scholarly journals Development and evaluation of the Dutch Healthy Diet index 2015

2017 ◽  
Vol 20 (13) ◽  
pp. 2289-2299 ◽  
Author(s):  
Moniek Looman ◽  
Edith JM Feskens ◽  
Mariëlle de Rijk ◽  
Saskia Meijboom ◽  
Sander Biesbroek ◽  
...  

AbstractObjectiveTo update the Dutch Healthy Diet index, a measure of diet quality, to reflect adherence to the Dutch dietary guidelines 2015 and to evaluate against participants’ characteristics and nutrient intakes with the score based on 24 h recall (24 hR) data and FFQ data.DesignThe Dutch Healthy Diet index 2015 (DHD15-index) consists of fifteen components representing the fifteen food-based Dutch dietary guidelines of 2015. Per component the score ranges between 0 and 10, resulting in a total score between 0 (no adherence) and 150 (complete adherence).SettingWageningen area, the Netherlands, 2011–2013.SubjectsData of 885 men and women, aged 20–70 years, participating in the longitudinal NQplus study, who filled out two 24 hR and one FFQ, were used.ResultsMean (sd) score of the DHD15-index was 68·7 (16·1) for men and 79·4 (16·0) for women. Significant inverse trends were found between the DHD15-index and BMI, smoking, and intakes of energy, total fat and saturated fat. Positive trends were seen across sex-specific quintiles of the DHD15-index score with energy-adjusted micronutrient intakes. Mean DHD15-index score of the FFQ data was 15·5 points higher compared with 24 hR data, with a correlation coefficient of 0·56 between the scores. Observed trends of the DHD15-index based on FFQ with participant characteristics, macronutrient and energy-adjusted micronutrient intakes were similar to those with the DHD15-index based on 24 hR.ConclusionsThe DHD15-index score assesses adherence to the Dutch dietary guidelines 2015 and indicates diet quality. The DHD15-index score can be based on 24 hR data and on FFQ data.

1999 ◽  
Vol 81 (S1) ◽  
pp. S113-S117 ◽  
Author(s):  
Wulf Becker

The Nordic and Swedish Nutrition Recommendations emphasize the balance between macronutrients in the diet. The amount of saturated and total fat should be limited to c. 10 %energy and 30 %energy, respectively, and the amount of total carbohydrates should be 55–60 %energy. Data from the first Swedish national dietary survey in 1989 show that the average diet is too high in fat, especially saturated fat (36–37 %energy and 16 %energy, respectively) while the content of total carbohydrates and dietary fibre is too low. However, parts of the population consume a diet that meets the recommendation for a particular macronutrient. A comparison of subjects with a low or high intake of total fat and saturated fat, dietary fibre or fruit and vegetables show some common trends with respect to the characteristics of a dietary pattern equal or close to the recommendations, e.g. more frequent consumption of fruit and vegetables and a lower consumption of some fat-rich foods, such as spreads, cheese and sausages.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Victoria Miller ◽  
Patrick Webb ◽  
Renata Micha ◽  
Dariush Mozaffarian

