Food and vessels: the importance of a healthy diet to prevent cardiovascular disease
Received 15 April 2009; accepted 3 June 2009.
Aim
We attempted to quantify the burden of cardiovascular disease that can be prevented by broader adherence to recommendations on dietary intake of key nutrients.
Methods
A computer model capturing the epidemiology of chronic disease and risk factors in the Dutch population was used to simulate differences in the occurrence of cardiovascular disease under various scenarios defined by levels of intake of saturated and trans fatty acids, fruit, vegetables and fish. The following scenarios were compared with the current situation: (i) the whole population adhering to recommendations (optimum scenario); (ii) a moderate improvement and (iii) increased intake of fruit as has been achieved in an actual intervention (‘fruit at work’). Other outcome measures assessed were (differences in) life expectancy and healthy life expectancy for a 40-year-old individual.
Results
In the optimum scenario, cumulative incidence prevented over a period of 20 years was 240000 cases for acute myocardial infarction, or 30% of the expected number of cases, 328000 (16%) for other coronary heart disease and 215000 (21%) for stroke. For the moderate improvement scenario, the corresponding figures were 119000 (14%), 163000 (8%) and 105000 (10%), respectively. The individual contributions of each of the separate dietary factors were greatest for fish, followed in decreasing order by fruit, vegetables, saturated and trans fatty acids. Only fish and fruit contributed to a decrease in strokes. In the optimum scenario, 1 year was added to the life expectancy of a 40-year-old individual and half a year in the moderate improvement scenario.
Conclusion
Broader adherence to recommendations for daily intake of fruit, vegetables, fish and fatty acid composition may take away as much as 20–30% of the burden of cardiovascular disease and result in approximately 1 extra life year for a 40-year-old individual. Promotion of a healthy diet should be given more emphasis in the prevention of cardiovascular disease.
cExpertise Centre for Methodology and Information Services, National Institute for Public Health and the Environment, The Netherlands
Correspondence to Dr Monique Verschuren, RIVM National Institute for Public Health and the Environment, Centre for Prevention and Health Services Research, PO Box 1, 3720 BA Bilthoven, The Netherlands Tel: +31 30 2743508; fax: +31 30 27424407;
ABSTRACT