Diets Suitable for Reduction of Serum Cholesterol Levels

Author and Disclosure Information


FOUR years ago when the Cleveland Clinic Dietary Research Project began, evidence was accumulating that the incidence of ischemic heart disease was associated in some way with dietary fat and serum cholesterol levels.1 International epidemiologic studies had revealed a high incidence of coronary heart disease in countries such as the United States and Finland, where large amounts of fats are eaten, and a lower incidence (about one third as much) in countries such as Italy and Japan, where less fat is eaten. The average serum cholesterol levels in countries with low-fat consumption were approximately 25 per cent lower than in countries with high-fat consumption. It was also evident that the incidence of coronary heart disease increased in those groups who migrated from a country relatively free of the disease to one where it was prevalent. For instance, a Japanese moving from Tokyo to Los Angeles increased his fat consumption approximately threefold, his serum cholesterol rose to American levels, and his risk of developing heart disease doubled.

Aside from the evidence provided by population studies, it was well known that atherosclerosis was associated with diseases such as diabetes mellitus and hypothyroidism, in which the blood lipid concentrations are elevated. Furthermore, it was known that experimental atherosclerosis could not readily be produced in animals unless the serum cholesterol concentration was first increased with high-fat diets.

Apparently, man is more susceptible to atherosclerosis than other animals; the pathogenesis is not clear-cut and many factors are probably involved. The multi-faceted aspects of atherosclerotic heart . . .