The Dutch Healthy Diet index (DHD-index): an instrument to measure adherence to the Dutch Guidelines for a Healthy Diet

Nutr J. 2012 Jul 20:11:49. doi: 10.1186/1475-2891-11-49.

Abstract

Background: The objective was to develop an index based on the Dutch Guidelines for a healthy Diet of 2006 that reflects dietary quality and to apply it to the Dutch National Food Consumption Survey (DNFCS) to examine the associations with micronutrient intakes.

Methods: A total of 749 men and women, aged 19-30 years, contributed two 24-hour recalls and additional questionnaires in the DNFCS of 2003. The Dutch Healthy Diet index (DHD-index) includes ten components representing the ten Dutch Guidelines for a Healthy Diet. Per component the score ranges between zero and ten, resulting in a total score between zero (no adherence) and 100 (complete adherence).

Results: The mean ± SD of the DHD-index was 60.4 ± 11.5 for women and 57.8 ± 10.8 for men (P for difference = 0.002). Each component score increased across the sex-specific quintiles of the DHD-index. An inverse association was observed between the sex-specific quintiles of the DHD-index and total energy intake. Calcium, riboflavin, and vitamin E intake decreased with increasing DHD-index, an inverse association which disappeared after energy adjustment. Vitamin C showed a positive association across quintiles, also when adjusted for energy. For folate, iron, magnesium, potassium, thiamin, and vitamin B6 a positive association emerged after adjustment for energy.

Conclusions: The DHD-index is capable of ranking participants according to their adherence to the Dutch Guidelines for a Healthy Diet by reflecting variation in nine out of ten components that constitute the index when based on two 24-hour recalls. Furthermore, the index showed to be a good measure of nutrient density of diets.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Ascorbic Acid / administration & dosage
  • Calcium, Dietary / administration & dosage
  • Diet / standards*
  • Diet Surveys*
  • Energy Intake
  • Female
  • Folic Acid / administration & dosage
  • Guideline Adherence*
  • Guidelines as Topic
  • Humans
  • Iron, Dietary / administration & dosage
  • Magnesium / administration & dosage
  • Male
  • Micronutrients / administration & dosage
  • Netherlands
  • Nutrition Assessment
  • Potassium, Dietary / administration & dosage
  • Riboflavin / administration & dosage
  • Surveys and Questionnaires
  • Vitamin B 6 / administration & dosage
  • Vitamin E / administration & dosage
  • Young Adult

Substances

  • Calcium, Dietary
  • Iron, Dietary
  • Micronutrients
  • Potassium, Dietary
  • Vitamin E
  • Vitamin B 6
  • Folic Acid
  • Magnesium
  • Ascorbic Acid
  • Riboflavin