Edith J M Feskens

Wageningen University, Wageningen, Gelderland, Netherlands

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Publications (474)2056.58 Total impact

  • Artery Research 12/2014; 8(4).
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    ABSTRACT: Background/Objectives:Diets high in saturated and trans fat and low in unsaturated fat may increase type 2 diabetes (T2D) risk, but studies on foods high in fat per unit weight are sparse. We assessed whether the intake of vegetable oil, butter, margarine, nuts and seeds and cakes and cookies is related to incident T2D.Subjects/Methods:A case-cohort study was conducted, nested within eight countries of the European Prospective Investigation into Cancer (EPIC), with 12 403 incident T2D cases and a subcohort of 16 835 people, identified from a cohort of 340 234 people. Diet was assessed at baseline (1991-1999) by country-specific questionnaires. Country-specific hazard ratios (HRs) across four categories of fatty foods (nonconsumers and tertiles among consumers) were combined with random-effects meta-analysis.Results:After adjustment not including body mass index (BMI), nonconsumers of butter, nuts and seeds and cakes and cookies were at higher T2D risk compared with the middle tertile of consumption. Among consumers, cakes and cookies were inversely related to T2D (HRs across increasing tertiles 1.14, 1.00 and 0.92, respectively; P-trend <0.0001). All these associations attenuated upon adjustment for BMI, except the higher risk of nonconsumers of cakes and cookies (HR 1.57). Higher consumption of margarine became positively associated after BMI adjustment (HRs across increasing consumption tertiles: 0.93, 1.00 and 1.12; P-trend 0.03). Within consumers, vegetable oil, butter and nuts and seeds were unrelated to T2D.Conclusions:Fatty foods were generally not associated with T2D, apart from weak positive association for margarine. The higher risk among nonconsumers of cakes and cookies needs further explanation.European Journal of Clinical Nutrition advance online publication, 26 November 2014; doi:10.1038/ejcn.2014.249.
    European journal of clinical nutrition. 11/2014;
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    ABSTRACT: The aims of this study were to investigate the association between smoking and incident type 2 diabetes, accounting for a large number of potential confounding factors, and to explore potential effect modifiers and intermediate factors.
    Diabetes care. 10/2014;
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    ABSTRACT: The World Health Organization (WHO) has formulated guidelines for a healthy diet to prevent chronic diseases and postpone death worldwide. Our objective was to investigate the association between the WHO guidelines, measured using the Healthy Diet Indicator (HDI), and all-cause mortality in elderly men and women from Europe and the United States. We analyzed data from 396,391 participants (42% women) in 11 prospective cohort studies who were 60 years of age or older at enrollment (in 1988-2005). HDI scores were based on 6 nutrients and 1 food group and ranged from 0 (least healthy diet) to 70 (healthiest diet). Adjusted cohort-specific hazard ratios were derived by using Cox proportional hazards regression and subsequently pooled using random-effects meta-analysis. During 4,497,957 person-years of follow-up, 84,978 deaths occurred. Median HDI scores ranged from 40 to 54 points across cohorts. For a 10-point increase in HDI score (representing adherence to an additional WHO guideline), the pooled adjusted hazard ratios were 0.90 (95% confidence interval (CI): 0.87, 0.93) for men and women combined, 0.89 (95% CI: 0.85, 0.92) for men, and 0.90 (95% CI: 0.85, 0.95) for women. These estimates translate to an increased life expectancy of 2 years at the age of 60 years. Greater adherence to the WHO guidelines is associated with greater longevity in elderly men and women in Europe and the United States.
    American journal of epidemiology. 10/2014;
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    ABSTRACT: Some studies suggest a favorable role of antioxidants on breast cancer risk but this is still inconclusive. The aim of this study was to assess whether overall dietary antioxidant capacity, as assessed by dietary ferric reducing antioxidant potential (FRAP), and individual dietary antioxidant intake were associated with breast cancer risk.Data was used from women participating in the Rotterdam Study, a prospective cohort study among subjects aged 55 years and older (N=3209). FRAP scores and antioxidant intake (i.e. vitamin A, C, E, selenium, flavonoids, and carotenoids) was assessed at baseline by a food frequency questionnaire. Incident cases of breast cancer were confirmed through medical reports.During a median follow-up of 17 years, 199 cases with breast cancer were identified. High dietary FRAP score was associated with a lower risk of breast cancer (HR: 0.68; 95% CI: 0.49, 0.96). No overall association between individual antioxidant intake and breast cancer risk was found. However, low intake of alpha carotene and beta carotene was associated with a higher risk of breast cancer among smokers (HR: 2.48; 95% CI: 1.21, 5.12 and HR: 2.31; 95% CI: 1.12, 4.76 for alpha and beta carotene respectively) and low intake of flavonoids was associated with breast cancer risk in women over the age of 70 (HR: 1.80; 95% CI: 1.09, 2.99). These results suggest that high overall dietary antioxidant capacity are associated with a lower risk of breast cancer. Individual effects of dietary carotenoids and dietary flavonoids may be restricted to subgroups such as smokers and elderly. © 2014 Wiley Periodicals, Inc.
