Development of healthy and sustainable food-based dietary guidelines for the Netherlands

Brink, Elizabeth J.; Rossum, Caroline van; Postma-Smeets, Astrid; Stafleu, A.; Wolvers, D.; Dooren, Corné van; Toxopeus, Ido B; Buurma-Rethans, Elly J. M.; Geurts, Marjolein; Ocké, Marga C.

doi:10.1017/s1368980019001435

Cited by 142 publications

(141 citation statements)

References 38 publications

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“…Environmental sustainability is discussed in one chapter in the current NNR, however, sustainability has not been integrated into the Danish FBDG. So far, the sustainability of diets has only been incorporated into relatively few FBDG, e.g., in Sweden [33], Germany [34], UK [35] and the Netherlands [36]. FAO points out that countries should begin a process of incorporating sustainability into national dietary guidelines.…”

Section: Introductionmentioning

confidence: 99%

Development of a Danish Adapted Healthy Plant-Based Diet Based on the EAT-Lancet Reference Diet

2020

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Plant-based diets have been linked to both health benefits and a lower climate impact. However, plant-based diets may represent both healthy and unhealthy dietary practices. The present study aimed to develop a nationally adapted healthy plant-based diet based on the global EAT-Lancet reference diet. Development took place in a series of steps. First, the original EAT-Lancet reference diet was evaluated based on food availability, i.e., using Danish food data (Model 1). Then, the model was further modified to reflect national food based dietary guidelines (FBDG) and characteristics of current consumption pattern, e.g., by including processed food, discretionary foods and beverages in the diet (Model 2). The contents of macronutrients, vitamins and minerals, except for vitamin D and iodine, were found to be sufficient for Model 2, according to the recommended nutrient density to be used for planning diets for groups of individuals aged 6–65 years. In addition, the study gave an insight into the nutrients and foods to be aware of in planning a predominantly plant-based diet, thereby providing directions for future revisions of sustainable FBDGs. These include a stronger emphasis on the intake of legumes, nuts and seeds, fruit and vegetables including dark green vegetables, whole-grain products and vegetable oils as well as lowering meat intake.

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Section: Introductionmentioning

confidence: 99%

Development of a Danish Adapted Healthy Plant-Based Diet Based on the EAT-Lancet Reference Diet

2020

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“…Only ve participants mentioned the dietary guidelines or the Wheel of Five explicitly. A previous study has identi ed that about 92% of Dutch people reported having heard of the Wheel of Five [7]. Although many participants may have heard of the Wheel of Five, this representation of the Dutch dietary guidelines does not entirely seem to represent their ideas of a healthy diet.…”

Section: Discussionmentioning

confidence: 96%

“…Drinks 1.5-2 liters of drinks without sugar Note. More detail regarding the Dutch dietary guidelines can be found elsewhere [6,7]. a The numbers are dependent on age and sex.…”

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confidence: 99%

An exploration of perceptions and preferences for healthy eating in Dutch consumers: A qualitative pilot study

Coumans

Bolman

Lechner

et al. 2020

Preprint

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Background: Unhealthy dietary patterns are highly prevalent in Western countries, and they have been associated with depression, hypertension, heart disease, cancer, type 2 diabetes, and obesity. Many dietary interventions have been developed to promote healthier dietary behavior, yet most do not achieve the intended dietary change. This study aims to provide a better understanding of what Dutch consumers perceive as a healthy diet, how this relates to the current Dutch nutrition guidelines, and their preferences for how to eat more healthily. This is an essential consideration for the development of tailored interventions aimed to help people adopt changes in their dietary behavior. Methods: Seventy-eight participants filled in an online questionnaire containing both open-ended and closed-ended questions. The qualitative data was analyzed using content analysis resulting in a classification scheme. Two students then identified to which category each part of a participant’s answer belonged. Results: For both the perception of a healthy diet and how to eat healthily four major categories and a residual category were identified: dietary patterns, food processing, food products, content/nutrients, and non-food. These major categories consisted of several categories. The results showed that how people perceived a healthy diet was mostly represented at the level of food product (vegetables and fruit) and the content/nutrient level (carbohydrates); whereas how they would like to eat healthily was mostly represented at the level of food processing (preparation), food product (vegetables) and dietary patterns (amount). Conclusions: Our findings are mostly in line with how the Dutch dietary guidelines are communicated (“product level”). However, consumers primarily mention single aspects instead of naming the guidelines as a whole. Health policymakers can use this insight in future communications regarding guidelines to the general public. A challenge for future (eHealth) diet interventions is how to implement and tailor dietary information that optimally connects with the perceptions of the target population.

