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Nutritional Epidemiology$
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Walter Willett

Print publication date: 2012

Print ISBN-13: 9780199754038

Published to Oxford Scholarship Online: January 2013

DOI: 10.1093/acprof:oso/9780199754038.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 29 November 2021

Diet and Coronary Heart Disease

Diet and Coronary Heart Disease

(p.426) 19 Diet and Coronary Heart Disease
Nutritional Epidemiology

Walter Willett

Meir Stampfer

Oxford University Press

According to the classic “diet-heart” hypothesis, high intake of saturated fats and cholesterol and low intake of polyunsaturated fats increase the level of serum cholesterol, which leads to the development of atheromatous plaques. Accumulation of these plaques narrows the coronary arteries, reduces blood flow to the heart muscle, and finally leads to myocardial infarction. This chapter examines the epidemiologic evidence addressing this hypothesis and considers additional hypotheses relating diet to heart disease. Abundant evidence has shown that specific dietary fatty acids play important roles in coronary heart disease. Nevertheless, the dose-response relationships between specific fatty acids and cholesterol intake and rates of coronary heart disease (CHD) are not clearly defined. Modest reductions in CHD rates by further decreases in saturated fat and cholesterol intake are possible if saturated fat is replaced by unsaturated fat, but little or no benefit is likely if saturated fat is replaced by carbohydrate.

Keywords:   fat intake, cholesterol, epidemiologic studies, heart disease, saturated fat, unsaturated fat

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