Bmj Usa: Editorial

What is the optimal diet for cardiovascular health?

BMJ 2003; 327 doi: (Published 19 November 2003) Cite this as: BMJ 2003;327:E31
  1. Thomas E. Kottke, Professor of Medicine (
  1. Mayo Clinic and Foundation, Project Director, CardioVision 2020, Rochester, Minnesota 55905, USA

    Fruits, vegetables, grains, and fish should be advised for everyone over a lifetime

    This article originally appeared in BMJ USA

    After 25 years of follow-up in the Seven Countries Study, death rates from coronary heart disease (CHD) ranged from 268 per 1000 in East Finland to 25 per 1000 in Crete, Greece.1 This difference is one order of magnitude, and more than 90% of the variance across cohorts is attributable to differences in consumption of saturated fat. A systematic review of randomized controlled trials, published in this issue of BMJ USA, contributes to the evidence that the association between a low-fat diet and low death rates from CHD is causal.2 To take the next step and apply this information to practice, we need to answer four questions:

    • What diet should we recommend?

    • For how long should the diet be followed?

    • To whom do we recommend the diet?

    • How do we best promote adherence?

    What diet should we recommend?

    Among the Seven Countries Study cohorts, consumption of dairy products was …

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