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Optimal diets for prevention of coronary heart disease.
JAMA 2002; 288(20):2569-78JAMA

Abstract

CONTEXT

Coronary heart disease (CHD) remains the leading cause of mortality in industrialized countries and is rapidly becoming a primary cause of death worldwide. Thus, identification of the dietary changes that most effectively prevent CHD is critical.

OBJECTIVE

To review metabolic, epidemiologic, and clinical trial evidence regarding diet and CHD prevention.

DATA SOURCES AND STUDY SELECTION

We searched MEDLINE through May 2002 for epidemiologic and clinical investigations of major dietary factors (fat, cholesterol, omega-3 fatty acids, trans-fatty acids, carbohydrates, glycemic index, fiber, folate, specific foods, and dietary patterns) and CHD. We selected 147 original investigations and reviews of metabolic studies, epidemiologic studies, and dietary intervention trials of diet and CHD.

DATA EXTRACTION

Data were examined for relevance and quality and extracted by 1 of the authors.

DATA SYNTHESIS

Compelling evidence from metabolic studies, prospective cohort studies, and clinical trials in the past several decades indicates that at least 3 dietary strategies are effective in preventing CHD: substitute nonhydrogenated unsaturated fats for saturated and trans-fats; increase consumption of omega-3 fatty acids from fish, fish oil supplements, or plant sources; and consume a diet high in fruits, vegetables, nuts, and whole grains and low in refined grain products. However, simply lowering the percentage of energy from total fat in the diet is unlikely to improve lipid profile or reduce CHD incidence. Many issues remain unsettled, including the optimal amounts of monounsaturated and polyunsaturated fats, the optimal balance between omega-3 and omega-6 polyunsaturated fats, the amount and sources of protein, and the effects of individual phytochemicals, antioxidant vitamins, and minerals.

CONCLUSIONS

Substantial evidence indicates that diets using nonhydrogenated unsaturated fats as the predominant form of dietary fat, whole grains as the main form of carbohydrates, an abundance of fruits and vegetables, and adequate omega-3 fatty acids can offer significant protection against CHD. Such diets, together with regular physical activity, avoidance of smoking, and maintenance of a healthy body weight, may prevent the majority of cardiovascular disease in Western populations.

Authors+Show Affiliations

Department of Nutrition, Harvard School of Public Health, 665 Huntington Ave, Boston, MA 02115, USA. frank.hu@channing.harvard.eduNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Review

Language

eng

PubMed ID

12444864

Citation

Hu, Frank B., and Walter C. Willett. "Optimal Diets for Prevention of Coronary Heart Disease." JAMA, vol. 288, no. 20, 2002, pp. 2569-78.
Hu FB, Willett WC. Optimal diets for prevention of coronary heart disease. JAMA. 2002;288(20):2569-78.
Hu, F. B., & Willett, W. C. (2002). Optimal diets for prevention of coronary heart disease. JAMA, 288(20), pp. 2569-78.
Hu FB, Willett WC. Optimal Diets for Prevention of Coronary Heart Disease. JAMA. 2002 Nov 27;288(20):2569-78. PubMed PMID: 12444864.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Optimal diets for prevention of coronary heart disease. AU - Hu,Frank B, AU - Willett,Walter C, PY - 2002/11/28/pubmed PY - 2002/12/11/medline PY - 2002/11/28/entrez SP - 2569 EP - 78 JF - JAMA JO - JAMA VL - 288 IS - 20 N2 - CONTEXT: Coronary heart disease (CHD) remains the leading cause of mortality in industrialized countries and is rapidly becoming a primary cause of death worldwide. Thus, identification of the dietary changes that most effectively prevent CHD is critical. OBJECTIVE: To review metabolic, epidemiologic, and clinical trial evidence regarding diet and CHD prevention. DATA SOURCES AND STUDY SELECTION: We searched MEDLINE through May 2002 for epidemiologic and clinical investigations of major dietary factors (fat, cholesterol, omega-3 fatty acids, trans-fatty acids, carbohydrates, glycemic index, fiber, folate, specific foods, and dietary patterns) and CHD. We selected 147 original investigations and reviews of metabolic studies, epidemiologic studies, and dietary intervention trials of diet and CHD. DATA EXTRACTION: Data were examined for relevance and quality and extracted by 1 of the authors. DATA SYNTHESIS: Compelling evidence from metabolic studies, prospective cohort studies, and clinical trials in the past several decades indicates that at least 3 dietary strategies are effective in preventing CHD: substitute nonhydrogenated unsaturated fats for saturated and trans-fats; increase consumption of omega-3 fatty acids from fish, fish oil supplements, or plant sources; and consume a diet high in fruits, vegetables, nuts, and whole grains and low in refined grain products. However, simply lowering the percentage of energy from total fat in the diet is unlikely to improve lipid profile or reduce CHD incidence. Many issues remain unsettled, including the optimal amounts of monounsaturated and polyunsaturated fats, the optimal balance between omega-3 and omega-6 polyunsaturated fats, the amount and sources of protein, and the effects of individual phytochemicals, antioxidant vitamins, and minerals. CONCLUSIONS: Substantial evidence indicates that diets using nonhydrogenated unsaturated fats as the predominant form of dietary fat, whole grains as the main form of carbohydrates, an abundance of fruits and vegetables, and adequate omega-3 fatty acids can offer significant protection against CHD. Such diets, together with regular physical activity, avoidance of smoking, and maintenance of a healthy body weight, may prevent the majority of cardiovascular disease in Western populations. SN - 0098-7484 UR - https://www.unboundmedicine.com/medline/citation/12444864/Optimal_diets_for_prevention_of_coronary_heart_disease_ L2 - https://jamanetwork.com/journals/jama/fullarticle/vol/288/pg/2569 DB - PRIME DP - Unbound Medicine ER -