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Changes in dietary fat and declining coronary heart disease in Poland: population based study

BMJ 2005; 331 doi: (Published 21 July 2005) Cite this as: BMJ 2005;331:187
  1. Witold A Zatonski, director of the Cancer Epidemiology and Prevention Division1,
  2. Walter Willett, professor (
  1. 1 Cancer Centre and Institute of Oncology, 5 Roentgena Str, 02-781 Warsaw, Poland
  2. 2 Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA
  1. Correspondence to: W Willett


    We previously described a rapid decline in mortality due to coronary heart disease in Poland between 1991 and 1994, corresponding with increases in the ratio of polyunsaturated fat to saturated fat in people's diet and fruit consumption.1 The changes in food consumption followed changes in economic policy, including reductions in subsidies for dairy and other animal fats. We describe subsequent trends and use data from cohort studies to estimate the contributions from smoking and diet to these changes.

    Methods and results

    Mortality due to coronary heart disease has continued to fall in Poland in both sexes and across educational levels. Compared with 1990, by 2002 for the age band 45-64 years it had fallen by 38% in men (340 per 100 000 to 212/100 000) and by 42% in women (76/100 000 to 44/100 000). By 1999 (the latest year with comparable data), consumption of saturated fat had fallen by 7% (44.8 g/day to 41.5 g/day), consumption of polyunsaturated fat had risen by 57% (14.8 g/day to 23.3 …

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