Diet Quality Assessment and the Relationship between Diet Quality and Cardiovascular Disease Risk

Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality in the U.S. and globally. Dietary risk factors contribute to over half of all CVD deaths and CVD-related disability. The aim of this narrative review is to describe methods used to assess diet quality and the current state of evidence on the relationship between diet quality and risk of CVD. The findings of the review will be discussed in the context of current population intake patterns and dietary recommendations. Several methods are used to calculate diet quality: (1) a priori indices based on dietary recommendations; (2) a priori indices based on foods or dietary patterns associated with risk of chronic disease; (3) exploratory data-driven methods. Substantial evidence from prospective cohort studies shows that higher diet quality, regardless of the a priori index used, is associated with a 14–29% lower risk of CVD and 0.5–2.2 years greater CVD-free survival time. Limited evidence is available from randomized controlled trials, although evidence shows healthy dietary patterns improve risk factors for CVD and lower CVD risk. Current dietary guidance for general health and CVD prevention and management focuses on following a healthy dietary pattern throughout the lifespan. High diet quality is a unifying component of all dietary recommendations and should be the focus of national food policies and health promotion.     

Fried Food Consumption and Cardiovascular Health: A Review of Current Evidence

Fried food consumption and its effects on cardiovascular disease are still subjects of debate. The objective of this review was to summarize current evidence on the association between fried food consumption and cardiovascular disease, diabetes, hypertension and obesity and to recommend directions for future research. We used PubMed, Google Scholar and Medline searches to retrieve pertinent publications. Most available data were based on questionnaires as a tool to capture fried food intakes, and study design was limited to case-control and cohort studies. While few studies have reported a positive association between frequencies of fried food intake and risk of coronary artery disease, heart failure, diabetes or hypertension, other investigators have failed to confirm such an association. There is strong evidence suggesting a higher risk of developing chronic disease when fried foods are consumed more frequently (i.e., four or more times per week). Major gaps in the current literature include a lack of detailed information on the type of oils used for frying foods, stratification of the different types of fried food, frying procedure (deep and pan frying), temperature and duration of frying, how often oils were reused and a lack of consideration of overall dietary patterns. Besides addressing these gaps, future research should also develop tools to better define fried food consumption at home versus away from home and to assess their effects on chronic diseases. In summary, the current review provides enough evidence to suggest adverse health effects with higher frequency of fried food consumption. While awaiting confirmation from future studies, it may be advisable to the public to consume fried foods in moderation while emphasizing an overall healthy diet.     

Longitudinal study of Consumer Price Index (CPI) trends in core and non-core foods in Australia

Objective: This study examined trends in the price of healthy and less‐healthy foods from 1989 to 2007 using the Australian Consumer Price Index (CPI). Methods: CPI food expenditure classes were classified as ‘core’ or ‘non‐core’. Trends in the CPI were analysed to examine the rise in prices of core compared with non‐core foods. Results: On average, the CPI for core foods has risen at a slightly higher, though not statistically significant, rate than non‐core foods. Furthermore, selected groupings reveal interesting patterns. ‘Bread’ has risen in price significantly more than ‘cakes and biscuits’, and ‘milk’ has risen in price significantly more than ‘soft drinks, waters and juices’. Conclusions and implications: This investigation of food price trends reveals notable differences between core and non‐core foods. This should be investigated further to determine the extent to which this contributes to the higher prevalence of diet‐related diseases in low socio‐economic groups.     

Association between Ultra-processed Food Consumption and Dietary Intake and Diet Quality in Korean Adults

