Reduction of salt: will iodine intake remain adequate in The Netherlands?

Salt is the main vehicle for iodine fortification in The Netherlands. A reduction in salt intake may reduce the supply of iodine. Our aim was to quantify the effect of salt reduction on the habitual iodine intake of the Dutch population and the risk of inadequate iodine intake. We used data of the Dutch National Food Consumption Survey (1997–8) and an update of the food composition database to estimate habitual salt and iodine intake. To take into account uncertainty about the use of iodised salt (industrial and discretionary) and food supplements, a simulation model was used. Habitual iodine and salt intakes were simulated for scenarios of salt reduction and compared with no salt reduction. With 12, 25 and 50 % salt reduction in industrially processed foods, the iodine intake remained adequate for a large part of the Dutch population. For the extreme scenario of a 50 % reduction in both industrially and discretionary added salt, iodine intake might become inadequate for part of the Dutch population (up to 10 %). An increment of the proportion of industrially processed foods using iodised salt or a small increase in iodine salt content will solve this. Nevertheless, 8–35 % of 1- to 3-year-old children might have iodine intakes below the corresponding estimated average requirement (EAR), depending on the salt intake scenario. This points out the need to review the EAR value for this age group or to suggest the addition of iodine to industrially manufactured complementary food

Long-term wine consumption is related to cardiovascular mortality and life expectancy independently of moderate alcohol intake: the Zutphen Study

Background: Light to moderate alcohol intake lowers the risk of cardiovascular mortality, but whether this protective effect can be attributed to a specific type of beverage remains unclear. Moreover, little is known about the effects of long-term alcohol intake on life expectancy. Methods: The impact of long-term alcohol intake and types of alcoholic beverages consumed on cardiovascular mortality and life expectancy at age 50 was investigated in the Zutphen Study, a cohort of 1373 men born between 1900 and 1920 and examined repeatedly between 1960 and 2000. Hazard ratios (HRs) for total alcohol intake and alcohol from wine, beer and spirits were obtained from time-dependent Cox regression models. Life expectancy at age 50 was calculated from areas under survival curves. Results: Long-term light alcohol intake, that is =20 g per day, compared with no alcohol, was strongly and inversely associated with cerebrovascular (HR 0.43, 95% CI 0.26 to 0.70), total cardiovascular (HR 0.70, 95% CI 0.55 to 0.89) and all-cause mortality (HR 0.75, 95% CI 0.63 to 0.91). Independent of total alcohol intake, long-term wine consumption of, on average, less than half a glass per day was strongly and inversely associated with coronary heart disease (HR 0.61, 95% CI 0.41 to 0.89), total cardiovascular (HR 0.68, 95% CI 0.53 to 0.86) and all-cause mortality (HR 0.73, 95% CI 0.62 to 0.87). These results could not be explained by differences in socioeconomic status. Life expectancy was about 5 years longer in men who consumed wine compared with those who did not use alcoholic beverages. Conclusion: Long-term light alcohol intake lowered cardiovascular and all-cause mortality risk and increased life expectancy. Light wine consumption was associated with 5 years longer life expectancy; however, more studies are needed to verify this resul

Colours of fruit and vegetables and 10-year incidence of CHD

The colours of the edible part of fruit and vegetables indicate the presence of specific micronutrients and phytochemicals. The extent to which fruit and vegetable colour groups contribute to CHD protection is unknown. We therefore examined the associations between fruit and vegetables of different colours and their subgroups and 10-year CHD incidence. We used data from a prospective population-based cohort including 20 069 men and women aged 20–65 years who were enrolled between 1993 and 1997. Participants were free of CVD at baseline and completed a validated 178-item FFQ. Hazard ratios (HR) for the association between green, orange/yellow, red/purple, white fruit and vegetables and their subgroups with CHD were calculated using multivariable Cox proportional hazards models. During 10 years of follow-up, 245 incident cases of CHD were documented. For each 25 g/d increase in the intake of the sum of all four colours of fruit and vegetables, a borderline significant association with incident CHD was found (HR 0·98; 95 % CI 0·97, 1·01). No clear associations were found for the colour groups separately. However, each 25 g/d increase in the intake of deep orange fruit and vegetables was inversely associated with CHD (HR 0·74; 95 % CI 0·55, 1·00). Carrots, their largest contributor (60 %), were associated with a 32 % lower risk of CHD (HR 0·68; 95 % CI 0·48, 0·98). In conclusion, though no clear associations were found for the four colour groups with CHD, a higher intake of deep orange fruit and vegetables and especially carrots may protect against CH

Selecting informative food items for compiling food-frequency questionnaires: comparison of procedures

The authors automated the selection of foods in a computer system that compiles and processes tailored FFQ. For the selection of food items, several methods are available. The aim of the present study was to compare food lists made by MOM2, which identifies food items with highest between-person variance in intake of the nutrients of interest without taking other items into account, with food lists made by forward regression. The name MOM2 refers to the variance, which is the second moment of the nutrient intake distribution. Food items were selected for the nutrients of interest from 2 d of recorded intake in 3524 adults aged 25–65 years. Food lists by 80 % MOM2 were compared to those by 80 % explained variance for regression on differences between the number and type of food items, and were evaluated on (1) the percentage of explained variance and (2) percentage contribution to population intake computed for the selected items on the food list. MOM2 selected the same food items for Ca, a few more for fat and vitamin C, and a few less for carbohydrates and dietary fibre than forward regression. Food lists by MOM2 based on 80 % of variance in intake covered 75–87 % of explained variance for different nutrients by regression and contributed 53–75 % to total population intake. Concluding, for developing food lists of FFQ, it appears sufficient to select food items based on the contribution to variance in nutrient intake without taking covariance into accoun

