title: Modelling the impact of compliance with dietary recommendations on cancer and cardiovascular disease mortality in Canada.
abstract: OBJECTIVE
  Despite strong evidence indicating that unbalanced diets relate to chronic diseases and mortality, most adults do not comply with dietary recommendations. To help determine which recommendations could yield the most benefits, the number of deaths attributable to cardiovascular diseases and cancer that could be delayed or averted in Canada if adults changed their diet to adhere to recommendations were estimated.
  
  
  METHODS
  Macrosimulation based on national population-based survey and vital statistics data.
  
  
  METHODS
  A macrosimulation model was used to draw age- and sex-specific changes in relative risks based on the results of meta-analyses of relationship between food components and risk of cardiovascular disease and diet-related cancers. Inputs in the model included Canadian recommendations (fruit and vegetable, fibre, salt, and total-, monounsaturated-, polyunsaturated-, saturated-, and trans-fats), average dietary intake (from 35,107 participants with 24-h recall), and mortality from specific causes (from Canadian Vital Statistics). Monte Carlo analyses were used to compute 95% credible intervals (CI).
  
  
  RESULTS
  The estimates of this study suggest that 30,540 deaths (95% CI: 24,953, 34,989) per year could be averted or delayed if Canadians adhered to their dietary recommendations. By itself, the recommendation for fruit and vegetable intake could save as many as 72% (55-87%) of these deaths. It is followed by recommendations for fibres (29%, 13-43%) and salt (10%, 9-12%).
  
  
  CONCLUSIONS
  A considerable number of lives could be saved if Canadians adhered to the national dietary intake recommendations. Given the scarce resources available to promote guideline adhesion, priority should be given to recommendations for fruit and vegetable intake.
authors.affiliation: Department of Family Medicine, Université de Sherbrooke, Sherbrooke, Canada; Vitalité Health Network Research Centre, Moncton, Canada; Centre de formation médicale du Nouveau-Brunswick, Moncton, Canada. Electronic address: mathieu.f.belanger@usherbrooke.ca.
authors.forename: M
authors.initials: M
authors.lastname: Bélanger
authors.affiliation: Vitalité Health Network Research Centre, Moncton, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Poirier
authors.affiliation: Centre de formation médicale du Nouveau-Brunswick, Moncton, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Jbilou
authors.affiliation: British Heart Foundation Health Promotion Research Group, Department of Public Health, University of Oxford, Oxford, United Kingdom.
authors.forename: P
authors.initials: P
authors.lastname: Scarborough
mesh_terms: D000328:Adult; D002170:Canada / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000401:mortality*; D004032:Diet / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009369:Neoplasms / Q000401:mortality*; D018673:Nutrition Policy; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012306:Risk
keywords: Chronic disease; Mortality; Nutritional requirements; Statistics