Dutch Healthy Diet index, Lifelines Diet Score and mortality

In 2015, the Dutch Health Council has released an updated version of healthy dietary guidelines for the Dutch general population. These dietary guidelines include recommendations on physical activity, consumption of vegetables, fruit, fish, dietary fiber, saturated fatty acid, trans fatty acid, salt, food and beverages containing easily fermentable sugars, and alcohol intake. To measure adherence to the dietary guideline, the Dutch Healthy Diet Index has been established1,2. Many studies have shown that higher adherence to the dietary guideline, as measured by Dutch Healthy Diet Index, has been associated with reduced risk of various types of cardiometabolic disease3-5. However, evidence on the associations between Dutch Healthy Diet Index specifically and subsequent mortality risk is limited. For example, a study using data from the Rotterdam Study showed that a higher level of adherence to Dutch dietary guidelines was associated with lower all-cause mortality risk6. Similar findings were observed in EPIC-NL study5. More investigation is needed, especially in the larger study population where also at baseline important risk factors and health indicators have been assessed.