SESSION I BIOCHEMISTRY AND PATHOLOGY OF THE ARTERIAL WALL Chairman: DR K. P. BALL Essential fatty acids and the vulnerability of the artery during growth

Introduction The discussion on the role of diet in the aetiology of coronary heart disease has tended to focus on the negative: that is, on the allegedly harmful aspects of the diet such as saturated fats, cholesterol, sucrose or purified carbohydrates. The underlying atherosclerosis can be considered as a degenerative disease, strongly linked with environmental factors, which ends in coronary occlusion in adulthood. Yet little attention has been given to the positive nutrients on which the healthy growth of the artery must depend. Sinclair, as early as 1968, suggested that an essential fatty acid deficiency was responsible for atherosclerosis, yet few of the more recent expert committee reports on the prevention of coronary heart disease (CHD) mention the function of the essential fatty acids (EFA) in the context of arterial growth and health. In practice, the growth of every cell membrane in the body needs EFA which cannot be synthetized in the body and must be supplied in the diet in the same way as essential amino acids. In addition to their structural importance, EFA have a wide range of physiological functions. They control blood lipid levels and are the precursors of the prostaglandins responsible for the regulation of platelet aggregation. In the experimental approach to atherogenesis, the dietary fats have been supplied as saturated fats or cholesterol, but these diets have also been low in EFA. This approach to atherogenesis has neglected the simultaneous manipulation of dietary essential fats which are needed for proper growth and tissue repair. First to be discussed will be essential fatty acids which could be important factors in the growth ofthe artery and in thrombus formation. It will be suggested that, as with other nutritional problems, the period when the artery is most sensitive to dietary distortion is during its period of growth.