SECULAR TRENDS IN DIET AND RISK-FACTORS FOR CARDIOVASCULAR-DISEASE - THE FRAMINGHAM-STUDY

Objective In this study we examined changes in dietary intake and risk factors for cardiovascular disease that occurred over three decades i n a US-population-based sample. Design Secular trends in dietary profi les and risk factors were studied in cross-sectional samples of subjec ts from the Framingham Study in 1957-1960, 1966-1969, and 1984-1988. R esults Dietary levels of cholesterol appeared to have declined conside rably, whereas macronutrient and fatty acid intakes appeared to change only slightly. Men appeared to increase their saturated fat intakes f rom 16.4% in 1966-1969 to 17.0% in 1984-1988 (P<.01). In spite of rela tively stable mean total fat intake levels, 35% to 60% of Framingham S tudy men and women reported decreased consumption of higher-fat animal products over the 10-year period between 1974-1978 and 1984-1988. Fra mingham subjects who reported modifying their diets by substituting lo wer-fat foods for high-fat items between 1974-1978 and 1984-1988 were more likely to achieve the guidelines of the National Cholesterol Educ ation Program and Healthy People 2000 for dietary fat and cholesterol intake and for serum total cholesterol level. Levels of systolic and d iastolic blood pressure, total and low-density lipoprotein cholesterol , and cigarette smoking were also lower in 1984-1988 than in earlier t imes. Compared with 1957-1960, mean body mass index and prevalence rat es of overweight and hypertension were higher in 1984-1988, despite hi gher levels of reported physical activity. Conclusions The observed se cular trends in diet and risk factor levels for cardiovascular disease in the Framingham population are important to guide the development a nd implementation of population-based strategies for promoting cardiov ascular health, including nutrition interventions.