Primary prevention of coronary heart disease by diet.

THE subject of diet, atherosclerosis, and coronary heart disease was covered by Ancel Keys" at the Conference on Atherosclerosis and Coronary Heart Disease held on January i5, I97, and sponsored by the New York Heart Association. Among the major conclusions from Dr. Keys' epidemiologic studies of more than a decade ago were the following: i) There were very great differences between populations in the incidence of atherosclerosis and the mortality of coronary heart disease at given ages. 2) These differences were not explained by race, nationality, or climate or any nondietary factor studied. 3) The differences appeared to be closely correlated with the average serum cholesterol concentration in samples of the population. 4) Both the serum cholesterol concentration and the frequency of ischemic heart disease were unrelated to the amount of protein in the diet but there was a close correlation with the proportion of fats in the habitual diet. 5) Different dietary fats differed in their effect on serum cholesterol and, probably, on atherosclerosis; the common meat and dairy fats that dominated the American diet had a powerful tendency to raise the serum cholesterol level. One month after that conference, in February 1957, the Diet and Coronary Heart Disease Study Project (usually known as the AntiCoronary Club) originated in an executive order of the Commissioner of Health of the City of New York, and the pioneer investigation of the primary prevention of heart disease by diet was begun. The abovementioned conclusions of Keys instilled a fair degree of confidence that