Objective:To derive healthy and sustainable food-based dietary guidelines (FBDG) for different target groups in the Netherlands and describe the process.Design:Optimised dietary patterns for children, adolescents, adults and the elderly were calculated using an optimisation model. Foods high in saturated and trans-fatty acids, salt and sugar, and low in dietary fibre, were excluded. The dietary patterns resembled the current food consumption as closely as possible, while simultaneously meeting recommendations for food groups, nutrients, maximum limits for foods with a high environmental impact, and within 85 % of the energy requirement. Recommended daily amounts of food groups were based on the optimised dietary patterns and expert judgement.Setting:The Netherlands.Participants:FBDG were derived for Dutch people with different ages, genders, activity levels and food preferences.Results:For most target groups the optimisation model provided dietary patterns that complied with all requirements. For some food groups, the optimised amounts varied largely between target groups. For consistent messages to consumers, the optimised dietary patterns were adjusted to uniform recommendations per target group. Recommendations were visualised in the Wheel of Five. The advice is to eat the recommended amounts of foods according to the Wheel of Five and limit consumption of other foods.Conclusions:Based on an optimisation model, scientific evidence, information on dietary patterns and expert knowledge, we derived FBDG for different target groups. The Wheel of Five is a key food-counselling model that can help Dutch consumers to make their diets healthier and more environmentally sustainable.

The findings from this prospective cohort study provided no evidence of an association between dietary acid load and risk of hypertension in older adults.

Objectives: To study the effects of two different mixtures of the main conjugated linoleic acid (CLA) isomers cis-9, trans-11 CLA and trans-10, cis-12 CLA on human immune function. Design: Double-blind, randomized, parallel, reference-controlled intervention study. Subjects and intervention: Seventy-one healthy males aged 31 -69 y received one of the following treatments: (1) mixture of 50% c9,t11 CLA and 50% t10,c12 CLA isomers (CLA 50:50); (2) mixture of 80% c9,t11 CLA and 20% t10,c12 CLA isomers (CLA 80:20); and (3) sunflower oil fatty acids (reference). The treatments were given as supplements in softgel capsules providing a total of 1.7 g (c9,t11 þ t10,c12) CLA fatty acids (50:50) or 1.6 g (c9,t11 þ t10,c12) CLA glycerides (80:20) per day in treatment groups for 12 weeks. Results: Almost twice as many subjects reached protective antibody levels to hepatitis B when consuming CLA50:50 fatty acids (15=24, 62%) compared with subjects consuming the reference substance (7=21, 33%, P ¼ 0.075). In subjects consuming CLA 80:20 glycerides this was 8=22 (36%). Other aspects of immune function, ie DTH responses, NK cell activity, lymphocyte proliferation and production of TNF-a, IL1-b, IL6, IFN-g, IL2, IL4, and PGE 2 , were not affected.

Objective: To evaluate both efficacy and safety in humans of long-term consumption of spreads containing plant sterol esters. Design: Randomized double-blind placebo-controlled parallel trial. Subjects: Hundred and eighty-five healthy volunteers (35 -64 y). Intervention: Volunteers daily consumed 20 g spread enriched with 1.6 g plant sterols as fatty acid esters or a control spread for 1 y. They continued their habitual diet and lifestyle. Outcome measures included efficacy markers such as total and LDLcholesterol, a large range of safety parameters, and reporting of adverse events. Results: Consumption of the plant sterol ester-enriched spread consistently lowered total and LDL cholesterol during the 1 y period on average by 4 and 6%, respectively (0.01 < P < 0.05). Plant sterols intake did on average not result in a lower carotenoid concentration (when expressed per LDL-cholesterol) after 52 weeks (P > 0.05). However, carotenoid concentrations changed over time. Plant sterols intake reduced lipid adjusted a-and b-carotene-concentrations by only 15 -25% after 1 y, relative to control. Lipid-adjusted fat-soluble vitamin concentrations remained unchanged. Plant sterol concentrations in serum were increased from 2.76 to 5.31 (mmol=mmol total cholesterol) for campesterol (P < 0.0001) and from 1.86 to 2.47 (mmol=mmol total cholesterol) for b-sitosterol (P < 0.0001). The increase in total plant sterol concentration in red blood cells (5.29 -9.62 mg=g) did not affect red blood cell deformability. Hormone levels in males (free and total testosterone) and females (luteinizing hormone, follicle stimulating hormone, b-estradiol and progesterone) as well as all clinical chemical and hematological parameters measured were unaffected. Adverse events reported were not different between subjects consuming control spread and subjects consuming plant sterol esters-enriched spread. Conclusion: Consumption of a plant sterol esters-enriched spread is an effective way to consistently lower blood cholesterol concentrations and is safe to use over a long period of time.

Consumption of foods containing 110 mg/d of soy isoflavone aglycone equivalents for 1 y did not prevent postmenopausal bone loss and did not affect bone turnover in apparently healthy early postmenopausal white women. This trial was registered at clinicaltrials.gov as NCT00301353.