Dietary associates of serum total, LDL, and HDL cholesterol and triglycerides in patients with coronary heart disease

Background. Diet-Lipid associations established in clinical trials have in general been weak or nonexistent in cross-sectional studies within a popula tion. Our objective was to analyze the dietary associates of serum lipids i n patients with coronary heart disease (CHD) not using lipid-lowering medic ation. Methods. Patients with coronary bypass grafting (n = 49), balloon angioplas ty (n = 46), acute myocardial infarction (n = 79), and acute myocardial isc hemia (n 79) participated in a survey (EUROASPIRE). Patients were selected from hospital records at least 6 months after hospitalization. Diet was ass essed by a food record, a short questionnaire, and fatty acid composition o f serum cholesteryl esters (CE). Results. Neither the intake of total fat nor that of saturated, monounsatur ated, or polyunsaturated fatty acids was associated with serum lipids. Use of soft margarine on bread (though not in cooking or baking) and high intak e of fiber and cereal products were associated with low total cholesterol. Linoleic acid in CE was inversely associated with total cholesterol and tri glycerides, and eicosapentaenoic acid was inversely associated with triglyc erides and positively associated with HDL cholesterol. Conclusions. In the present study use of soft margarine on bread (though no t in cooking or baking) and high intake of fiber and cereal products were a ssociates of lowered serum cholesterol concentrations in CHD patients. Fatt y acid composition of CE reflected dietary fatty acid intake involved in ch olesterol lowering better than food records. (C) 1999 American Health Found ation and Academic Press.