Search Results (16)

Background: Dietary assessment in inflammatory bowel disease (IBD) is moving away from individual food and nutrient analyses and towards dietary patterns (e.g., Mediterranean diet, Western diet) and diet quality assessment that are increasingly implicated in IBD onset and course. However, an IBD-specific diet quality index (DQI) does not exist. This review aimed to identify current DQIs and assess their suitability for an IBD population. Methods: MEDLINE and EmCare databases were systematically searched for a-priori, food-based DQI reflecting current dietary guidelines and/or nutrition science. Data extracted were adapted from optimal DQI criteria, including quality measures of adequacy, moderation, variety and balance and DQI evaluation. Results: Twenty-four DQI were identified. No DQI included all optimal DQI criteria. The Dietary Guideline Index 2013 (DGI-2013) most closely met the criteria, followed by the Dutch Healthy Diet Index-2015 (DHD-Index 2015), Planetary Health Diet Index (PHDI) and Healthy Eating Index for Australian Adults-2013 (HEIFA-2013). Most DQI assessed adequacy (22/24, 92%) and moderation (21/24, 88%), half assessed balance (12/24) while few assessed variety (8/24, 33%). Application of other optimal DQI criteria varied. Food frequency questionnaire (13/24) and 24 h diet recall (12/24) were the most common dietary assessment methods used. Most DQI (17/24, 71%) were validated; however, not for an IBD population. Few were evaluated for reliability (6/24) or reproducibility (1/24). Conclusions: No DQI meets all optimal criteria for an IBD-specific DQI. The DGI-2013 met the most criteria, followed by the DHD Index-2015, PHDI and HEIFA-2013 and may be most appropriate for an IBD population. An IBD-specific DQI is lacking and needed. Full article

Background/Objectives: Inflammatory bowel disease (IBD) is characterized by a relapsing-remitting disease course, influenced by dietary factors. This study aims to examine diet quality in IBD patients and investigate its association with disease activity. Methods: In total, 477 participants from a prospective IBD cohort study at two Dutch hospitals were approached to complete a population-specific food frequency questionnaire (GINQ-FFQ) at baseline and after one year. Disease characteristics were assessed at multiple time points. Food-related Quality of Life (FrQoL) was assessed at baseline. Diet quality was measured via the Dietary Inflammatory Index (DII), Mediterranean Diet Score (MDS), Healthy Diet Indicator score (HDI), ultra-processed food intake, and Principal Component Analysis (PCA) to identify dietary patterns. The outcomes were compared to the general Dutch population. Results: In total, 191 participants completed the GINQ-FFQ at baseline, of whom 53 had active disease. Patients in remission had higher FrQoL than patients with active disease (p = 0.020). Diet quality and adherence to specific dietary patterns were not associated with disease activity. However, logistic regression showed a trend toward increased odds of increase in disease activity with an animal protein-rich pattern (OR: 1.479, p = 0.088) and a potential association between the Convenience diet and decreased disease activity (OR: 1.396, p = 0.060). Both the Dutch population and the patient cohort scored poor on all diet quality scores. Conclusions: The current study shows no conclusive evidence of an association between disease activity and both diet quality and dietary patterns in patients with IBD. However, the findings do suggest a possible association between animal protein-rich diets with more disease activity and Convenience-like diets with less disease activity. Furthermore, a similar diet quality was observed in IBD patients and the general Dutch population. Nevertheless, diet quality was generally poor and can be improved. Full article

