Staff Publications

Staff Publications

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    'Staff publications' is the digital repository of Wageningen University & Research

    'Staff publications' contains references to publications authored by Wageningen University staff from 1976 onward.

    Publications authored by the staff of the Research Institutes are available from 1995 onwards.

    Full text documents are added when available. The database is updated daily and currently holds about 240,000 items, of which 72,000 in open access.

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    A national FFQ for the Netherlands (the FFQ-NL1.0): development and compatibility with existing Dutch FFQs
    Eussen, Simone ; Dongen, M.C.J.M. van; Wijckmans, N.E. ; Meijboom, S. ; Brants, H.A.M. ; Vries, J.H.M. de; Bueno-de-Mesquita, H.B. ; Geelen, M.M.E.E. ; Sluik, D. ; Feskens, E.J.M. ; Ocke, M.C. ; Dagnelie, P.C. - \ 2018
    Public Health Nutrition 21 (2018)12. - ISSN 1368-9800 - p. 2221 - 2229.
    Objective In the Netherlands, various FFQs have been administered in large cohort studies, which hampers comparison and pooling of dietary data. The present study aimed to describe the development of a standardized Dutch FFQ, FFQ-NL1.0, and assess its compatibility with existing Dutch FFQs. Design Dutch FFQTOOLTM was used to develop the FFQ-NL1.0 by selecting food items with the largest contributions to total intake and explained variance in intake of energy and thirty-nine nutrients in adults aged 25–69 years from the Dutch National Food Consumption Survey (DNFCS) 2007–2010. Compatibility with the Maastricht-FFQ, Wageningen-FFQ and EPICNL-FFQ was assessed by comparing the number of food items, the covered energy and nutrient intake, and the covered variance in intake. Results FFQ-NL1.0 comprised 160 food items, v. 253, 183 and 154 food items for the Maastricht-FFQ, Wageningen-FFQ and EPICNL-FFQ, respectively. FFQ-NL1.0 covered ≥85 % of energy and all nutrients reported in the DNFCS. Covered variance in intake ranged from 57 to 99 % for energy and macronutrients, and from 45 to 93 % for micronutrients. Differences between FFQ-NL1.0 and the other FFQs in covered nutrient intake and covered variance in intake were <5 % for energy and all macronutrients. For micronutrients, differences between FFQ-NL and other FFQs in covered level of intake were <15 %, but differences in covered variance were much larger, the maximum difference being 36 %. Conclusions The FFQ-NL1.0 was compatible with other FFQs regarding energy and macronutrient intake. However, compatibility for covered variance of intake was limited for some of the micronutrients. If implemented in existing cohorts, it is advised to administer the old and the new FFQ in combination to derive calibration factors.
    Reproducibility and relative validity of a food frequency questionnaire to estimate intake of dietary phylloquinone and menaquinones
    Zwakenberg, S.R. ; Engelen, A.I.P. ; Dalmeijer, G.W. ; Booth, S.L. ; Vermeer, C. ; Drijvers, J.J.M.M. ; Ocke, M.C. ; Feskens, E.J.M. ; Schouw, Y.T. van der; Beulens, J.W.J. - \ 2017
    European Journal of Clinical Nutrition 71 (2017). - ISSN 0954-3007 - p. 1423 - 1428.
    Background/Objectives: This study aims to investigate the reproducibility and relative validity of the Dutch food frequency questionnaire (FFQ), to estimate intake of dietary phylloquinone and menaquinones compared with 24-h dietary recalls (24HDRs) and plasma markers of vitamin K status.
    Subjects/Methods: In a cross-sectional study among 63 men and 58 women, the FFQ was completed three times over a 1-year period and the reproducibility was calculated over these measurements. Twelve-monthly 24HDR were collected to estimate relative validity. In addition, the relative validity of the FFQ, compared with plasma phylloquinone and desphospho-uncarboxylated matrix Gla protein (dpucMGP), was assessed cross-sectionally among 507 postmenopausal women.
    Results: Intraclass correlations showed a good reproducibility, with correlations ranging from 0.65 to 0.83. The relative validity for phylloquinone intake compared with 24HDR was lower for women (rs=0.28) than men (rs=0.40). The relative validity, compared with 24HDR, for intake of short-chain menaquinones were ranging between 0.30 and 0.34. Long-chain menaquinones showed good relative validity (rs=0.60–0.69). Plasma phylloquinone concentrations were weakly correlated with phylloquinone intake (rs=0.16 (0.07-0.24). Plasma dpucMGP was negatively but weakly correlated with phylloquinone intake (rs=−0.09 (−0.18; −0.01)) and long-chain menaquinones (rs=−0.13 (−0.21; −0.04)), but not with short-chain menaquinones (rs=−0.04 (−0.13; 0.05)).
    Conclusions: The FFQ is reproducible to rank subjects for phylloquinone and menaquinone intake.The relative validity of our FFQ, compared with 24HDR, to estimate intake of phylloquinone and short-chain menaquinones was low, but the relative validity for long-chain menaquinones was good. The relative validity of our FFQ, compared with plasma phylloquinone and dpucMGP, was relatively low for both phylloquinone and menaquinone intake.
