Development and evaluation of the Dutch Healthy Diet index 2015

Looman, Moniek; Feskens, Edith J. M.; Rijk, Mariëlle G de; Meijboom, Saskia; Biesbroek, Sander; Temme, Elisabeth H. M.; Vries, Jeanne de; Geelen, Anouk

doi:10.1017/s136898001700091x

Cited by 220 publications

(250 citation statements)

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“…Adherence to the Dutch Dietary Guidelines of 2015 was assessed with the DHD15-index, and details of this index are described elsewhere [9]. In short, the DHD15-index includes adequacy-, moderation-, optimum-, ratio-, and quality components.…”

Section: Dutch Healthy Diet Indexmentioning

confidence: 99%

“…The main differences are that the Dutch guidelines now include novel food groups, compared to other guidelines, and that adherence is scored based on Dutch consumption values, whereas an AHEI is based on American consumption values or a DASH is based on quintiles in the study population. The Dutch Healthy Diet index of 2015 (DHD15-index) has been developed to assess the adherence to the Dutch dietary guidelines of 2015 [9], based on methods used in the Dutch Healthy Diet index of 2006.…”

Section: Introductionmentioning

confidence: 99%

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Adherence to a food group-based dietary guideline and incidence of prediabetes and type 2 diabetes

et al. 2019

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Purpose In this study, we investigated the association between adherence to the Dutch Healthy Diet index 2015 (DHD15-index) and incidence of prediabetes (preT2D) and Type 2 Diabetes (T2D) in a representative sample for the general Dutch population. Methods Two prospective cohort studies, The Hoorn and The New Hoorn Study, were used for data analyses. In total, data from 2951 participants without diabetes at baseline (mean age 56.5 ± 7.5 years; 49.6% male) were harmonized. Baseline dietary intake was assessed with validated Food Frequency Questionnaires and adherence to the DHD15-index was calculated (range 0–130). PreT2D and T2D were classified according to the WHO criteria 2011. Poisson regression was used to estimate prevalence ratios between participant scores on the DHD15-index and preT2D and T2D, adjusted for follow-up duration, energy intake, socio-demographic, and lifestyle factors. Change in fasting plasma glucose levels (mmol/L) over follow-up was analysed using linear regression analyses, additionally adjusted for baseline value. Results During a mean follow-up of 6.3 ± 0.7 years, 837 participants developed preT2D and 321 participants developed T2D. The highest adherence to the DHD15-index was significantly associated with lower T2D incidence [model 3, PR T3vsT1 : 0.70 (0.53; 0.92), p trend = 0.01]. The highest adherence to the DHD15-index pointed towards a lower incidence of preT2D [PR T3vsT1 : 0.87 (0.74; 1.03), p trend = 0.11]. Higher adherence to the DHD15-index was not associated with change in fasting plasma glucose levels [ β 10point : − 0.012 (− 0.034; 0.009)mmol/L]. Conclusion The present study showed that the highest compared to the lowest adherence to the DHD15-index was associated with a lower T2D incidence, and pointed towards a lower incidence of preT2D. These results support the benefits of adhering to the guidelines in T2D prevention. Electronic supplementary material The online version of this article (10.1007/s00394-019-02064-8) contains supplementary material, which is available to authorized users.

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Section: Dutch Healthy Diet Indexmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Adherence to a food group-based dietary guideline and incidence of prediabetes and type 2 diabetes

et al. 2019

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“…We calculated the Dutch Healthy Diet index 2015 score as an indicator of the healthiness of the diet (Looman et al 2017) in our study population. A proportional score between 0 and 10 was assigned to each of the 15 recommendations (Supplemental Table 2).…”

Section: Assessment Of Healthiness Of Dietsmentioning

confidence: 99%

“…For this type of recommendation, we created a ratio by dividing the intake of the recommended food by the intake of the replaced food. When the oils/fats ratio was higher than 13, a score of 10 points was received, gradually decreasing to 0 points when the ratio was lower than 0.6 (Looman et al 2017). For coffee, the recommendation is to consume filtered instead of unfiltered coffee.…”

