Dietary Prevention of Coronary Heart Disease: The Finnish Mental Hospital Study

Abstract

A controlled intervention trial, with the purpose of testing the hypothesis that the incidence of coronary heart disease (CHD) could be decreased by the use of serum-cholesterol-lowering (SCL) diet, was carried out in 2 mental hospitals near Helsinki in 1959--71. The subjects were hospitalized middle-aged men. One of the hospitals received the SCL diet, i.e. a diet low in saturated fats and cholesterol and relatively high in polyunsaturated fats, while the other served as the control with a normal hospital diet. Six years later the diets were reversed, and the trial was continued another 6 years. The use of the SCL diet was associated with markedly lowered serum-cholesterol values. The incidence of CHD, as measured by the appearance of certain electrocardiographic patterns and by the occurrence of coronary deaths, was in both hospitals during the SCL-diet periods about half that during the normal-diet periods. An examination of a number of potential confounding variables indicated that the changes in them were small and failed to account for the considerable reduction in the incidence of CHD. It is concluded that the use of the serum-cholesterol-lowering diet exerted a substantial preventive effect on CHD.

Some problems with Cochrane reviews of diet and chronic disease

“…On the other hand, Hooper et al excluded the big Helsinki Mental Hospital Trial which was a large crossover trial in two long-stay hospitals (Turpeinen et al, 1979;Miettinen et al, 1983). First one, then after 7 y the other hospital implemented a reduced saturated, increased polyunsaturated fat diet across the institution, while the other hospital served the standard Finnish diet of the 1960s.…”

<a name="top"></a>Ácidos graxos e doenças cardiovasculares: uma revisão

“…Posteriormente, Kromhout & Coulander (1984) não encontraram associação significante entre os diferentes tipos de ácidos graxos e a incidência de DCV. Turpeinen et al (1979) em um ensaio clínico controlado, realizado com pacientes hospitalizados iniciado em 1959, com duração de 12 anos, concluíram que o uso de dieta pobre em SFA e colesterol, e relativamente rica em PUFA, exercia um efeito protetor substancial anti--DCV. Bassett et al (1969) procuraram observar a dieta de havaianos e japoneses, uma vez que a prevalência de DCV entre esses dois grupos apresentava-se bastante distinta, e os fatores de riscos ambientais diferiam muito pouco entre eles.…”

Fatores de risco cardiovascular e mortalidade: seguimento em longo prazo (até 20 anos) em programa preventivo realizado pela medicina ocupacional

“…Results from those investigations allowed for verifying that the reduction of cholesterolemia is able to decrease significantly the clinical events and the deaths resulting from CAD, as well as cardiovascular mortality [17][18][19][20][21][22][23][24][25][26][27] .…”