Research and policy

Daan Kromhout has contributed to various facets of public health research, and the fruits of that labor have been published in many peer-reviewed articles. He also contributed to the translation of research findings into health policy advice. A selection of Daan’s research and health policy advice interests is shown on this page.

Fish, flavonoids, dietary patterns & cardiovascular disease

Daan´s research on diet and cardiovascular diseases is focused on fish consumption, flavonoid intake and dietary patterns. The most frequently cited papers on these topics are:

  • Eating fish once or twice a week is associated with a 50% lower risk of fatal coronary heart disease (Kromhout et al. N Engl J Med 1985;312:1205-1209)
  • An intake of at least 20 mg flavonols (very strong antioxidants) per day is related to a more than 60% lower risk of fatal coronary heart disease. Flavonols are a rich source of tea, apples, onions and red wine. (Hertog et al. Lancet 1993;342:1007-1011)
  • A Mediterranean style of diet is associated with a 40% lower risk of coronary heart disease, a 30% lower risk of cardiovascular and a 20% lower risk of all-cause mortality (Knoops et al. JAMA 2004;292:1433-1439)

A remarkable result was that even in the elderly 60% of cardiovascular and all-cause mortality might be prevented by healthy diet and lifestyle habits (non-smoking, physical activity and moderate alcohol intake) (Knoops et al. JAMA 2004;292:1433-1439)

Prospective epidemiologic studies

Daan is leading various prospective epidemiologic studies on diet, lifestyle, risk factors, cardiovascular diseases and healthy aging. A short list:

  • Zutphen Study. Since 1978 Daan is the PI of the Zutphen Study, a prospective cohort study on diet, lifestyle and cardiovascular diseases in originally 878 middle-aged men, who have been followed for 50 years.
  • Seven Countries Study. Daan is currently co-chair of this major prospective study on risk factors of cardiovascular diseases in 16 cohorts of 12,763 men from the USA, Japan and five European countries.
  • Alpha Omega Trial. From 2001 onwards Daan is also the PI of the Alpha Omega Trial, the first double-blind placebo-controlled dietary intervention study in which the effect of omega-3 fatty acids on major cardiovascular events is evaluated in more than 4,800 patients after heart attack.
  • HALE-project. Daan is also the PI of the Healthy Aging Longitudinal study in Europe (HALE) project in which 3,000 elderly men and women have been followed for 10 years.

Many talented young researchers participated in Daan´s research projects, 48 defended succesfully their PhD thesis, and eight of them became full professor.

From research to health policy advice

Daan Kromhout is was the Vice-President of the Health Council of the Netherlands from 2005 – 2018. Under his responsiblity advices appeared about different aspects of healthy diets, overnutrition, undernutrition and dietary reference values. The advisory reports of the Health Council can be downloaded from

As Division Director of the National Institute for Public Health and the Environment (RIVM) Daan was responsible for publications requested by the Minister of Public Health such as “Our food, our health” about healthy diet and safe food in the Netherlands of which the Dutch version was published in 2004 and the English version in 2006. This was for years the most frequently visited document of the RIVM website and can be viewed from

Research funding

The Zutphen Study was funded by Netherlands Health Foundation (Praeventiefonds), European Union, National Institute of Aging USA, Dutch Heart Foundation, Netherlands Nutriton Council, Food Organisation TNO.

The Alpha Omega Trial was financially supported by the Dutch Heart Foundation, National Institutes of Health (NIH), USA and Unilever Research. Unilever paid for the development, production and distribution of the trial margarines.

Health policy advices

Our food, our health. Healhty diet and safe food in the Netherlands.Kreijl CF van, Knaap AGAC, Raaij JMA van (Editors-in-chief), Busch MCM, Havelaar AH, Kramers PGN, Kromhout D, Leeuwen FXR van, Van Leent-Loenen HMJA, Ocké MC, Verkleij H (Editors). Our food, our health. Healthy diet and safe food in the Netherlands. RIVM, Bilthoven, The Netherlands. ISBN 90-6960-135-4. 2006:1-363.

A sample of the Health Council advisory reports on nutrition and health that were published since 2005:

  • Evaluation of dietary reference values for vitamin D.
  • Undernutrition in the elderly.
  • Guidelines for a healthy diet: an ecological perspective.
  • Healthy nutrition: a closer look at logos.
  • Guidelines for a healthy diet 2006.