    Reporting accuracy of population dietary sodium intake using duplicate 24 h dietary recalls and a salt questionnaire
    Keyzer, W. de; Dofkova, M. ; Lillegaard, I.T.L. ; Maeyer, M. de; Frost Andersen, L. ; Ruprich, J. ; Rehurkova, I. ; Geelen, Anouk ; Veer, P. van 't; Henauw, S. de; Crispim, S.P. ; Boer, Evelien de; Ocke, M.C. ; Slimani, N. ; Huybrechts, I. - \ 2015
    The British journal of nutrition 113 (2015). - ISSN 0007-1145 - p. 488 - 497.
    Diet surveys - Self-reports - Biological markers/urine - Dietary sodium - European Food Consumption Validation
    High dietary Na intake is associated with multiple health risks, making accurate assessment of population dietary Na intake critical. In the
    present study, reporting accuracy of dietary Na intake was evaluated by 24 h urinary Na excretion using the EPIC-Soft 24 h dietary recall
    (24-HDR). Participants from a subsample of the European Food Consumption Validation study (n 365; countries: Belgium, Norway and
    Czech Republic), aged 45–65 years, completed two 24 h urine collections and two 24-HDR. Reporting accuracy was calculated as the
    ratio of reported Na intake to that estimated from the urinary biomarker. A questionnaire on salt use was completed in order to assess
    the discretionary use of table and cooking salt. The reporting accuracy of dietary Na intake was assessed using two scenarios: (1) a salt
    adjustment procedure using data from the salt questionnaire; (2) without salt adjustment. Overall, reporting accuracy improved when
    data from the salt questionnaire were included. The mean reporting accuracy was 0·67 (95% CI 0·62, 0·72), 0·73 (95% CI 0·68, 0·79)
    and 0·79 (95% CI 0·74, 0·85) for Belgium, Norway and Czech Republic, respectively. Reporting accuracy decreased with increasing BMI among male subjects in all the three countries. For women from Belgium and Norway, reporting accuracy was highest among those classified as obese (BMI $30 kg/m2: 0·73, 95% CI 0·67, 0·81 and 0·81, 95% CI 0·77, 0·86, respectively). The findings from the present study showed considerable underestimation of dietary Na intake assessed using two 24-HDR. The questionnaire-based salt adjustment procedure improved reporting accuracy by 7–13%. Further development of both the questionnaire and EPIC-Soft databases (e.g. inclusion of a facet to describe salt content) is necessary to estimate population dietary Na intakes accurately.
    Monitoring salt and iodine intakes in Dutch adults between 2006 and 2010 using 24 h urinary sodium and iodine excretions
    Hendriksen, M.A.H. ; Raaij, J.M.A. van; Geleijnse, J.M. ; Wilson-van den Hooven, E.C. ; Ocke, M.C. ; A, D.L. van der - \ 2014
    Public Health Nutrition 17 (2014)7. - ISSN 1368-9800 - p. 1431 - 1438.
    cardiovascular-disease - reduction - collections - deficiency - world
    Objective To monitor the effectiveness of salt-reduction initiatives in processed foods and changes in Dutch iodine policy on Na and iodine intakes in Dutch adults between 2006 and 2010. Design Two cross-sectional studies among adults, conducted in 2006 and 2010, using identical protocols. Participants collected single 24 h urine samples and completed two short questionnaires on food consumption and urine collection procedures. Daily intakes of salt, iodine, K and Na:K were estimated, based on the analysis of Na, K and iodine excreted in urine. Setting Doetinchem, the Netherlands. Subjects Men and women aged 19 to 70 years were recruited through random sampling of the Doetinchem population and among participants of the Doetinchem Cohort Study (2006: n 317, mean age 48·9 years, 43 % men; 2010: n 342, mean age 46·2 years, 45 % men). Results While median iodine intake was lower in 2010 (179 µg/d) compared with 2006 (257 µg/d; P <0·0001), no difference in median salt intake was observed (8·7 g/d in 2006 v. 8·5 g/d in 2010, P = 0·70). In 2006, median K intake was 2·6 g/d v. 2·8 g/d in 2010 (P <0·01). In this 4-year period, median Na:K improved from 2·4 in 2006 to 2·2 in 2010 (P <0·001). Conclusions Despite initiatives to lower salt in processed foods, dietary salt intake in this population remains well above the recommended intake of 6 g/d. Iodine intake is still adequate, although a decline was observed between 2006 and 2010. This reduction is probably due to changes in iodine policy.
    Bias in protein and potassium intake collected with 24-h recalls (EPIC-Soft) is rather comparable across European populations
    Crispim, S.P. ; Geelen, A. ; Freisling, H. ; Souverein, O.W. ; Hulshof, P.J.M. ; Ocke, M.C. ; Boshuizen, H.C. ; Andersen, L.F. ; Ruprich, J. ; Keizer, W. de; Huybrechts, I. ; Lafay, L. ; DeMagistris, M.S. ; Ricceri, F. ; Tumino, R. ; Krogh, V. ; Bueono-de-Mesquita, H.B. ; Beulens, J.W.J. ; Boutron-Ruault, M.C. ; Naska, A. ; Crowe, F.L. ; Boeing, H. ; McTaggart, A.R. ; Kaaks, R. ; Veer, P. van 't; Slimani, N. - \ 2012
    European Journal of Nutrition 51 (2012)8. - ISSN 1436-6207 - p. 997 - 1010.
