Can dietary changes rapidly decrease cardiovascular mortality rates?

Most heart attacks and ischaemic strokes are caused by complicated atheroma, usually compounded by thrombosis suddenly reducing blood flow in a critical artery. Extensive evidence suggests that this atheroma silently builds up over decades. Thus, early atheroma streaks were seen in classical autopsy studies on Korean war casualties and teenage traffic fatalities. Hence, the emerging paradigm describing the temporal relationship between risk factor change and the corresponding change in CVD mortality. The time scales for this paradigm are generally perceived in terms of decades. Thus, Rose thought the ‘incubation period’ was a decade or more, whereas Law et al. proposed a three-decade lag time to explain the paradoxically low French CVD rates. Reversing the CVD process following reductions in major cardiovascular risk factors has therefore also been assumed to require decades. However, this is wrong.