BACKGROUND: Cardiovascular disease (CVD) represents a leading cause of mortality worldwide, especially in the elderly. Lowering the number of CVD deaths requires preventive strategies targeted on the elderly. OBJECTIVE: The objective was to generate evidence on the association between WHO dietary recommendations and mortality from CVD, coronary artery disease (CAD), and stroke in the elderly aged ≥60 y. DESIGN: We analyzed data from 10 prospective cohort studies from Europe and the United States comprising a total sample of 281,874 men and women free from chronic diseases at baseline. Components of the Healthy Diet Indicator (HDI) included saturated fatty acids, polyunsaturated fatty acids, mono- and disaccharides, protein, cholesterol, dietary fiber, and fruit and vegetables. Cohort-specific HRs adjusted for sex, education, smoking, physical activity, and energy and alcohol intakes were pooled by using a random-effects model. RESULTS: During 3,322,768 person-years of follow-up, 12,492 people died of CVD. An increase of 10 HDI points (complete adherence to an additional WHO guideline) was, on average, not associated with CVD mortality (HR: 0.94; 95% CI: 0.86, 1.03), CAD mortality (HR: 0.99; 95% CI: 0.85, 1.14), or stroke mortality (HR: 0.95; 95% CI: 0.88, 1.03). However, after stratification of the data by geographic region, adherence to the HDI was associated with reduced CVD mortality in the southern European cohorts (HR: 0.87; 95% CI: 0.79, 0.96; I(2) = 0%) and in the US cohort (HR: 0.85; 95% CI: 0.83, 0.87; I(2) = not applicable). CONCLUSION: Overall, greater adherence to the WHO dietary guidelines was not significantly associated with CVD mortality, but the results varied across regions. Clear inverse associations were observed in elderly populations in southern Europe and the United States.

• MeSH
• adherence pacienta MeSH
• cholesterol dietní aplikace a dávkování   MeSH
• chronická nemoc MeSH
• dieta normy   MeSH
• dietní proteiny aplikace a dávkování   MeSH
• dietní sacharidy aplikace a dávkování   MeSH
• etnicita MeSH
• hodnocení stavu výživy MeSH
• kardiovaskulární nemoci mortalita   prevence a kontrola   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mastné kyseliny aplikace a dávkování   MeSH
• metaanalýza jako téma MeSH
• nenasycené mastné kyseliny MeSH
• ovoce MeSH
• potravní vláknina aplikace a dávkování   MeSH
• prospektivní studie MeSH
• senioři MeSH
• Světová zdravotnická organizace MeSH
• výživová politika * MeSH
• zelenina MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Geografické názvy
• Evropa MeSH
• Spojené státy americké MeSH

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.

• MeSH
• biologické markery moč   MeSH
• dietní záznamy * MeSH
• energetický příjem MeSH
• index tělesné hmotnosti MeSH
• lidé středního věku MeSH
• lidé MeSH
• průzkumy a dotazníky MeSH
• reprodukovatelnost výsledků MeSH
• rozpomínání * MeSH
• senioři MeSH
• sexuální faktory MeSH
• sodík dietní aplikace a dávkování   MeSH
• sodík moč   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Belgie MeSH
• Česká republika MeSH
• Norsko MeSH

OBJECTIVE: To evaluate the impact of different modes of administration (face-to-face v. telephone), recall days (first v. second), days of the week (weekday v. weekend) and interview days (1 d later v. 2 d later) on bias in protein and K intakes collected with 24 h dietary recalls (24-HDR). DESIGN: Two non-consecutive 24-HDR (collected with standardised EPIC-Soft software) were used to estimate protein and K intakes by a face-to-face interview at the research centres and a telephone interview, and included all days of the week. Two 24 h urine collections were used to determine biomarkers of protein and K intake. The bias in intake was defined as the ratio between the 24-HDR estimate and the biomarker. SETTING: Five centres in Belgium, Czech Republic, France, the Netherlands and Norway in the European Food Consumption Validation (EFCOVAL) study. SUBJECTS: About 120 adults (aged 45-65 years) per centre. RESULTS: The bias in protein intake in the Czech Republic and Norway was smaller for telephone than face-to-face interviews (P = 0·01). The second 24-HDR estimates of protein intake in France and K intake in Belgium had a larger bias than the first 24-HDR (P = 0·01 and 0·04, respectively). In the Czech Republic, protein intake estimated during weekends and K intake estimated during weekdays had a larger bias than during other days of the week (P = 0·01). In addition, K intake collected 2 d later in the Czech Republic was likely to be overestimated. CONCLUSIONS: The biases in protein and K intakes were comparable between modes of administration, recall days, days of the week and interview days in some, but not all, study centres.

• MeSH
• dieta - přehledy * MeSH
• dieta MeSH
• dietní proteiny aplikace a dávkování   MeSH
• dietní záznamy MeSH
• draslík dietní aplikace a dávkování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• reprodukovatelnost výsledků MeSH
• rozpomínání * MeSH
• senioři MeSH
• software MeSH
• telefon MeSH
• zkreslení výsledků (epidemiologie) MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Belgie MeSH
• Česká republika MeSH
• Francie MeSH
• Nizozemsko MeSH
• Norsko MeSH

The use of two non-consecutive 24 h recalls using EPIC-Soft for standardised dietary monitoring in European countries has previously been proposed in the European Food Consumption Survey Method consortium. Whether this methodology is sufficiently valid to assess nutrient intake in a comparable way, among populations with different food patterns in Europe, is the subject of study in the European Food Consumption Validation consortium. The objective of the study was to compare the validity of usual protein and K intake estimated from two non-consecutive standardised 24 h recalls using EPIC-Soft between five selected centres in Europe. A total of 600 adults, aged 45-65 years, were recruited in Belgium, the Czech Republic, France, The Netherlands and Norway. From each participant, two 24 h recalls and two 24 h urines were collected. The mean and distribution of usual protein and K intake, as well as the ranking of intake, were compared with protein and K excretions within and between centres. Underestimation of protein (range 2-13%) and K (range 4-17%) intake was seen in all centres, except in the Czech Republic. We found a fair agreement between prevalences estimated based on the intake and excretion data at the lower end of the usual intake distribution (< 10% difference), but larger differences at other points. Protein and K intake was moderately correlated with excretion within the centres (ranges = 0·39-0·67 and 0·37-0·69, respectively). These were comparable across centres. In conclusion, two standardised 24 h recalls (EPIC-Soft) appear to be sufficiently valid for assessing and comparing the mean and distribution of protein and K intake across five centres in Europe as well as for ranking individuals.

• MeSH
• dieta - přehledy metody   MeSH
• dietní proteiny aplikace a dávkování   moč   MeSH
• draslík dietní aplikace a dávkování   moč   MeSH
• lidé středního věku MeSH
• lidé MeSH
• reprodukovatelnost výsledků MeSH
• rozpomínání MeSH
• senioři MeSH
• software * MeSH
• zkreslení výsledků (epidemiologie) MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• validační studie MeSH
• Geografické názvy
• Belgie MeSH
• Česká republika MeSH
• Francie MeSH
• Nizozemsko MeSH
• Norsko MeSH