    consumption validation efcoval - diet recall - urinary nitrogen - nutrition - cancer - calibration - telephone - countries - biomarker - centers
    Purpose: We investigated whether group-level bias of a 24-h recall estimate of protein and potassium intake, as compared to biomarkers, varied across European centers and whether this was influenced by characteristics of individuals or centers. Methods: The combined data from EFCOVAL and EPIC studies included 14 centers from 9 countries (n = 1,841). Dietary data were collected using a computerized 24-h recall (EPIC-Soft). Nitrogen and potassium in 24-h urine collections were used as reference method. Multilevel linear regression analysis was performed, including individual-level (e.g., BMI) and center-level (e.g., food pattern index) variables. Results: For protein intake, no between-center variation in bias was observed in men while it was 5.7% in women. For potassium intake, the between-center variation in bias was 8.9% in men and null in women. BMI was an important factor influencing the biases across centers (p <0.01 in all analyses). In addition, mode of administration (p = 0.06 in women) and day of the week (p = 0.03 in men and p = 0.06 in women) may have influenced the bias in protein intake across centers. After inclusion of these individual variables, between-center variation in bias in protein intake disappeared for women, whereas for potassium, it increased slightly in men (to 9.5%). Center-level variables did not influence the results. Conclusion: The results suggest that group-level bias in protein and potassium (for women) collected with 24-h recalls does not vary across centers and to a certain extent varies for potassium in men. BMI and study design aspects, rather than center-level characteristics, affected the biases across centers
    Rationale and methods of the European Food Consumption Validation (EFCOVAL) Project
    Boer, E.J. de; Slimani, N. ; Boeing, H. ; Feinberg, M. ; Leclerq, C. ; Trolle, E. ; Amiano, P. ; Andersen, L.F. ; Freisling, H. ; Geelen, A. ; Harttig, U. ; Huybrechts, I. ; Kaic-Rak, A. ; Lafay, L. ; Lillegaard, I.T.L. ; Ruprich, J. ; Vries, J.H.M. de; Ocke, M.C. - \ 2011
    European Journal of Clinical Nutrition 65 (2011). - ISSN 0954-3007 - p. S1 - S4.
    epic-soft software - dietary exposure - calibration - centers
    Background/Objectives: The overall objective of the European Food Consumption Validation (EFCOVAL) Project was to further develop and validate a trans-European food consumption method to be used for the evaluation of the intake of foods, nutrients and potentially hazardous chemicals within the European population. Subjects/Methods: The EFCOVAL Project was carried out by 13 institutes from 11 European countries. The main activities were centered on the three main objectives of the project organized in different sub-projects. Results: In EFCOVAL, EPIC-Soft (the software developed to conduct 24-h dietary recalls (24-HDRs) in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study) was reprogrammed and adapted according to prioritized specifications, resulting in a software program working under the Windows operating system. In parallel of the EPIC-Soft development, the repeated 24-HDR method using EPIC-Soft and a food propensity questionnaire was evaluated against biomarkers in 24-h urine collections and in blood samples among adults from Belgium, the Czech Republic, (the South of) France, the Netherlands and Norway. As a result from an expert workshop on a proposed dietary assessment method for children (4–12 years), the suggested method was tested in a feasibility study in Denmark and Spain among children of 4–5, 7–8 and 12–13 years. To ensure that collected data had sufficient detail in food description for the assessment of additives and contaminants to foods the EPIC-Soft databases were adapted. Finally, the EFCOVAL Consortium developed a statistical tool (Multiple Source Method) for estimating the usual intake and distribution, which has been tested using real food consumption data and compared with three other statistical methods through a simulation study. In addition, a methodology was developed to quantify uncertainty due to portion-size estimation in usual intake distributions. Conclusion: The findings of EFCOVAL provide sufficient evidence to conclude that the repeated 24-HDR using EPIC-Soft for standardization in combination with a food propensity questionnaire and modeling of usual intake is a suitable method for pan-European surveillance of nutritional adequacy and food safety among healthy adults and maybe in children aged 7 years and older
    Biomarker-based evaluation of two 24-h recalls for comparing usual fish, fruit and vegetable intakes across European centers in the EFCOVAL Study
    Vries, J.H.M. de; Crispim, S.P. ; Souverein, O.W. ; Hulshof, P.J.M. ; Ruprich, J. ; Dofkova, M. ; Huybrechts, I. ; Keyzer, W. de; Lillegaard, I.T.L. ; Lafay, L. ; Rousseau, A.S. ; Ocke, M.C. ; Slimani, N. ; Veer, P. van 't - \ 2011
    European Journal of Clinical Nutrition 65 (2011). - ISSN 0954-3007 - p. S38 - S47.
