The health loss presented above has been calculated by means of a comparison with the situation in which all Dutch people follow the dietary and weight recommendations. It should therefore be regarded as the maximum theoretical health gain. However, because it would be overly optimistic to assume that everyone will adopt a healthy diet overnight, a calculation has also been made on the basis of dietary patterns which are partially improved in the direction of the recommendations.
Experience with small-scale dietary interventions suggests that such an improvement is feasible. In these ‘middle’ scenarios we assume the following changes in the dietary patterns of persons who do not yet meet the recommendations in full:
- consumption of saturated fatty acids to be reduced by 2.5 energy per cent
- consumption of trans fatty acids to be reduced by 0.5 energy per cent
- consumption of fish to be increased by one or two portions per month
- consumption of vegetables to be increased by 50 grams per day
- consumption of fruit to be increased by 50 grams per day.
These dietary interventions will reduce the maximum annual incidence of disease and mortality attributable to the dietary composition (with regard to the five factors stated) by approximately fifty per cent (see figure 3). A significant assumption in these calculations is that the success of the small-scale interventions can be extrapolated to the level of the entire population.
Maximum and middle scenarios
The improvements cited have varying relationships to the current trends. In the case of trans fatty acids, target consumption under the middle scenario is in line with the rapid decline seen in recent years. By contrast, the middle scenario target for fruit and vegetable. Reduction in annual incidence of disease in the Netherlands: maximum and middle scenarios.
The policy’s target for saturated fatty acids is a reduction to 10 energy per cent by the year 2010, while that for trans fatty acids is a reduction to 1 energy per cent. These figures are in line with the dietary recommendations. The policy does not state any specific target for fish consumption, and while it does seek to increase consumption of fruit and vegetables, no firm figures are stated. f