Optimal Diets for Prevention of Coronary Heart Disease

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Abstract
The relationship between diet and coronary heart disease (CHD) has been studied intensively for nearly a century. In 1908, Ignatowski produced atherosclerosis in rabbits with a diet high in cholesterol and saturated fat1; feeding the rabbits cholesterol alone produced identical lesions. In the early 1950s, controlled feeding studies demonstrated that saturated fatty acids and, to a lesser extent, cholesterol increased serum cholesterol concentration in humans.2 Meanwhile, epidemiologic studies found that increased serum cholesterol predicted risk of CHD in human populations. These discoveries led to the classic diet-heart hypothesis, which postulated a primary role of dietary saturated fat and cholesterol in the cause of atherosclerosis and CHD in humans.3 The diet-heart hypothesis gained further support from ecological correlations relating saturated fat intake to rates of CHD in cohorts from different countries4 and from studies of migrants from low- to high-risk countries.5