The anti-coronary club. A dietary approach to the prevention of coronary heart disease--a seven-year report.

THE Anti-Coronary Club Study Project represents an epidemiological approach to a test of the hypothesis that adherence to a serum cholesterol-lowering diet will be associated with a decreased incidence of coronary heart disease. The Diet and Coronary Heart Disease Study conducted by the Bureau of Nutrition of the New York City Department of Health has been in progress since 1957. In previous reports the composition of the experimental diet (or "Prudent Diet") has been described, and data presented which suggested that adherence to this diet can significantly lower the level of serum cholesterol of both normal and overweight coronary and noncoronary subjects.1-18 Concurrent with the maintenance of lowered level of serum cholesterol over a five-year period, a progressive increase in the per cent composition of linoleic acid in the depot fat of AntiCoronary Club subjects has been observed.14 According to present knowledge, linoleic acid, an essential unsaturated fatty acid, can only be derived from dietary sources. This observed increase in depot fat linoleic acid therefore indicates that adherence to the study diet has been satisfactory. Experimental demonstration of the serum cholesterol-lowering effect of diets relatively rich in polyunsaturated fats,15-18 supports the conviction that our study diet is responsible for the long-term depression of serum cholesterol observed in Anti-Coronary Club subjects. Recent investigations on the effect of the experimental diet on serum vitamin E and vitamin A levels of study subjects have affirmed the nutritional adequacy of the diet with respect to these nutrients.19 Furthermore it was found that long-term adherence to the study diet has no demonstrable effect in increasing serum triglyceride levels. Finally, preliminary data have been published in-