Three Diet Strategies Help Prevent Coronary Heart Disease

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Doctor's Guide

" Three Diet Strategies Help Prevent Coronary Heart Disease "

Journal of the American Medical Association (JAMA)

11/27/2002

By Elda Hauschildt

Three dietary strategies have proven effective in preventing coronary

heart disease (CHD), researchers in the United States report.

These strategies are: substituting unsaturated fats (especially

polyunsaturated fats) for saturated and trans-fats, increasing use of

omega-3 fatty acids from fish oil or plant sources and consuming a diet

high in fruits, vegetables, nuts and whole grains but low in refined

grains.

" A combination of these approaches can confer greater benefits than a

single approach, " say investigators from Harvard University and Brigham

and Women's Hospital in Boston, Massachusetts.

They state: " Evidence is now clear that diets including non-hydrogenated

unsaturated fats as the predominant form of dietary fat, whole grains as

the main form of carbohydrate, an abundance of fruit and vegetables and

adequate omega-3 fatty acids can offer significant protection against

CHD.

" Such diets, together with regular physical activity, avoidance of

smoking and maintaining a healthy weight may prevent the majority of

cardiovascular disease in Western populations. "

Simply lowering the percentage of energy from total fat in the diet is

unlikely to improve lipid profile or reduce CHD incidence, they say.

They also suggest that while prevailing dietary guidelines emphasize

target macronutrients, these numerical criteria are not based on solid

scientific evidence, and the public finds it difficult to change diets

using them.

The investigators conducted a literature search through May 2002 looking

for clinical and epidemiological investigations of 10 major dietary

factors and CHD. These factors included: fat, cholesterol, omega-3 fatty

acids, trans-fatty acids, carbohydrates, glycemic index, fibre, folate,

specific foods and dietary patterns.

A selection of 147 original studies and reviews of metabolic,

epidemiological and dietary intervention studies provided " compelling "

evidence that the three strategies are effective in preventing CHD, they

suggest.

Many dietary issues remain unsettled, the researchers point out: optimal

amounts of monounsaturated and polyunsaturated fats, the optimal balance

between omega-3 and omega-6 polyunsaturated fats, amounts and sources of

protein and effects of individual phytochemicals, antioxidant vitamins

and minerals.

JAMA, 2002; 288: 2569-2578

http://www.docguide.com/news/content.nsf/news/8525697700573E1885256C7E000AC4B1

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Mayo Clinic in Rochester

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s Hopkins Medicine

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