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Conclusion may have been underplayed
| The first 150 words of the full text of this article appear below. |
EDITOR
The paper by Hooper et al may fulfil the Cochrane review
criteria for a meta-analysis of clinical trials, but it does not
provide a systematic review of the issues relating to dietary fat
intake and the prevention of cardiovascular disease.1
It is important to consider the overall appropriateness of each
trial before its inclusion in a meta-analysis. Several of the trials
included are small or of short duration. It is difficult to imagine how
the risk of coronary heart disease that has accrued over a
prolonged period may be reversed by dietary modification in less than
two years. The diet and infarction trial (fat modification arm)
contributed the greatest number of cardiovascular end points, yet there
are at least two reasons why this trial was unlikely to show a
beneficial effect. Limited dietary instruction was given, so there was
little change in cholesterol concentrations. Since modification of fat
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