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INTRODUCTION Traditionally, nutritional epidemiology focused on investigating associations between energy, single nutrients, food products, or food groups, and diseases. However, several biological and statistical arguments have been put forward to [...], BACKGROUND/OBJECTIVES: The Dutch guidelines for a healthy diet aim to reduce major chronic diseases. However, supporting evidence on their overall association with all-cause and cause-specific mortality is limited. Recently, the Dutch Healthy Diet-index (DHD-index) has been developed to assess adherence to these guidelines. The aim was to examine the association between the DHD-index and all-cause mortality and deaths from cardiovascular disease (CVD), coronary heart disease (CHD), stroke and cancer. SUBJECTS/METHODS: We followed 3593 men and women aged 55 years and older enrolled in the Rotterdam Study, a populationbased prospective cohort study, from baseline in 1990-1993 to 2011. A validated 170-item food frequency questionnaire at baseline was used to calculate the DHD-index score (maximum 90 points). Cox proportional hazard models were used to estimate hazard ratios (HRs) adjusting for age, sex, total energy intake, smoking and educational level. RESULTS: During the 20-year follow-up, 1831 (51%) deaths were reported. Mean DHD-index score was 60.6 (s.d. 10.6). The score was inversely associated with all-cause mortality (highest vs lowest quartile HR 0.77;95% confidence interval (CI) 0.67, 0.89). Inverse but non-significant associations were observed for mortality due to CVD (HR 0.74;95% CI 0.55, 1.01), CHD (HR 0.60;95% CI 0.34, 1.06) and stroke (HR 0.67;95% CI 0.36,1.22), whereas no association was observed with cancer mortality (HR 0.99;95% CI 0.90,1.11). CONCLUSIONS: A higher level of adherence to the Dutch dietary guidelines, as assessed with the DHD-index, was associated with a lower risk of all-cause mortality, probably due to an inverse association with cardiovascular causes of death. European Journal of Clinical Nutrition (2016) 70, 262-268; doi:10.1038/ejcn.2015.163; published online 21 October 2015

INTRODUCTION Adequate nutrition is an important modifiable factor for maintaining bone mineral density (BMD). Although the emphasis in previous studies has been on the intake of calcium and vitamin D, [...], BACKGROUND/OBJECTIVES: High vitamin A intake may be associated with a decreased bone mineral density (BMD) and increased risk of fractures. Our objectives were to study whether dietary intake of vitamin A (total, retinol or beta-carotene) is associated with BMD and fracture risk and if associations are modified by body mass index (BMI) and vitamin D. SUBJECTS/METHODS: Participants were aged 55 years and older (n = 5288) from the Rotterdam Study, a population-based prospective cohort. Baseline vitamin A and D intake was measured by a food frequency questionnaire. BMD was measured by dual-energy X-ray absorptiometry at four visits between baseline (1989-1993) and 2004. Serum vitamin D was assessed in a subgroup (n = 3161). Fracture incidence data were derived from medical records with a mean follow-up time of 13.9 years. RESULTS: Median intake of vitamin A ranged from 684 retinol equivalents (REs)/day (quintile 1) to 2000 REs/day (quintile 5). After adjustment for confounders related to lifestyle and socioeconomic status, BMD was significantly higher in subjects in the highest quintile of total vitamin A (mean difference in BMD (95% confidence interval (CI)) = 11.53 (0.37-22.7) mg/[cm.sup.2]) and retinol intake (mean difference in BMD (95% CI) = 12.57 (1.10-24.05) mg/[cm.sup.2]) than in the middle quintile. Additional adjustment for BMI diluted these associations. Fracture risk was reduced in these subjects. Significant interaction was present between intake of retinol and overweight (BMI >25 kg/[m.sup.2]) in relation to fractures (P for interaction =0.05), but not BMD. Stratified analysis showed that these favourable associations with fracture risk were only present in overweight subjects (BMI >25 kg/[m.sup.2]). No effect modification by vitamin D intake or serum levels was observed. CONCLUSIONS: Our results suggest a plausible favourable relation between high vitamin A intake from the diet and fracture risk in overweight subjects, whereas the association between vitamin A and BMD is mainly explained by BMI. European Journal of Clinical Nutrition (2015) 69, 1360-1368;doi: 10.1038/ejcn.2015.154; published online 16 September 2015

INTRODUCTION The prevalence of childhood obesity has increased dramatically over the past decades. In 2010, it was estimated to be 11.7% in the developed countries. (1) Similarly, intake of sugar-containing [...], BACKGROUND/OBJECTIVE: Intake of sugar-containing beverages (SCBs) has been associated with higher body mass index (BMI) in childhood. The potential effect of SCB intake during infancy is unclear. We examined the association of SCB intake at 13 months with BMI development until 6 years and body composition at age 6 years. SUBJECTS/METHODS: This study included 2371 Dutch children from a population-based prospective cohort study. SCB intake at 13 months was assessed using a Food Frequency Questionnaire with validation against 24-h recalls and was standardized for total energy. BMI was calculated from repeated weight and height measurements, and age- and sex- specific s.d. scores were calculated. Adiposity was measured using Dual-energy X-ray absorptiometry. RESULTS: In girls, higher SCB intake at 13 months was significantly associated with higher BMI at ages 2, 3, 4 and 6 years (at age 6 years BMI (s.d. score) increase 0.11 (95% confidence interval (CI) +0.00;0.23), high versus low intake). We observed a tendency towards higher android/gynoid fat ratio in girls with high intake (s.d. increase 0.14 (95% CI - 0.02;0.29), versus low intake) but not with body fat percentage. In boys, there was no association with BMI or body composition, but boys with high SCB intake at 13 months were taller at age 6 years (s.d. increase 0.14 (95% CI +0.00; 0.27), versus low intake). CONCLUSIONS: Higher SCB intake at 13 months was associated with higher BMI up to age 6 years in girls but not in boys. Our results imply that the unfavorable effects of SCB intake start early in life and that dietary advice regarding limiting SCB intake should already be given early in life. European Journal of Clinical Nutrition (2015) 69, 314-321; doi: 10.1038/ejcn.2015.2; published online 4 February 2015

INTRODUCTION The first year of life includes many transitions in food consumption. (1) Appropriate nutrition during infancy is essential for adequate growth, development and health. (2) The World Health Organization [...], BACKGROUND/OBJECTIVES: Many parents do not follow recommendations for the timing of introduction of complementary feeding. The aim of this study was to identify determinants associated with the timing of introduction of complementary feeding in a multiethnic birth cohort. SUBJECTS/METHODS: Subjects were 3561 mothers and infants participating in a prospective cohort study. The timing of introduction of complementary feeding and maternal and infant characteristics were obtained by parent-derived questionnaires. Regression analyses were performed to identify determinants for the timing of introduction of complementary feeding ( RESULTS: In total, 62% of infants were introduced to complementary feeding before the age of 6 months. Determinants for very early ( CONCLUSIONS: This study confirmed determinants for the timing of introduction of complementary feeding that have been identified by previous studies, which may be appropriate targets for education and guidance. Moreover, mothers whose infants attend day care and have a family history of asthma, atopy or allergy to cow's milk may need guidance to follow infant feeding recommendations. European Journal of Clinical Nutrition (2013) 67, 625-630;doi: 10.1038/ejcn.2013.50; published online 6 March 2013 Keywords: introduction of solids; infant feeding; complementary feeding; weaning