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Abstract
BackgroundThe objective was to develop an index based on the Dutch Guidelines for a healthy Diet of 2006 that reflects dietary quality and to apply it to the Dutch National Food Consumption Survey (DNFCS) to examine the associations with micronutrient intakes.MethodsA total of 749 men and women, aged 19–30 years, contributed two 24-hour recalls and additional questionnaires in the DNFCS of 2003. The Dutch Healthy Diet index (DHD-index) includes ten components representing the ten Dutch Guidelines for a Healthy Diet. Per component the score ranges between zero and ten, resulting in a total score between zero (no adherence) and 100 (complete adherence).ResultsThe mean ± SD of the DHD-index was 60.4 ± 11.5 for women and 57.8 ± 10.8 for men (P for difference = 0.002). Each component score increased across the sex-specific quintiles of the DHD-index. An inverse association was observed between the sex-specific quintiles of the DHD-index and total energy intake. Calcium, riboflavin, and vitamin E intake decreased with increasing DHD-index, an inverse association which disappeared after energy adjustment. Vitamin C showed a positive association across quintiles, also when adjusted for energy. For folate, iron, magnesium, potassium, thiamin, and vitamin B6 a positive association emerged after adjustment for energy.ConclusionsThe DHD-index is capable of ranking participants according to their adherence to the Dutch Guidelines for a Healthy Diet by reflecting variation in nine out of ten components that constitute the index when based on two 24-hour recalls. Furthermore, the index showed to be a good measure of nutrient density of diets.
Highlights
Diets have a complex nature, as foods and nutrients are consumed in combinations which can induce interactions and synergies between dietary components
Two Dutch indices have been developed by Löwik et al [14], both based on the Dutch Guidelines for a Healthy Diet of 1986
We developed a new index, the Dutch Healthy Diet index (DHD-index), based on the Dutch Guidelines for a Healthy Diet of 2006 [5], the official background document [15] and the information provided by the Netherland Nutrition Centre (NNC) [16]
Summary
Diets have a complex nature, as foods and nutrients are consumed in combinations which can induce interactions and synergies between dietary components. One approach of assessing dietary patterns is to construct an a priori dietary index These indices are mainly based on national or international dietary recommendations, which are designed to decrease the risk of chronic. The score, ranging from zero (low quality) to five (high quality), was inversely related to energy intake and positively associated with a higher prevalence of following a prescribed diet and a higher educational level [14]. The score, ranging from zero (low quality) to seven (high quality), was positively associated with energy intake and all evaluated nutrient densities (calcium, iron, vitamin A, thiamin, riboflavin, vitamin B6 and vitamin C) [14]. The objective was to develop an index based on the Dutch Guidelines for a healthy Diet of 2006 that reflects dietary quality and to apply it to the Dutch National Food Consumption Survey (DNFCS) to examine the associations with micronutrient intakes
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