Skip to main content
SpringerLink
Log in

Healthy Food and Nutrient Index and All Cause Mortality

  • Nutritional Epidemiology
  • Published:
European Journal of Epidemiology Aims and scope Submit manuscript

Abstract

Objectives: To develop a Healthy Food and Nutrient Index (HFNI) and to relate this index to the all cause mortality observed in two Belgian communities. Design: Using the 10-years follow-up mortality data from the ‘Belgian Interuniversity Research on Nutrition and Health’ (BIRNH) study, the association of a Healthy Food and Nutrient Index (HFNI) and all cause mortality was investigated in 5,887 men and 5,306 women aged 25–74 years. The HFNI was developed on the basis of the national dietary guidelines. The higher the index the more the diet can be considered to conform to the recommendations. Results: After adjustment for classic all cause mortality risk factors, HFNI was related with mortality for men. A decrease in risk of death is noted from Quartile 1 to Quartile 4. Among the women, HFNI remains non-significant. The ability of the models (with and without HFNI) to discriminate the living and the dead was evaluated by constructing a receiver operating characteristic (ROC) curves. For all models, areas under the Roc curves were between 0.80 and 0.85 indicating that all models discriminate well alive subjects of deceased. However, comparison of the areas under the ROC curves of the models without HFNI with the ROC areas of the models with HFNI showed no improvement in our ability to discriminate between the living and the dead. Conclusion: Although it is not demonstrated in our study, we think that the overall approach offers an opportunity to improve our understanding of the role of diet in the risks of morbidity or mortality associated with the overall dietary pattern rather than some individual foods and nutrients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. M Kornitzer L. Bara InstitutionalAuthorName For the BIRNH study group (1989) ArticleTitleDifferences between North and South in coronary risk factors, food habits and mortality in Belgium Acta Cardiol 44 145–155 Occurrence Handle1:STN:280:BiaA3MbksVM%3D Occurrence Handle2750415

    CAS  PubMed  Google Scholar 

  2. S Henauw ParticleDe D Bacquer ParticleDe P Smet Particlede M Kornitzer G. Backer ParticleDe (1999) ArticleTitleTrends in coronary heart disease rates in two Belgian areas: Results from the MONICA Ghent-Charleroi study J Epidemiol Community Health 53 89–98 Occurrence Handle10396469

    PubMed  Google Scholar 

  3. Henauw Stefaan ParticleDe Bacquer Dirk ParticleDe Smet Patrick Particlede Kornitzer Marcel H. Hemingway (2000) ArticleTitleTrends and regional differences in coronary risk factors in two areas in Belgium: Final results from the MONICA Ghent-Charleroi study J Cardiovasc Risk 7 IssueID5 348–357

    Google Scholar 

  4. O Houte ParticleVan H. Kesteloot (1972) ArticleTitleAn epidemiological survey of risk factors for ischaemic heart disease in 42, 804 men Acta Cardiol 27 527–564 Occurrence Handle4539690

    PubMed  Google Scholar 

  5. M Vastesaeger L Lefebvre P Graulich W Page F. Vanderveiken (1974) ArticleTitleCholestérolémie, triglyceridemie et prévalence des cardiopathies ischémiques chez des postiers Belges volontaires d’expressions française et d’expression néerlandaise Acta Cardiol 29 441–454 Occurrence Handle1:STN:280:CSqC3crkvVc%3D Occurrence Handle4548792

    CAS  PubMed  Google Scholar 

  6. M Kornitzer G Backer ParticleDe M Dramaix C. Thilly (1979) ArticleTitleRegional differences in risk factor distributions, food habits and coronary heart disease mortality and morbidity in Belgium Int J Epid 8 23–31 Occurrence Handle1:STN:280:Bi%2BD38nmt1E%3D

    CAS  Google Scholar 

  7. R Doll R. Peto (1981) ArticleTitleThe causes of cancer J Natl Cancer Inst 66 1101–1308

    Google Scholar 

  8. GE. Fraser (1994) ArticleTitleDiet and coronary heart disease: Beyond dietary fats and low-, density- lipoprotein cholesterol Am J Clin Nutr 59 IssueID5 Suppl 1117S–1123S Occurrence Handle1:STN:280:ByuB38ngslc%3D Occurrence Handle8172111

    CAS  PubMed  Google Scholar 

  9. U. Ravnskov (1998) ArticleTitleThe questionable role of saturated and polyunsaturated fatty acids in cardiovascular disease J Clin Epidemiol 51 IssueID6 443–460 Occurrence Handle10.1016/S0895-4356(98)00018-3 Occurrence Handle1:STN:280:DyaK1c3psl2itA%3D%3D Occurrence Handle9635993

    Article  CAS  PubMed  Google Scholar 

  10. KL Esrey L Joseph SA. Grover (1996) ArticleTitleRelationship between dietary intake and coronary heart disease mortality: Lipid research clinics prevalence follow-up study J Clin Epidemiol 49 IssueID2 211–216 Occurrence Handle10.1016/0895-4356(95)00066-6 Occurrence Handle1:STN:280:BymC1c%2FjvVU%3D Occurrence Handle8606322

