Adherence to a Healthy Diet According to the World Health Organization Guidelines and All-Cause Mortality in Elderly Adults From Europe and the United States

Jankovic, Nicole; Geelen, Anouk; Streppel, Martinette T; Groot, Lisette C. P. G. M. de; Orfanos, Philippos; Hooven, Edith H. van den; Pikhart, Hynek; Boffetta, Paolo; Trichopoulou, Antonia; Bobák, Martin; Bueno‐de‐Mesquita, H. Bas; Kee, Frank; Franco, Oscar H.; Park, Yikyung; Hallmans, Göran; Tjønneland, Anne; May, Anne M.; Pająk, Andrzej; Malyutina, Sofia; Kubínová, Růžena; Amiano, Pilar; Kampman, Ellen; Feskens, Edith J. M.

doi:10.1093/aje/kwu229

Cited by 96 publications

(84 citation statements)

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“…In another study that analysed data from prospective follow-up of 11 cohorts with nearly 400,000 respondents, overall diet quality was evaluated using a score of up to 70 points. Higher scores using that scale were found to be associated with prolonged survival (by mean 2 years) [24]. Similar observation in the Eastern European population showed an inverse association between HDI scores and CVD and coronary artery disease mortality, with no association with mortality due to other causes [25].…”

Section: Discussionsupporting

confidence: 64%

Are dietary habits of the Polish population consistent with the recommendations for prevention of cardiovascular disease? — WOBASZ II project

et al. 2016

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A b s t r a c tBackground: Diet is a modifiable risk factor for cardiovascular disease (CVD). Aim:To assess diet quality in the adult Polish population, taking into consideration consumption of various nutrients as well as the total diet quality. Methods:Within the frame of the National Multicentre Health Survey (WOBASZ II), a random sample of the whole Polish population aged 20 years and above was screened during the years 2013-2014. Dietary habits were assessed in 5690 subjects (2554 men and 3136 women). Nutrient intakes were compared to the Dietary Reference Intakes. Total diet quality was measured using the Healthy Diet Indicator (HDI) score, based on the World Health Organisation recommendations for CVD prevention, that includes 7 nutrients (saturated and polyunsaturated fatty acids, cholesterol, protein, dietary fibre, fruits and vegetables, free sugars) and ranges from 0 (the least healthy diet) to 7 (the healthiest diet). Results:The studied group was characterised by a high prevalence of overweight and obesity (69% in men vs. 59% in women), hypercholesterolaemia (56% vs. 55%, respectively), hypertension (50% vs. 42%), and diabetes (12% vs. 10%). At the same time, a significant percentage of Poles had improper dietary habits. A low fat and low cholesterol diet was reported by only 8% and a low calorie diet by 1% of the respondents. Adding salt to already seasoned dishes was reported by 27% of men and 18% of women, and 56% and 30% of them, respectively, consumed meat products with visible fat. The diet of most adult Polish citizens was found to be not balanced. Vitamins A, C, E, B1, B2, B6, and B12, protein, dietary cholesterol and fruits/vegetables were consumed in recommended doses only by 44-80% of the respondents. The recommended intake of fat, saturated and polyunsaturated fatty acids, which significantly affect lipid levels, was found in 18-37% of the respondents. Dietary intakes of folate and minerals important for the prevention of hypertension were insufficient. The desired level of folate intake was found only in 13-26% of the respondents, and that of magnesium, calcium and potassium in 5-36% of them. The average HDI value was about 3.2 (out of the maximum of 7). A healthy diet (5-7 points) was noted in 15% of adult Poles. Most subjects (60%) were characterised by a low quality diet (0-3 points). Nevertheless, about 55% of respondents believed that their diet was appropriate. Conclusions:The quality of dietary habits of the majority of the adult Polish population falls far short of the recommendations relevant for CVD prevention.

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Section: Discussionsupporting

confidence: 64%

Are dietary habits of the Polish population consistent with the recommendations for prevention of cardiovascular disease? — WOBASZ II project

et al. 2016

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“…Indeed, dietary patterns rather than food groups consider more realistic ways of eating by considering the ways differently processed foods are combined together into meals. Thus, recent observational studies and subsequent meta-analyses have tended to show that the prudent (16), healthy (16), vegetarian (17), Nordic (18), and Mediterranean-style (19) dietary patterns are more protective than the Western diet (20,21). Whereas healthy dietary patterns are generally characterized by a high level of plant-based and/or local traditional foods (e.g., in the Nordic and Mediterranean-style diets), the Western diet is characterized by a high level of processed animal-based and/or refined foods, most of which are ultraprocessed food and drink products, i.e., formulated with previously refined ingredients (22).…”