    serum cholesteryl esters - life-style factors - n-3 fatty-acids - food-consumption - plasma carotenoids - alcohol-consumption - level correlations - adipose-tissue - lipid classes - dietary
    Background/Objectives: A standardized methodology is important to enable consistent monitoring of dietary intake across European countries. For this reason, we evaluated the comparability of the assessment of usual food intake collected with two non-consecutive computerized 24-h dietary recalls (24-HDRs) and a food propensity questionnaire (FPQ) among five European centers. Subjects/Methods: Two 24-HDRs using EPIC-Soft (the software developed to conduct 24-HDRs in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study) were performed to determine fish, fruit and vegetable (FV) consumed by 600 adults in Belgium (BE), the Czech Republic (CZ), France (FR), the Netherlands (NL) and Norway (NO) in a validation study. An FPQ was used to identify non-consumers. Information from the 24-HDRs and FPQ were used to estimate individual usual food intake by the Multiple Source Method (MSM). Blood samples were drawn to determine fatty acids in phospholipids and serum carotenoids as biomarkers of fish, and FV intake, respectively. Results: The pooled correlation between usual fish intake and eicosapentaenoic acid plus docosahexaenoic acid in phospholipids was 0.19 in men and 0.31 in women (P for heterogeneity >0.50) and center-specific correlations ranged between 0.08 (CZ) and 0.28 (BE and NO) in men, and between 0.19 (BE) and 0.55 (FR) in women. For usual FV intake, the pooled correlation with serum carotenoids was 0.31 in men and 0.40 in women (P for heterogeneity >0.10); the center-specific correlations varied between 0.07 (NO) and 0.52 (FR) in men, and between 0.25 (NL) and 0.45 (NO) in women. Conclusion: Two standardized 24-HDRs using EPIC-Soft and an FPQ appeared to be appropriate to rank individuals according to their fish and FV intake in a comparable way among five European centers.
    Colours of fruit and vegetables and 10-year incidence of CHD
    Oude Griep, L.M. ; Verschuren, W.M.M. ; Kromhout, D. ; Ocke, M.C. ; Geleijnse, J.M. - \ 2011
    The British journal of nutrition 106 (2011)10. - ISSN 0007-1145 - p. 1562 - 1569.
    coronary-heart-disease - food frequency questionnaire - los-angeles-atherosclerosis - cardiovascular-disease - relative validity - flavonoid intake - postmenopausal women - physicians health - alpha-carotene - vitamin-c
    The colours of the edible part of fruit and vegetables indicate the presence of specific micronutrients and phytochemicals. The extent to which fruit and vegetable colour groups contribute to CHD protection is unknown. We therefore examined the associations between fruit and vegetables of different colours and their subgroups and 10-year CHD incidence. We used data from a prospective population-based cohort including 20 069 men and women aged 20–65 years who were enrolled between 1993 and 1997. Participants were free of CVD at baseline and completed a validated 178-item FFQ. Hazard ratios (HR) for the association between green, orange/yellow, red/purple, white fruit and vegetables and their subgroups with CHD were calculated using multivariable Cox proportional hazards models. During 10 years of follow-up, 245 incident cases of CHD were documented. For each 25 g/d increase in the intake of the sum of all four colours of fruit and vegetables, a borderline significant association with incident CHD was found (HR 0·98; 95 % CI 0·97, 1·01). No clear associations were found for the colour groups separately. However, each 25 g/d increase in the intake of deep orange fruit and vegetables was inversely associated with CHD (HR 0·74; 95 % CI 0·55, 1·00). Carrots, their largest contributor (60 %), were associated with a 32 % lower risk of CHD (HR 0·68; 95 % CI 0·48, 0·98). In conclusion, though no clear associations were found for the four colour groups with CHD, a higher intake of deep orange fruit and vegetables and especially carrots may protect against CHD
    Inventory of experiences from national/regional dietary monitoring surveys using EPIC-Soft
    Huybrechts, I. ; Casagrande, C. ; Nicolas, G. ; Geelen, A. ; Crispim, S.P. ; Keyzer, W. de; Freisling, H. ; Henauw, S. de; Maeyer, M. de; Krems, C. ; Amiano, P. ; Boer, E.J. de; Ocke, M.C. ; Vries, J.H.M. de; Slimani, N. - \ 2011
    European Journal of Clinical Nutrition 65 (2011). - ISSN 0954-3007 - p. S16 - S28.
    recall - calibration - program - cancer
    Background/Objectives: The EPIC-Soft 24-h recall (the software developed to conduct 24-h dietary recalls (24-HDRs) in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study) has been used in several regional/national dietary monitoring surveys. The main objective of the study was to present and discuss design, settings, logistics, data management and quality controls of dietary monitoring surveys that used EPIC-Soft for the collection of food consumption data. Subjects/Methods: Within European Food Consumption Validation (EFCOVAL), a questionnaire including questions on current/past EPIC-Soft experiences and requirements for the future was developed and sent to all institutes that used EPIC-Soft in their food consumption survey(s) (five surveys in four different countries). Results: EPIC-Soft was used in the national food consumption survey in Belgium (greater than or equal to15–97 years), Germany (14–80 years), the Netherlands (19–30 years and 2–6 years) and Spain (regional only; 4–18 years). Participation rates in these surveys were 46% (Belgium), 42% (Germany), 42% (Dutch survey in adults), 79% (Dutch survey in children) and 77% (Basque survey). Two 24-HDRs were collected by conducting face-to-face interviews in Belgium and Spain, and through telephone interviews in Germany and the Netherlands. Except the Netherlands (19–30 years), where the study was conducted only in autumn, in all other countries the study was conducted throughout the four seasons, including all days of the week. Interviews were conducted by dietitians, except in Germany and Spain. Mean EPIC-Soft interview time was 20–34¿min. The dropout rate between the first and second interviews was low (
    Potential and requirements for a standarized pan-European food consumption survey using the EPIC-Soft software
    Ocke, M.C. ; Slimani, N. ; Brants, H.A.M. ; Buurma-Rethans, E. ; Casagrande, C. ; Nicolas, G. ; Dofkova, M. ; Donne, C. le; Freisling, H. ; Geelen, A. ; Huybrechts, I. ; Keyzer, W. de; Laan, J.D. van der; Lafay, L. ; Lillegaard, I.T.L. ; Niekerk, E.M. ; Vries, J.H.M. de; Wilson-van den Hooven, E.C. ; Boer, E.J. de - \ 2011
    European Journal of Clinical Nutrition 65 (2011). - ISSN 0954-3007 - p. S48 - S57.