    Article  CAS  PubMed  Google Scholar 

  11. D Mozaffarian SK Kumanyika R Lemaître JL Olson GL Burke DS. Siscovick (2003) ArticleTitleCereal, fruit, and vegetable fiber intake and the risk of cardiovascular disease in elderly individuals JAMA 289 IssueID13 1659–1666 Occurrence Handle10.1001/jama.289.13.1659 Occurrence Handle12672734

    Article  PubMed  Google Scholar 

  12. S Liu I-M Lee U Ajani SR Cole JE Buring JE. Manson (2001) ArticleTitleIntake of vegetables rich in carotenoids and risk of coronary heart disease in men: The physicians’ health study Int J Epid 30 130–135 Occurrence Handle1:CAS:528:DC%2BD3MXlvVyktbc%3D

    CAS  Google Scholar 

  13. LH Kushi KA Meyer DR. Jacobs (1999) ArticleTitleCereals, vegetables, and chronic disease risk reduction: Evidence from epidemiological studies Am J Clin Nutr 70 IssueID3 451S–458S Occurrence Handle1:CAS:528:DyaK1MXmtVaju7g%3D Occurrence Handle10479217

    CAS  PubMed  Google Scholar 

  14. FB Hu WC. Willett (2002) ArticleTitleOptimal diets for prevention of coronary heart disease JAMA 288 IssueID20 2569–2578 Occurrence Handle10.1001/jama.288.20.2569 Occurrence Handle1:CAS:528:DC%2BD38XptFOgsr8%3D Occurrence Handle12444864

    Article  CAS  PubMed  Google Scholar 

  15. FB. Hu (2002) ArticleTitleDietary pattern analysis: A new direction in nutritional epidemiology Current Opinion in lipodology 13 3–19 Occurrence Handle1:CAS:528:DC%2BD38XitV2ms7k%3D

    CAS  Google Scholar 

  16. DR Jacobs LM. Steffen (2003) ArticleTitleNutrients, foods, and dietary patterns as exposures in research: A framework for food synergy Am. J. Clin. Nutr. 78 IssueID3 508S–513S Occurrence Handle1:CAS:528:DC%2BD3sXntFekt7g%3D Occurrence Handle12936941

    CAS  PubMed  Google Scholar 

  17. AK Kant G Block A Schatzkin RG Ziegler M. Nestle (1991) ArticleTitleDietary diversity in the US population, NHANES II, 1976–1980 J Am Diet Assoc 91 IssueID12 1526–1531 Occurrence Handle1:STN:280:By2D2s7ltVc%3D Occurrence Handle1960344

    CAS  PubMed  Google Scholar 

  18. AK. Kant (2000) ArticleTitleA prospective study of Diet Quality Index and mortality in women JAMA 283 IssueID16 2109–2115 Occurrence Handle10.1001/jama.283.16.2109 Occurrence Handle1:STN:280:DC%2BD3c3ltVWnsw%3D%3D Occurrence Handle10791502

    Article  CAS  PubMed  Google Scholar 

  19. AK. Kant (2004) ArticleTitleIndexes of overall diet quality J Am Diet Assoc 96 785–791

    Google Scholar 

  20. MJ Mc Cullough D Feskanich MJ Stampfer EL Giovannucci EB Rimm FB. Hu et al. (2002) ArticleTitleDiet quality and major chronic disease risk in men and women: Moving toward improved dietary guidance Am J Clin Nutr 76 IssueID6 1261–1271 Occurrence Handle1:CAS:528:DC%2BD38Xpt1emt7s%3D

    CAS  Google Scholar 

  21. KB Michels A. Wolk (2002) ArticleTitleA prospective study of variety of healthy foods and mortality in women Int J Epidemiol 31 847–854 Occurrence Handle10.1093/ije/31.4.847 Occurrence Handle12177033

    Article  PubMed  Google Scholar 

  22. M Osler B Heitman LU Gerdes LM Jorgensen M. Schroll (2001) ArticleTitleDietary patterns and mortality in Danish men and women: A prospective observational study Br J Nutr 85 219–225 Occurrence Handle1:CAS:528:DC%2BD3MXisVSkurw%3D Occurrence Handle11242490

    CAS  PubMed  Google Scholar 

  23. JD Seymour EE Calle EW Flagg RJ Coates ES Ford MJ. Thun (2003) ArticleTitleDiet Quality Index as a predictor of short term mortality in The American Cancer Society Cancer Prevention Study II Nutrition Cohort Am J Epidemiol 157 IssueID11 980–988 Occurrence Handle10.1093/aje/kwg077 Occurrence Handle12777361

    Article  PubMed  Google Scholar 

  24. ML Slattery KM Boucher BJ Caan JD Potter K-N. Ma (1998) ArticleTitleEating patterns and risk of colon cancer Am J Epidemiol 148 4–16 Occurrence Handle1:STN:280:DyaK1czis1Ggsg%3D%3D Occurrence Handle9663397

