For 15 years, recommendations concerning the primary prevention of coronary heart disease (CHD) have been made by international bodies or national agencies. In a national Belgian nutritional study (the B.I.R.N.H. Study), the authors review how far the Belgian population is from the recommended nutritional goals and ideal serum cholesterol. They also make comparisons between genders and look at differences according to the linguistic background (French- or Dutch-speaking subjects). Only a small percentage of the Belgian population reach the nutritional goals for total fat intake in males (8.4%) and females (7%), saturated fat intake (7.0% and 6.2%, respectively), and P/S ratio (13.5% and 12.4%, respectively). The percentages reaching nutritional goals are somewhat higher for polyunsaturated fat intake (27.9% and 28.6%, respectively) and dietary cholesterol (39.4% and 54.6% respectively). A total of 29.9% of the male population, and 32.7% of the female population are at ‘high risk’ of CHD according to their serum cholesterol levels. In general the results are better for the Dutch-speaking population than for their French-speaking counterparts. In conclusion, despite modifications in eating patterns and a decrease in CHD mortality in Belgium during the 1970s, a very high percentage of males and females are still far from the recommended nutritional goals and ideal serum cholesterol levels.