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

Consumption of dairy products and associations with incident diabetes, CHD and mortality in the Whitehall II study

Few prospective studies have examined the effects of different types of dairy food on the risks of type 2 diabetes, CHD and mortality. We examined whether intakes of total dairy, high-fat dairy, low-fat dairy, milk and fermented dairy products were related to these outcomes in the Whitehall II prospective cohort study. At baseline, dairy consumption was assessed by FFQ among 4526 subjects (72 % men) with a mean age 56 (sd 6) years. Death certificates and medical records were used to ascertain CHD mortality and non-fatal myocardial infarction. Incident diabetes was detected by the oral glucose tolerance test or self-report. Incidence data were analysed using Cox proportional hazards models, adjusted for lifestyle and dietary factors. During approximately 10 years of follow-up, 273 diabetes, 323 CHD and 237 all-cause mortality cases occurred. In multivariable models, intakes of total dairy and types of dairy products were not significantly associated with incident diabetes or CHD (all P values for trend >0·1). Fermented dairy products was inversely associated with overall mortality (hazard ratios approximately 0·7 in the middle and highest tertiles; P for trend 0·3). In conclusion, intakes of total dairy and types of dairy products showed no consistent relationship with incident diabetes, CHD or all-cause mortality

N-6 and N-3 Fatty Acid Cholesteryl Esters in Relation to Fatal CHD in a Dutch Adult Population: A Nested Case-Control Study and Meta-Analysis

Background: Dietary polyunsaturated fatty acids (PUFA) are inversely related to coronary heart disease (CHD) in epidemiological studies. We examined the associations of plasma n-6 and n-3 PUFA in cholesteryl esters with fatal CHD in a nested case-control study. Additionally, we performed a dose-response meta-analysis of similar prospective studies on cholesteryl ester PUFA. Methods: We used data from two population-based cohort studies in Dutch adults aged 20-65y. Blood and data collection took place from 1987-1997 and subjects were followed for 8-19y. We identified 279 incident cases of fatal CHD and randomly selected 279 controls, matched on age, gender, and enrollment date. Odds ratios (OR) were calculated per standard deviation (SD) increase of cholesteryl ester PUFA. Results: After adjustment for confounders, the OR (95% CI) for fatal CHD per SD increase in plasma linoleic acid was 0.89 (0.74-1.06). Additional adjustment for plasma total cholesterol and systolic blood pressure attenuated this association (OR:0.95; 95% CI: 0.78-1.15). Arachidonic acid was not associated with fatal CHD (OR per SD:1.11; 95% CI: 0.92-1.35). The ORs (95% CI) for fatal CHD for an SD increase in n-3 PUFA were 0.92 (0.74-1.15) for alpha-linolenic acid and 1.06 (0.88-1.27) for EPA-DHA. In the meta-analysis, a 5% higher linoleic acid level was associated with a 9% lower risk (relative risk: 0.91; 95% CI: 0.84-0.98) of CHD. The other fatty acids were not associated with CHD. Conclusion: In this Dutch population, n-6 and n-3 PUFA in cholesteryl esters were not significantly related to fatal CHD. Our data, together with findings from previous prospective studies, support that linoleic acid in plasma cholesteryl is inversely associated with CHD

Achievement of weight loss in overweight patients during dietetic treatment in primary health care

An observational study data based on real life practice data of overweight patients during the period 2013–2017, derived from dietetic practices that participated in the Nivel Primary Care Database. This study investigated weight change after dietetic treatment and associations with patient characteristics

Logopedische zorg in kaart gebracht: jaarcijfers 2012 en trendcijfers 2008-2012.

