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Studies of dietary intake in The Netherlands during 1987 to 1988 and 1992 revealed a continuing gap in nutritional value and unhealthful eating habits. In a sampling of 5,898 individuals between 1 and 85 years of age, dietary intake of fiber and carbohydrate energy were low, while intake of protein was high, particularly among older subjects. High fat intake is a significant health risk, as obesity in the Dutch population continues to be a problem., 1. Summary From April 1987-March 1988, the first Dutch National Food Consumption Survey (DNFCS) was carried out among 2203 households comprising 5898 subjects, aged 1-85. In 1992 (January-December) the second [...]

The Dutch National Food Consumption Survey studied alcohol consumption, food intake and smoking in 1145 men and 1171 women to find out how alcohol consumption affects dietary and smoking habits. Alcohol consumption was found to lead to a higher energy intake, in part because food intake was not reduced to compensate for increased calories from alcohol. Alcohol consumption was strongly related to smoking. It was weakly related to increased fat intake in men and cholesterol intake in women.

Objective: To determine whether a gum-containing thickener maintains its viscosity better during oral processing than a completely starch-based thickener., Methods: Thirty-five healthy volunteers participated in a double-blind, cross-over study. Artificial tap water was thickened to honey-like consistency (effective viscosity of 1,300±100 mPa·s at a shear rate of 50 per second at 20℃) with a starch-based thickener (SB) or a gum-containing thickener (GC). Bolus viscosity was determined after standardized oral processing of the thickened water by the subjects for 10 and 20 seconds. Significant effects were determined by ANOVA analysis and pairwise comparisons., Results: Both thickeners were susceptible to breakdown during oral processing. However, GC-thickened water retained its viscosity significantly better than SB-thickened water., Conclusion: The presence of gums has a protective effect on the starch hydrolysis by salivary amylase in thickened drinks, which may facilitate safer swallowing.

Objective: To validate an FFQ designed to estimate energy intake in children against doubly labelled water (DLW). To investigate how quality control and standard beverage portion sizes affect the validity of the FFQ., Design: Thirty healthy children, aged 4-6 years, participated. Total energy expenditure (EE) was measured by the DLW method during an observation period of 15 d. At the end of this period parents filled out an FFQ designed to assess the child's habitual energy intake (EI) of the preceding four weeks., Setting: Validation study in The Netherlands., Subjects: Thirty healthy children (fifteen boys and fifteen girls), aged 4-6 years., Results: Mean EI (6117 (sd 1025) kJ/d) did not differ significantly from mean EE (6286 (sd 971) kJ/d; P = 0·15); the mean EI:EE ratio was 0·98. The Pearson correlation coefficient between EI and EE was 0·62. The Bland-Altman plot showed no systematic bias and a constant bias close to zero. Less intensive quality control of the FFQ maintained the mean EI:EE ratio and decreased the correlation slightly. Using standard instead of individually measured beverage portion sizes decreased the mean EI:EE ratio, but maintained the correlation., Conclusions: It can be concluded that the developed FFQ is a valid instrument to estimate mean energy intake in a group of 4- to 6-year-old children and performs reasonably well to rank the subjects with respect to energy intake. It is therefore a useful instrument to estimate energy intake in children in surveys and epidemiological studies in The Netherlands.

In conventional analytical chemistry it is customary to report figures of merit - such as precision, analysis time, limit of detection - for the chemical analysis performed. Usually, such figures of merit are reported for each analyte separately, generating a list of figures of merit. In metabolomics such a listing is not informative, since very many compounds are measured. An ANOVA-based strategy is proposed for a global measure of precision of the whole experiment, broken down in components of variation contributing to the total variation. This strategy uses well established statistical techniques and can be used easily. It was implemented to study the reproducibility of different comprehensive GC- and LC-MS methods for the analysis of tobacco aerosols. The results give insight into different sources of variation contributing to the total variation, such as biological variability, sampling variability and repeatability. For the specific example, median CV values ranged from 4.6% to 12.5% for repeatability; from 14.7% to 18.0% for sampling variability and, finally, from 24.2% to 26.8% for biological variability. Such a breakdown of sources of variability gives clues for improving the methods.

