Cholesterol lowering diets and coronary heart disease

BMJ 1998;317:1253 ( 31 October )

Letters

Cholesterol lowering diets and coronary heart disease

Advice should now be to increase intake of vegetable oils and fish

Dietary advice should focus on promoting antioxidants and the right sort of fats

Advice should now be to increase intake of vegetable oils and fish

The first 150 words of the full text of this article appear below.

EDITOR $---$ The systematic review by Tang et al analysed the effect of various diets, particularly the American Heart Associationstep 1 and step 2 diets, on reducing total blood cholesterol concentration.¹Overall, the effect of diet on blood cholesterol concentrationsin free-living communities was no more than about 6%, with step1 diets achieving a 3% reduction and diets that increase the ratioof polyunsaturated to saturated fatty acids around an 8%fall.

The effect of diet on coronary heart disease rates is complementary.² In six primary prevention trials of low fat and lowcholesterol diets the odds ratio for death from coronary heartdisease was 1.04 (95% confidence interval 0.43 to 2.06) and fornon-fatal events 1.05 (0.46 to 2.98); in two secondary preventiontrials with a similar regimen the respective odds ratios were1.21 (0.66 to 1.78) and 1.00 (0.76 to1.37).

Four secondary prevention trials increased the ratio of polyunsaturated to saturated fats above 1.0 by using vegetable . . . [Full text of this article]

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