title: Evaluation of dietary quality in relationship to nutritional and lifestyle factors in elderly people of the US Framingham Heart Study and the European SENECA study.
abstract: OBJECTIVE
  To evaluate dietary quality of European and American elderly subjects using different derivatives of dietary patterns (dietary scores and clusters) and to investigate the relationship of these approaches to nutritional and lifestyle factors.
  
  
  METHODS
  Data from the cross-sectional SENECA baseline study and Framingham Heart Study (original cohort and offspring) were used for data analysis. Food intake data were summarised into dietary clusters and into dietary scores (Healthy Diet Indicator and Mediterranean Diet Score). These measures of dietary quality were then tested for associations with lifestyle factors and measures of nutritional status.
  
  
  METHODS
  The study population, aged 70-77 y, consisted of 828 subjects from Framingham, MA (USA) and 1282 subjects from the following European centres: Hamme, Belgium; Roskilde, Denmark; Padua, Italy; Culemborg, The Netherlands; Vila Franca de Xira, Portugal; Betanzos, Spain; and Yverdon, Burgdorf and Bellinzona, Switzerland.
  
  
  RESULTS
  Dietary intake varied widely across the European and American research centres. In general, Southern European centres and Framingham had higher mean diet scores, indicating a higher dietary quality, than Northern European centres (MD-scores: 4.2-4.4 vs 2.7-3.5). Cluster analysis identified the following five dietary patterns characterised by: (1) sugar and sugar products; (2) fish and grain; (3) meat, eggs and fat; (4) milk and fruit; and (5) alcohol intake. The meat, eggs and fat pattern had significantly lower average dietary quality, as measured with all three diet scores than all other groups except the alcohol group. The fish and grain group had significantly better Mediterranean diet scores than all other groups.
  
  
  CONCLUSIONS
  Dietary scores and dietary clusters are complementary measures to classify dietary quality. The associations with nutritional and lifestyle factors indicate the adequate categorisation into dietary quality groups.
  
  
  BACKGROUND
  European Union, US Department of Agriculture, Agriculture Research Service, under agreement (58-1950-9-001), Haak Bastiaanse-Kuneman Foundation.
authors.affiliation: Division of Human Nutrition and Epidemiology, Wageningen University, Wageningen, The Netherlands. Annemien.Haveman@staff.nutepi.wau.nl
authors.forename: A
authors.initials: A
authors.lastname: Haveman-Nies
authors.forename: K L
authors.initials: KL
authors.lastname: Tucker
authors.forename: L C
authors.initials: LC
authors.lastname: de Groot
authors.forename: P W
authors.initials: PW
authors.lastname: Wilson
authors.forename: W A
authors.initials: WA
authors.lastname: van Staveren
mesh_terms: D000368:Aged; D016000:Cluster Analysis; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004032:Diet / Q000592:standards* / Q000706:statistics & numerical data; D004034:Diet Surveys; D005060:Europe; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D009752:Nutritional Status; D011795:Surveys and Questionnaires