Adherence to the Dutch dietary guidelines and 15-year incidence of heart failure in the EPIC-NL cohort

Marjolein C. Harbers*, Marleen A. de Kroon, Jolanda M.A. Boer, Folkert W. Asselbergs, Johanna M. Geleijnse, Monique W. Verschuren, Yvonne T. van der Schouw, Ivonne Sluijs

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Purpose: A healthy diet may contribute to the primary prevention of heart failure (HF), but evidence is still inconclusive. We aimed to study the association between adherence to the Dutch dietary guidelines and incidence of HF. Methods: We studied 37,468 participants aged 20–70 years and free of HF at baseline from the EPIC-NL cohort. At baseline (1993–1997), data were collected on demographics, lifestyle, and presence of chronic diseases. Dietary intake was assessed using a 178-item validated food frequency questionnaire. Dietary intake data were used to calculate scores on the Dutch Healthy Diet 2015 Index (DHD15-index) measuring adherence to the Dutch dietary guidelines. The DHD15-index is based on the average daily intake of 14 food groups resulting in a total score ranging between 0 and 140, with higher scores indicating better adherence. HF morbidity and mortality during follow-up were ascertained through linkage with national registries. Cox proportional hazards analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the association between DHD15 adherence and HF risk, adjusting for sociodemographic and lifestyle characteristics. Results: The average score on the DHD15-index was 71 (SD = 15). During a median follow-up of 15.2 years (IQR 14.1–16.5), 674 HF events occurred. After adjustment for demographic and lifestyle characteristics, higher scores on the DHD15-index were associated with lower risk of HF (HRQ4vsQ1 0.73; 95% CI 0.58–0.93; Ptrend 0.001). Conclusion: In a large Dutch population of middle-aged adults, higher adherence to the Dutch dietary guidelines was associated with lower risk of HF.

Original languageEnglish
JournalEuropean Journal of Nutrition
DOIs
Publication statusE-pub ahead of print - 7 Jan 2020

Fingerprint

Nutrition Policy
Heart Failure
Incidence
Life Style
Demography
Confidence Intervals
Primary Prevention
Registries
Chronic Disease
Eating
Healthy Diet
Morbidity
Food
Mortality

Keywords

  • Dietary patterns
  • Dutch dietary guidelines
  • Dutch Healthy Diet 2015 Index
  • Heart failure

Cite this

Harbers, Marjolein C. ; de Kroon, Marleen A. ; Boer, Jolanda M.A. ; Asselbergs, Folkert W. ; Geleijnse, Johanna M. ; Verschuren, Monique W. ; van der Schouw, Yvonne T. ; Sluijs, Ivonne. / Adherence to the Dutch dietary guidelines and 15-year incidence of heart failure in the EPIC-NL cohort. In: European Journal of Nutrition. 2020.
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title = "Adherence to the Dutch dietary guidelines and 15-year incidence of heart failure in the EPIC-NL cohort",
abstract = "Purpose: A healthy diet may contribute to the primary prevention of heart failure (HF), but evidence is still inconclusive. We aimed to study the association between adherence to the Dutch dietary guidelines and incidence of HF. Methods: We studied 37,468 participants aged 20–70 years and free of HF at baseline from the EPIC-NL cohort. At baseline (1993–1997), data were collected on demographics, lifestyle, and presence of chronic diseases. Dietary intake was assessed using a 178-item validated food frequency questionnaire. Dietary intake data were used to calculate scores on the Dutch Healthy Diet 2015 Index (DHD15-index) measuring adherence to the Dutch dietary guidelines. The DHD15-index is based on the average daily intake of 14 food groups resulting in a total score ranging between 0 and 140, with higher scores indicating better adherence. HF morbidity and mortality during follow-up were ascertained through linkage with national registries. Cox proportional hazards analysis was used to estimate hazard ratios (HRs) and 95{\%} confidence intervals (95{\%} CIs) for the association between DHD15 adherence and HF risk, adjusting for sociodemographic and lifestyle characteristics. Results: The average score on the DHD15-index was 71 (SD = 15). During a median follow-up of 15.2 years (IQR 14.1–16.5), 674 HF events occurred. After adjustment for demographic and lifestyle characteristics, higher scores on the DHD15-index were associated with lower risk of HF (HRQ4vsQ1 0.73; 95{\%} CI 0.58–0.93; Ptrend 0.001). Conclusion: In a large Dutch population of middle-aged adults, higher adherence to the Dutch dietary guidelines was associated with lower risk of HF.",
keywords = "Dietary patterns, Dutch dietary guidelines, Dutch Healthy Diet 2015 Index, Heart failure",
author = "Harbers, {Marjolein C.} and {de Kroon}, {Marleen A.} and Boer, {Jolanda M.A.} and Asselbergs, {Folkert W.} and Geleijnse, {Johanna M.} and Verschuren, {Monique W.} and {van der Schouw}, {Yvonne T.} and Ivonne Sluijs",
year = "2020",
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doi = "10.1007/s00394-019-02170-7",
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Adherence to the Dutch dietary guidelines and 15-year incidence of heart failure in the EPIC-NL cohort. / Harbers, Marjolein C.; de Kroon, Marleen A.; Boer, Jolanda M.A.; Asselbergs, Folkert W.; Geleijnse, Johanna M.; Verschuren, Monique W.; van der Schouw, Yvonne T.; Sluijs, Ivonne.

