Younger generations are more at risk of developing health problems due to obesity and high blood pressure than previous generations. These risk factors are becoming more common and are developing at a younger age. At the end of the 1980s, 7-8 percent of people in their 40s had obesity and this had increased to 11-15 percent 16 years later. More than 80 percent of all cardiovascular diseases in men and women aged 20-60 were attributable to unfavorable levels of blood pressure,cholesterol, weight and smoking. This is a conclusion of Gerben Hulsegge's doctoral research, carried out by RIVM in collaboration with the University Medical Centre Utrecht, Julius Center. 

A comparison of four ‘generations’ 

In a large cohort study, lifestyle changes and key risk factors relating to cardiovascular diseases were studied. This study followed adults aged between 20 and 60 for a total of 21 years. The researchers monitored four ‘generations’ who were 20-29, 30-39, 40-49 and 50-59 years old at the beginning of the study. In every new, younger generation, overweight, obesity and high blood pressure were more prevalent compared to the previous generation. For example, 8 percent of the women and 7 percent of the men who were in their 40s at the end of the 1980s had obesity. Sixteen years later, this was increased to 15 percent in the females and 11% in the males who were then in their 40s. Future generations of adults will, therefore, have overweight and obesity more often and at a younger age, which increases the risk of diabetes, for example. 

Risk profiles 

Given these unfavorable changes, less than 10 percent of the adults maintained a healthy weight, low blood pressure and cholesterol and no smoking for 10 years. The importance of this is reflected in the low risk of cardiovascular diseases that this group had; their risk was 7 times lower than that of those with an unfavorable risk profile. On the basis of these results, more than 80 percent of the cardiovascular disease instances in this group were attributable to an unfavorable risk profile. 


The thesis shows that public health could improve significantly if more adults managed to maintain a more favorable risk profile. Lifestyle improvements, such as more exercise and healthier food, can play a very important part in this. 

This research was carried out in the framework of RIVM Strategic Programme (SPR), in which expertise and innovative projects prepare RIVM to respond to future issues in health and sustainability.