We aimed to evaluate the criterion validity of the 2015 food-based Dutch dietary guidelines, which were formulated based on evidence on the relation between diet and major chronic diseases.
We studied 9,701 participants of the Rotterdam Study, a population-based prospective cohort in individuals aged 45 years and over.
Dietary intake was assessed at baseline with a food-frequency questionnaire. For all participants, we examined adherence (yes/no) to fourteen items of the guidelines: vegetables (≥200g/d), fruit (≥200g/d), whole-grains (≥90g/d), legumes (≥135g/wk), nuts (≥15g/d), dairy (≥350g/d), fish (≥100g/wk), tea (≥450mL/d), ratio whole-grains:total grains (≥50%), ratio unsaturated fats & oils:total fats (≥50%), red and processed meat (<300g/wk), sugar-containing beverages (<150mL/d), alcohol (<10 g/d) and salt (≤6g/d). Total adherence was calculated as sum-score of the adherence to the individual items (0-14). Information on disease incidence and all-cause mortality was collected during a median follow-up period of 13.5 years (range 0-27.0).
Using Cox proportional-hazards models adjusted for confounders, we observed that every additional component adhered to was associated with a 3% lower mortality risk (HR=0.97,95% CI=0.95 - 0.98), lower risk of stroke (HR=0.95,95%CI 0.92;0.99), chronic obstructive pulmonary disease (HR=0.94,95%CI=0.91-0.98), colorectal cancer (HR=0.90,95%CI=0.84;0.96), and depression (HR=0.97,95%CI=0.95-0.999), but not with incidence of coronary heart disease, type 2 diabetes, heart failure, lung cancer, breast cancer, or dementia.
Adherence to the Dutch dietary guidelines was associated with a lower mortality risk and a lower risk of developing some but not all of the chronic diseases on which the guidelines were based.
Conflict of interest and financial support: none declared.