Section: Introductionmentioning

confidence: 99%

Current Food Classifications in Epidemiological Studies Do Not Enable Solid Nutritional Recommendations for Preventing Diet-Related Chronic Diseases: The Impact of Food Processing

Fardet

Rock

Bassama

et al. 2015

Advances in Nutrition

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To date, observational studies in nutrition have categorized foods into groups such as dairy, cereals, fruits, and vegetables. However, the strength of the association between food groups and chronic diseases is far from convincing. In most international expert surveys, risks are most commonly scored as probable, limited, or insufficient rather than convincing. In this position paper, we hypothesize that current food classifications based on botanical or animal origins can be improved to yield solid recommendations. We propose using a food classification that employs food processes to rank foods in epidemiological studies. Indeed, food health potential results from both nutrient density and food structure (i.e., the matrix effect), both of which can potentially be positively or negatively modified by processing. For example, cereal-based foods may be more or less refined, fractionated, and recombined with added salt, sugars, and fats, yielding a panoply of products with very different nutritional values. The same is true for other food groups. Finally, we propose that from a nutritional perspective, food processing will be an important issue to consider in the coming years, particularly in terms of strengthening the links between food and health and for proposing improved nutritional recommendations or actions. Adv Nutr 2015;6:629-38.

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“…A healthy diet is correlated with higher education and a healthier overall lifestyle (6) , and adherence to dietary guidelines has been associated with reduced all-cause mortality (7,8) . Thus, further efforts are required to foster healthy eating.…”

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confidence: 99%

Consumers’ practical understanding of healthy food choices: a fake food experiment

et al. 2016

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Little is known about laypeople's practical understanding of a healthy diet, although this is important to successfully promote healthy eating. The present study is the first to experimentally examine how consumers define healthy and balanced food choices for an entire day compared with normal choices and compared with dietary guidelines. We used an extensive fake food buffet (FFB) with 179 foods commonly consumed in the Swiss diet. The FFB is a validated method to investigate food choice behaviour in a well-controlled laboratory setting. People from the general population in Switzerland (n 187; 51·9 % females), aged between 18 and 65 years, were randomly assigned to one of two conditions. In the control group, the participants were instructed to serve themselves foods they would eat on a normal day, whereas in the 'healthy' group they were instructed to choose foods representing a healthy diet. Participants chose significantly more healthy foods, with 4·5 g more dietary fibre, 2 % more protein and 2 % less SFA in the 'healthy' group compared with the control group. However, in both experimental conditions, participants served themselves foods containing twice as much sugar and salt than recommended by dietary guidelines. The results suggest that laypeople lack knowledge about the recommended portion sizes and the amounts of critical nutrients in processed food, which has important implications for communicating dietary guidelines. Furthermore, the energy of the food served was substantially correlated with the energy needs of the participants, demonstrating the potential of the fake food buffet method. For effective promotion of healthy eating among the general population, more insights about people's understanding of healthy food choices and how they translate their knowledge into practice are needed. Although consumers are surrounded by dietary information from various sources such as television, the Internet, food labels and health professionals, which sometimes provide conflicting messages, laypeople's perception about healthy eating seems to be strongly influenced by national dietary guidelines (1) . For instance, fruits and vegetables are perceived as healthy, whereas consumers usually associate foods containing high amounts of fat, sugar and salt with unhealthy eating (1) . Although consumers have some ideas about the healthiness of specific foods, they also have conceptions about production and preparation methods, as well as knowledge about the concepts of balance, variety and moderation, as suggested by dietary guidelines (1)(2)(3) .However, in Switzerland, adherence to dietary recommendations is low for most food categories and has not significantly improved over the past decade (4,5) . A healthy diet is correlated with higher education and a healthier overall lifestyle (6) , and adherence to dietary guidelines has been associated with reduced all-cause mortality (7,8) . Thus, further efforts are required to foster healthy eating. However, to set the right priorities among the large number of...

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Adherence to a Healthy Diet According to the World Health Organization Guidelines and All-Cause Mortality in Elderly Adults From Europe and the United States

Cited by 96 publications

References 23 publications

Are dietary habits of the Polish population consistent with the recommendations for prevention of cardiovascular disease? — WOBASZ II project

Are dietary habits of the Polish population consistent with the recommendations for prevention of cardiovascular disease? — WOBASZ II project

Current Food Classifications in Epidemiological Studies Do Not Enable Solid Nutritional Recommendations for Preventing Diet-Related Chronic Diseases: The Impact of Food Processing

Consumers’ practical understanding of healthy food choices: a fake food experiment

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