    International Journal of Cancer 10/2014; · 6.20 Impact Factor
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    ABSTRACT: Several markers of iron metabolism have been associated with insulin resistance (IR) and type 2 diabetes mellitus in cross-sectional studies. However, prospective data on these associations are scarce, and it is currently unclear in which tissues iron metabolism may contribute to IR. Therefore, we investigated whether markers of iron metabolism were associated with IR in muscle, liver, and adipocytes, and with glucose intolerance over a 7-year follow-up period.
    Acta diabetologica. 10/2014;
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    ABSTRACT: several studies have been pointing towards a non-linear relationship between serum 25(OH)D and cardiovascular disease. Next to vitamin D deficiency, also higher levels of 25(OH)D have been reported to be associated with increased cardiovascular risk. We aimed to investigate the nature of the relationship between serum 25(OH)D and measures of arterial stiffness and arteriosclerosis in an elderly population.
    Age and Ageing 07/2014; · 3.82 Impact Factor
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    ABSTRACT: Background/Objectives:Unhealthy diet has been proposed as one of the main reasons for the high mortality in Central and Eastern Europe (CEE) and the former Soviet Union (FSU) but individual-level effects of dietary habits on health in the region are sparse. We examined the associations between the healthy diet indicator (HDI) and all-cause and cause-specific mortality in three CEE/FSU populations.Subjects/Methods:Dietary intakes of foods and nutrients, assessed by food frequency questionnaire in the Health, Alcohol and Psychosocial Factors in Eastern Europe (HAPIEE) cohort study, were used to construct the HDI, which follows the WHO 2003 dietary recommendations. Among 18 559 eligible adult participants (age range: 45-69 years) without a history of major chronic diseases at baseline, 1209 deaths occurred over a mean follow-up of 7 years. The association between HDI and mortality was estimated by Cox regression.Results:After adjusting for covariates, HDI was inversely and statistically significantly associated with cardiovascular disease (CVD) and coronary heart disease (CHD) mortality, but not with other cause-specific and all-cause mortality in the pooled sample. Hazard ratios per one standard deviation (s.d.) increase in HDI score were 0.95 (95% confidence interval=0.89-1.00, P=0.068), 0.90 (0.81-0.99, P=0.030) and 0.85 (0.74-0.97, P=0.018) for all-cause, CVD and CHD mortality, respectively. Population attributable risk fractions for low HDI were 2.9% for all-cause, 14.2% for CVD and 10.7% for CHD mortality.Conclusions:These findings support the hypothesis that unhealthy diet has had a role in the high CVD mortality in Eastern Europe.European Journal of Clinical Nutrition advance online publication, 16 July 2014; doi:10.1038/ejcn.2014.134.
