RELATIONSHIP BETWEEN DIETARY-INTAKE AND CORONARY HEART-DISEASE MORTALITY - LIPID RESEARCH CLINICS PREVALENCE FOLLOW-UP-STUDY

The diet-heart hypothesis proposes that elevated intakes of total fat, saturated fat, and dietary cholesterol raise serum cholesterol, which in turn increases the risk of developing coronary heart disease (CHD) . To examine the relationship between dietary intake and 12-year CHD m ortality we used data from the Lipid Research Clinics Prevalence Follo w Up Study. Dietary intake was measured at study entry using the 24-ho ur recall technique among 4546 North American men and women who were a t least 30 years old and initially free of CHD, Proportional hazards a nalyses controlling for total energy intake indicated that increasing percentages of energy intake as total fat (RR 1.04, 95% CI = 1.01-1.08 ), saturated fat (RR 1.11, CI = 1.04-1.18), and monounsaturated fat (R R 1.08, CI = 1.01-1.16) were significant risk factors for CHD mortalit y among 30 to 59 year olds. The increasing percentage of energy intake from carbohydrate had a significant protective effect (RR-0196, CI = 0.94-0.99). The strength of these associations was not diminished afte r adjustment for specific serum lipids, suggesting that serum lipids d id not mediate the effect of diet on CHD mortality. None of the dietar y components were significantly associated with CHD mortality among th ose aged 60-79 years. We conclude that future research must be directe d toward better understanding the pathway between dietary intake and c oronary disease as the current diet-lipid-heart hypothesis may be over ly simplistic.