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ABSTRACT BACKGROUND/OBJECTIVES Many diet quality scores exist, but fully food-based scores based on contemporary evidence are scarce. Our aim was to develop a food-based diet score based on

international literature and examine its discriminative capacity and socio-demographic determinants. SUBJECTS/METHODS Between 2006 and 2013, dietary intake of 129,369 participants of the

Lifelines Cohort (42% male, 45 ± 13 years (range 18–93)) was assessed with a 110-item food frequency questionnaire. Based on the 2015 Dutch Dietary Guidelines and underlying literature, nine

food groups with positive (vegetables, fruit, whole grain products, legumes&nuts, fish, oils&soft margarines, unsweetened dairy, coffee and tea) and three food groups with negative

health effects (red&processed meat, butter&hard margarines and sugar-sweetened beverages) were identified. Per food group, the intake in grams per 1000 kcal was categorized into

quintiles, awarded 0 to 4 points (negative groups scored inversely) and summed. Food groups with neutral, unknown or inconclusive evidence are described but not included. RESULTS The

Lifelines Diet Score (LLDS) discriminated well between high and low consumers of included food groups. This is illustrated by e.g. a 2-fold higher vegetable intake in the highest, compared

to the lowest LLDS quintile. Differences were 5.5-fold for fruit, 3.5-fold for fish, 3-fold for dairy and 8-fold for sugar-sweetened beverages. The LLDS was higher in females and positively

associated with age and educational level. CONCLUSIONS The LLDS is based on the latest international evidence for diet-disease relations at the food group level and has high capacity to

discriminate people with widely different intakes. Together with the population-based quintile approach, this makes the LLDS a flexible, widely applicable tool for diet quality assessment.

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support SIMILAR CONTENT BEING VIEWED BY OTHERS DIET QUALITY AS ASSESSED BY HEALTHY EATING INDEX-2015 AMONG HUNGARIAN ROMA LIVING IN SETTLEMENTS OF NORTHEAST HUNGARY Article Open access 10

November 2022 VALIDATION OF FOOD COMPASS WITH A HEALTHY DIET, CARDIOMETABOLIC HEALTH, AND MORTALITY AMONG U.S. ADULTS, 1999–2018 Article Open access 22 November 2022 REPRODUCIBILITY AND

VALIDITY OF THE TORONTO-MODIFIED HARVARD FOOD FREQUENCY QUESTIONNAIRE IN A MULTI-ETHNIC SAMPLE OF YOUNG ADULTS Article 13 September 2022 CHANGE HISTORY * _ 24 JUNE 2019 An amendment to this

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Download references ACKNOWLEDGEMENTS The Lifelines Biobank initiative has been made possible by funds from FES (Fonds Economische Structuurversterking), SNN (Samenwerkingsverband Noord

Nederland), and REP (Ruimtelijk Economisch Programma). We acknowledge the services of the Lifelines Cohort Study, the contributing research centers delivering data to Lifelines, and all

study participants. FUNDING This study was partly funded by the Nutrition & Health initiative of the University of Groningen. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of

Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands Petra C. Vinke, Eva Corpeleijn & Daan Kromhout * Department of Nephrology,

University Medical Center Groningen, University of Groningen, Groningen, The Netherlands Louise H. Dekker & Gerjan Navis * Division of Epidemiology and Community Health, School of Public

Health, University of Minnesota, Minneapolis, MN, USA David R. Jacobs Jr Authors * Petra C. Vinke View author publications You can also search for this author inPubMed Google Scholar * Eva

Corpeleijn View author publications You can also search for this author inPubMed Google Scholar * Louise H. Dekker View author publications You can also search for this author inPubMed 

Google Scholar * David R. Jacobs Jr View author publications You can also search for this author inPubMed Google Scholar * Gerjan Navis View author publications You can also search for this

author inPubMed Google Scholar * Daan Kromhout View author publications You can also search for this author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to Petra C. Vinke.

ETHICS DECLARATIONS CONFLICT OF INTEREST The authors declare that they have no conflict of interest. ELECTRONIC SUPPLEMENTARY MATERIAL CLASSIFICATION OF FOOD ITEMS IN THE 22 ESTABLISHED FOOD

GROUPS FOOD GROUPS AND KNOWN ASSOCIATIONS WITH CHRONIC DISEASES AND CAUSAL RISK FACTORS RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Vinke, P.C.,

Corpeleijn, E., Dekker, L.H. _et al._ Development of the food-based Lifelines Diet Score (LLDS) and its application in 129,369 Lifelines participants. _Eur J Clin Nutr_ 72, 1111–1119 (2018).

https://doi.org/10.1038/s41430-018-0205-z Download citation * Received: 02 February 2018 * Revised: 20 April 2018 * Accepted: 07 May 2018 * Published: 12 June 2018 * Issue Date: August 2018

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