Abstract Objectives Meeting most of the UN Sustainable Development Goals (SGDs) will require a strong focus on tackling all forms of malnutrition─ addressing maternal and child health (MCH) as well as diet-related non-communicable diseases (NCDs). Yet, the optimal metrics to define a healthy diet remain unclear. Our aim was to comprehensively review diet metrics and assess the evidence on each metric's association with MCH and NCDs. Methods Using comprehensive searches and expert discussions, we identified metrics that i) are used in ≥3 countries to link diet to health, ii) quantify the number of foods/food groups consumed and/or iii) quantify recommended nutrient intakes. We reviewed and summarized each metric's development, components and scoring. For each identified metric, we systematically searched PubMed to identify meta-analyses or narrative reviews evaluating these metrics with nutrient adequacy and health outcomes. We assessed validity by grading the number of studies included and the consistency of the diet metric-disease relationship. Results We identified 6 MCH, 13 NCD and 0 MCH/NCD metrics. Most were developed for describing adherence to dietary guidelines or patterns, and others were developed for predicting micronutrient adequacy. On average, the metrics included 14 food groups/nutrients (range 4–45), with 10 food-group only metrics and 0 nutrient-only metrics. The most frequent metric components were grains/roots/tubers, fruits and vegetables. We identified 16 meta-analyses and 14 narrative reviews representing 102 metric-disease relationships (98 metric-NCD and 4 metric-MCH relationships, respectively). We found 5 metrics that have been consistently validated in meta-analyses and narrative reviews for NCDs, 1 metric with limited evidence for MCH, but 0 metrics for both. Of the metrics, the Alternative Healthy Eating Index (aHEI), Dietary Approaches to Stop Hypertension (DASH), Healthy Eating Index (HEI), and Mediterranean Diet Score (MED) were most commonly validated, especially for all-cause mortality and cardiovascular disease (Figure 1). Conclusions Few diet metrics have been used in multiple countries to define a healthy diet. This suggests a serious gap in global analyses of diet quality relating to malnutrition in all its forms, which hinders effective policy action. Funding Sources Gates Foundation. Supporting Tables, Images and/or Graphs


2013 ◽  
Vol 2 ◽  
Author(s):  
Linde van Lee ◽  
Edith J. M. Feskens ◽  
Eveline J. C. Hooft van Huysduynen ◽  
Jeanne H. M. de Vries ◽  
Pieter van 't Veer ◽  
...  

AbstractThe Dutch Healthy Diet index (DHD-index) was developed using data from two 24 h recalls (24hR) and appeared useful to evaluate diet quality in Dutch adults. As many epidemiologic studies use FFQ, we now estimated the DHD-index score using FFQ data. We compared whether this score showed similar associations with participants' characteristics, micronutrient intakes, and biomarkers of intake and metabolism compared with the DHD-index using 24hR data. Data of 121 Dutch participants of the European Food Consumption Validation study were used. Dietary intake was assessed by two 24hR and a 180-item FFQ. Biomarkers measured were serum total cholesterol and carotenoids, EPA + DHA in plasma phospholipids and 24 h urinary Na. A correlation of 0·48 (95 % CI 0·33, 0·61) was observed between the DHD-index score based on 24hR data and on FFQ data. Classification of participants into the same tertiles of the DHD-index was achieved for 57 %. Women showed higher DHD-index scores. Energy intake was inversely associated with both DHD-index scores. Furthermore, age and intakes of folate, Fe, Mg, K, vitamin B6 and vitamin C were positively associated with both DHD-index scores. DHD-index scores showed acceptable correlations with the four combined biomarkers taking energy intake into account (r24hR 0.55; rFFQ 0.51). In conclusion, the DHD-index score based on FFQ data shows similar associations with participants' characteristics, energy intake, micronutrient intake and biomarkers compared with the score based on 24hR data. Furthermore, ranking of participants was acceptable for both methods. FFQ data may therefore be used to assess diet quality using the DHD-index in Dutch populations.


2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Christine Mulligan ◽  
Beatriz Franco-Arellano ◽  
Mary R L'Abbe

