[Nutrition and health--recommendations of the Health Council of the Netherlands regarding energy, proteins, fats and carbohydrates].

The present report of the Health Council of the Netherlands, entitled 'Dietary reference intakes: energy, proteins, fats and digestible carbohydrates' is the second of a series of updated and revised recommendations in which the emphasis has shifted from nutritional deficiencies to the risks for some chronic diseases caused by the affluent nutrition of the 'developed' Western countries. The recommendation for total fat differs between people with an optimum weight and those who are overweight. The range for normal intake, from 20 to 40 energy per cent, has been enlarged due to a higher upper threshold. For persons who are already overweight, the narrower range from 20 to 30/35 energy percent has been maintained. Due attention should be given to the fatty acid composition of the fat and the favourable effects of unsaturated fatty acids on some chronic diseases, particularly coronary heart disease. The adequate intake of alpha-linolenic acid has been raised to 1 energy per cent while maintaining linoleic acid at 2 energy per cent. The benefits of the n-3-polyunsaturated fatty acids from fish are emphasised. Trans fatty acids should be limited to 1 energy per cent. The recommendation of 50 to 40 energy per cent for digestible carbohydrates from birth to old age is lower than in foreign recommendations. The estimate is derived from the production of endogenous glucose. No specific effects on chronic diseases are known. The recommended dietary allowances for protein are lower than those in the previous Dutch recommendation. They are now in line with most recommendations in other countries. With respect to the energy requirement, an abnormal level of physical activity should be reflected in a correction factor on the normal energy consumption.