    24-hour diet recall - plasma carotenoids - level correlations - nutrient intake - nutrition - cancer - recommendations - questionnaires - calibration - validation
    Background/Objectives: To describe the strengths, limitations and requirements of using EPIC-Soft software (the software developed to conduct 24-h dietary recalls in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study) in pan-European food consumption surveys, and to discuss potentials and barriers for a harmonized pan-European food consumption survey. Subjects/Methods: The paper is based on the experiences in the ‘European Food Consumption and Validation’ Project, which included updating six existing and preparing one new country-specific EPIC-Soft version, applying EPIC-Soft in validation and feasibility studies, and estimating the intake of nutrients and flavoring substances. The experiences were discussed in the September 2009 workshop ‘Pan-European Food Consumption Surveys—for Standardized and Comparable Transnational Data Collection’. Results: EPIC-Soft is suitable for detailed and standardized food consumption data collection in pan-European food consumption surveys. A thorough preparation of all aspects of the food consumption survey is important for the quality and efficiency during data collection and processing. The preparation and data-handling phase of working with EPIC-Soft is labor intensive and requires trained, motivated and qualified personnel. Conclusions: Given the suitability of EPIC-Soft as standardized dietary assessment tool in European dietary monitoring, the proposed strategy toward a pan-European food consumption survey is to prepare well, to allow flexibility in national extensions and to start with a limited number of countries that are interested
    The standardized computerized 24-h dietary recall method EPIC-Soft adapted for pan-European dietary monitoring
    Slimani, N. ; Casagrande, C. ; Nicolas, G. ; Freisling, H. ; Huybrechts, I. ; Ocke, M.C. ; Niekerk, E.M. ; Rossum, C. van; Bellemans, M. ; Maeyer, M. de; Lafay, L. ; Krems, C. ; Amiano, P. ; Trolle, E. ; Geelen, A. ; Vries, J.H.M. de; Boer, E.J. de - \ 2011
    European Journal of Clinical Nutrition 65 (2011)S1. - ISSN 0954-3007 - p. S5 - S15.
    nutrition - cancer - calibration - project - validation - rationale - countries - nitrogen - centers - program
    Background/Objectives: The EPIC-Soft program (the software initially developed to conduct 24-h dietary recalls (24-HDRs) in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study) was recommended as the best way to standardize 24-HDRs for future pan-European dietary monitoring. Within European Food Consumption Validation (EFCOVAL), EPIC-Soft was adapted and further developed on various aspects that were required to optimize its use. In this paper, we present the structure and main interview steps of the EPIC-Soft program, after implementation of a series of new specifications deemed to satisfy specific requirements of pan-European monitoring surveys and other international studies. Subjects/Methods: Updates to optimize the EPIC-Soft program were ascertained according to the following stepwise approach: (1) identification of requested specifications to be potentially implemented through an ad hoc ‘EPIC-Soft specifications questionnaire’ sent to past, current and possible future users of the software; (2) evaluation of the specifications in collaboration with two ad hoc task force groups and through a workshop; (3) development of a technical solution for each retained specification; (4) implementation of the specifications by software developers; (5) testing and amendment of bugs. Results: A number of new specifications and facilities were implemented to EPIC-Soft program. In addition, the software underwent a full reprogramming and migration to a modern Windows environment, including changes in its internal architecture and user interface. Although the overall concept and structure of the initial software were not changed substantially, these improvements ease the current and future use of EPIC-Soft and increase further its adaptation to other countries and study contexts. Conclusions: EPIC-Soft is enriched with further functions and facilities expected to fulfil specific needs of pan-European dietary monitoring and risk assessment purposes. The validity, feasibility and relevance of this software for different national and international study designs, and the logistical aspects related to its implementation are reported elsewhere.
    The European Food Consumption Validation Project: conclusions and recommendations
    Boer, E.J. de; Slimani, N. ; Veer, P. van 't; Boeing, H. ; Feinberg, M. ; Leclerq, C. ; Trolle, E. ; Amiano, P. ; Andersen, L.F. ; Freisling, H. ; Geelen, A. ; Harttig, U. ; Huybrechts, I. ; Kaic-Rak, A. ; Lafay, L. ; Lillegaard, I.T.L. ; Ruprich, J. ; Vries, J.H.M. de; Ocke, M.C. - \ 2011
    European Journal of Clinical Nutrition 65 (2011). - ISSN 0954-3007 - p. S102 - S107.