AbstractThe Health Canada Surveillance Tool (HCST), a Canadian nutrient profile (NP) model, assesses products’ adherence to the 2007 Canada's Food Guide (CFG), using thresholds for total fat, saturated fat, sugars and sodium. In 2019, new dietary guidelines were published (i.e., CFG 2019); however; the HCST has not been updated to reflect changes implemented in this new guide. Given suggestions to adapt previously validated NP models rather than create new models, this research aimed to assess whether the HCST could be a useful tool to assess alignment with updated dietary guidance. Specifically, the objective of this study was to test the agreement between products’ alignment with the CFG 2007 (as per the HCST) and products’ alignment with the recently released CFG 2019 guidelines. This study analyzed data from the University of Toronto Food Label Information Program (FLIP) 2017 database. FLIP contains label and nutrition information for prepackaged food products from top Canadian grocery retailers. Products were categorized into Tiers based on HCST thresholds: Tiers 1 and 2 were considered “in line” with dietary guidance, while Tiers 3, 4 and “Other” (i.e. foods not addressed by CFG) were considered “not in line”. Two raters independently classified foods according to their alignment to CFG 2019. Proportions of products that were considered “in line” with CFG 2007 and 2019 were calculated. Overall agreement between alignment with CFG 2007 and 2019 was determined by cross-classifications of the proportion of products considered “in line” or “not in line” with both CFG versions. Cohen's Kappa (κ) statistic tested the level of agreement (Interpretation of κ: 0.01–0.20, “slight”; 0.21–0.40, “fair”; 0.41–0.60, “moderate”; 0.61–0.80, “substantial”; and 0.81–0.99, “almost perfect”). Analyses were conducted overall and by Health Canada's Table of Reference Amounts for Food category. In total, n = 16,973 products were analyzed, with 98% inter-rater reliability for CFG 2019 alignment. Overall, 30.2% and 28.2% of products were “in line” with CFG 2007 and 2019, respectively, with 80.4% overall agreement and “moderate” kappa agreement (κ [95% CI]: 0.49 [0.46, 0.49]). Overall agreement in individual food categories ranged from 100% (Dessert Toppings, Sauces, Sugars and Sweets; κ: N/A) to 54.8% (Eggs, κ: 0.21 [-0.01, 0.4]). From these results, the HCST appears to be an effective NP model for assessing alignment with CFG 2019. Further analysis could elucidate specific areas for adaptation of the HCST to optimize its functionality in this context.


2011 ◽  
Vol 15 (3) ◽  
pp. 518-526 ◽  
Author(s):  
Mary AT Flynn ◽  
Clare M O'Brien ◽  
Gemma Faulkner ◽  
Cliona A Flynn ◽  
Magda Gajownik ◽  
...  

AbstractObjectiveTo evaluate Ireland's food-based dietary guidelines and highlight priorities for revision.DesignEvaluation with stakeholder input. Energy and nutrient intake goals most appropriate for Ireland were determined. Advice from Ireland's food guide was translated into 4 d food intake patterns representing age and gender groups from 5 to 51+ years. Nutritional content of the food patterns was compared with identified goals and appropriateness of food advice was noted. Feedback from stakeholders was obtained on portion size of foods within the Bread, Cereal and Potato group and of portion descriptors for meat and cereal foods.SettingGovernment agency/community.SubjectsGeneral population aged 5+ years, dietitians/nutritionists (n 44) and 1011 consumers.ResultsGoals were identified for energy, macronutrients, fibre, Fe, Ca and vitamin D. Goals not achieved by the food patterns included energy, total fat, saturated fat, fibre and vitamin D. Energy content of food portions within the Bread, Cereal and Potato group varied widely, yet advice indicated they were equivalent. Dietitians/nutritionists agreed with the majority of consumers surveyed (74 %, n 745) that larger portion sizes within the Bread, Cereal and Potato group were more meaningful. ‘Palm of hand’ as a descriptor for meat portions and a ‘200 ml disposable cup’ for quantifying cereal foods were preferred.ConclusionsRevision of the guidelines requires specific guidance on energy and vitamin D intakes, and comprehensive advice on how to reduce fat and saturated fat and increase fibre intakes. Advice should use portion descriptors favoured by consumers and enlarged portion sizes for breads, cereals and potatoes that are equivalent in terms of energy.


Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2561 ◽  
Author(s):  
Masip ◽  
Keski-Rahkonen ◽  
Pietiläinen ◽  
Kujala ◽  
Rottensteiner ◽  
...  

