Seven countries study on risk factors for cardiovascular diseases

The Seven Countries Study (SCS for short) is the first major study to investigate diet and lifestyle along with other risk factors for cardiovascular disease, across contrasting countries and cultures and over an extended period of time.


The main hypothesis was that the rate of coronary disease in populations and individuals would vary in relation to their physical characteristics and lifestyle, particularly in fat composition of the diet and serum cholesterol levels.


The objective was to explore in detail the associations of diet, other risk factors, and disease rates between populations and among individuals within populations, using standard measures by trained survey teams, with blindfolded coding and analysis of data.

The Zutphen (Elderly) Study


In 1960 a sample from the town of Zutphen in the eastern part of The Netherlands was examined for the Seven Countries Study. The survey consisted of a medical examination including an electrocardiogram and major cardiovascular risk factors such as serum cholesterol, blood pressure and smoking. Additional risk factors such as energy expenditure and lung function were also measured. The Zutphen Study is unique because of its dietary surveys carried out in all participants in 1960, 1965 and 1970.
In 1985 when 50% of the participants had died, the cohort was extended with an additional random sample of men from the same birth cohort. The survey consisted of three parts: a similar cardiovascular examination as in the first 25 years of the study, a dietary survey and a questionnaire that provided information about the physical, mental and social aspects of health. The surveys were repeated in 1990, 1995 and 2000 and in 1990 also a physical performance test and a glucose tolerance test were carried out.

More research: Nutrition and cardiovascular disease

More research: Disease aetiology and prevention