Background In addition to recommendations about the consumption of specific foods and nutriens, a measure of overall diet quality is useful. Over the years, a number of countries, but not Canada, have developed indexes to evaluate diet quality. Data and methods The American Healthy Eating Index was adapted to conform to recommendations in Canada's Food Guide. Data from 33,664 respondents to the 2004 Canadian Community Health Survey-Nutrition were used. Usual index scores were calculated with the Software for Intake Distribution Estimation program. Multiple linear regression models were used to examine associations between index scores and various characteristics, particularly the frequency of vegetable and fruit consumption. Results For the population aged 2 or older, the average score on the Canadian adaptation of the Healthy Eating Index in 2004 was 58.8 out of a possible 100 points. Children aged 2 to 8 had the highest average scores (65 or more). Average scores tended to fall into early adolescence, stabiilizing around 55 at ages 14 to 30. A gradual upturn thereafter brought the average score to around 60 at age 71 or older. At all ages, women's scores exceeded those of men. The frequency of vegetable and fruit consumption was linked to index scores. Interpretation The American Healthy Eating Index can be adapted to Canadian food intake recommendations. Canadian Community Health Survey questions about the frequency of vegetable and fruit consumption can be used as an approximation of diet quality.

Diet quality in Canada.

Background: The purpose of this study was to analyze the prevalence of nutrient intake inadequacy in Europe, applying the Nordic Nutritional Recommendations in the context of the EU

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Projected prevalence of inadequate nutrient intakes in Europe.

Individual diet modeling translates nutrient recommendations into realistic and individual-specific food choices

Maternal Dietary Patterns and Birth Outcomes: A Systematic Review and Meta-Analysis

This review summarizes recent developments in nutrition and cardiovascular disease (CVD) prevention. Contemporary dietary guidance recommends healthy dietary patterns with emphasis on food-based recommendations because the totality of the diet (i.e., the combinations and quantities of foods and nutrients consumed) is an important determinant of health. In many guidelines, recommendations are still made for saturated fat, added sugar, sodium, and dietary cholesterol because these are over-consumed by many people and are related to chronic disease development. Epidemiological research illustrates the importance of considering the total diet and the interrelatedness of nutrients in a dietary pattern. Traditionally, epidemiological research focused on individual nutrients in isolation, which can result in erroneous conclusions. An example of this, which has led to substantial controversy, is the evidence from studies evaluating the association between saturated fat and CVD without considering the replacement nutrient. Another controversial topic is the relationship between dietary cholesterol and CVD, which is confounded by saturated fat intake. Finally, the totality of evidence shows that high sodium intake is associated with greater CVD risk; however, some epidemiological research has suggested that a low-sodium intake is detrimental, which has caused some controversy. Overall, this reductionist approach has led to a debate about recommendations for saturated fat, cholesterol, and sodium. However, if approaches that accounted for the interrelatedness of nutrients had been taken, it is likely that there would be less controversy about these nutrients. To encourage dietary pattern-based approaches and consideration of total intake, dietary guidelines should emphasize food-based recommendations that meet nutrient targets. Thus, nutrient targets should underpin food-based dietary guidelines, and recommended dietary patterns should comply with nutrient-based targets. The evidence reviewed shows that it is imperative to consider total dietary patterns for CVD prevention. Dietary guidance should be aligned with nutrient targets and recommendations should be food and dietary pattern based.

Nutrition and Cardiovascular Disease-an Update.

A food intake pattern specifying amounts and types of food was created for Canada's revised food guide, Eating Well with Canada's Food Guide (2007), using a two-step modeling process. In step one, food composites were manipulated to develop a food intake pattern. The second step used the step one food intake pattern to create 500 simulated diets for each of 16 age and gender groups. The resulting nutrient content distributions were evaluated relative to Dietary Reference Intake reference values. The modeling cycled between these two steps until a satisfactory pattern was achieved. The final pattern reflects modeling, a review of associations between foods and chronic disease, and input received during consultation.

Janice L. Johnston

Papers

Eating well with Canada's Food Guide (2007): development of the food intake pattern.