The 2015 Dutch food-based dietary guidelines

The objective of this study was to derive food-based dietary guidelines for the Dutch population. The dietary guidelines are based on 29 systematic reviews of English language meta-analyses in PubMed summarizing randomized controlled trials and prospective cohort studies on nutrients, foods and food patterns and the risk of 10 major chronic diseases: coronary heart disease, stroke, heart failure, diabetes, breast cancer, colorectal cancer, lung cancer, chronic obstructive pulmonary disease, dementia and depression. The committee also selected three causal risk factors for cardiovascular diseases or diabetes: systolic blood pressure, low-density lipoprotein cholesterol and body weight. Findings were categorized as strong or weak evidence, inconsistent effects, too little evidence or effect unlikely for experimental and observational data separately. Next, the committee selected only findings with a strong level of evidence for deriving the guidelines. Convincing evidence was based on strong evidence from the experimental data either or not in combination with strong evidence from prospective cohort studies. Plausible evidence was based on strong evidence from prospective cohort studies only. A general guideline to eat a more plant food-based dietary pattern and limit consumption of animal-based food and 15 specific guidelines have been formulated. There are 10 new guidelines on legumes, nuts, meat, dairy produce, cereal products, fats and oils, tea, coffee and sugar-containing beverages. Three guidelines on vegetables, fruits, fish and alcoholic beverages have been sharpened, and the 2006 guideline on salt stayed the same. A separate guideline has been formulated on nutrient supplements. Completely food-based dietary guidelines can be derived in a systematic and transparent way.


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Appendix 1: Members and advisors to the committee Members of Health Council committees are appointed in a personal capacity because of their special expertise in the matters to be addressed. Nonetheless, it is precisely because of this expertise that they may also have interests. This in itself does not necessarily present an obstacle for membership of a Health Council committee. Transparency regarding possible conflicts of interest is nonetheless important, both for the chairperson and members of a committee and for the President of the Health Council. On being invited to join a committee, members are asked to submit a form detailing the functions they hold and any other material and immaterial interests which could be relevant for the committee's work. It is the responsibility of the President of the Health Council to assess whether the interests indicated constitute grounds for nonappointment. An advisorship will then sometimes make it possible to exploit the expertise of the specialist involved. Advisors cannot, however, vote on the formulation of the committee's conclusions or recommendations and they have no responsibility for the contents of advisory reports. During the inaugural meeting the declarations issued are discussed, so that all members of the committee are aware of each other's possible interests.
a) The associations observed in cohort studies regarding calcium supplements are reported here because the quantities involved are consistent with normal dairy product consumption. Hence, the findings regarding such supplements are relevant in relation to dairy products. In the Netherlands, 58 per cent of calcium intake derives from dairy products. 45  ► represents an effect; ♦ represents an association.
a Nuts or linseed. ► represents an effect; ♦ represents an association.
a) Diastolic blood pressure. ► represents an effect; ♦ represents an association.
a) 10% of energy is 10 per cent of total daily energy intake. ► represents an effect; ♦ represents an association. a) Eating 1 portion of fish a week is sufficient to obtain the maximum health gain.
b) In cardiac patients and high-risk groups.
a) Relate to the risk relative to people whose alcohol consumption was more than 0, but less than 15 grams a day.
b) Different definitions of binge drinking were used in the cohort studies. The committee considers binge drinking to be 60 grams of alcohol or more per occasion.
a) The quantities relate to the amount of alcohol in the drink.
b) Relate to the risk relative to people whose alcohol consumption was more than 0, but less than 5 grams a day. a) The quantities in this table relate to the amount of alcohol in the drink.
b) Relate to the risk relative to people whose alcohol consumption was more than 0, but less than 3 grams a day.
c) Relate to the risk relative to people who did not consume any alcohol.  ► represents an effect.
a) In smokers and asbestos workers.
b) Elderly people, particularly post-menopausal women. ► represents an effect; ♦ represents an association.