Comparison of fat intake of American men and women; possible relationship to incidence of clinical coronary artery disease.

RECENTLY a number of epidemiologic studies1-6 have been published concerning the possible causes of the relative immunity of various classes and groups of non-American men against overt coronary artery disease. Since a low-fat intake was thought to be a trait common to all of these groups, it was concluded that this dietary habit was chiefly responsible for the observed relative infrequency of clinical coronary artery disease in these individuals. Impressive as is this relative immunity of the poverty-stricken Bantu,45 the similarly stricken Southern Chinese,7' 8 the economically depressed Italian2 and Spaniard,6 and similar groups against overt coronary disease, the immunity of the young, premenopausal American woman of any class is perhaps even more striking. Thus, before the age of 40, if she is neither hypertensive nor diabetic, she exhibits more than 20 times more resistance to symptomatic coronary disease than does her American male counterpart.9-12 In view of this truly astounding immunity of the young American female, it has seemed rather strange to us that no attempts, as far as we know, have been made to determine her daily fat intake. Yet if the reputed greater intake of fat on the part of her male counterpart (as compared to that of the non-American men referred to above) is held responsible by some observerst-6 for his greater incidence of coronary artery disease, certainly her daily fat intake warrants scrutiny. Only in this manner can the possible relationship of fat intake to her immunity be assessed.