Section: Assessment Of Healthiness Of Dietsmentioning

confidence: 99%

Identification of data-driven Dutch dietary patterns that benefit the environment and are healthy

et al. 2018

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More sustainable dietary patterns are needed to mitigate global warming. This study aims to identify data-driven healthy dietary patterns that benefit the environment. In EPIC-NL, diet was assessed using a 178-item FFQ in 36,203 participants aged 20-70 years between 1993 and 1997. The Dutch Healthy Diet index 2015 (DHD15-index) was used to score healthiness of the diet. As proxy for environmental impact, greenhouse gas (GHG) emissions were calculated using life cycle analysis. To determine patterns that are both healthy and environmentally friendly, reduced rank regression was applied. A BPlant-based Pattern^characterized by high consumption of fruits, vegetables, and legumes, and low consumption of fries, red meat, and processed meat and a BDairy-based Pattern^characterized by high consumption of dairy, and nuts and seeds and low consumption of coffee and tea, sugar-containing sodas, lowfiber bread, and savory sauces were derived. At equal energy intake, the diet of adherents (highest quartile) to the BPlant-based Pattern^were significantly healthier (89.8 points on the DHD15-index, p < 0.0001) and more sustainable (3.96 kg C0 2 -eq/day, p < 0.0001) compared to the average diet (76.2 points, 4.06 kg C0 2 -eq/day), whereas the BDairy-based Pattern^was somewhat healthier (77.9 points, p < 0.0001), but less sustainable (4.43 kg C0 2 -eq/day, p < 0.0001). When deriving dietary patterns based on health and environmental aspects of the diets, a BPlant-based^and a BDairy-based^pattern were observed in our study population. Of these, the plant-based diet benefits health as well as the environment.

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“…In order to assess differences in dietary quality between baseline and follow-up, a modification of the Dutch Healthy Diet index 2015 (DHD15-index) was calculated ( 28 ) . The DHD15-index estimates the level of adherence to the most recent 2015 Dutch dietary guidelines from the Dutch Health Council ( 29 ) .…”

Section: Participants and Methodsmentioning

confidence: 99%

Are our diets getting healthier and more sustainable? Insights from the European Prospective Investigation into Cancer and Nutrition – Netherlands (EPIC-NL) cohort

Biesbroek

Boer

Schouw

et al. 2019

Public Health Nutr.

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Objective:To identify differences in dietary quality, dietary greenhouse gas (GHG) emissions and food consumption over 20 years in a Dutch cohort.Design:Participants (n 8932) filled out an FFQ in 1993–1997 and in 2015. The Dutch Healthy Diet index 2015 (DHD15-index) score, GHG emissions and consumption of food groups (g/4184 kJ (1000 kcal)) were compared between the time points with paired t tests.Setting:The Netherlands.Participants:European Prospective Investigation into Cancer and Nutrition – Netherlands (EPIC-NL) cohort, aged 18–65 years at baseline.Results:Total energy intake decreased by –678 (95 % CI –4908, 3377) kJ/d (–162 (95 % CI –1173, 807) kcal/d) for men and –372 (95 % CI –3820, 3130) kJ/d (–89 (95 % CI –913, 748) kcal/d) for women. DHD15-index scores increased by 11 % (from 64·8 to 71·9 points) and 13 % (from 65·2 to 73·6 points) in men and women, respectively (P < 0·0001), mainly due to an increased (shell)fish and nuts/seeds/nut paste consumption. After energy intake adjustment, dietary-related GHG emissions increased by 5 % in men (2·48–2·61 kg CO2-eq/4184 kJ (1000 kcal), P < 0·0001) and were similar in women (0·4 %, 2·70–2·71 kg CO2-eq/4184 kJ (1000 kcal), P = 0·3930) due to the increased consumption of (shell)fish, nuts/seeds/nut paste, poultry and higher GHG-intensive red meats such as beef.Conclusions:This Dutch cohort analyses showed more healthy diets without mitigated GHG emissions over a 20-year period, at similar energy intakes. Higher consumption of (shell)fish and poultry was not yet at the expense of red and processed meat. Lower consumption of animal-based foods is needed to achieve healthier as well as environmentally friendly diets.

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Development and evaluation of the Dutch Healthy Diet index 2015

Abstract: The 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.

Cited by 220 publications

References 22 publications

Adherence to a food group-based dietary guideline and incidence of prediabetes and type 2 diabetes

Adherence to a food group-based dietary guideline and incidence of prediabetes and type 2 diabetes

Identification of data-driven Dutch dietary patterns that benefit the environment and are healthy

Are our diets getting healthier and more sustainable? Insights from the European Prospective Investigation into Cancer and Nutrition – Netherlands (EPIC-NL) cohort

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