We constructed a food-based diet quality score (DQS) and examined its association with obesity measures, eating styles and nutrient intakes. Participants were 3592 individuals (764 dizygotic [DZ] and 430 monozygotic [MZ] twin pairs) from the FinnTwin16 study. The DQS (0–12 points) was constructed from a short 14 item food frequency questionnaire. Anthropometric measures and eating styles were self-reported. Nutrient intakes were calculated from food diaries completed in a subsample of 249 individuals (45 same-sex DZ and 60 MZ twin pairs). Twins were analyzed both as individuals and as twin pairs. The DQS was inversely associated with body mass index (β = −0.12, per one-unit increase in DQS, p < 0.001), waist circumference (β = −0.34, p < 0.001), obesity (odds ratio [OR]: 0.95, p = 0.004) and abdominal obesity (OR: 0.88, p < 0.001), independent of sex, age, physical activity and education. A higher DQS was associated with health-conscious eating, having breakfast, less snacking, fewer evening meals, and a higher frequency and regularity of eating. The DQS was positively correlated with the intakes of protein, fiber and magnesium and negatively correlated with the intakes of total fat, saturated fat and sucrose. Within twin pairs, most of the associations between the DQS with eating styles and some nutrients remained, but the DQS was not associated with obesity measures within twin pairs. The DQS is an easy-to-use tool for ranking adults according to diet quality and shows an association with obesity measures, eating styles and key nutrients in the expected direction.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Catherine M. Milte ◽  
Kylie Ball ◽  
David Crawford ◽  
Sarah A. McNaughton

Abstract Background To date much research into nutrition and cognitive function has been at the nutrient or food level, with inconsistent results. There is increasing interest in the dietary pattern approach to assess whole diet quality and its association with cognitive function. This study investigated if diet quality is associated with cognitive function in men and women aged 55 years and over. Methods Adults aged 55–65 years in the Wellbeing, Eating and Exercise for a Long Life (WELL) study in Victoria, Australia (n = 617) completed a postal survey including a 111-item food frequency questionnaire in 2010 and 2014. Diet quality was assessed via the revised dietary guideline index (DGI-2013) and also by its individual components which assessed key food groups and dietary behaviours from the Australian Dietary Guidelines. The Telephone Interview of Cognitive Status (TICS-m) measured cognitive function in 2014. Associations between past (2010) and recent (2014) diet quality and its components, and cognitive function were assessed by linear regression adjusted for covariates. Results After adjustment for age, sex, education, urban/rural status and physical activity there were no associations between diet quality in 2010 and cognitive function in 2014. However participants who reported higher dietary variety (B = 0.28, 95% CI 0.03, 0.52) and women who reported “sometimes” adding salt to food after cooking (B = 0.98, 95% CI 0.25, 1.71) in 2010 displayed better cognitive function in 2014. In 2014, usual consumption of higher fibre bread choices in the total sample (B = 1.32, 95% CI 0.42, 2.23), and higher diet quality (B = 0.03, 95% CI 0.00, 0.07) and greater fluid consumption (B = 0.14, 95% CI 0.01, 0.27) in men were all associated with better cognitive function. In addition, men who reported “usually” adding salt to their food during cooking displayed poorer cognitive function (B = -1.37, 95% CI -2.39, − 0.35). There were no other associations between dietary intake and cognitive function observed in the adjusted models. Conclusion An association between dietary variety and some limited dietary behaviours and cognitive function was observed, with variation by gender. Future research should consider trajectories of dietary change over longer time periods as determinants of health and function in older age.


2020 ◽  
Vol 150 (5) ◽  
pp. 1252-1258
Author(s):  
Karina Kvist ◽  
Anne Sofie Dam Laursen ◽  
Kim Overvad ◽  
Marianne Uhre Jakobsen

ABSTRACT Background Food-based dietary guidelines recommend replacement of whole-fat dairy products with low-fat variants based on data suggesting that diets high in saturated fat are associated with a higher risk of ischemic heart disease. However, the health effects of saturated fat may depend on the source. Objectives The aim was to investigate substitutions between different subgroups of dairy products and the risk of myocardial infarction (MI). Methods Data were from the Danish Diet, Cancer and Health cohort and included 54,903 men and women aged 50–64 y at enrollment and without an MI diagnosis. Information about intake of dairy products was obtained by a semiquantitative food-frequency questionnaire. Incident MI cases were identified through nationwide registries. We used Cox proportional hazards regression to estimate associations between specified substitutions of dairy products and MI risk. Results During a median follow-up of 15.9 y, 3033 cases were identified. Whole-fat yogurt products in place of low-fat or whole-fat milk were associated with a lower risk of MI (HR: 0.89; 95% CI: 0.80, 0.99 per 200 g/d replaced; and HR: 0.87; 95% CI: 0.78, 0.98 per 200 g/d replaced, respectively). Substitution of 20 g/d of cheese for 200 g/d of low-fat or whole-fat milk was also associated with a lower risk of MI (HR: 0.96; 95% CI: 0.92, 0.99; and HR: 0.95; 95% CI: 0.89, 0.99, respectively). Conclusions Among middle-aged Danish men and women, intake of whole-fat yogurt products or cheese in place of milk, regardless of fat content, was associated with a lower risk of development of MI.