BackgroundFood environments have changed rapidly, and the global interest in ultra-processed foods has increased. Ultra-processed foods are typically energy dense, high in sugars and fat, and low in fiber, protein, minerals, and vitamins.ObjectiveThis study aimed to estimate the energy contribution of ultra-processed foods in the diet of Korean adults and to examine the association between ultra-processed food consumption and dietary intake and diet quality.DesignThis study is a secondary analysis of cross-sectional data from the Korea National Health and Nutrition Examination Survey (2016–2018).Participants/settingsA total of 16,657 adults aged ≥19 years who completed a 1-day 24-hour recall.Main outcome measuresAbsolute and relative intake of energy and nutrients were measured and dietary quality was assessed using the Korean Healthy Eating Index (KHEI).Statistical analysisMultiple regression models adjusted for sociodemographic variables were used to examine the association between quintiles of ultra-processed foods dietary energy contribution and dietary intake and quality.ResultsMean reported daily energy intake was 2,031 kcal, with 25.1% of calories coming from ultra-processed foods. Mean energy contribution from ultra-processed foods ranged from 3.6% kcal (Q1) to 52.4% kcal (Q5). Energy contribution of ultra-processed foods was positively associated with reported intake of daily energy, total sugars, and total and saturated fat and inversely associated with reported intake of carbohydrates, fiber, minerals, and vitamins. Both sodium and potassium were negatively associated with percentage of energy from ultra-processed foods. However, the sodium-to-potassium ratio was high regardless of quintile of energy contribution from ultra-processed foods, and the ratio was positively associated with percentage of total energy from ultra-processed foods. Although the KHEI score was inversely associated with percentage of daily energy from ultra-processed foods, all levels of ultra-processed food consumption were associated with poor diet quality.ConclusionsThe ultra-processed foods consumption of Korean adults accounted for one fourth of daily energy intake, and a higher dietary energy contribution from ultra-processed foods was associated with poorer dietary intakes and a lower dietary quality. Further studies are needed to understand factors influencing selection and consumption of ultra-processed foods and to identify effective strategies to promote healthy food choices.     

The Benefits of Including Hummus and Hummus Ingredients into the American Diet to Promote Diet Quality and Health: A Comprehensive Review

Over the last decade, hummus has become an increasingly popular food. Given the ingredients (i.e., primarily chickpeas and tahini), nutrient composition, versatility, and acceptability, hummus can play a unique role when included in the American diet, to promote diet quality and improve health. The purpose of this paper is to provide a comprehensive review of the scientific evidence examining the effects of acute and long-term consumption of hummus and hummus ingredients on diet quality and risk factors related to type 2 diabetes, cardiovascular disease, and obesity. In addition, food pattern/menu modeling is included to illustrate the potential nutritional impact of consuming hummus to meet dietary guidelines. In general, the consumption of hummus and/or its respective ingredients has been shown to improve postprandial glycemic control, fasting lipids, appetite control, and daily food intake compared to other commonly consumed foods. The incorporation of hummus into the American diet can also improve diet quality by replacing foods higher in saturated fats, sodium, or added sugars. Collectively, these findings support the addition of hummus and/or hummus ingredients as an important component of a healthy dietary pattern.     

Changing dietary habits of ethnic groups in Europe and implications for health

A systematic review of the literature suggests the dietary habits of some ethnic groups living in Europe are likely to become less healthy as individuals increase consumption of processed foods that are energy dense and contain high levels of fat, sugar, and salt. Such products often replace healthy dietary components of the native diet, such as fruits, vegetables, nuts, and grains. Mixed food habits are emerging mainly amongst younger people in the second and third generations, most likely due to acculturation and adoption of a Western lifestyle. Age and immigrant generation are the major factors accounting for changes in dietary habits, whilst income, level of education, dietary laws, religion, and food beliefs are also important factors. Obesity, cardiovascular disease, diabetes, and hypertension present major problems for the mainstream European population. However, the risk of chronic disease is reported to be higher in ethnic populations, particularly South Asians, African Caribbeans, and Mexicans.     

Relevance of food‐based dietary guidelines to food and nutrition security: A South African perspective

Food‐based dietary guidelines are often developed at country level to assist in bringing dietary intakes closer to nutrient intake goals and, ultimately, to prevent nutrition‐related diseases. However, high food prices, alongside growing inflation, increasingly restrict food choices. This can leave those who are already vulnerable and less well off more exposed to the associated health implications of a nutrient deficient diet. With food and nutrition security being a high priority on the global nutrition agenda, this paper explores the feasibility of food‐based dietary guidelines to assist in improving food and nutrition security, focusing on nutritionally vulnerable groups in South Africa. It is argued that increased food prices, together with population growth, urbanisation and inflation, constrain everyday healthy food choices of a large proportion of South Africans. The South African food‐based dietary guidelines released in 2012 advocate the consumption of a daily diet containing a variety of foods. Unfortunately, even when the most basic and low‐cost food items are selected to make up a recommended daily diet, the associated costs are well out of reach of poor individuals residing in South Africa. The average household income of the poor in South Africa equips many households to procure mainly low‐cost staple foods such as maize meal porridge, with limited added variety. Although the ability to procure enough food to maintain satiety of all family members might categorise them as being food secure, the nutritional limitations of such monotonous diets may have severe implications in terms of their health, development and quality of life. Food‐based dietary guidelines alone have little relevance in such circumstances where financial means limit food choice. Alternative interventions are therefore required to equip the poor to follow recommended healthy diets and to improve individual food intake and nutrition security.     

