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Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.e8707 (Published 05 February 2013) Cite this as: BMJ 2013;346:e8707

Re: Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis

what a marvellous job by the authors on a potentially paradigm-shifting endeavour akin to throwing a pebble into a pond and hanging around anxiously to see what the ripples will be.

in a nutshell, the study shows LA is a 'substrate' for oxidative stress convertible to toxic derivatives, mechanistically adverse to the cardiovascular-coronary integrity;

an otherwise good dietary item, LA's bad company (smoke/alcohol) wrecks its good potential.

the methodological and statistical avenues in use here are impeccable;

what remains is to see how the study as done can be reproduced in the larger context;

as well as some better pruning in the non-intervention group to minimise dietary components veering in the direction of the control without at the same time undermining the non-intervention integrity of the cohort.

it will also be nice to see whether n-3 fatty acids or other non n-6 species can be just as vulnerable substrates to oxidative stress or other free radical mediated insults.

the impact implicit to this study is potentially major and multivalent (clinical, nutritional, industrial pharmaceutical etc) and so reproducibility studies/checks need be carried out sooner rather than later to leave no ripples in the pond for too long .

until such cross-checking is done and unambiguously similar evidence based results emerge, it may be premature to demand that our pts start cutting new teeth inside their lipid cuisines;

but never wrong to insist on continuing avoidance of what remains a consensus; smoking and alcohol with all of their evidently deleterious effects, alone or in combination.

Competing interests: No competing interests

07 February 2013
basil b FADIPE
surgeon
justin fadipe centre
mero heights. commonwealth of dominca
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