2014 ◽  
Vol 17 (12) ◽  
pp. 2641-2649 ◽  
Author(s):  
Tiffany M Powell-Wiley ◽  
Paige E Miller ◽  
Priscilla Agyemang ◽  
Tanya Agurs-Collins ◽  
Jill Reedy

AbstractObjectiveThe Dietary Approaches to Stop Hypertension (DASH) dietary pattern has been shown to reduce cardiometabolic risk. Little is understood about the relationship between objective diet quality and perceived diet quality (PDQ), a potential psychosocial barrier to appropriate dietary intake. We compared PDQ and diet quality measured by a nutrient-based DASH index score in the USA.DesignCross-sectional study. Participants in the 2005–2006 National Health and Nutrition Examination Survey (NHANES) rated diet quality on a 5-point Likert scale and PDQ scores were generated (low, medium, high). A single 24 h dietary recall was used to estimate DASH index scores (range 0–9 points) by assigning 0, 0·5 or 1 point (optimal) for nine target nutrients: total fat, saturated fat, protein, cholesterol, fibre, Ca, Mg, K and Na.SettingNationally representative sample of the US population.SubjectsAdults aged ≥19 years in 2005–2006 NHANES (n 4419).ResultsParticipants with high PDQ (33 %) had higher DASH index scores (mean 3·0 (sd 0·07)) than those with low PDQ (mean 2·5 (sd 0·06), P < 0·001), but average scores did not align with targets for intermediate or optimal DASH accordance. Adults with high PDQ reported higher total fat, saturated fat and Na intakes compared with optimal DASH nutrient goals. Differences between those with high v. low PDQ were similar for Whites and Blacks, but there was no difference between PDQ groups for Mexican Americans.ConclusionsAmong Whites and Blacks, but not Mexican Americans, high PDQ may be associated with higher diet quality, but not necessarily a diet meeting DASH nutrient goals. This disconnect between PDQ and actual diet quality may serve as a target in obesity prevention.


Author(s):  
Jaana Lindström ◽  
Kirsikka Aittola ◽  
Auli Pölönen ◽  
Katri Hemiö ◽  
Kirsti Ahonen ◽  
...  

Lack of tools to evaluate the quality of diet impedes dietary counselling in healthcare. We constructed a scoring for a validated food intake questionnaire, to measure the adherence to a healthy diet that prevents type 2 diabetes (T2D). The Healthy Diet Index (HDI) consists of seven weighted domains (meal pattern, grains, fruit and vegetables, fats, fish and meat, dairy, snacks and treats). We studied the correlations of the HDI with nutrient intakes calculated from 7-day food records among 52 men and 25 women, and associations of HDI with biomarkers and anthropometrics among 645 men and 2455 women. The HDI correlated inversely with total fat (Pearson’s r = −0.37), saturated fat (r = −0.37), monounsaturated fat (r = −0.37), and the glycaemic index of diet (r = −0.32) and positively with carbohydrates (r = 0.23), protein (r = 0.25), fibre (r = 0.66), magnesium (r = 0.26), iron (r = 0.25), and vitamin D (r = 0.27), (p < 0.05 for all). In the linear regression model adjusted for BMI and age, HDI is associated inversely with waist circumference, concentrations of fasting and 2-h glucose and triglycerides in men and women, total and LDL cholesterol in women, and fasting insulin in men (p < 0.05 for all). The HDI proved to be a valid tool to measure adherence to a health-promoting diet and to support individualised dietary counselling.


Sign in / Sign up

Export Citation Format

Share Document