    epic-soft software - dietary exposure - calibration - databases - centers
    Background/Objectives: To outline and discuss the main results and conclusions of the European Food Consumption Validation (EFCOVAL) Project. Subjects/Methods: The EFCOVAL Project was carried out within the EU Sixth Framework Program by researchers in 11 EU countries. The activities focused on (1) the further development of the EPIC-Soft software (the software developed to conduct 24-h dietary recalls (24-HDRs) in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study) and the validation of the 2-day non-consecutive 24-HDR method using EPIC-Soft, (2) defining and investigating the applicability of the most appropriate dietary assessment method to younger age groups and expanding the applicability of the software for use in exposure assessment of some potentially hazardous chemicals and (3) to improve the methodology and statistical methods that estimate usual intake distributions from short-term dietary intake information and develop a methodology to quantify uncertainty in usual intake distributions. Results: The preexisting EPIC-Soft application was reprogrammed into a Windows environment and more than 60 new specifications were implemented in the software. A validation study showed that two non-consecutive EPIC-Soft 24-HDRs are suitable to estimate the usual intake distributions of protein and potassium of European adult populations. The 2-day non-consecutive 24-HDRs in combination with a food propensity questionnaire also appeared to be appropriate to rank individuals according to their fish and fruit and vegetable intake in a comparable way in five European centers. Dietary intake of (young) children can be assessed by the combination of EPIC-Soft 24-HDRs and food recording booklets. The EPIC-Soft-standardized method of describing foods is useful to estimate dietary exposure to potentially hazardous chemicals such as specific flavoring substances. With the developed Multiple Source Method, repeated non-consecutive 24-HDR data in combination with food propensity data can be used to estimate the population distribution of the usual intake by estimating the individual usual intakes.
    A three-part, mixed-effects model to estimate the habitual total vitamin D intake distribution from food and dietary supplements in Dutch young children
    Verkaik-Kloosterman, J. ; Dodd, K.W. ; Dekkers, A.L.M. ; Veer, P. van 't; Ocke, M.C. - \ 2011
    The Journal of Nutrition 141 (2011)1. - ISSN 0022-3166 - p. 2055 - 2063.
    multivitamin-multimineral supplements - consumption - nutrients - population - nutrition - frequency - exposure
    Statistical modeling of habitual micronutrient intake from food and dietary supplements using short-term measurements is hampered by heterogeneous variances and multimodality. Summing short-term intakes from food and dietary supplements prior to simple correction for within-person variation (first add then shrink) may produce estimates of habitual total micronutrient intake so badly biased as to be smaller than estimates of habitual intake from food sources only. A 3-part model using a first shrink then add approach is proposed to estimate the habitual micronutrient intake from food among nonsupplement users, food among supplement users, and supplements. The population distribution of habitual total micronutrient intake is estimated by combining these 3 habitual intake distributions, accounting for possible interdependence between Eq. 2 and 3. The new model is an extension of a model developed by the USA National Cancer Institute. Habitual total vitamin D intake among young children was estimated using the proposed model and data from the Dutch food consumption survey (n = 1279). The model always produced habitual total intakes similar to or higher than habitual intakes from food sources only and also preserved the multimodal shape of the observed total vitamin D intake distribution. This proposed method incorporates several sources of covariate information that should provide more precise estimates of the habitual total intake distribution and the proportion of the population with intakes below/above cutpoint values. The proposed methodology could be useful for other complex situations, e.g. where high concentrations of micronutrients appear in episodically consumed foods.
    Comparing four methods to estimate usual intake distributions
    Souverein, O.W. ; Dekkers, A.L. ; Geelen, A. ; Haubrock, J. ; Vries, J.H.M. de; Ocke, M.C. ; Harttig, U. ; Boeing, H. ; Veer, P. van 't - \ 2011
    European Journal of Clinical Nutrition 65 (2011). - ISSN 0954-3007 - p. S92 - S101.
    short-term measurements - episodically consumed foods - consumption - exposure - model - population - validation - nutrients - centers - recall
    Background/Objectives: The aim of this paper was to compare methods to estimate usual intake distributions of nutrients and foods. As ‘true’ usual intake distributions are not known in practice, the comparison was carried out through a simulation study, as well as empirically, by application to data from the European Food Consumption Validation (EFCOVAL) Study in which two 24-h dietary recalls (24-HDRs) and food frequency data were collected. The methods being compared were the Iowa State University Method (ISU), National Cancer Institute Method (NCI), Multiple Source Method (MSM) and Statistical Program for Age-adjusted Dietary Assessment (SPADE). Subjects/Methods: Simulation data were constructed with varying numbers of subjects (n), different values for the Box–Cox transformation parameter (¿BC) and different values for the ratio of the within- and between-person variance (rvar). All data were analyzed with the four different methods and the estimated usual mean intake and selected percentiles were obtained. Moreover, the 2-day within-person mean was estimated as an additional ‘method’. These five methods were compared in terms of the mean bias, which was calculated as the mean of the differences between the estimated value and the known true value. The application of data from the EFCOVAL Project included calculations of nutrients (that is, protein, potassium, protein density) and foods (that is, vegetables, fruit and fish). Results: Overall, the mean bias of the ISU, NCI, MSM and SPADE Methods was small. However, for all methods, the mean bias and the variation of the bias increased with smaller sample size, higher variance ratios and with more pronounced departures from normality. Serious mean bias (especially in the 95th percentile) was seen using the NCI Method when rvar=9, ¿BC=0 and n=1000. The ISU Method and MSM showed a somewhat higher s.d. of the bias compared with NCI and SPADE Methods, indicating a larger method uncertainty. Furthermore, whereas the ISU, NCI and SPADE Methods produced unimodal density functions by definition, MSM produced distributions with ‘peaks’, when sample size was small, because of the fact that the population's usual intake distribution was based on estimated individual usual intakes. The application to the EFCOVAL data showed that all estimates of the percentiles and mean were within 5% of each other for the three nutrients analyzed. For vegetables, fruit and fish, the differences were larger than that for nutrients, but overall the sample mean was estimated reasonably. Conclusions: The four methods that were compared seem to provide good estimates of the usual intake distribution of nutrients. Nevertheless, care needs to be taken when a nutrient has a high within-person variation or has a highly skewed distribution, and when the sample size is small. As the methods offer different features, practical reasons may exist to prefer one method over the other.