A proof-of-concept study to assess the safety and efficacy of a traditional Chinese medicine formula as treatment for primary dysmenorrhea showed no statistically significant benefit over placebo. However, some efficacy parameters suggested possible superiority of the active treatment and so a larger study needs to be performed to determine whether this remedy has a role in the treatment of dysmenorrhea.

In the Netherlands, the nationwide Fat Watch campaign aiming at a reduction in fat consumption was organized from 1991 onwards. This study describes the effects of the first three consecutive campaign years on attention to fat, diet and health, attitudes, self-efficacy expectations and intentions related to dietary fat reduction, and self-rated fat intake. Data were collected each year according to the Solomon design, by telephone interviews among about 1200 consumers responsible for household purchases. Campaign awareness was high in each campaign year, but a decrease in campaign awareness was found after the first campaign in 1991. The 1991 campaign was primarily aimed at getting the attention of the Dutch public for the fat-reduction message and indeed resulted in increased attention. The second campaign year resulted in small but statistically significant positive changes in attitudes, which was the specific target of the 1992 campaign. Intention to buy low-fat food products was also significantly increased. The 1993 campaign failed to realize the targeted increases in self-efficacy among the study population, but a significant campaign effect on intentions was found. The evaluation of all three campaigns indicated that the Dutch underestimate their personal fat intake and this has been identified as an important barrier to a further reduction in fat consumption. Making subjects aware of their personal fat consumption will be given priority in future campaigns.

Objective: To assess the prevalence of low and marginal iodine intake and urinary iodine excretion among adults in the Netherlands and to investigate determinants of urinary iodine excretion., Design and Subjects: The study population consisted of 444 people aged 20-79 y, balanced for sex and 10 y age classes with an over-representation of people with a low habitual intake of vitamin B6. Food consumption was measured by three day food records and 24 h urine was sampled twice., Results and Conclusions: On average, iodine intake (mean of three days) in men was in the recommended range of 150-300 microg/d, but average intake in women was not. Mean 24 h urinary excretion values confirmed this observation. Estimation of the prevalence of low iodine excretion depended on the parameter chosen (absolute per 24 h, per kg body weight per 24 h, as concentration or per creatinin). The prevalence of low iodine supply, based on intake <100 microg/d (mean of three days) and intake or excretion parameters per creatinin excretion or per kg body weight, varied from 4-14% among adult women and from 5-17% among adult men. The prevalence of marginal iodine intake (<50 microg/d) and excretion was less than 5% in all adult age-sex groups. Urinary iodine excretion was most strongly associated with intake of iodine as such or as bread in combination with urinary excretion of sodium or potassium, confirming the importance of iodized salt (in bread) for iodine status. Age and total energy intake had a relatively minor impact on urinary iodine excretion.

Objective: To assess the adequacy of micronutrient status among the adult population, with special reference to vitamin B6 status., Design and Subjects: Micronutrient status was assessed among a random sample of the adult Dutch population (reference group, n = 300), aged 20-79 y, stratified for age and gender, and among a group with a low vitamin B6 intake (n = 144)., Results: Low vitamin B6 groups had lower mean levels of erythrocyte and plasma pyridoxal (PL) and pyridoxal-5'-phosphate (PLP), urinary excretion of 4-pyridoxic acid, basal and stimulated erythrocyte aspartate aminotransferase (EAST) and erythrocyte alanine aminotransferase (EALT) activities and EAST stimulation coefficients but not of EALT stimulation coefficients, handgripstrength and 24 h homocysteine excretion before and after a methionin load test. Besides, plasma levels of vitamin C, B12 and folate were lower among low B6 than among reference groups indicating a combined low vitamin status. Direct biomarkers of vitamin B6 intake (plasma PLP and 4-pyridoxic acid excretion) were significantly related to more functional parameters (EAST, EALT and alpha-EAST). Among random reference groups the prevalence of plasma PLP values below 19 nmol/l was 3-7% for different age-gender groups, with the highest value of 16% among men aged 50-79 years. The prevalence of high values of erythrocyte glutathion reductase stimulation coefficient (alpha-EGR) and low levels of serum vitamin B12 and C was not more than 5% among different age-gender reference groups., Conclusions: Direct biomarkers of vitamin B6 intake confirmed the preselection of a group with a low vitamin B6 intake. The results suggest that the sensitivity of vitamin B6 status parameters for low vitamin B6 intake was highest for the direct vitamin B6 status parameters and lowest for handgripstrength and homocysteine excretion after a methionin load; results for enzyme stimulation coefficients were intermediate. The prevalence of below adequate status parameters for vitamin B2, B6, B12 and C was not more than 7% among the different age-gender groups, with the exception of a value of 16% for plasma PLP levels below 19 nmol/l among men aged 50-79.