Le coût et la qualité nutritionnelle des groupes d’aliments: quelle hiérarchie?

Based on the mean retail price of 691 foods grouped in 7 food-groups and 26 sub-groups, and on the consumption of these foods by 4 834 participants to the SUVIMAX study, we estimated the cost, the nutrient density and the excess in undesirable components in 10 MJ provided by each food group and sub-group. Meat/fish/eggs and fruits and vegetables, which are the most expensive sources of energy, have the highest nutritional quality. High sugar, fat and salt containing products and added fats, which are the cheapest sources of energy, have the lowest nutritional quality. Unrefined staples are interesting because they are cheap sources of energy that have a low content in undesirable components. In each group, some food-groups have a higher nutritional quality/price ratio than others, suggesting that, by selecting them preferentially, a healthy diet could be obtained at a moderate cost.     

Glycemic index: overview of implications in health and disease

The glycemic index concept is an extension of the fiber hypothesis, suggesting that fiber consumption reduces the rate of nutrient influx from the gut. The glycemic index has particular relevance to those chronic Western diseases associated with central obesity and insulin resistance. Early studies showed that starchy carbohydrate foods have very different effects on postprandial blood glucose and insulin responses in healthy and diabetic subjects, depending on the rate of digestion. A range of factors associated with food consumption was later shown to alter the rate of glucose absorption and subsequent glycemia and insulinemia. At this stage, systematic documentation of the differences that exist among carbohydrate foods was considered essential. The resulting glycemic index classification of foods provided a numeric physiologic classification of relevant carbohydrate foods in the prevention and treatment of diseases such as diabetes. Since then, low-glycemic-index diets have been shown to lower urinary C-peptide excretion in healthy subjects, improve glycemic control in diabetic subjects, and reduce serum lipids in hyperlipidemic subjects. Furthermore, consumption of low-glycemicindex diets has been associated with higher HDL-cholesterol concentrations and, in large cohort studies, with decreased risk of developing diabetes and cardiovascular disease. Case-control studies have also shown positive associations between dietary glycemic index and the risk of colon and breast cancers. Despite inconsistencies in the data, sufficient, positive findings have emerged to suggest that the dietary glycemic index is of potential importance in the treatment and prevention of chronic diseases.     

Ultra-processed foods increase noncommunicable chronic disease risk

Several studies have associated the food processing classification – NOVA – and health, but this is not true for all noncommunicable chronic diseases (NCDs). This study aimed to systematically review the association between the intake of NOVA food groups and NCDs. We hypothesized that ultra-processed foods and drinks (UPFD) and processed foods (PF) could increase the risk of NCDs, and that unprocessed (UPF) and minimally processed foods (MPF) may provide protection. We carried out a systematic review of observational studies in January 2021. Searches were performed in SCOPUS, MEDLINE (via PubMed), EMBASE, WEB OF SCIENCE, SCIELO, related articles, hand-searching of reference lists, and direct author contact. In all, 2217 citations were identified and 38 articles met the eligibility criteria for inclusion in this systematic review. Among the analyzed food groups, higher UPFD consumption was positively associated with obesity and associated with the development of all NCDs, mainly hypertension, diabetes and dyslipidemia. However, only a few studies have demonstrated the protective effect of natural foods and MPF consumption on the occurrence of NCDs. In conclusion, UPF may increase the risk of NCDs, and natural foods and MPF may reduce it. Our results reinforce the need for the implementation of policies to mitigate the intake of UPF by the population, as it would improve the quality of the dietary patterns, and directly impact on the incidence of NCDs.     

The Carbohydrate-Fat Problem: Can We Construct a Healthy Diet Based on Dietary Guidelines?

