 1996; 50 (12): 826831.
28French SA, Harnack L, Jeffery RW. Fast food restaurant use among women in the Pound of Prevention study: dietary, behavioral and demographic correlates. International Journal of Obesity and Related Metabolic Disorders 2000; 24 (10): 13531359.
29Haines PS, Hungerford DW, Popkin BM, Guilkey DK. Eating patterns and energy and nutrient intakes of US women. Journal of the American Dietetic Association 1992; 92 (6): 698704, 707.
30Nielsen SJ, Siega-Riz AM, Popkin BM. Trends in food locations and sources among adolescents and young adults. Preventive Medicine 2002; 35 (2): 107113.
31Clemens LH, Slawson DL, Klesges RC. The effect of eating out on quality of diet in premenopausal women. Journal of the American Dietetic Association 1999; 99 (4): 442444.
32McCrory MA, Fuss PJ, Hays NP, Vinken AG, Greenberg AS, Roberts SB. Overeating in America: association between restaurant food consumption and body fatness in healthy adult men and women ages 19 to 80. Obesity Research 1999; 7 (6): 564571.
33Jeffery RW, French SA. Epidemic obesity in the United States: are fast foods and television viewing contributing? American Journal of Public Health 1998; 88 (2): 277280.
34Jahns L, Siega-Riz AM, Popkin BM. The increasing prevalence of snacking among US children from 1977 to 1996. Journal of Pediatrics 2001; 138 (4): 493498.
35Zizza C, Siega-Riz AM, Popkin BM. Significant increase in young adults’ snacking between 1977–1978 and 1994–1996 represents a cause of concern! Preventive Medicine 2001; 32 (4): 303310.
36Gillis LJ, Bar-Or O. Food away from home, sugar-sweetened drink consumption and juvenile obesity. Journal of the American College of Nutrition 2003; 22 (6): 539545.
37Taveras EM, Berkey CS, Rifas-Shiman SL, Ludwig DS, Rockett HR, Field AE, et al. . Association of consumption of fried food away from home with body mass index and diet quality in older children and adolescents. Pediatrics 2005; 116 (4): e518e524.
38Binkley JK, Eales J, Jekanowski M. The relation between dietary change and rising US obesity. International Journal of Obesity and Related Metabolic Disorders 2000; 24 (8): 10321039.
39Ma Y, Bertone ER, 3rdStanek EJ, Reed GW, Hebert JR, Cohen NL, et al. . Association between eating patterns and obesity in a free-living US adult population. American Journal of Epidemiology 2003; 158 (1): 8592.
40Lafay L, Basdevant A, Charles MA, Vray M, Balkau B, Borys JM, et al. . Determinants and nature of dietary underreporting in a free-living population: the Fleurbaix Laventie Ville Sante (FLVS) Study. International Journal of Obesity and Related Metabolic Disorders 1997; 21 (7): 567573.
41Heitmann BL, Lissner L, Osler M. Do we eat les fat, or just report so? International Journal of Obesity and Related Metabolic Disorders 2000; 24 (4): 435442.
42Armitage P, Berry G. Statistical Methods in Medical Research, 3rd ed. Oxford: Blackwell, 1994.
43Willett WC. Nature of variation in diet. In: Willett WC, ed. Nutritional Epidemiology, 2nd ed. New York: Oxford University Press, 1998; 3349.
44Willett WC. Correction for the effects of measurement error. In: Willett WC, ed. Nutritional Epidemiology, 2nd ed. New York: Oxford University Press, 1998; 302320.
45Buzzard M. 24-Hour dietary recall and food record methods. In: Willett WC, ed. Nutritional Epidemiology, 2nd ed. New York: Oxford University Press, 1998; 5067.
46Ferrari P, Slimani N, Ciampi A, Trichopoulou A, Naska A, Lauria C, et al. . Evaluation of under- and overreporting of energy intake in the 24-hour diet recalls in the European Prospective Investigation into Cancer and Nutrition (EPIC). Public Health Nutrition 2002; 5 (6B): S1329S1345.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 29
Total number of PDF views: 313 *
Loading metrics...

Abstract views

Total abstract views: 600 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 20th February 2018. This data will be updated every 24 hours.