Reproducibility and relative validity of dietary glycaemic index and glycaemic load assessed by the food-frequency questionnaire used in the Dutch cohorts of the European prospective investigation into Cancer and Nutrition

Limited information is available on the reproducibility and validity of dietary glycaemic index (GI) and glycaemic load (GL) estimated by habitual diet assessment methods such as FFQ, including the FFQ used in the Dutch cohorts of the European Prospective Investigation into Cancer and Nutrition study. To examine the reproducibility and relative validity of GI and GL, we used data from 121 Dutch men and women aged 23–72 years. They completed the FFQ three times at intervals of 6 months and twelve 24-h dietary recalls (24HDR) monthly during 1991–2. GI and GL were calculated using published values. Intra-class correlation coefficients of the three repeated FFQ were 0·78 for GI and 0·74 for GL. Pearson correlation coefficients between the first FFQ and the weighted average of the 24HDR were 0·63 for both GI and GL. Weighted ¿ values between the first FFQ and the average of the 24HDR (in quintiles) were 0·40 for GI and 0·41 for GL. Bland–Altman plots showed a proportional bias in GI (ß = 0·46), but not in GL (ß = 0·06). In conclusion, this FFQ can be used in epidemiological studies to investigate the relationship of GI and GL with disease risks, but the proportional bias should be taken into account when using this FFQ to assess the absolute GI values

Food photographs in nutritional surveillance: errors in portion size estimation using drawings of bread and photographs of margarine and beverages consumption

Food photographs are widely used as instruments to estimate portion sizes of consumed foods. Several food atlases are available, all developed to be used in a specific context and for a given study population. Frequently, food photographs are adopted for use in other studies with a different context or another study population. In the present study, errors in portion size estimation of bread, margarine on bread and beverages by two-dimensional models used in the context of a Belgian food consumption survey are investigated. A sample of 111 men and women (age 45–65 years) were invited for breakfast; two test groups were created. One group was asked to estimate portion sizes of consumed foods using photographs 1–2 d after consumption, and a second group was asked the same after 4 d. Also, real-time assessment of portion sizes using photographs was performed. At the group level, large overestimation of margarine, acceptable underestimation of bread and only small estimation errors for beverages were found. Women tended to have smaller estimation errors for bread and margarine compared with men, while the opposite was found for beverages. Surprisingly, no major difference in estimation error was found after 4 d compared with 1–2 d. Individual estimation errors were large for all foods. The results from the present study suggest that the use of food photographs for portion size estimation of bread and beverages is acceptable for use in nutrition surveys. For photographs of margarine on bread, further validation using smaller amounts corresponding to actual consumption is recommended

T polymorphism in determining hepatic lipase activity: the Hoorn Study

T polymorphism, after adjustment for age, sex, carbohydrate and protein intakes, and insulin or body mass inde

Een voedingsmiddelentabel voor het uitvoeren van trendanalyses in de Zutphen Studie

De gegevens in oude voedingsmiddelentabellen zijn minder betrouwbaar doordat laboratoriumbepalingen voor sommige voedingsstoffen in het verleden niet mogelijk waren of onnauwkeuriger waren dan tegenwoordig. Voor trendanalyses op basis van voedselconsumptieonderzoek in de Zutphen Studie wordt geadviseerd de in deze studie verbeterde voedingsmiddelentabel voor de periode 1960-1970 te gebruiken.Dit rapport beschrijft de samenstelling van een verbeterde voedingsmiddelentabel voor het uitvoeren van trendanalyses. De meest geconsumeerde producten in de Zutphen Studie zijn beoordeeld op hun samenstelling wat betreft totaal eiwit, totaal vet, verzadigd vet, enkelvoudig en meervoudig onverzadigd vet, eicosapentaeenzuur, docosahexaeenzuur, totaal koolhydraten, voedingsvezel en alcohol. De methode die Stichting Nederlands Voedingsstoffenbestand heeft gebruikt voor het samenstellen van tijdspecifieke voedingsmiddelentabellen is hierbij als referentie gebruikt. Over het algemeen is de inname van energie en voedingsstoffen hoger geworden vergeleken met de oorspronkelijke voedingsstofinname, behalve voor de inname van enkelvoudig onverzadigd vet, eicosapentaeenzuur, voedingsvezel en alcohol. Voor trendanalyses in de Zutphen Studie is het dan ook van belang om de verbeterde voedingsmiddelentabel te gebruiken. De rangordening van de deelnemers aan de Zutphen Studie van lage naar hoge inneming van voedingsstoffen verandert echter nauwelijks, waardoor het gebruik van de verbeterde voedingsmiddelentabel weinig invloed heeft op het bestuderen van de relatie tussen voeding en ziekten in de Zutphen Studi