Aims: Various dietary risk factors for type 2 diabetes have been identified. A short assessment of dietary patterns related to the risk for type 2 diabetes mellitus may be relevant in clinical practice given the largely preventable nature of the disease. The aim of this study was to investigate the reproducibility of a short food frequency questionnaire based on available knowledge of diabetes-related healthy diets. In addition, we aimed to investigate whether a Diabetes Dietary Quality Index based on this questionnaire was related to metabolic risk factors, including measures of beta cell function and insulin sensitivity. Methods: A short food frequency questionnaire was composed by selecting fourteen questions (representing eight dietary factors) from existing food frequency questionnaires on the basis of their reported relationship with diabetes risk. Healthy participants (N = 176) from a Dutch family study completed the questionnaire and a subgroup (N = 123) completed the questionnaire twice. Reproducible items from the short questionnaire were combined into an index. The association between the Diabetes Dietary Quality index and metabolic risk factors was investigated using multiple linear regression analysis. Measures of beta cell function and insulin sensitivity were derived from a mixed meal test and an euglycemic–hyperinsulinemic and modified hyperglycemic clamp test. Results: Our results show that this new short food frequency questionnaire is reliable (Intraclass Correlations ranged between 0.5 and 0.9). A higher Diabetes Dietary Quality index score was associated with lower 2 h post-meal glucose (β −0.02, SE 0.006, p < 0.05), HbA1c (β −0.07, SE 0.02, p < 0.05), total cholesterol, (β −0.02, SE 0.07, p < 0.05), LDL cholesterol, (β −0.19, SE 0.07, p < 0.05), fasting (β −0.4, SE 0.16, p < 0.05) and post-load insulin, (β −3.9, SE 1.40, p < 0.05) concentrations and the incremental AUC of glucose during MMT (β −1.9, SE 0.97, p < 0.05). The scores obtained for the oral glucose insulin sensitivity-derived mixed meal test were higher in subjects who scored higher on the Diabetes Dietary Quality index (β 0.89, 0.39, p < 0.05). In contrast, we found no significant associations between the Diabetes Dietary Quality index and clamp measures of beta cell function. Conclusions: We identified a questionnaire-derived Diabetes Dietary Quality index that was reproducible and inversely associated with a number of type 2 diabetes mellitus and metabolic risk factors, like 2 h post-meal glucose, Hba1c and LDL, and total cholesterol. Once relative validity has been established, the Diabetes Dietary Quality index could be used by health care professionals to identify individuals with diets adversely related to development of type 2 diabetes. Full article

Background: Quality of life (QoL) is traditionally assessed using multiple-item questionnaires. These can be either general, global assessments of QoL or disease-specific questionnaires. However, the use of single-item QoL scales is becoming increasingly popular, as these are more time- and cost-effective, with a readily available and easy-to-interpret outcome. In particular, these are often preferred for quick assessments (e.g., ‘at home’ testing and mobile phone assessments), and other cases when time constraints are common (e.g., clinical trials and clinical practice). Previous research revealed that multiple-item questionnaires and single-item assessments of QoL have the same validity and reliability. Here we further evaluate the relationship of QoL, assessed with a single-item QoL scale, with well-being, mood, health correlates (e.g., immune fitness, and having underlying diseases), and lifestyle (e.g., sleep, nutrition). Methods: Data from two online surveys are presented. In Study 1, 100 students participated. The single-item QoL score was compared with the World Health Organization Well-Being Index (WHO-5), a single-item score of sleep quality, the Regensburg Insomnia Scale (RIS) score, and the Healthy Diet Scale (HDS). Study 2 comprised a survey among 1415 Dutch adults. Single-item QoL was evaluated and compared with assessments of mood, health correlates (immune fitness and disease status), and lifestyle factors (e.g., sleep, nutrition, stress). Results: The first study revealed significant correlations between QoL and well-being, sleep quality, insomnia ratings, and attaining a healthy diet. The second study revealed significant correlations between QoL and mood, health status, and lifestyle factors (e.g., the ability to cope with stress). Conclusions: The results presented here demonstrate that the single-item QoL scale is an effective and easy-to-implement assessment tool that can be used in both clinical practice and research. Full article

Dietary biodiversity, defined as the variety of consumed plants, animals and other organisms, can be measured by dietary species richness (DSR). This study investigated associations between DSR and diet quality in Dutch adults. Dietary intake data of 2078 Dutch participants, aged 19 to 79 years, were collected by the Dutch National Food Consumption Survey between 2012 and 2016 via two non-consecutive 24-h dietary recalls. DSR scores were calculated based on the total count of unique species consumed per individual over the two measurement days. An overall DSR score and separate scores for fruit and vegetable species consumption were calculated. The Dutch Healthy Diet index 2015 (DHD15-index) was used to measure diet quality. Linear regression analyses were performed to investigate associations between DSR scores and DHD15-index. Analyses were stratified by age and adjusted for relevant confounders. In total, 157 unique species were identified within the investigated food groups. On average, individuals consumed 13 unique species over two days (SD 4.55). For every additional species consumed, the DHD15-index increased by 1.40 points (95%CI 1.25–1.55). Associations between DSR and DHD15-index were higher in younger adults. DSR fruit showed the strongest associations with DHD15-index (β 4.01 [95%CI 3.65–4.38]). Higher DSR scores are associated with higher diet quality in Dutch adults. These newly developed DSR scores create opportunities for further research to explore the implications of dietary biodiversity in Western diets on health and related outcomes. Full article