In: European Journal of Nutrition, 07.01.2020.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Adherence to the Dutch dietary guidelines and 15-year incidence of heart failure in the EPIC-NL cohort

AU - Harbers, Marjolein C.

AU - de Kroon, Marleen A.

AU - Boer, Jolanda M.A.

AU - Asselbergs, Folkert W.

AU - Geleijnse, Johanna M.

AU - Verschuren, Monique W.

AU - van der Schouw, Yvonne T.

AU - Sluijs, Ivonne

PY - 2020/1/7

Y1 - 2020/1/7

N2 - Purpose: A healthy diet may contribute to the primary prevention of heart failure (HF), but evidence is still inconclusive. We aimed to study the association between adherence to the Dutch dietary guidelines and incidence of HF. Methods: We studied 37,468 participants aged 20–70 years and free of HF at baseline from the EPIC-NL cohort. At baseline (1993–1997), data were collected on demographics, lifestyle, and presence of chronic diseases. Dietary intake was assessed using a 178-item validated food frequency questionnaire. Dietary intake data were used to calculate scores on the Dutch Healthy Diet 2015 Index (DHD15-index) measuring adherence to the Dutch dietary guidelines. The DHD15-index is based on the average daily intake of 14 food groups resulting in a total score ranging between 0 and 140, with higher scores indicating better adherence. HF morbidity and mortality during follow-up were ascertained through linkage with national registries. Cox proportional hazards analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the association between DHD15 adherence and HF risk, adjusting for sociodemographic and lifestyle characteristics. Results: The average score on the DHD15-index was 71 (SD = 15). During a median follow-up of 15.2 years (IQR 14.1–16.5), 674 HF events occurred. After adjustment for demographic and lifestyle characteristics, higher scores on the DHD15-index were associated with lower risk of HF (HRQ4vsQ1 0.73; 95% CI 0.58–0.93; Ptrend 0.001). Conclusion: In a large Dutch population of middle-aged adults, higher adherence to the Dutch dietary guidelines was associated with lower risk of HF.

AB - Purpose: A healthy diet may contribute to the primary prevention of heart failure (HF), but evidence is still inconclusive. We aimed to study the association between adherence to the Dutch dietary guidelines and incidence of HF. Methods: We studied 37,468 participants aged 20–70 years and free of HF at baseline from the EPIC-NL cohort. At baseline (1993–1997), data were collected on demographics, lifestyle, and presence of chronic diseases. Dietary intake was assessed using a 178-item validated food frequency questionnaire. Dietary intake data were used to calculate scores on the Dutch Healthy Diet 2015 Index (DHD15-index) measuring adherence to the Dutch dietary guidelines. The DHD15-index is based on the average daily intake of 14 food groups resulting in a total score ranging between 0 and 140, with higher scores indicating better adherence. HF morbidity and mortality during follow-up were ascertained through linkage with national registries. Cox proportional hazards analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the association between DHD15 adherence and HF risk, adjusting for sociodemographic and lifestyle characteristics. Results: The average score on the DHD15-index was 71 (SD = 15). During a median follow-up of 15.2 years (IQR 14.1–16.5), 674 HF events occurred. After adjustment for demographic and lifestyle characteristics, higher scores on the DHD15-index were associated with lower risk of HF (HRQ4vsQ1 0.73; 95% CI 0.58–0.93; Ptrend 0.001). Conclusion: In a large Dutch population of middle-aged adults, higher adherence to the Dutch dietary guidelines was associated with lower risk of HF.

KW - Dietary patterns

KW - Dutch dietary guidelines

KW - Dutch Healthy Diet 2015 Index

KW - Heart failure

U2 - 10.1007/s00394-019-02170-7

DO - 10.1007/s00394-019-02170-7

M3 - Article

JO - European Journal of Nutrition

JF - European Journal of Nutrition

SN - 1436-6207

ER -