    CAS  PubMed  Google Scholar 

  25. MJ Stampfer FB Hu JE Manson EB Rimm WC. Willett (2000) ArticleTitlePrimary prevention of coronary heart disease in women through diet and lifestyle N Engl J Med 343 16–22 Occurrence Handle10.1056/NEJM200007063430103 Occurrence Handle1:STN:280:DC%2BD3czisVOmuw%3D%3D Occurrence Handle10882764

    Article  CAS  PubMed  Google Scholar 

  26. RE Patterson PS Haines BM. Popkin (1994) ArticleTitleDiet Quality Index: Capturing a multidimensional behavior J Am Diet Assoc 54 57–64

    Google Scholar 

  27. ET Kennedy J Ohls S Carlson K. Fleming (1995) ArticleTitleThe Healthy Eating Index: Design and applications J Am Diet Assoc 95 1103–1108 Occurrence Handle10.1016/S0002-8223(95)00300-2 Occurrence Handle1:STN:280:BymD3czmsFc%3D Occurrence Handle7560680

    Article  CAS  PubMed  Google Scholar 

  28. M McCullough D Feskanich EB. Rimm (2000) ArticleTitleAdherence to Dietary Guidelines for Americans and risk of major chronic disease in men Am J Clin Nutr 72 1223–1231 Occurrence Handle1:CAS:528:DC%2BD3cXnvF2nurY%3D Occurrence Handle11063453

    CAS  PubMed  Google Scholar 

  29. M McCullough D Feskanich M. Stampfer et al. (2000) ArticleTitleAdherence to Dietary Guidelines for Americans and risk of major chronic disease in women Am J Clin Nutr 72 1214–1222 Occurrence Handle1:CAS:528:DC%2BD3cXnvF2nurg%3D Occurrence Handle11063452

    CAS  PubMed  Google Scholar 

  30. P Huijbregts E Feskens L Räsänen F Fidanza A Nissinen A. Menotti et al. (1997) ArticleTitleDietary pattern and 20 year mortality in eldery men in Finland, Italy, and the Netherlands: Longitudinal cohort study BMJ 315 13–17 Occurrence Handle1:STN:280:ByiA2sjms1Y%3D Occurrence Handle9233319

    CAS  PubMed  Google Scholar 

  31. M Kornitzer M. Dramaix (1989) ArticleTitleThe Belgian Interuniversity Research on Nutrition and Health (BIRNH): General introduction Acta Cardiologica XLIV IssueID2 89–99

    Google Scholar 

  32. Voorlichtingsbureau voor de Voeding. Nederlandse voedingsmiddelentabel. druk 32. 1979. Nederlands’ Gravenhage.

  33. Paul AA, Southgate D. 1980. The Composition of Foods. 4th edn. MRC report, 297, London.

  34. Conseil National de la Nutrition Ministère des Affaires Sociales et de la Santé Publique et de l’Environnement. Recommandations nutritionnelles pour la Belgique. 2003.

  35. D Katz B. Foxman (1993) ArticleTitleHow well do prediction equations predict? Using receiver operating characteristic curves and accuracy curves to compare validity and generalizability Epidemiology 4 IssueID4 319–326 Occurrence Handle1:STN:280:ByyA2M%2FgsF0%3D Occurrence Handle8347742

    CAS  PubMed  Google Scholar 

  36. InstitutionalAuthorNameSPSS (1999) Statistical Package for the Social Sciences EditionNumber10 SPSS Chicago

    Google Scholar 

  37. WC Willett (1998) Nutritional Epidemiology EditionNumber2 Oxford University Press New York/Oxford

    Google Scholar 

  38. S Henauw ParticleDe P Smet Particlede W Aelvoet M Kornitzer G. Backer ParticleDe (1998) ArticleTitleMisclassification of coronary heart disease in mortality statistics. Evidence from WHO MONICA Ghent-Charleroi study in Belgium J Epidemiol Community Health 52 513–519 Occurrence Handle9876363

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dept. of Epidemiology & Health Promotion, School of Public Health, Université Libre de Bruxelles, 808 Route de Lennik, 1070, Bruxelles, Belgium

    Christine Bazelmans, Michel Dramaix, Marcel Kornitzer & Alain Levêque

  2. Department of Public Health, Ghent University, UZ-2 Blok A, De Pintelaan 185, B-9000, Gent, Belgium

    Stefaan De Henauw, Christof Matthys & Guy De Backer

Authors
  1. Christine Bazelmans
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stefaan De Henauw
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christof Matthys
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michel Dramaix
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marcel Kornitzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Guy De Backer
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Alain Levêque
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christine Bazelmans.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bazelmans, C., De Henauw, S., Matthys, C. et al. Healthy Food and Nutrient Index and All Cause Mortality. Eur J Epidemiol 21, 145–152 (2006). https://doi.org/10.1007/s10654-005-5699-8

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10654-005-5699-8

Keywords

Search

Navigation