Type 2 diabetes mellitus (T2DM) has become a global epidemic. To effectively control T2DM, individuals must adhere to a high-quality diet that encompasses not only healthy dietary patterns but also promotes positive eating behaviors. We conducted a cross-sectional study on 314 patients with T2DM, and we evaluated the diet quality and also examined the associations between eating behavior, diet quality, and anthropometric and clinical factors in T2DM patients. We used the Diet Quality Index-International and Dutch Eating Behavior Questionnaire to assess dietary characteristics. We found that women had a significantly higher diet quality than men (61.40 vs. 58.68, p = 0.002) but were also more prone to emotional eating (2.00 vs. 1.53, p < 0.001) and restrained eating (2.39 vs. 2.05, p = 0.002). Restrained eating correlated with duration of diabetes (r = −0.169, p = 0.003), body mass index (r = 0.182, p = 0.001), and external eating with glycated hemoglobin (r = 0.114, p = 0.044). Patients with emotional eating had a higher vitamin C adequacy score (β = 0.117, p = 0.045). External eating was positively associated with grain adequacy (β = 0.208, p < 0.001) and negatively associated with empty-calorie food moderation score (β = −0.125, p = 0.032). For restrained eating, we found associations with vitamin C adequacy (β = −0.138, p = 0.017) and fruit adequacy (β = 0.125, p = 0.033). In conclusion, the results of this study provide valuable insight into dietary behavior and emphasize the importance of promoting healthy eating habits for T2DM patients. Full article

Biodiversity is essential for human and environmental health, yet our food system is one of the primary drivers of biodiversity loss. Food biodiversity, defined as the variety of consumed plants, animals and other organisms, can be measured by Dietary Species Richness (DSR). A higher DSR is associated with a lower mortality risk in European populations; however, less is known about DSR and diet quality in Dutch populations. We assessed the associations between fruit DSR and diet quality in a representative sample of 2078 Dutch participants aged from 19 to 79 years. Data were retrieved from the Dutch National Food Consumption Survey (DNFCS) between 2012 and 2016 by two non-consecutive 24 h diet recalls. Fruit DSR was calculated based on the absolute count of unique fruit species consumed over two measurement days, regardless of the total amount (grams) of consumed fruits. The Dutch Healthy Diet index 2015 (DHD15-index) consisting of 14 components was used to measure diet quality. Per component, participants could score between 0 and 10, with a total score between 0 and 140. Linear regression analyses were performed to investigate the association between fruit DSR and DHD15-index. Analyses were stratified by age and sex and corrected for total energy intake. In total, 45 (DSR fruit: median 2 [IQR 1–3]) different fruit species were consumed by 2078 participants in this sample. On average, participants consumed 260 g of fruit (SD265) over two days. Malus domestica (apple) was the most frequently consumed species (23.9%), and 462 participants (22.2%) did not consume any fruits. Overall, moderate scores for diet quality were found (DHD15-index: M59; SD18; min–max11-115) and females seem to have healthier diets than males. For every additional fruit species consumed, the DHD15-index score increased by 4.17 points (95%CI 3.79–4.54). The strongest associations between DSR fruit and DHD15-index were found in Dutch adults between 19 and 30 years (β4.7 [95%CI 3.9–5.5]). Fruit DSR was associated with diet quality. Every additional consumed fruit species led to a higher DHD15-index score. This is in line with previous studies, but further research in this sample is needed to explore if these associations also exist between overall DSR and diet quality. This research is ongoing. Full article

Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) share common culprit foods and potential pathophysiological factors. However, how diet may contribute to disease course and whether this differs between both entities is unclear. We therefore investigated the association of dietary indices with intestinal inflammation and gastrointestinal symptoms in both IBD and IBS patients. Food frequency questionnaires from 238 IBD, 261 IBS and 195 healthy controls (HC) were available to calculate the overall diet quality by the Dutch Healthy Diet-Index 2015 (DHD-2015) and its inflammatory potential by the Adapted Dietary Inflammatory Index (ADII). Intestinal inflammation and symptoms were evaluated by faecal calprotectin and the Gastrointestinal Symptom Rating Scale, respectively. The DHD-2015 was lower in IBD and IBS versus HC (p < 0.001), being associated with calprotectin levels in IBD (b = −4.009, p = 0.006), and with abdominal pain (b = −0.012, p = 0.023) and reflux syndrome (b = −0.016, p = 0.004) in IBS. ADII scores were comparable between groups and were only associated with abdominal pain in IBD (b = 0.194, p = 0.004). In this side-by-side comparison, we found a lower diet quality that was differentially associated with disease characteristics in IBD versus IBS patients. Longitudinal studies are needed to further investigate the role of dietary factors in the development of flares and predominant symptoms. Full article

