The objective of this study was to derive food-based dietary guidelines for the Dutch population. The dietary guidelines are based on 29 systematic reviews of English language meta-analyses in PubMed summarizing randomized controlled trials and prospective cohort studies on nutrients, foods and food patterns and the risk of 10 major chronic diseases: coronary heart disease, stroke, heart failure, diabetes, breast cancer, colorectal cancer, lung cancer, chronic obstructive pulmonary disease, dementia and depression. The committee also selected three causal risk factors for cardiovascular diseases or diabetes: systolic blood pressure, low-density lipoprotein cholesterol and body weight. Findings were categorized as strong or weak evidence, inconsistent effects, too little evidence or effect unlikely for experimental and observational data separately. Next, the committee selected only findings with a strong level of evidence for deriving the guidelines. Convincing evidence was based on strong evidence from the experimental data either or not in combination with strong evidence from prospective cohort studies. Plausible evidence was based on strong evidence from prospective cohort studies only. A general guideline to eat a more plant food-based dietary pattern and limit consumption of animal-based food and 15 specific guidelines have been formulated. There are 10 new guidelines on legumes, nuts, meat, dairy produce, cereal products, fats and oils, tea, coffee and sugar-containing beverages. Three guidelines on vegetables, fruits, fish and alcoholic beverages have been sharpened, and the 2006 guideline on salt stayed the same. A separate guideline has been formulated on nutrient supplements. Completely food-based dietary guidelines can be derived in a systematic and transparent way.

Energy metabolism was measured in 24 women before pregnancy and during lactation (2 mo postpartum). Resting metabolic rate (RMR) increased by 0.17 +/- 0.38 kJ/min and postprandial metabolic rate (PPMR) showed a similar increase (0.17 +/- 0.45 kJ/min). Thus, the thermic effect of the meal (PPMR minus RMR) was not affected by lactation. Between subjects, the lactation-induced increase in RMR appeared to be positively related to body weight. During lactation gross metabolic rates during cycling (CMR) were slightly reduced and net metabolic rates during cycling (CMR minus RMR) tended to decrease by 0.6 kJ/min at all workloads; however, the decrease was statistically significant only at the lowest workload. Changes in metabolic rate during the recovery period after exercise were not significant, but resembled changes in RMR rather than changes in CMR. We conclude that no major changes in metabolic efficiency occurred during lactation.

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To investigate changes in the thermic effect of a meal (TEM) during pregnancy, metabolic rate was measured in the fasting state and during the first 180 min after consumption of a standardized test meal in twenty-seven women before, and in each trimester of pregnancy. Resting metabolic rate (RMR) showed a steady increase over pregnancy: values in weeks 24 and 35 of pregnancy were significantly higher than the prepregnancy baseline (Tukey's studentized range test). The pattern of changes of postprandial metabolic rate (PPMR) was similar to that of RMR. Consequently TEM, calculated as PPMR minus RMR, did not change over pregnancy; mean T E M values (kJ/180 min) before and in weeks 13, 24 and 35 of pregnancy were 117.3 (SD 19.4), 116.4 (SD 23.7), 111.6 (SD 24.4) and 111.5 (SD 26.7) respectively. We consider changes in TEM of less than 15% to be of little importance physiologically. If true changes in TEM over pregnancy are 15 % or more we would have had a 90 % chance of observing significant changes in T E M in the present study, given the number of subjects and the methods used. Therefore, we conclude that no substantial reduction in TEM occurs during pregnancy. In the present study we tried to investigate whether TEM is reduced during pregnancy, using a longitudinal approach including baseline measurements which were carried out before the onset of pregnancy. The number of subjects in our study was sufficient to detect a 15 YO change in TEM with a statistical power of 90 %. Pregnancy S U B J E C T S A N D METHODS Study designResting MR (RMR), postprandial MR (PPMR) and body weight (BW) were measured in twenty-seven healthy Dutch women before, and in weeks 13,24 and 35 of pregnancy. TEM https://www.cambridge.org/core/terms. https://doi

To investigate changes in energy metabolism during pregnancy, complete 8-d energy balances were measured before pregnancy and at 12, 23, and 34 wk gestation in 12 healthy Dutch women. While for each individual woman experimental diets were kept constant throughout the study with average intakes of 8.76 +/- 0.92 MJ/d (before pregnancy), 8.72 +/- 1.08 MJ/d (week 12), 8.85 +/- 0.93 MJ/d (week 23), and 8.72 +/- 1.12 MJ/d (week 34), neither the digestibility nor the metabolizability of the supplied diets showed significant changes from before pregnancy (92.8% and 88.6%, respectively) throughout pregnancy (92.7% and 88.2%, respectively). Twenty-four-hour energy expenditure (24-h EE) increased significantly from 8.63 +/- 0.80 MJ/d (before pregnancy) to 8.73 +/- 1.15, 9.08 +/- 1.08, and 9.94 +/- 0.94 MJ/d in weeks 12, 23, and 34 of gestation, to the extent predictable from changes in resting metabolic rate so that in an experimental setting with physical activity and energy intake standardized there seems little scope for other adaptive mechanisms.