Objective: To assess the adequacy of the iodine supply in the Netherlands and to study possible ways of increasing the iodine intake. DESIGN, SETTINGS AND SUBJECTS: Goitre and nutrition surveillance studies (intake and urinary excretion of iodine) among population groups (age: 12-85 y, n=57-1704) in the Netherlands in the period 1981-1993. Simulation studies, based on the Dutch Nutrition Food Consumption Surveys (n=6000), calculating iodine intake among population groups after fictively iodizing different food groups., Results: Mean intake of iodine, measured with different food consumption methods in the period 1984-1993, met the recommended amount of 150-300 microg per day in males, but not in females. Median urinary iodine excretion levels were in the range for mild Iodine Deficiency Disorders in both sexes. According to dietary methods reflecting habitual intake and urinary iodine excretion per kg body weight or per mmol creatinin the prevalence of low iodine supply among adults is between 4 and 20% for women and between 5 and 15% for men. Iodization of different products would increase mean iodine intakes by up to 45% and would give a reduction of roughly 65% in the prevalence of low iodine intakes., Conclusion: The present goitre prophylaxis in the Netherlands is not optimally effective. The iodine supply is below cut-off points in 4-20% of the adult population. It is possible to decrease the prevalence of low iodine intakes without a clear risk of exceeding the maximum acceptable daily iodine intake by increasing the iodine content of baker's salt and/or by adding iodine to other foods.

In 1992, a community-based 'Fat Watch' campaign was held in the city of Alkmaar in the Netherlands. The campaign was implemented within the framework of the nationwide mass-mediated 'Fat Watch' campaign (1991-1994), which aimed at a 10% reduction in fat intake among the general Dutch population. The intervention was carried out as a pilot project to study the effectiveness of strategies and activities, and to apply them subsequently in more cities. The campaign aimed primarily at the active involvement of intermediaries. Effects of the campaign were studied by telephone questionnaires among about 500 respondents, before and after the campaign in both the experimental and a control community. The questionnaire was based on the 'attitude, social influence, self-efficacy' (ASE) model. The results showed that 56% of the respondents were aware of a campaign in their community and that the campaign was positively evaluated by those familiar with it. After the campaign, self-rated fat consumption was significantly higher. No differences between the experimental and control community were found regarding attitude, social influence or self-efficacy expectations towards a reduction in fat consumption or intention to buy low-fat food products. However, as opposed to the control community, there was a significant decrease in actual fat consumption between pre- and post-test in Alkmaar. Furthermore, after the campaign, significantly more respondents in the experimental community intended to eat lower-fat food products and reported a behavioral change in the last six months. It was concluded that the campaign was quite successful as far as campaign awareness was concerned, but that it did not result in substantial change of behavior. The limited decrease in fat consumption observed should be interpreted with care.

