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‘Protective nutrients’ and up-to-date dietary recommendations

D. Kromhout*

Division of Public Health Research, National Institute of Public Health and the Environment, BA Bilthoven, The Netherlands

* Correspondence: D. Kromhout, Division of Public Health Research, National Institute of Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands.

Abstract

In the past, dietary recommendations were focused on reductions in the consumption of foods and nutrients deemed bad for health, such as saturated fat, dietary cholesterol and salt. In more recent years, an increased consumption of foods and nutrients deemed good for health has also been emphasized, e.g., increased consumption of vegetables, fruits, legumes, fish, dietary fibre and polyunsaturated fatty acids. Another major development has been the change from dietary recommendations for specific diseases, such as coronary heart disease and diabetes, to integrated, comprehensive dietary recommendations for chronic diseases and health in general. A healthy diet forms an important component of a healthy lifestyle. This also includes advice not to smoke and to be physically active for at least 30 min each day. Such a lifestyle prevents coronary heart disease and is important for both primary and secondary prevention.

Observational studies and clinical trials on n-3 polyunsaturated fatty acids suggest that besides a diet low in saturated and trans fatty acids and in cholesterol, a healthy diet also needs to contain adequate amounts of alpha-linolenic acid (2 g. day–1) and EPA and DHA (200 mg. day–1).

Evidence that a diet rich in fruits and vegetables may protect against coronary heart disease is increasing. Fruits and vegetables are plentiful sources of antioxidants. Until recently, most research in this area was focused on the so-called nutritive antioxidants, vitamins with antioxidant properties such as tocopherol (vitamin E), carotenoids and vitamin C. Recently, there is an increasing interest in the so-called non-nutritive antioxidants. These are polyphenols present in plant foods and have strong antioxidant properties.

Clinical trials with vitamin E supplements were mainly negative. High-dose pharmacological supplementation of diet with so-called ‘protective’ nutrients, however, do not relate to the nutritional domain. In future trials a dose corresponding to a multiple of the recommended dietary allowance of 10 mg. day–1 should be used rather than the high, pharmacological doses used so far.

Key Words: Healthy diet • fatty acids • antioxidants • n-3 polyunsaturated fatty acids • vitamin E

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