Prevention of Coronary Artery Disease through Diet

Abstract

Our understanding of the potential role of diet in the prevention and risk reduction of coronary artery disease C"D has evolved in the past years. Data on trends in food consumption and ecological studies are the early evidences that showed associations between prevalence and fat intake across and within countries. The last years of epidemiology and clinical trials have focused on the efficiency of nutritional interventions in the prevention of C"D.The original diet-heart hypothesis was very simple Cholesterol is a constituent of atherosclerotic plaque. This hypothesis was based on the differences in average population serum cholesterol levels and population rates of C"D mortality. The Seven Country study was the first to show that the intake of saturated fat varied considerably by region and populations, with the greatest intake of saturated fat were found to have the highest serum cholesterol levels. Follow-up studies confirmed that these study groups also had the highest incidence of C"D. Thus, it was thought that there was a direct relation between cholesterol in diet, cholesterol in blood, and cholesterol in the plaque and its clinical complications such as myocardial infarction MI . These findings stimulated further inquiry to determine whether altering the diet could decrease serum cholesterol levels and, thereby, decrease the incidence of C"D. Nearly all clinical trials in the s, s, and s compared usual diets with those characterized by low total fat, low saturated fat, low dietary cholesterol, and increased polyunsaturated fats. "ctually, these diets did reduce cholesterol levels. However, they did not reduce the incidence of MI and C"D mortality. With accumulating evidence, we have now moved away from a focus on total fat and cholesterol to the importance of considering the content of fat and total calories in the diet. In other words, the type of fat, rather than the total or the ratio or balance between the saturated and certain unsaturated fats may be the determinant. Recent meta-analyses of intervention studies confirm the beneficial effects of replacing saturated with polyunsaturated fatty acid on C"D risk. "dditionally, recent studies indicate that dietary patterns consistent with the traditional Mediterranean-style diets MedD with a strong focus on veggies, fruits, fish, whole grain, and olive oil are effective in preventing C"D to a degree greater than low-fat diets and equal to or greater than the benefit observed in statin trials. Recent secondary prevention studies have convincingly demonstrated the © 2015 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.benefit of diets that closely followed the MedD in reducing re-infarction and clinical manifestations of C"D.In conclusion, C"D is still a significant problem and a growing health concern worldwide...