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“…Despite these contributions, our study is subject to several limitations. With respect to the rst study, the healthier snacks were developed and selected by the supermarket chain, and they did not all meet the Guidelines of the Dutch Nutrition Centre (36). They were however healthier options than those that were regularly offered for sale.…”

Section: General Discussion (Study 1 and Study 2)mentioning

confidence: 99%

“…We conducted separate comparisons of the sales of the three types of healthier snacks during each two-week period to the sales during the two-week control period for the placement intervention and the placement + price interventions. The healthier snacks were selected by the research team and met the guidelines of the Dutch Nutrition Centre (36). The unhealthy snacks remained in their usual place at the checkout counters.…”

Section: Healthy Checkout Counter (Hcc) Interventionmentioning

confidence: 99%

Can healthy checkout counters in supermarkets promote healthier food choices? Two real-life experiments in supermarkets in a disadvantaged urban area in the Netherlands

Huitink¹,

Poelman²,

Seidell³

et al. 2020

Preprint

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Background Most foods displayed at supermarket checkouts are unhealthy and do not support healthy purchases. This study investigates the sales effects of introducing healthier alternatives at supermarket checkouts. Methods We performed two real-life quasi-experimental studies in supermarkets located in a disadvantaged urban area in the Netherlands. In Study 1, we examined the impact of substituting healthier options for all the unhealthy snacks at checkouts (n = 1 supermarket). In Study 2, we investigated the impact of placing healthier snacks at checkouts (placement intervention), as well as the impact of offering a discount on healthier checkout snacks (placement + price intervention), while continuing to display unhealthy snacks for sale (n = 2 supermarkets). Supermarket sales data were used to measure purchases. Results In Study 1, median weekly sales/1000 customers of checkout snacks were 2.3 times lower (SE: 1.1, 95% CI: 1.9–2.7) during the intervention period – when healthier options were substituted for the entire unhealthy snack assortment – (median: 10, IQR: 2.8), as compared to the control period (median: 24, IQR: 2.8). In Study 2, median daily sales/1000 customers of healthier snacks were 2.1 times higher (SE: 1.3, 95% CI: 1.3–3.3) during the placement-intervention period (median: 7.8, IQR: 4.6), as compared to the control period (median: 4.2, IQR: 4.6). Similarly, median daily sales/1000 customers of healthier snacks were 2.7 times higher (SE: 1.2, 95%CI: 2.0–3.6) during the placement + price-intervention period (median: 5.8, IQR: 2.2), as compared to the control period (median: 2.2, IQR: 4.7). There was no difference between the effect of the placement intervention and that of the placement + price intervention (ratio: 1.1, SE: 1.3, 95% CI: 1.7–1.9). Neither did we observe a decline in purchases of unhealthy snacks (ratio: 1.3, SE: 1.1, 95% CI: 1.1–1.5). Conclusions This study showed that if we want to promote healthier food purchases at supermarket checkouts the substitution of the unhealthy snacks with healthier alternatives is an effective intervention, which is not the case if the unhealthy snacks remain in place at the checkouts, even with discounts on the healthier snacks. Future research should assess the feasibility and willingness of eliminating unhealthy checkout snacks in supermarkets.

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Development of healthy and sustainable food-based dietary guidelines for the Netherlands

Cited by 142 publications

References 38 publications

Development of a Danish Adapted Healthy Plant-Based Diet Based on the EAT-Lancet Reference Diet

Development of a Danish Adapted Healthy Plant-Based Diet Based on the EAT-Lancet Reference Diet

An exploration of perceptions and preferences for healthy eating in Dutch consumers: A qualitative pilot study

Can healthy checkout counters in supermarkets promote healthier food choices? Two real-life experiments in supermarkets in a disadvantaged urban area in the Netherlands

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