The literature on predefined indexes of overall diet quality is reviewed. Their association with nutrient adequacy and health outcome is considered, but our primary interest is in the make-up of the scores. In total, twenty different indexes have been reviewed, four of which have gained most attention, and many others were based on those four. The various scores differ in many respects, such as the items included, the cut-off values used, and the exact method of scoring, indicating that many arbitrary choices have been made. Correlations in intake between dietary components may not be adequately addressed. In general, diet quality scores show an association with mortality or disease risk, but these relations are generally modest. Existing indexes do not predict morbidity or mortality significantly better than individual dietary factors. Although conclusions from the review may provide guidance in the construction of a diet quality score, it is questionable whether a dietary score can be obtained that is a much better predictor of health outcome.

Objective: To investigate the association of a posteriori dietary patterns with overall survival of older Europeans. Design and setting: This is a multi-centre cohort study. Cox regression analysis was used to investigate the association of the prevailing, a posteriori-derived, plant-based dietary pattern with all-cause mortality in a population of subjects who were 60 years

A Healthy Traditional Dutch diet, rather than a Mediterranean diet, appears beneficial for longevity and feasible for health promotion in older Dutch women. This diet is comparable with other reported healthy or prudent diets that have been shown to be protective against morbidity or mortality.

Dietary intake data often stem from short-term measurements. However, for dietary assessment, generally the habitual intake distribution is of interest. Currently, habitual intake distributions are often estimated separately for subgroups of gender and age and do not take into account the variation in intake caused by age within age groups. Therefore, we developed an age-dependent dietary assessment model, which was demonstrated and tested using folate intakes from the third Dutch National Food Consumption Survey, conducted in 1997/98. The proposed model produced estimates of the mean habitual intake and intake percentiles as a function of age. The methodology has clear advantages in estimating habitual intakes in children. Also, given the large variation in intakes of several dietary components, estimated habitual intakes produced by other methods may have low precision and be less reliable if numbers are small. In our age-dependent model, all available data can be used to estimate the parameters of the habitual intake distribution, improving the precision of the estimates, and providing consistent estimates for a larger population sample as no subgroups need to be created. Although the model may still be further developed, the feature of age dependency shows clear advantages above methods currently used to estimate habitual intakes.

The sympathetic nervous system is involved in the control of energy metabolism and expenditure. Diet-induced thermogenesis is mediated partly by the ß-adrenergic component of this system. The aim of the present study was to investigate the role of genetic variation in the ß 2 -adrenoceptor in diet-induced thermogenesis. Data from twenty-four subjects (fourteen men and ten women; BMI 26·7(SEM 0·8) kg/m 2 ; age 45·2(SEM1·4) years) with different polymorphisms of the ß 2 -adrenoceptor at codon 16 (Gly16Gly, Gly16Arg or Arg16Arg) were recruited for this study. Subjects were given a high-carbohydrate liquid meal, and the energy expenditure, respiratory exchange ratio, and plasma concentrations of NEFA, glycerol, glucose, insulin and catecholamines were measured before and over 4 h after the meal. The AUC of energy expenditure (diet-induced thermogenesis) was not significantly different between polymorphism groups, nor was the response of any of the other measured variables to the meal. In a multiple regression model, the only variable that explained a significant proportion (32 %) of the variation in diet-induced thermogenesis was the increase in plasma adrenaline in response to the meal (P,0·05). The ß 2 -adrenoceptor codon16 polymorphisms did not contribute significantly. In conclusion, an independent contribution of the codon 16 polymorphism of the ß 2 -adrenoceptor gene to the variation in thermogenic response to a high-carbohydrate meal could not be demonstrated. The interindividual variation in thermogenic response to the meal was correlated with variations in the plasma adrenaline response to the meal. Energy expenditure (EE) is an important factor in body-weight regulation. Diet-induced thermogenesis (DIT) is the EE associated with ingestion, absorption and storage of food and accounts for 10 -15 % to the total daily EE. DIT shows considerable interindividual variation (Donahoo et al. 2004), and it can be hypothesised that a low DIT contributes to weight gain. Many studies have investigated DIT in obese and lean subjects, but these studies show equivocal results (de Jonge & Bray, 1997Granata & Brandon, 2002). Nevertheless, when multiple interfering factors are taken into account simultaneously, the evidence for a reduction in DIT in obesity becomes stronger (de Jonge & Bray, 2002). In addition, several studies show no change in DIT after weight reduction, suggesting that a reduced DIT in obesity is not the consequence of the obese state per se (Bessard et al. 1983;Schutz et al. 1984). In response to feeding, especially to carbohydrate intake, sympathetic nervous system activity increases (Schwartz et al. 1999;Tappy, 2004). The sympathetic nervous system-mediated thermogenic response is also referred to as facultative thermogenesis (Tappy, 2004). The sympathetic nervous system response is biphasic, with an initial increase in noradrenaline and a delayed adrenaline response (Astrup et al. 1986(Astrup et al. , 1989. The sympathetic nervous system-mediated component of DIT can be blocked by ß-adrenoceptor antagon...