Summary
Comparisons of different countries have shown that populations with a low dietary intake of saturated fat also have a low mortality from coronary heart disease. Controlledfeeding experiments have shown that the potential for altering plasma cholesterol levels and, consequently, altering the risk of coronary heart disease by dietary modification is great. However, in practice the influence of dietary advice to the general population on plasma cholesterol levels has been less pronounced.
Several investigators have shown that by decreasing the intake of saturated fats and dietary cholesterol and increasing the intake of polyunsaturated fats and foods providing soluble fibre, plasma cholesterol levels can be reduced by up to 29% and low density lipoprotein (LDL)-cholesterol by over 33%. In most studies, levels of high density lipoprotein (HDL)-cholesterol are not materially altered by modern lipid-lowering diets; generally, plasma levels are maintained, or increased after correction of overweight is achieved. It has been calculated that the risk of fatal coronary heart disease is 32% lower in subjects consuming such a diet than in those following a typical American diet, and life expectancy is 5 years greater in the former group. Life expectancy is also 2 to 3 years longer in populations habitually following low fat diets than in Western populations.
Frequent exercise has been inversely related to risk of coronary heart disease. Physically active individuals have a more favourable lipoprotein profile than sedentary individuals but the extent of a direct effect of exercise on lipoprotein levels is not known.
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References
Choudhury S, Jackson P, Katan MB, Marenah CB, Cortese C, et al. A multifactorial diet in the management of hyperlipidaemia. Atherosclerosis 50: 93–103, 1984
International Collaborative Study Group. Metabolic epidemiology of plasma cholesterol. Lancet 2: 991–996, 1986
Keys A. Seven countries study, Cambridge, Harvard University Press, Massachusetts, 1980
Lewis B. Composition of plasma cholesterol ester in relation to coronary-artery disease and dietary fat. Lancet 2: 71–73, 1958
Lewis B. Hyperlipidaemia. In Cohen R, et al. (Eds) Metabolic and molecular basis of acquired disease, Balliere-Tindall, Division of Academic Press, London, 1990
Lewis B, Hammett F, Katan MB, Kay RM, Merkx I, et al. Towards an improved lipid-lowering diet: additive effects of changes in nutrient intake. Lancet 2: 1310–1313, 1981
Lewis B, Mann JI, Mancini M. Reducing the risks of coronary heart disease in individuals and in the population. Lancet 1: 956–959, 1986
McGill Jr MC (Ed.). The geographic pathology of atherosclerosis, Williams & Wilkins, Baltimore, 1968
Miettinen TA, Naukkarinen V, Huttunen JK, Mattila S, Kumlin T. Fatty acid composition of serum lipids predicts myocardial infarction. British Medical Journal 285: 993–996, 1982
Mistry P, Miller NE, Laker M, Hazzard WR, Lewis B. Individual variation in the effects of dietary cholesterol on plasma lipoproteins and cellular cholesterol homeostasis in man. Journal of Clinical Investigation 67: 493–502, 1981
Riemersma RA, Wood DA, Butler S, Elton RA, Oliver M, et al. Linoleic acid content in adipose tissue and coronary heart disease. British Medical Journal 292: 1423–1427, 1986
Ruys T, Sturgess I, Shaikh M, Watts GF, Nordestgaard BG, et al. Effects of exercise and fat ingestion on high density lipoprotein production by peripheral tissues. Lancet 2: 1119–1122, 1989
Stamler J, Shekelle RB. Dietary cholesterol and human coronary heart disease. Archives of Pathology and Laboratory Medicine 112: 1032–1040, 1988
Turner PR, Konarska R, Revill J, Masana LI, La Ville A, et al. Metabolic study of variation in plasma cholesterol level in normal men. Lancet 2: 663–665, 1984
Wood PD, Haskell WL. The effect of exercise on plasma high density lipoproteins. Lipids 14: 417–427, 1979
Reference
Crouse JR. Gender, lipoproteins, diet, and cardiovascular risk: sauce for the goose may not be sauce for the gander. Lancet 1: 318–319, 1989
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Lewis, B. Diet and Exercise as Regulators of Lipid Risk Factors. Drugs 40 (Suppl 1), 19–25 (1990). https://doi.org/10.2165/00003495-199000401-00006
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DOI: https://doi.org/10.2165/00003495-199000401-00006