    European journal of clinical nutrition. 07/2014;
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    ABSTRACT: Increasing protein intake and soy consumption appear to be promising approaches to prevent metabolic syndrome (MetS). However, the effect of soy consumption on insulin resistance, glucose homeostasis, and other characteristics of MetS is not frequently studied in humans. We aimed to investigate the effects of a 4-wk strictly controlled weight-maintaining moderate high-protein diet rich in soy on insulin sensitivity and other cardiometabolic risk factors. We performed a randomized crossover trial of 2 4-wk diet periods in 15 postmenopausal women with abdominal obesity to test diets with 22 energy percent (En%) protein, 27 En% fat, and 50 En% carbohydrate. One diet contained protein of mixed origin (mainly meat, dairy, and bread), and the other diet partly replaced meat with soy meat analogues and soy nuts containing 30 g/d soy protein. For our primary outcome, a frequently sampled intravenous glucose tolerance test (FSIGT) was performed at the end of both periods. Plasma total, LDL, and HDL cholesterol, triglycerides, glucose, insulin, and C-reactive protein were assessed, and blood pressure, arterial stiffness, and intrahepatic lipid content were measured at the start and end of both periods. Compared with the mixed-protein diet, the soy-protein diet resulted in greater insulin sensitivity [FSIGT: insulin sensitivity, 34 ± 29 vs. 22 ± 17 (mU/L)(-1) · min(-1), P = 0.048; disposition index, 4974 ± 2543 vs. 2899 ± 1878, P = 0.038; n = 11]. Total cholesterol was 4% lower after the soy-protein diet than after the mixed-protein diet (4.9 ± 0.7 vs. 5.1 ± 0.6 mmol/L, P = 0.001), and LDL cholesterol was 9% lower (2.9 ± 0.7 vs. 3.2 ± 0.6 mmol/L, P = 0.004; n = 15). Thus, partly replacing meat with soy in a moderate high-protein diet has clear advantages regarding insulin sensitivity and total and LDL cholesterol. Therefore, partly replacing meat products with soy products could be important in preventing MetS. This trial was registered at clinicaltrials.gov as NCT01694056.
    The Journal of nutrition. 07/2014;
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    ABSTRACT: To investigate the association between serum 25-hydroxyvitamin D concentrations (25(OH)D) and mortality in a large consortium of cohort studies paying particular attention to potential age, sex, season, and country differences.
    BMJ Clinical Research 06/2014; 348:g3656. · 14.09 Impact Factor
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    ABSTRACT: Pilot-testing of the adapted Study on Lifestyle intervention and Impaired glucose tolerance Maastricht (SLIM) and to determine its feasibility and likelihood of achieving desired impact.
    Patient Education and Counseling 06/2014; · 2.60 Impact Factor
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    ABSTRACT: Several studies support the general conclusion that plant-based diets have a lower environmental impact than animal-based diets. These studies, however, do not account for the nutritional quality of diets. The main objective of our study, therefore, was to explore if accounting for nutritional quality affects the comparison of the environmental impacts of human diets varying in their percentage of animal-source food products (ASFP). We also explored whether meals or daily diets are equally suitable to compare environmental impacts of diets. Fifty peer-reviewed studies were found that examined the environmental impact of diets, generally using life cycle assessment (LCA). Only 12 of these studies were reviewed, based on five criteria: study contains more than one scenario; diet scenarios vary in their percentage of ASFP; the weight of each food product was provided; the study assessed global warming potential and/or land use; diet scenarios are not designed for specific (health) groups. For each diet described in the reviewed studies, we quantified the daily intake of nine qualifying and three disqualifying nutrients. Global warming potential and land use, as provided by the reviewed studies, were expressed in four ways: per day, per daily protein intake capped to the recommended intake level of 57 g; per daily protein intake uncapped; and per NRD9.3 (i.e. a composite nutrient score of a diet). We concluded that the nutrient intake resulting from a meal cannot be used to assess the nutritional quality of a daily diet and, hence, the environmental impact of meals cannot be compared to that of daily diets. Studies on meals were therefore excluded from further analysis. Our results further show that daily diets that had higher percentages of ASFP were associated with higher (excess) intakes of total protein and lower values of NRD9.3. Diets that had higher percentages of ASFP were associated with higher GWPs and LU's per gram protein capped and per unit NRD9.3. Without capping protein to the recommended intake level, GWP and LU per gram of protein were generally lower for diets that had higher percentages of ASFP. Without capping, diets with higher percentages of ASFP are credited for overconsumption of protein. Since overconsumption of protein does not benefit health, we recommend capping to the recommended intake level. The effect of using NRD9.3 rather than day as functional unit was small for GWP. For LU we found no effect. When using NRD9.3 as functional unit, it must be considered that this functional unit requires more data than day or protein. Our analysis is based on a limited number of studies. Although initially a substantial number of studies were found, many of these were excluded because insufficient data were provided about diet composition, only one diet scenario was assessed, or because the studies assessed the environmental impact of meals rather than of diets. We found mainly Western-oriented diets, often designed by the researchers and not representative for actual consumption. For further research on the environmental impact of diets, we therefore recommend analysis on representative daily diets.
    Journal of Cleaner Production 06/2014; 73:88–99. · 3.59 Impact Factor
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    ABSTRACT: Hypertension has recently been identified as the leading risk factor for global mortality. This study aims to present the national prevalence of hypertension and prehypertension and, their determinants in Vietnamese adults.