Het NIVEL en de Nederlandse Vereniging voor Logopedie en Foniatrie (NVLF) werken samen om reguliere gegevens, zoals kenmerken van cliënten, diagnoses en behandelingen, uit de administratie van logopediepraktijken op te nemen in NIVEL Zorgregistraties eerste lijn. Dan wordt het mogelijk deze gegevens te combineren met gegevens van andere beroepsgroepen en om informatie te krijgen over de gezondheidsproblemen van deze cliënten, de toegang tot logopedie, het gebruik van eerdere zorg en het effect van de behandeling. Op basis van een beperkte set declaratiegegevens is een voorstudie gedaan over de periode 2008-2012. Uit deze studie bleek dat logopedisten kinderen met spraak- en taalproblemen helpen en ook ouderen met stemproblemen na bijvoorbeeld een herseninfarct. Volwassenen met stemproblemen kregen gemiddeld 12 behandelingen per jaar en kinderen met een taalontwikkelingsstoornis 20. Er was tussen 2008 en 2012 een verschuiving zichtbaar in de leeftijd van kinderen die voor behandeling bij een logopedist kwamen. In verhouding minder kinderen tot 7 jaar en meer tussen 8 en 16 jaar. Bezuinigingen in het onderwijs en preventieve logopedie “Naast een verschuiving in de leeftijdsgroepen, zien we zeker bij de 8 tot 12 jarigen ook een verschuiving in de diagnosen. Deze kinderen komen veel vaker met taalontwikkelingsstoornissen vergeleken met 5 jaar geleden”, stelt NIVEL-programmaleider Cindy Veenhof. “Deze voorstudie geeft nog geen uitsluitsel over de oorzaken hiervan. Meer transparantie in het werk van logopedisten krijgen we zodra we gegevens van meer praktijken hebben. Dan kunnen we de zorg van logopedisten beter in kaart brengen en trends verklaren. Daarom is het goed dat logopedisten zich aansluiten bij NIVEL Zorgregistraties.” Onderzoek Voor het onderzoek is gebruikgemaakt van declaratiegegevens van 23.738 cliënten uit 33 logopediepraktijken. Deze gegevens zijn anoniem aangeleverd door WinBase

Intermediate weight changes and follow-up of dietetic treatment in primary healthcare: an observational study.

Background Primary health care data have shown that most patients who were treated for overweight or obesity by a dietitian did not accomplish the recommended treatment period. It is hypothesised that a slow rate of weight loss might discourage patients from continuing dietetic treatment. This study evaluated intermediate weight changes during regular dietetic treatment in Dutch primary health care, and examined whether weight losses at previous consultations were associated with attendance at follow-up consultations. Methods This observational study was based on real life practice data of overweight and obese patients during the period 2013-2017, derived from Dutch dietetic practices that participated in the Nivel Primary Care Database. Multilevel regression analyses were conducted to estimate the mean changes in body mass index (BMI) during six consecutive consultations and to calculate odds ratios for the association of weight change at previous consultations with attendance at follow-up consultations. Results The total study population consisted of 25,588 overweight or obese patients, with a mean initial BMI of 32.7 kg/m2. The BMI decreased between consecutive consultations, with the highest weight losses between the first and second consultation. After six consultations, a mean weight loss of - 1.5 kg/m2 was estimated. Patients who lost weight between the two previous consultations were more likely to attend the next consultation than patients who did not lose weight or gained weight. Conclusions Body mass index decreased during consecutive consultations, and intermediate weight losses were associated with a higher attendance at follow-up consultations during dietetic treatment in overweight patients. Dietitians should therefore focus on discussing intermediate weight loss expectations with their patients

Achievement of weight loss in patients with overweight during dietetic treatment: an observational study in primary healthcare.

Introduction Dietitians are the preferred primary health care professionals for nutritional care in overweight patients. Guidelines for dietitians recommend a weight reduction of ≥ 5% of initial body weight after one year of treatment. The purpose of this study was to evaluate weight change in patients with overweight who were treated by dietitians in Dutch primary health care, and to identify patient characteristics that were associated with it. Materials and methods This observational study data was based on real life practice data of patients with overweight during the period 2013–2017, derived from dietetic practices that participated in the Nivel Primary Care Database. Multilevel linear regression analyses were performed to investigate weight change after dietetic treatment and to explore associations with patient characteristics. Results In total, data were evaluated from 56 dietetic practices and 4722 patients with a body mass index (BMI) ≥ 25 kg/m2 . The mean treatment time was 3 hours within an average timeframe of 5 months. Overall, patients had a mean weight change of -3.5% (95% CI: -3.8; -3.1) of their initial body weight, and a quarter of the patients reached a weight loss of 5% or more, despite the fact that most patients did not meet the recommended treatment duration of at least one year. The mean BMI change was -1.1 kg/m2 (95% CI: -1.2; -1.0). Higher weight reductions were shown for patients with a higher initial BMI and for patients with a longer treatment time. Sex and age were not associated with weight change, and patients with other dietetic diagnoses, such as diabetes, hypertension, and hypercholesterolemia, had lower weight reductions. Conclusions This study showed that dietetic treatment in primary health care coincided with modest weight reduction in patients with overweight. The weight loss goals were not reached for most patients, which was possibly due to a low treatment adherence