    Food photographs in nutritional surveillance: errors in portion size estimation using drawings of bread and photographs of margarine and beverages consumption
    Keyzer, W. de; Huybrechts, I. ; Maeyer, M. de; Ocke, M.C. ; Slimani, N. ; Veer, P. van 't; Henauw, S. de - \ 2011
    The British journal of nutrition 105 (2011)7. - ISSN 0007-1145 - p. 1073 - 1083.
    atlas - validity
    Food photographs are widely used as instruments to estimate portion sizes of consumed foods. Several food atlases are available, all developed to be used in a specific context and for a given study population. Frequently, food photographs are adopted for use in other studies with a different context or another study population. In the present study, errors in portion size estimation of bread, margarine on bread and beverages by two-dimensional models used in the context of a Belgian food consumption survey are investigated. A sample of 111 men and women (age 45–65 years) were invited for breakfast; two test groups were created. One group was asked to estimate portion sizes of consumed foods using photographs 1–2 d after consumption, and a second group was asked the same after 4 d. Also, real-time assessment of portion sizes using photographs was performed. At the group level, large overestimation of margarine, acceptable underestimation of bread and only small estimation errors for beverages were found. Women tended to have smaller estimation errors for bread and margarine compared with men, while the opposite was found for beverages. Surprisingly, no major difference in estimation error was found after 4 d compared with 1–2 d. Individual estimation errors were large for all foods. The results from the present study suggest that the use of food photographs for portion size estimation of bread and beverages is acceptable for use in nutrition surveys. For photographs of margarine on bread, further validation using smaller amounts corresponding to actual consumption is recommended.
    Raw and processed fruit and vegetable consumption and 10-year stroke incidence in a Dutch Population-Based Cohort Study
    Oude Griep, L.M. ; Geleijnse, J.M. ; Kromhout, D. ; Ocke, M.C. ; Verschuren, W.M.M. - \ 2010
    In: Abstract book of the American Heart Association Joint 50th Cardiovascular Disease Epidemiology and Prevention and Nutrition, Physical Activity and Metabolism, 2-5 March 2010, San Francisco. - San Fransisco : - p. 141 - 141.
    Prospective cohort studies have shown that high fruit and vegetables is related to a lower risk of stroke. It is unknown whether processing affects this association. Objective To evaluate the associations of raw and processed fruit and vegetable consumption with 10-year stroke incidence and stroke subtypes in a population-based study in the Netherlands. Design Prospective population-based cohort study, including 20,069 men and women aged 20 to 65 years, enrolled between 1993-1997, free of cardiovascular diseases at baseline and followed for 10 years. Hazard ratios were calculated for 10-year stroke incidence and ischaemic and haemorrhagic stroke separately. Diet was assessed by using a validated 178 item food frequency questionnaire. Results During a mean follow-up time of 10.3 y, 233 incident cases of stroke were documented (139 ischaemic strokes, 45 haemorrhagic strokes and 49 other, unspecified strokes). After adjusting for potential confounders, the risk of total stroke incidence was 36% lower for subjects with a high intake of raw fruit and vegetables (>262 g/d; HR: 0.64; 95% CI: 0.43-0.95) compared to subjects with a low intake (150 vs 233 g/d vs
    Raw and processed fruit and vegetable consumption and risk of stroke incidence in a population-based cohort study in the Netherlands
    Oude Griep, L.M. ; Verschuren, W.M.M. ; Kromhout, D. ; Ocke, M.C. ; Geleijnse, J.M. - \ 2010
    In: EGEA 6th edition : Social and Health Benefits of Balanced Diet: The role of Fruit and Vegetables : Abstractbook. - Brussel : - p. 93 - 93.
    Prospective cohort studies have shown that high fruit and vegetables is related to a lower risk of stroke. It is unknown whether processing affects this association. Objective To evaluate the associations of raw and processed fruit and vegetable consumption with 10-year stroke incidence and stroke subtypes in a population-based study in the Netherlands. Design Prospective population-based cohort study, including 20,069 men and women aged 20 to 65 years, enrolled between 1993-1997, free of cardiovascular diseases at baseline and followed for 10 years. Hazard ratios were calculated for 10-year stroke incidence and ischaemic and haemorrhagic stroke separately. Diet was assessed by using a validated 178 item food frequency questionnaire. Results During a mean follow-up time of 10.3 y, 233 incident cases of stroke were documented (139 ischaemic strokes, 45 haemorrhagic strokes and 49 other, unspecified strokes). After adjusting for potential confounders, the risk of total stroke incidence was 36% lower for subjects with a high intake of raw fruit and vegetables (>262 g/d; HR: 0.64; 95% CI: 0.43-0.95) compared to subjects with a low intake (150 vs 233 g/d vs
    Reduction of salt: will iodine intake remain adequate in The Netherlands?