    American journal of hypertension. 05/2014;
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    ABSTRACT: OBJECTIVE Immune dysregulation can affect insulin resistance (IR) and β-cell function and hence contribute to development of type 2 diabetes mellitus (T2DM). The complement system, as a regulator of immune and inflammatory homeostasis, may be a relevant contributor therein. However, longitudinal studies focusing on complement as a determinant of T2DM and IR are scarce. Therefore, we prospectively investigated the association of plasma complement factor 3 (C3) with (estimates of) IR in muscle, liver, and adipocytes, as well as with glucose tolerance, including incident T2DM.RESEARCH DESIGN AND METHODS Fasting C3, nonesterified fatty acids, glucose, and insulin (the latter two during oral glucose tolerance tests) were measured at baseline (n = 545) and after 7 years of follow-up (n = 394) in a prospective cohort study.RESULTSOver the 7-year period, C3 levels (per 0.1 g/L) were longitudinally associated with higher homeostasis model assessment of IR (HOMA2-IR; β = 15.2% [95% CI 12.9-17.6]), hepatic IR (β = 6.1% [95% CI 4.7-7.4]), adipocyte IR (β = 16.0% [95% CI 13.0-19.1]), fasting glucose (β = 1.8% [95% CI 1.2-2.4]), 2-h glucose (β = 5.2% [95% CI 3.7-6.7]), and area under the curve for glucose (β = 3.6% [95% CI 2.7-4.6]). In addition, greater changes in C3 (per 0.1 g/L) were associated with greater changes in HOMA2-IR (β = 0.08 [95% CI 0.02-0.15]) and greater changes in hepatic IR (β = 0.87 [95% CI 0.12-1.61]) over 7 years, but not glucose tolerance. Moreover, baseline C3 was associated with the 7-year incidence of T2DM (odds ratio 1.5 [95% CI 1.1-2.0]).CONCLUSIONS Changes in C3 were associated with changes in several measures of IR and may reflect progression of metabolic dysregulation, which eventually leads to abnormalities in glucose tolerance and T2DM.
    Diabetes care 04/2014; · 7.74 Impact Factor
  • International journal of cardiology 04/2014; · 6.18 Impact Factor
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    ABSTRACT: OBJECTIVE The long-term association between dietary protein and type 2 diabetes incidence is uncertain. We aimed to investigate the association between total, animal, and plant protein intake and the incidence of type 2 diabetes.RESEARCH DESIGN AND METHODS The prospective European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study consists of 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 individuals from eight European countries, with an average follow-up time of 12.0 years. Pooled country-specific hazard ratios (HRs) and 95% CI of prentice-weighted Cox regression analyses were used to estimate type 2 diabetes incidence according to protein intake.RESULTSAfter adjustment for important diabetes risk factors and dietary factors, the incidence of type 2 diabetes was higher in those with high intake of total protein (per 10 g: HR 1.06 [95% CI 1.02-1.09], Ptrend <0.001) and animal protein (per 10 g: 1.05 [1.02-1.08], Ptrend = 0.001). Effect modification by sex (P < 0.001) and BMI among women (P < 0.001) was observed. Compared with the overall analyses, associations were stronger in women, more specifically obese women with a BMI >30 kg/m(2) (per 10 g animal protein: 1.19 [1.09-1.32]), and nonsignificant in men. Plant protein intake was not associated with type 2 diabetes (per 10 g: 1.04 [0.93-1.16], Ptrend = 0.098).CONCLUSIONS High total and animal protein intake was associated with a modest elevated risk of type 2 diabetes in a large cohort of European adults. In view of the rapidly increasing prevalence of type 2 diabetes, limiting iso-energetic diets high in dietary proteins, particularly from animal sources, should be considered.
