Non-communicable disease burden through adhering to Dutch dietary guidelines: a modeling study to estimate future reductions

Summary

Background
Non-optimal food consumption is a major modifiable risk factor for non-communicable diseases (NCDs). We aimed to estimate the potential reductions in NCD burden that could be achieved in 2050 by adhering to eleven components of the Dutch dietary guidelines in the Netherlands.

Methods
Counterfactual scenarios, in which the entire Dutch population adhered to components of the dietary guidelines, were implemented to estimate future reductions in NCD burden using the DYNAMO-HIA software. Input data included nationally-representative food consumption data (Dutch National Food Consumption Survey 2012–2016), relative risks of food consumption on NCDs, Dutch NCD epidemiology, and the Dutch population structure.

Findings
Adhering to processed meat (0 g/d) and fruit (≥200 g/d) recommendations showed the largest reductions. By 2050, eliminating processed meat consumption could reduce per 100,000 population cases of coronary heart disease by 18.5% (95% Uncertainty Interval [UI]: 3.9%, 36.2%) in women and 23.8% (95% UI: 5.7%, 44.1%) in men, type 2 diabetes by 18.6% (95% UI: 11.6%, 27.4%) in women and 24.5% (95% UI: 15.3%, 35.4%) in men, and colorectal cancer by 8.7% (95% UI: 5.1%, 13.0%) in women and 10.4% (95% UI: 5.0%, 16.4%) in men. Adhering to fruit recommendation could reduce stroke cases by 17.7% (95% UI: 11.1%, 21.9%) in women and 19.1% (95% UI: 12.2%, 23.4%) in men, and lung cancer cases by 8.2% (95% UI: 4.4%, 12.8%) in women and 7.2% (95% UI: 3.4%, 12.0%) in men. Eliminating processed meat could increase life expectancy at age 50 by 0.310 (95% UI: 0.181, 0.453) years for women and 0.724 (95% UI: 0.398, 1.092) years for men, and disease-free life expectancy by 1.554 (95% UI: 1.032, 2.189) years for women and 2.494 (95% UI: 1.627, 3.504) years for men.

Interpretation
Our model suggests that adhering to Dutch dietary guidelines could reduce future NCD burden in the Netherlands. Reducing processed meat and increasing fruit consumption should be priority prevention targets.