Food-based dietary guidelines: some assumptions tested for the Netherlands

Recently, the concept of food-based dietary guidelines has been introduced by WHO and FAO. For this concept, several assumptions were necessary. The v alidity and potential consequences of some of these assumptions are discuss ed in this paper on the basis of the Dutch National Food Consumption Survey s. The topics were interrelationships among dietary characteristics, nutrie nt density, diets in accordance with the guidelines, and food variety. To obtain insight into overall diet quality, a dietary quality index based on nutrients and a food-based quality index based on food groups were creat ed and tested. As expected the results showed that a higher dietary quality index was associated with an improved intake of the nutrients included in the index, in particular a lower intake of total fat and cholesterol. This was related to a lower consumption of cheese, fats and oils, meat and meat products, and a higher consumption of fruit and vegetables. The information obtained with a dietary quality index can be used to assess the feasibilit y of a particular goal in combination with other relevant goals and to obta in clues or confirmation for recommendations regarding food consumption. The food-based quality index created showed that a combination of several f ood-based goals (formulated in quantitative terms) was associated with an i ncrease in food consumption, without a clear relevance for the dietary qual ity. Therefore, the formulation of food-based guidelines should be based on explicitly stated dietary goals. The findings regarding nutrient density w ere in the direction of what was assumed, namely a positive association bet ween density and absolute intake, although the expected effects were not co mpletely found. The results regarding the association between variety and d ietary intake were characterized mainly by differences in quantity rather t han dietary quality. The data indicate that energy intake may be an important pitfall in impleme nting food-based dietary guidelines, that 'eat a variety of food' can be an empty slogan and that nutrient density is positively related to the absolu te intake of specific micronutrients. Further, the 'absence' of interrelati onships among risk nutrients indicates that a selection process has to be a pplied.