During puberty, rapid, complex hormonal, physical and cognitive changes occur that affect body image and eating behavior. The aim of this cross-sectional study, a secondary analysis of data from the Greek Healthy Growth Study, was to explore associations of disordered eating behaviors and body image in 1206 10–12-year-old girls during pubertal maturation, with serum leptin and adiponectin levels, according to body mass index (BMI). Eating behavior and disordered eating were assessed with the Dutch Eating Behavior Questionnaire (DEBQ) and the Children Eating Attitudes Test Questionnaire (ChEAT), respectively. Associations of components of DEBQ and ChEAT with maturation according to Tanner Stage (TS) and levels of leptin and adiponectin were explored by univariate and multivariate regression analysis. Adiponectin levels in girls at TS 1 were positively associated with the “social pressure to eat” score of ChEAT. Leptin levels in girls at TS 4 were positively correlated with the “restraint eating” score of DEBQ, and the “dieting”, “body image” and “food awareness” scores of ChEAT. After adjustment for TS and BMI, only “body image” and leptin remained significant. Further research may shed light on how these hormonal changes affect eating behaviors at various pubertal stages, contributing to “TS-specific” preventive strategies for eating disorders in girls. Full article

This study investigated major healthy and sustainable dietary patterns in the Dutch population. Two 24-hour dietary recalls were collected in 2078 participants aged 19–79 years in the Dutch National Food Consumption Survey 2012–2016. Dietary patterns were identified using reduced rank regression. Predictor variables were food groups and response variables were Dutch Healthy Diet index 2015 (DHD15-index) score, greenhouse gas emissions (GHGE), and blue water use. Three patterns were discovered, including a “high fruit and vegetable dietary pattern”, a “low meat dietary pattern”, and a “high dairy, low fruit juices dietary pattern”. Diets in the highest quartile of these patterns had higher DHD15-index score than the average population. However, diets of the “high fruit and vegetable dietary pattern” were associated with higher dietary GHGE (14%) and blue water use (69.2%) compared to the average population. Diets of the “low meat dietary pattern” were associated with lower GHGE (19.6%) and higher blue water use (7.7%). Concluding, the “low meat dietary pattern” was the most healthy and sustainable dietary pattern in this population. The addition of blue water use as an environmental impact indicator shows the difficulty of finding existing dietary patterns that have low environmental impact in all determinants. Full article

Background: Delayed sleep-wake phase disorder (DSPD), characterized by delayed sleep-onset and problems with awakening in the morning, is mostly prevalent in adolescents. Several studies have suggested chrono-nutrition could present a possible modifiable risk factor for DSPD. Objective: To describe differences in chrono-nutrition and diet quality in adolescents with DSPD compared to age-related controls. Methods: Chrono-nutrition and diet quality of 46 adolescents with DSPD, aged 13–20 years, and 43 controls were assessed via questionnaires. Diet quality included the Dutch Healthy Diet index (DHD-index) and Eating Choices Index (ECI). Results were analysed using logistic regression and Spearman’s partial correlation. Results: Compared with controls, DSPD patients consumed their first food of the day significantly later on weekdays (+32 ± 12 min, p = 0.010) and weekends (+25 ± 8 min, p = 0.005). They consumed their dinner more regularly (80.4% vs. 48.8%, p = 0.002) and consumed morning-snacks less frequently (3.0 ± 2.1 days vs. 4.2 ± 1.7 days, p = 0.006). No differences in clock times of breakfast, lunch, or dinner were found. Moreover, no significant differences in overall diet quality were observed. Conclusion: This descriptive study showed chrono-nutritional differences between adolescents with and without DPSD. Further studies are needed to explore features of chrono-nutrition as a possible treatment of DPSD. Full article

Food consumption patterns affect the environment as well as public health, and monitoring is needed. The aim of this study was to evaluate the Dutch food consumption patterns for environmental (greenhouse gas (GHG) emissions and blue water use) and health aspects (Dutch Healthy Diet index 2015), according to age, gender, and consumption moments. Food consumption data for 4313 Dutch participants aged 1 to 79 years were assessed in 2012 to 2016, by two non-consecutive 24-h recalls. The environmental impact of foods was quantified using a life cycle assessment for, e.g., indicators of GHG emissions and blue water use. The healthiness of diet, operationalized by the Dutch Healthy Diet index 2015, was assessed for 2078 adults aged ≥19 years. The average daily diet in the Netherlands was associated with 5.0 ± 2.0 kg CO₂-equivalents of GHG emissions and 0.14 ± 0.08 m³ of blue water use. Meat, dairy and non-alcoholic beverages contributed most to GHG emissions, and non-alcoholic beverages, fruits, and meat to blue water use. More healthy diets were associated with a lower GHG emission and higher blue water use. Different associations of environmental indicators (GHG emissions and blue water use) with health aspects of diets need to be considered when aligning diets for health and sustainability. Full article