    Diabetes care 04/2014; · 7.74 Impact Factor
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    ABSTRACT: An increased intake of dietary fiber has been associated with reduced appetite and reduced energy intake. Research on the effects of seemingly identical classes of dietary fiber on appetite has, however, resulted in conflicting findings. The present study investigated the effects of different fiber properties, including methods of supplementation, on appetite and energy intake. This was a randomized crossover study with 29 subjects (21 ± 2y, BMI 21.9 ± 1.8 kg/m2) consuming dairy based liquid test products (1.5 MJ, 435 g) containing either: no pectin, bulking pectin (10 g), viscous pectin (10 g), or gelled pectin (10 g). The gelled pectin was also supplemented as capsules (10 g), and as liquid (10 g). Physicochemical properties of the test products were assessed. Appetite, glucose, insulin and gastric emptying were measured before ingestion and after fixed time intervals. Energy intake was measured after 3 hours. Preload viscosity was larger for gelled > viscous > bulking > no pectin, and was larger for gelled > liquid > capsules. Appetite reduced after gelled pectin compared to bulking (p < 0.0001), viscous (p = 0.005) and no pectin (p < 0.0001), without differences in subsequent energy intake (p = 0.32). Gastric emptying rate was delayed after gelled pectin (82 ± 18 min) compared to no pectin (70 ± 19 min, p = 0.015). Furthermore, gelled (p = 0.002) and viscous (p < 0.0001) pectin lowered insulin responses compared to no pectin, with minor reductions in glucose response. Regarding methods of supplementation, appetite reduced after the gelled test product compared to after capsules (p < 0.0001) and liquid (p < 0.0001). Energy intake was lower after capsules compared to liquid (-12.4%, p = 0.03). Different methods of supplementation resulted in distinct metabolic parameters. Results suggest that different physicochemical properties of pectin, including methods of supplementation, impact appetite and energy intake differently. Reduced appetite was probably mediated by preload physical properties, whereas inconsistent associations with metabolic parameters were found.
    Physiology & Behavior 04/2014; · 3.16 Impact Factor
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    ABSTRACT: Epidemiological studies have shown associations between vitamin D, mental health and glucose homeostasis in the elderly. Causal evidence, however, is still lacking. The objective of this study was to investigate the importance of vitamin D in the prevention of emotional disturbances and cognitive decline in aging C57BL/6 mice, with pre-diabetes type II as potential effect modifier. Mice were exposed to one of four diets from 10 months till 24 months of age: low fat vitamin D adequate (LFD), LF vitamin D deficient (LF), moderate fat vitamin D adequate (MFD), and MF vitamin D deficient (MF). The MFD/MF diet was applied to induce a condition resembling pre-diabetes type II. Behavior was assessed twice in the same group of mice at 6-8 and at 22-23 months of age using the Open Field Test (OFT), Elevated Plus Maze (EPM), Object Recognition Test (ORT) and the Morris Water Maze (MWM). We successfully induced vitamin D deficiency in the LF/MF mice. Moreover, fasting glucose and fasting insulin levels were significantly higher in MFD/MF mice than in LFD/LF mice. A significant aging effect was observed for most behavioral parameters. A MF(D) diet was shown to delay or prevent the age-related increase in emotional reactivity in the EPM. No effect of vitamin D or vitamin D*fat on behavioral outcomes was measured. Aging significantly affected emotional reactivity and cognitive performance. Although other studies have shown effects of vitamin D on emotional reactivity and cognitive performance in mice, these findings could not be confirmed in aged C57BL/6 mice in this study.
    Behavioural brain research 03/2014; · 3.22 Impact Factor
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    ABSTRACT: The value of measuring levels of glycated hemoglobin (HbA1c) for the prediction of first cardiovascular events is uncertain. To determine whether adding information on HbA1c values to conventional cardiovascular risk factors is associated with improvement in prediction of cardiovascular disease (CVD) risk. Analysis of individual-participant data available from 73 prospective studies involving 294,998 participants without a known history of diabetes mellitus or CVD at the baseline assessment. Measures of risk discrimination for CVD outcomes (eg, C-index) and reclassification (eg, net reclassification improvement) of participants across predicted 10-year risk categories of low (<5%), intermediate (5% to <7.5%), and high (≥7.5%) risk. During a median follow-up of 9.9 (interquartile range, 7.6-13.2) years, 20,840 incident fatal and nonfatal CVD outcomes (13,237 coronary heart disease and 7603 stroke outcomes) were recorded. In analyses adjusted for several conventional cardiovascular risk factors, there was an approximately J-shaped association between HbA1c values and CVD risk. The association between HbA1c values and CVD risk changed only slightly after adjustment for total cholesterol and triglyceride concentrations or estimated glomerular filtration rate, but this association attenuated somewhat after adjustment for concentrations of high-density lipoprotein cholesterol and C-reactive protein. The C-index for a CVD risk prediction model containing conventional cardiovascular risk factors alone was 0.7434 (95% CI, 0.7350 to 0.7517). The addition of information on HbA1c was associated with a C-index change of 0.0018 (0.0003 to 0.0033) and a net reclassification improvement of 0.42 (-0.63 to 1.48) for the categories of predicted 10-year CVD risk. The improvement provided by HbA1c assessment in prediction of CVD risk was equal to or better than estimated improvements for measurement of fasting, random, or postload plasma glucose levels. In a study of individuals without known CVD or diabetes, additional assessment of HbA1c values in the context of CVD risk assessment provided little incremental benefit for prediction of CVD risk.