Vitamin B6 is considered to be a risk nutrient for elderly people. Conversion of most naturally available vitamin B6 to its functional coenzyme pyridoxal 5'-phosphate (PLP) depends on riboflavin. Therefore, interrelations were studied between riboflavin and vitamin B6 among 473 elderly people not using supplements containing B-vitamins. Habitual food consumption (assessed through dietary history with cross-check), plasma PLP levels and enzyme activities of erythrocyte glutathione reductase (EGR) and erythrocyte aspartate aminotransferase (EAST), with and without added flavin adenine dinucleotide and PLP, respectively, were determined. The results showed that unstimulated and stimulated EAST activity was higher when EGR activity (both simulated and unstimulated) was higher. Plasma PLP was positively associated with (un)stimulated EGR activities, but these correlations were not significant, probably due to the lower number of observations. Adjusted for the intake of vitamin B6 similar observations were made for the forementioned interactions between the biochemical indicators. To identify the strongest correlates of the vitamin B6 status indicators, stepwise regression analysis was carried out. The results showed that in each model an indicator of the riboflavin status was included. Our findings suggest an interaction between the status of riboflavin and vitamin B6 at intake levels normally found among Dutch elderly people.

Magnesium (Mg) requirements depend on body weight. Recommended dietary allowances (RDA) are mostly given in absolute amounts and are mostly similar for adults, despite differences in body composition in the adult age range. We therefore studied the interrelations of 24 h urinary Mg excretion with body build and body composition indicators, as well as with factors potentially affecting the metabolism of Mg, among 520 elderly men and women seen in a nationwide survey. Mg intake data were also obtained in the Dutch Food Composition Survey amount 5898 subjects. The results showed lower mean Mg intake among elderly people (especially men) and positive associations of body weight and body height with urinary Mg excretion, but not when expressed per mmol of creatinine excreted. Mg excretion per mmol of creatinine was not associated with body weight, body height, body mass index or body fatness (women), suggesting that the amount of fat mass did not affect Mg excretion. Mg excretion was positively correlated with Mg intake, creatinine clearance, excretion of sodium, potassium and calcium, and coffee consumption, indicating interactions at the kidney level that may increase Mg losses. Elderly people using diuretics and/or anticholinergics and male diabetics had a higher mean Mg excretion per mmol of creatinine. The results show that, besides the Mg intake, several factors affect the urinary Mg excretion among elderly people. These factors were body build and body composition, dietary intake, drug use, kidney function, and diabetes. A quantification of the effects cannot be made yet, and controlled studies on those factors potentially affecting the requirement of Mg are needed.

In order to establish the effect of an increased dietary selenium supply on platelet glutathione peroxidase (EC 1.11.1.9.; GSH-Px) and platelet aggregation, six healthy subjects were supplemented with 200 micrograms Se as Se-rich bread for 6 weeks. Another six subjects received low-Se bread and served as controls. Platelet GSH-Px activity increased significantly in the supplementation group, whereas no effect could be observed on platelet aggregation. The results of this study do not support the hypothesis that an increased dietary Se intake has a favourable influence on platelet aggregation.

Changes in dietary intake, nutritional status, body composition and well-being were studied in 108 cancer patients over a period of 20 weeks. The patients, constituting a group of elderly women with uterine cancer, a group of elderly men with urological cancer and a group of male and female patients of various ages with malignant lymphoma, were prospectively followed during and after aggressive treatment given with curative intent. Detailed information on the dietary intake was measured by a dietary history and cross-check method covering the 2 months prior to the onset of therapy and a 48-hr dietary record which was applied seven times during the observation period. The nutritional status was monitored by anthropometric measurements and laboratory assays in blood and urine. The patient's well-being was assessed by the use of standard performance scales by the observers and the application of patient's questionnaires concerning complaints, ability to self-care, mobility and daily activities. The main results are described here, indicating that: (1) most patients studied had a more than adequate diet during the 2 months preceding cancer therapy when compared to the Dutch Recommended Dietary Allowances; (2) the impact on dietary intake and nutritional status was relatively minor and generally transient; and (3) the treatment course was accompanied by distinct changes of well-being associated with, but not necessarily resulting from or leading to, changes of dietary intake.