As nutrition is one of the modifiable risk factors for cognitive decline, we studied the relationship between dietary quality and clinical characteristics in cognitively normal individuals with subjective cognitive decline (SCD). We included 165 SCD subjects (age: 64 ± 8 years; 45% female) from the SCIENCe project, a prospective memory clinic based cohort study on SCD. The Dutch Healthy Diet Food Frequency Questionnaire (DHD-FFQ) was used to assess adherence to Dutch guidelines on vegetable, fruit, fibers, fish, saturated fat, trans fatty acids, salt and alcohol intake (item score 0–10, higher score indicating better adherence). We measured global cognition (Mini Mental State Examination), cognitive complaints (Cognitive Change Index self-report; CCI) and depressive symptoms (Center for Epidemiologic Studies Depression Scale; CES-D). Using principal component analysis, we identified dietary components and investigated their relation to clinical characteristics using linear regression models adjusted for age, sex and education. We identified three dietary patterns: (i) “low-Fat-low-Salt”, (ii) “high-Veggy”, and (iii) “low-Alcohol-low-Fish”. Individuals with lower adherence on “low-Fat-low-Salt” had more depressive symptoms (β −0.18 (−2.27–−0.16)). Higher adherence to “high-Veggy” was associated with higher MMSE scores (β 0.30 (0.21–0.64)). No associations were found with the low-Alcohol-low-Fish component. We showed that in SCD subjects, dietary quality was related to clinically relevant outcomes. These findings could be useful to identify individuals that might benefit most from nutritional prevention strategies to optimize brain health. Full article

Diet-quality scores (DQS), which are developed across the globe, are used to define adherence to specific eating patterns and have been associated with risk of coronary heart disease and type-II diabetes. We explored the association between five diet-quality scores (Healthy Eating Index, HEI; Alternate Healthy Eating Index, AHEI; MedDietScore, MDS; PREDIMED Mediterranean Diet Score, P-MDS; Dutch Healthy Diet-Index, DHDI) and markers of metabolic health (anthropometry, objective physical activity levels (PAL), and dried blood spot total cholesterol (TC), total carotenoids, and omega-3 index) in the Food4Me cohort, using regression analysis. Dietary intake was assessed using a validated Food Frequency Questionnaire. Participants (n = 1480) were adults recruited from seven European Union (EU) countries. Overall, women had higher HEI and AHEI than men (p < 0.05), and scores varied significantly between countries. For all DQS, higher scores were associated with lower body mass index, lower waist-to-height ratio and waist circumference, and higher total carotenoids and omega-3-index (p trends < 0.05). Higher HEI, AHEI, DHDI, and P-MDS scores were associated with increased daily PAL, moderate and vigorous activity, and reduced sedentary behaviour (p trend < 0.05). We observed no association between DQS and TC. To conclude, higher DQS, which reflect better dietary patterns, were associated with markers of better nutritional status and metabolic health. Full article

A high sugar intake is a subject of scientific debate due to the suggested health implications and recent free sugar recommendations by the WHO. The objective was to complete a food composition table for added and free sugars, to estimate the intake of total sugars, free sugars, and added sugars, adherence to sugar guidelines and overall diet quality in Dutch children and adults. In all, 3817 men and women (7–69 years) from the Dutch National Food Consumption Survey 2007–2010 were studied. Added and free sugar content of products was assigned by food composition tables and using labelling and product information. Diet was assessed with two 24-h recalls. Diet quality was studied in adults with the Dutch Healthy Diet-index. Total sugar intake was 22% Total Energy (%TE), free sugars intake 14 %TE, and added sugar intake 12 %TE. Sugar consumption was higher in children than adults. Main food sources of sugars were sweets and candy, non-alcoholic beverages, dairy, and cake and cookies. Prevalence free sugar intake <10 %TE was 5% in boys and girls (7–18 years), 29% in women, and 33% in men. Overall diet quality was similar comparing adults adherent and non-adherent to the sugar guidelines, although adherent adults had a higher intake of dietary fiber and vegetables. Adherence to the WHO free sugar guidelines of <5 %TE and <10 %TE was generally low in the Netherlands, particularly in children. Adherence to the added and free sugar guidelines was not strongly associated with higher diet quality in adults. Full article