The inclusion of nutrition economics in dietary guidance would help ensure that the Dietary Guidelines for Americans benefit equally all segments of the US population. The present review outlines some novel metrics of food affordability that assess nutrient density of foods and beverages in relation to cost. Socioeconomic disparities in diet quality in the United States are readily apparent. In general, groups of lower socioeconomic status consume cheaper, lower-quality diets and suffer from higher rates of noncommunicable diseases. Nutrient profiling models, initially developed to assess the nutrient density of foods, can be turned into econometric models that assess both calories and nutrients per reference amount and per unit cost. These novel metrics have been used to identify individual foods that were affordable, palatable, culturally acceptable, and nutrient rich. Not all nutrient-rich foods were expensive. In dietary surveys, both local and national, some high-quality diets were associated with relatively low cost. Those population subgroups that successfully adopted dietary guidelines at an unexpectedly low monetary cost were identified as “positive deviants.” Constructing a healthy diet based on dietary guidelines can be done, provided that nutrient density of foods, their affordability, as well as taste and social norms are all taken into account.     

Tackling food security issues in indigenous communities in Canada: The Manitoba experience

Aims: The promotion of healthy living and chronic disease prevention are predicated on the ability of individuals and communities to make healthy choices. Having access to nutritious affordable food is one of the conditions required to make such choices possible but one that is too often not available, especially to families in remote regions of Canada. The present paper reviews food security issues as they pertain to indigenous communities, particularly in northern Manitoba, and describes community and government approaches to tackling food insecurity. Method: A narrative review was formed drawing on international literature and Canadian research and practice. Results: Strategies such as those described above have the potential to significantly enhance access to affordable, nutritious food in Northern Communities thereby improving food security, healthy living and preventing chronic disease. Conclusions: Community‐based action combined with structural changes and a supportive policy environment hold out the prospect of changing the conditions of food access that underlie the ultimate success of healthy living and chronic disease prevention efforts. While there appears to be a growing interest in local food production and the reintroduction of traditional foods to the diet, an important key to successful change is the engagement of youth, whose food habits and preferences have been heavily influenced by mainstream commercial food culture.     

Cooking as a Health Behavior: Examining the Role of Cooking Classes in a Weight Loss Intervention

Americans are cooking fewer meals at home and eating more convenience foods prepared elsewhere. Cooking at home is associated with higher quality diets, while a reduction in cooking may be associated with increases in obesity and risk factors for chronic disease. The aims of this study were to examine cooking as an intervention for weight control in overweight and obese adults, and whether such an intervention increases participants’ food agency and diet quality. Overweight and obese adults were randomized into one of two intervention conditions: active or demonstration. Both conditions received the same 24-week behavioral weight loss intervention, and bi-weekly cooking classes. The active condition prepared a weekly meal during a hands-on lesson, while the demonstration condition observed a chef prepare the same meal. The active condition lost significantly more weight at six months compared with the demonstration condition (7.3% vs. 4.5%). Both conditions saw significant improvements in food agency scores and Healthy Eating Index scores, though no significant differences were noted between groups. The addition of active cooking to a weight management intervention may improve weight loss outcomes, though benefits in diet quality and cooking behaviors may also be seen with the addition of a demonstration-only cooking intervention.     

Food Processing and the Mediterranean Diet

The benefits of the Mediterranean diet (MD) for protecting against chronic disorders such as cardiovascular disease are usually attributed to high consumption of certain food groups such as vegetables, and low consumption of other food groups such as meat. The influence of food processing techniques such as food preparation and cooking on the nutrient composition and nutritional value of these foods is not generally taken into consideration. In this narrative review, we consider the mechanistic and epidemiological evidence that food processing influences phytochemicals in selected food groups in the MD (olives, olive oil, vegetables and nuts), and that this influences the protective effects of these foods against chronic diseases associated with inflammation. We also examine how the pro-inflammatory properties of meat consumption can be modified by Mediterranean cuisine. We conclude by discussing whether food processing should be given greater consideration, both when recommending a MD to the consumer and when evaluating its health properties.     

