Diet and Hypercholesteremia
CONCERN with the amount of serum cholesterol, its relation to dietary fat and to cholesterol, and the association of hypercholesteremia with atherogenesis is widespread. It is reflected in the divergent opinions expressed both in scientific and in lay journals and in the recent report1 of a Joint Commitee of the American Heart Association and the American Society for the Study of Arteriosclerosis. The latter report reviews primarily the problem of a diet that is good for the general population. It suggests that from 25 to 30 per cent of calories be obtained from fat, with the further provision that the fat be sufficient “to meet caloric and essential fatty acid demands.” Most physicians are less concerned with diets for general consumption than with diets for their individual patients who have definite elevations of serum cholesterol concentration (more than 300 mg. per 100 ml. as determined by most methods) and also may present family or personal histories either of xanthoma or of premature arteriosclerosis or of both diseases. The purpose of this paper is to summarize present-day dietary approaches to the control of hypercholesteremia.
Two dietary programs are currently employed. One is the strictly low-fat diet and the other is a diet containing a minimum of animal fat along with sufficient vegetable oil to provide a normal total fat intake. These two distinctly different approaches, unfortunately, are sometimes misinterpreted as being interchangeable. Misunderstanding may be fostered by commercial advertisements that seem to lead one to believe that control can be established. . .