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Adherence to the Dutch dietary guidelines is inversely associated with 20-year mortality in a large prospective cohort study.

Abstract：

BACKGROUND/OBJECTIVES:The Dutch guidelines for a healthy diet aim to reduce major chronic diseases. However, supporting evidence on their overall association with all-cause and cause-specific mortality is limited. Recently, the Dutch Healthy Diet-index (DHD-index) has been developed to assess adherence to these guidelines. The aim was to examine the association between the DHD-index and all-cause mortality and deaths from cardiovascular disease (CVD), coronary heart disease (CHD), stroke and cancer. SUBJECTS/METHODS:We followed 3593 men and women aged 55 years and older enrolled in the Rotterdam Study, a population-based prospective cohort study, from baseline in 1990-1993 to 2011. A validated 170-item food frequency questionnaire at baseline was used to calculate the DHD-index score (maximum 90 points). Cox proportional hazard models were used to estimate hazard ratios (HRs) adjusting for age, sex, total energy intake, smoking and educational level. RESULTS:During the 20-year follow-up, 1831 (51%) deaths were reported. Mean DHD-index score was 60.6 (s.d. 10.6). The score was inversely associated with all-cause mortality (highest vs lowest quartile HR 0.77; 95% confidence interval (CI) 0.67, 0.89). Inverse but non-significant associations were observed for mortality due to CVD (HR 0.74; 95% CI 0.55, 1.01), CHD (HR 0.60; 95% CI 0.34, 1.06) and stroke (HR 0.67; 95% CI 0.36, 1.22), whereas no association was observed with cancer mortality (HR 0.99; 95% CI 0.90, 1.11). CONCLUSIONS:A higher level of adherence to the Dutch dietary guidelines, as assessed with the DHD-index, was associated with a lower risk of all-cause mortality, probably due to an inverse association with cardiovascular causes of death.

journal_name

Eur J Clin Nutr

journal_title

European journal of clinical nutrition

authors

van Lee L,Geelen A,Kiefte-de Jong JC,Witteman JC,Hofman A,Vonk N,Jankovic N,Hooft van Huysduynen EJ,de Vries JH,van 't Veer P,Franco OH,Feskens EJ

doi

10.1038/ejcn.2015.163

subject

Has Abstract

pub_date

2016-02-01 00:00:00

pages

262-8

issue

eissn

0954-3007

issn

1476-5640

pii

ejcn2015163

journal_volume

pub_type

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Adherence to the Dutch dietary guidelines is inversely associated with 20-year mortality in a large prospective cohort study.