A prospective study of variety of healthy foods and mortality in women

BACKGROUND: To assess the overall influence of diet on health and disease in epidemiological studies, the habitual diet of the study participants has to be captured as a pattern rather than individual foods or nutrients. The simplest way to describe dietary preferences is to separate foods considered beneficial to health from foods considered to promote disease, and separate individuals on the basis of their regular consumption of these foods. METHODS: We used data from 59 038 women participating in the prospective Mammography Screening Cohort in Sweden to investigate the influence of variety of healthy and less healthy foods on all-cause and cause-specific mortality. RESULTS: Women who followed a healthy diet defined as consumption of a high variety of fruits, vegetables, whole grain breads, cereals, fish, and low fat dairy products had a significantly lower mortality than women who consumed few of these foods (3710 deaths total). Women who reported regularly consuming 16-17 healthy foods had a 42% lower all-cause mortality (95% CI: 32-50%) compared to women reporting consumption of 0-8 healthy foods with any regularity (P for trend <0.0001). For each additional healthy food consumed the risk of death was about 5% lower (95% CI: 4-6%). Cardiovascular mortality was particularly low among women who reported consuming a high variety of healthy foods. A less healthy diet defined as consumption of a high variety of red meats, refined carbohydrates and sugars, and foods high in saturated or trans fats was not directly associated with a higher overall mortality. However, women who reported consuming many less healthy foods were significantly more likely to die from cancer than those who consumed few less healthy foods. CONCLUSIONS: A healthy diet can affect longevity. It appears more important to increase the number of healthy foods regularly consumed than to reduce the number of less healthy foods regularly consumed.     

Inedible Food Waste Linked to Diet Quality and Food Spending in the Seattle Obesity Study SOS III

Americans waste about a pound of food per day. Some of this is represented by inedible food waste at the household level. Our objective was to estimate inedible food waste in relation to diet quality and participant socio-economic status (SES). Seattle Obesity Study III participants (n = 747) completed the Fred Hutch Food Frequency Questionnaire (FFQ) and socio-demographic and food expenditure surveys. Education and geo-coded tax-parcel residential property values were measures of SES. Inedible food waste was calculated from diet records. Retail prices of FFQ component foods (n = 378) were used to estimate individual-level diet costs. The NOVA classification was used to identify ultra-processed foods. Multivariable linear regressions tested associations between inedible food waste, SES, food spending, Nutrient Rich Food (NRF_9.3) and Healthy Eating Index (HEI-2015) scores. Inedible food waste was estimated at 78.7 g/d, mostly from unprocessed vegetables (32.8 g), fruit (30.5 g) and meat, poultry, and fish (15.4 g). Greater inedible food waste was associated with higher HEI-2015 and NRF_9.3 scores, higher food expenditures and lower percent energy from ultra-processed foods. In multivariable models, more inedible food waste was associated with higher food expenditures, education and residential property values. Higher consumption of unprocessed foods were associated with more inedible food waste and higher diet costs. Geo-located estimates of inedible food waste can provide a proxy index of neighborhood diet quality.     

An overview of the role of rice in the UK diet

Rice is a staple food for over half of the world's population. Eighty percent of the British population buy rice, predominantly white rice, with the average person consuming approximately 5.6 kg per year. Rice consumption in the UK is expected to increase slightly, as a result of the growing ethnic population and food diversification. Starchy foods such as rice, potatoes, bread and cereals are our main source of carbohydrate and play an important role in a healthy diet. As well as providing energy, rice contains other essential nutrients such as thiamine, riboflavin, niacin, vitamin E, zinc, potassium, iron and fibre. On cooking, rice swells to at least three times its original weight and therefore benefits from a low‐energy density compared to other starchy carbohydrate foods (e.g. bread), as well as a low‐sodium content (unless salt is added to rice products). It has a low allergenicity and is relatively easy to digest, making it a useful food for early weaning or during convalescence. The Department of Health encourage the selection of wholegrain versions of starchy carbohydrate foods as these are higher in fibre. Brown rice also has a higher proportion of important bioactive phytochemicals such as hemicelluloses and lignans with antioxidant and anti‐inflammatory properties that may benefit health. Despite the common perception that starchy carbohydrate foods are ‘fattening’, diets containing rice have been shown to achieve weight loss in obese subjects, although greater weight reduction has been shown with mixed rice compared with white rice. Although the reported glycaemic index (GI) of different rice varieties is inconsistent, most types of rice are classified as low or medium ‘GI’ foods but this is influenced by cooking time, the degree of gelatinisation and rice type. While there are numerous studies that have examined the link between high‐carbohydrate intakes and risk of chronic diseases such as obesity, type 2 diabetes and cardiovascular disease, relatively few have investigated the role of rice specifically, particularly in western populations. In Asian populations in whom rice is a staple food, higher white rice consumption has been associated with elevated risk of diabetes and metabolic syndrome. Some prospective cohort studies in the US have linked regular consumption of white rice with higher risk of type 2 diabetes, whereas brown rice intake was associated with lower risk. These studies were however observational in nature and so cannot determine a ‘cause and effect’ relationship, whilst their findings may be subject to residual confounding. Future studies should consider potential differences of white rice varieties, which vary in amylose content, as well as the effect of processing methods.     