    Verkaik-Kloosterman, J. ; Veer, P. van 't; Ocke, M.C. - \ 2010
    The British journal of nutrition 104 (2010)11. - ISSN 0007-1145 - p. 1712 - 1718.
    blood-pressure
    Salt is the main vehicle for iodine fortification in The Netherlands. A reduction in salt intake may reduce the supply of iodine. Our aim was to quantify the effect of salt reduction on the habitual iodine intake of the Dutch population and the risk of inadequate iodine intake. We used data of the Dutch National Food Consumption Survey (1997–8) and an update of the food composition database to estimate habitual salt and iodine intake. To take into account uncertainty about the use of iodised salt (industrial and discretionary) and food supplements, a simulation model was used. Habitual iodine and salt intakes were simulated for scenarios of salt reduction and compared with no salt reduction. With 12, 25 and 50 % salt reduction in industrially processed foods, the iodine intake remained adequate for a large part of the Dutch population. For the extreme scenario of a 50 % reduction in both industrially and discretionary added salt, iodine intake might become inadequate for part of the Dutch population (up to 10 %). An increment of the proportion of industrially processed foods using iodised salt or a small increase in iodine salt content will solve this. Nevertheless, 8–35 % of 1- to 3-year-old children might have iodine intakes below the corresponding estimated average requirement (EAR), depending on the salt intake scenario. This points out the need to review the EAR value for this age group or to suggest the addition of iodine to industrially manufactured complementary foods
    Selecting informative food items for compiling food-frequency questionnaires: comparison of procedures
    Molag, M.L. ; Vries, J.H.M. de; Duif, N. ; Ocke, M.C. ; Dagnelie, P.C. ; Goldbohm, R.A. ; Veer, P. van 't - \ 2010
    The British journal of nutrition 104 (2010)3. - ISSN 0007-1145 - p. 446 - 456.
    validation - health - diet - consumption - validity
    The authors automated the selection of foods in a computer system that compiles and processes tailored FFQ. For the selection of food items, several methods are available. The aim of the present study was to compare food lists made by MOM2, which identifies food items with highest between-person variance in intake of the nutrients of interest without taking other items into account, with food lists made by forward regression. The name MOM2 refers to the variance, which is the second moment of the nutrient intake distribution. Food items were selected for the nutrients of interest from 2 d of recorded intake in 3524 adults aged 25–65 years. Food lists by 80 % MOM2 were compared to those by 80 % explained variance for regression on differences between the number and type of food items, and were evaluated on (1) the percentage of explained variance and (2) percentage contribution to population intake computed for the selected items on the food list. MOM2 selected the same food items for Ca, a few more for fat and vitamin C, and a few less for carbohydrates and dietary fibre than forward regression. Food lists by MOM2 based on 80 % of variance in intake covered 75–87 % of explained variance for different nutrients by regression and contributed 53–75 % to total population intake. Concluding, for developing food lists of FFQ, it appears sufficient to select food items based on the contribution to variance in nutrient intake without taking covariance into account
    Dietary exposure to flavouring substances: from screening methods to detailed assessments using food consumption data collected with EPIC-Soft software
    Crispim, S.P. ; Geelen, A. ; Donne, C. Le; Vries, J.H.M. de; Sette, S. ; Raffo, A. ; Siebelink, E. ; Ocke, M.C. ; Veer, P. van 't; Leclercq, C. - \ 2010
    Food Additives & Contaminants. Pt. A, Chemistry, Analysis, Control, Exposure & Risk Assessment 27 (2010)4. - ISSN 1944-0049 - p. 433 - 446.
    coumarin - licorice - health - hazard
    This study aimed to compare different methods of assessing dietary exposure to flavourings in the context of a stepwise approach. The dietary exposure to four flavourings - raspberry ketone, glycyrrhizinic acid, coumarin, and caffeine - was determined. When dietary exposure exceeded the safety limits, the need for more detailed assessment using less aggregated data was judged necessary. First, screening methods - maximized survey-derived daily intake (MSDI), single-portion exposure technique (SPET), and modified theoretical added maximum daily intake (mTAMDI) - were applied. Next, individual food consumption data were used for creating models with different levels of detail to identify the foods: a model based on food groups and models based on food items. These were collected from 121 Dutch adults using a standardized 2 24-h dietary recall (EPIC-Soft) in the European Food Consumption Validation (EFCOVAL) study. Three food item models were developed: without improvements of the flavouring descriptor built in the software; with improvements; and with use of non-specified flavour descriptors. Based on the results of at least one of the three screening methods, refined assessment was necessary for raspberry ketone, glycyrrhizinic acid, and caffeine. When applying the food group model, the need for refinement was indicated for the four flavourings. When applying the food item models, only glycyrrhizinic acid and caffeine presented dietary exposure above the safety limits. In the raspberry ketone case, dietary exposure increased when improvements in food description were considered. The use of non-specified flavour descriptors hardly changed the results. The collection of detailed food consumption data at the individual level is useful in the dietary exposure assessment of these flavourings
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