The influence of diet on the appearance of new lesions in human coronary arteries

• Published in: JAMA : the journal of the American Medical Association Vol. 263; no. 12; p. 1646
• Main Authors: Blankenhorn, D H, Johnson, R L, Mack, W J, el Zein, H A, Vailas, L I
• Format: Journal Article
• Language: English
• Published: United States 23.03.1990
• Subjects: absorcion de substancias nutritivas; absorption de substances nutritives; Adult; Angiography; arteriosclerose; arteriosclerosis; blood vessels; cholesterol; Cholesterol, Dietary - administration & dosage; colesterol; Coronary Disease - diagnostic imaging; Coronary Disease - etiology; corps gras; diet; dieta; dieta terapeutica; Dietary Fats - administration & dosage; Dietary Fats, Unsaturated - administration & dosage; Energy Intake; fats; grasas; hombres; homme; Humans; Male; men; Middle Aged; Multivariate Analysis; nutrient uptake; radiografia; radiographie; radiography; Randomized Controlled Trials as Topic; regime alimentaire; regime therapeutique; Regression Analysis; therapeutic diets; vaisseau sanguin; vasos sanguineos
• ISSN: 0098-7484; 1538-3598
• DOI: 10.1001/jama.1990.03440120068039

The Cholesterol Lowering Atherosclerosis Study, a randomized, placebo-controlled trial of blood lipid lowering, demonstrated significant benefit in 2-year coronary angiograms. Using angiograms of subjects in the Cholesterol Lowering Atherosclerosis Study who received a placebo and 24-hour dietary recall data, we performed an epidemiologic study of risk factors for formation of new atherosclerotic lesions. Age and baseline plus on-trial lipid levels, blood pressure levels, and diet variables were included. Significant dietary energy sources were protein, carbohydrate, alcohol, total fat, and polyunsaturated fat. Each quartile of increased consumption of total fat and polyunsaturated fat was associated with a significant increase in risk of new lesions. Increased intake of lauric, oleic, and linoleic acids significantly increased risk. Subjects in the Cholesterol Lowering Atherosclerosis Study in whom new lesions did not develop increased dietary protein to compensate for reduced intake of fat by substituting low-fat meats and dairy products for high-fat meats and dairy products. These results indicate that when total and saturated fat intakes are reduced to levels recommended by the National Cholesterol Education Program, protein and carbohydrate are preferred substitutes for fat calories, rather than monounsaturated or polyunsaturated fat.