“More Than Buying Extra Fruits and Veggies,Please Hide the Fats and Sugars”: Children’s Diet Latent Profiles and Family-Related Factors

Promoting children’s healthy diets is a key public health priority. Family can play a relevant role in children’s eating patterns. The goals of the current research were to identify different latent diet profiles in children based on their food consumption and to assess the relationship between profiles and family-related factors. A total of 678 school-aged children from the fifth and sixth grades participated. The study design was cross-sectional and questionnaire based. Research assessed healthy (fruit and vegetables) and unhealthy (fast food, sugar-sweetened beverages, and candies) food consumption and family-related factors. A latent profile analysis and multivariate data analysis were developed. Four diet profiles were identified: Combined Diet, Mainly Healthy Diet, Mainly Unhealthy Diet, and Very Unhealthy Diet. Nearly half of the children (45.22%) showed a Combined Diet profile, meaning that they reported eating nearly the same amount of healthy and unhealthy types of foods. Associations between the diet profiles, family income, and food availability were found. For example, the Mainly Healthy Diet profile was statistically associated with a higher family income and less access to unhealthy foods. The present study reinforces the idea that profiling diets can allow for a tailored healthy eating intervention model according to the specific needs of each diet profile.     

Dietary Advanced Glycation End Products and Risk Factors for Chronic Disease: A Systematic Review of Randomised Controlled Trials

Dietary advanced glycation end-products (AGEs) form during heating and processing of food products and are widely prevalent in the modern Western diet. Recent systematic reviews indicate that consumption of dietary AGEs may promote inflammation, oxidative stress and insulin resistance. Experimental evidence indicates that dietary AGEs may also induce renal damage, however, this outcome has not been considered in previous systematic reviews. The purpose of this review was to examine the effect of consumption of a high AGE diet on biomarkers of chronic disease, including chronic kidney disease (CKD), in human randomized controlled trials (RCTs). Six databases (SCOPUS, CINHAL, EMBASE, Medline, Biological abstracts and Web of Science) were searched for randomised controlled dietary trials that compared high AGE intake to low AGE intake in adults with and without obesity, diabetes or CKD. Twelve dietary AGE interventions were identified with a total of 293 participants. A high AGE diet increased circulating tumour necrosis factor-alpha and AGEs in all populations. A high AGE diet increased 8-isoprostanes in healthy adults, and vascular cell adhesion molecule-1 (VCAM-1) in patients with diabetes. Markers of CKD were not widely assessed. The evidence presented indicates that a high AGE diet may contribute to risk factors associated with chronic disease, such as inflammation and oxidative stress, however, due to a lack of high quality randomised trials, more research is required.     

Consumers’ knowledge of healthy diets and its correlation with dietary behaviour

Background: Procedural nutrition knowledge is knowledge of how to eat a healthy diet. This type of knowledge potentially plays an important role in dietary behaviour. Previous studies of consumers' nutrition knowledge did not systematically assess procedural nutrition knowledge. Thus, we administered a survey of procedural nutrition knowledge to Swiss consumers to assess the prevalence of misconceptions about healthy eating. Methods: We developed 13 procedural nutrition knowledge items. Nine items were based on qualitative consumer interviews and four items were derived from expert guidelines. The items had a true/false format. We administered the items to a random population sample in a written postal survey (n = 1,043). The survey also assessed the consumers' self‐reported food consumption. For each respondent, we computed the number of correctly answered knowledge items and we correlated this number with food consumption frequencies. Results: The procedural nutrition knowledge items received between 3% and 38% incorrect answers. Individuals with a higher number of correctly answered items consumed more vegetables (r = 0.29). Higher knowledge was associated with the female gender, younger age, higher education, nutrition‐related qualifications and not being on a diet (P < 0.001). Conclusions: Our findings indicate that misconceptions exist in the general population about healthy eating. These misconceptions are associated with a decreased consumption of foods usually defined as healthy. Some population sub‐groups seem particularly susceptible to holding such misconceptions. The implications for nutrition education, particularly concerning the role of fruit and vegetable consumption as well as the food pyramid are discussed.