    JAMA The Journal of the American Medical Association 03/2014; 311(12):1225-33. · 29.98 Impact Factor
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    ABSTRACT: Background/Objectives:The nutrient-rich food (NRF) index assesses nutrient quality of individual food items by ranking them according to their nutrient composition. The index reflects the nutrient density of the overall diet. We examined the associations between the NRF9.3 index-a score on the basis of nine beneficial nutrients (protein, fiber, vitamins and minerals) and three nutrients to limit (saturated fat, sugar and sodium)-incidence of cardiovascular disease (CVD) events and all-cause mortality.Subjects/Methods:A total of 4969 persons aged 55 and older from the Rotterdam Study, a prospective cohort study in the Netherlands, were studied. First, all foods were scored on the basis of their nutrient composition, resulting in an NRF9.3 score on food item level. Subsequently, they were converted into individual weighted scores on the basis of the amount of calories of each food item consumed by the subjects and the total energy intake. The hazard ratios (HRs) of the NRF9.3 index score were adjusted for age, gender, body mass index, smoking history, doctor-prescribed diet, alcohol consumption and education.Results:Food groups that contributed most to the NRF9.3 index score were vegetables, milk and milk products, fruit, bread and potatoes. A high NRF9.3 index score was inversely associated with all-cause mortality (HR Q4 versus Q1: 0.84 (95% confidence interval: 0.74, 0.96)). Associations were stronger in women than in men. The NRF9.3 index score was not associated with incidence of CVD.Conclusion:Elderly with a higher NRF9.3 index score, indicating more beneficial components and/or less limiting components, had a lower risk of all-cause mortality. Consuming a nutrient-dense diet may improve survival.European Journal of Clinical Nutrition advance online publication, 19 March 2014; doi:10.1038/ejcn.2014.35.
    European journal of clinical nutrition 03/2014; · 3.07 Impact Factor

Publication Stats

14k Citations
2,056.58 Total Impact Points

Institutions

  • 1996–2014
    • Wageningen University
      • Division of Human Nutrition
      Wageningen, Gelderland, Netherlands
    • University of Groningen
      • Department of Internal Medicine
      Groningen, Province of Groningen, Netherlands
  • 2013
    • Sokoine University of Agriculture (SUA)
      • Department of Food Science and Nutrition
      Murogoro, Morogoro Region, Tanzania
    • Medical Research Council (UK)
      Londinium, England, United Kingdom
    • Catharina Hospital
      Eindhoven, North Brabant, Netherlands
  • 2003–2013
    • Maastricht University
      • • Humane Biologie
      • • Interne Geneeskunde
      Maastricht, Provincie Limburg, Netherlands
  • 2012
    • University Medical Center Utrecht
      • Julius Center for Health Sciences and Primary Care
      Utrecht, Provincie Utrecht, Netherlands
  • 2003–2012
    • Leiden University Medical Centre
      • Department of Medical Statistics and Bioinformatics
      Leyden, South Holland, Netherlands
  • 1993–2012
    • National Institute for Public Health and the Environment (RIVM)
      • • Centre for Prevention and Health Services Research (PZO)
      • • Centre for Nutrition and Health
      Utrecht, Utrecht, Netherlands
  • 2009–2011
    • University of Cambridge
      • Department of Public Health and Primary Care
      Cambridge, England, United Kingdom
  • 2010
    • University of Oxford
      • Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU)
      Oxford, ENG, United Kingdom
  • 2001
    • Erasmus Universiteit Rotterdam
      • Department of Public Health (MGZ)
      Rotterdam, South Holland, Netherlands
  • 2000
    • University of Tampere
      • Department of Paediatrics
      Tampere, Western Finland, Finland
  • 1999
    • VU University Amsterdam
      • Institute for Cardiovascular Research VU
      Amsterdam, North Holland, Netherlands
  • 1997–1998
    • University of Glasgow
      • Human Nutrition Section
      Glasgow, SCT, United Kingdom
  • 1996–1998
    • Utrecht University
      Utrecht, Utrecht, Netherlands