Rationale of the Diet-Heart Statement of the American Heart Association | Report of Nutrition Committee

Grundy, Scott M.; Bilheimer, David W.; Blackburn, Henry; Brown, W. Virgil; Kwiterovich, Peter O.; Mattson, F.H.; Schonfeld, Gustav; Weidman, William H.

doi:10.1097/00017285-198209000-00004

Cited by 69 publications

(71 citation statements)

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“…It is widely accepted that diets high in saturated fat increase the risk of CHD [52][53][54], and there is a fairly broad-based consensus on the role of dietary fat (especially saturated fatty acids) in hyperlipidemia and on the role of hyperlipidemia in CHD. Patients with diabetes are particularly vulnerable to CHD.…”

Section: Discussionmentioning

confidence: 99%

Low-carbohydrate and high-fat intake among adult patients with poorly controlled type 2 diabetes mellitus

Olendzki

Hafner

et al. 2006

Nutrition

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Objective-This study examined baseline dietary intake, body weight, and physiologic status in patients enrolled in a dietary intervention for type 2 diabetes mellitus (T2DM).Methods-Dietary, physiologic, and demographic information were collected at baseline from 40 adult patients with poorly controlled T2DM (glycosylated hemoglobin >7%) who participated in a clinical trial at an academic medical center in Worcester, Massachusetts, USA.Results-The average age at enrollment was 53.5 y (SD 8.4), average body mass index was 35.48 kg/m 2 (SD 7.0), and glycosylated hemoglobin was 8.3% (SD 1.2). Participants were predominantly white, married, and employed full time. Forty-eight percent were men. Seventy-eight percent had hyperlipidemia, and 68% had hypertension. Reported baseline daily average energy intake was 1778 kcal (SD 814), daily carbohydrate was 159 g (SD 71.5), and dietary fiber was 11.4 g (SD 5.2). The dietary composition was 35% carbohydrate, 45% fat (15% saturated fat), and 20% protein. The American Diabetes Association (ADA) guidelines recommends 45-65% of energy from carbohydrate, 20-35% from fat (<7% saturated), and 20% from protein.Conclusion-These patients reported a low-carbohydrate, low-fiber, high-fat (especially saturated) diet, although they stated they are not following any of the popular low-carbohydrate diets. Patients with T2DM may find the current trend toward reducing weight through low-carbohydrate diets attractive for control of blood glucose, despite ADA recommendations. This dietary pattern may represent a popular trend that extends beyond our particular study and, if so, has serious cardiovascular implications in this vulnerable population of T2DM patients.

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Section: Discussionmentioning

confidence: 99%

Low-carbohydrate and high-fat intake among adult patients with poorly controlled type 2 diabetes mellitus

Olendzki

Hafner

et al. 2006

Nutrition

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“…Numerous metabolic studies have shown that linoleic acid has a lowering effect on total cholesterol and LDL-cholesterol (Grundy et al 1982;Sacks, 1994;Mensink et al 2003), while other beneficial effects include improvement in platelet function (Mutanen & Freese, 1996), improved insulin sensitivity (Lovejoy & DiGirolamo, 1992;Lovejoy, 1999) and anti-arrhythmic effects (Abeywardena et al 1991).…”

Section: Biological Effects Of the Various Classes Of Fatty Acidmentioning

confidence: 99%

“…In particular, the mortality rate from CHD is very low in the traditional Mediterranean populations that use olive oil as the primary source of fat (Grundy et al 1982). Prospective cohort studies examining MUFA intake and CHD risk are sparse.…”

Section: Mufa and Chdmentioning

confidence: 99%

Fatty acids and CHD

Woodside¹,

Kromhout

2005

Proc. Nutr. Soc.

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During the last century much evidence has accumulated to suggest that from a public health perspective the type of fat is more important than the amount of fat. Saturated and trans-fatty acids increase and both n-6 and n-3 PUFA decrease the risk of CHD. Most of the knowledge about the effects of dietary fatty acids on CHD risk is based on observational studies and controlled dietary experiments with intermediate end points (e.g. blood lipoprotein fractions). Information from high-quality randomised controlled trials on fatty acids and CHD is lacking. The Netherlands Institute for Public Health has calculated the potential health gain that can be achieved if the fatty acid composition of the current Dutch diet is replaced by the recommended fatty acid composition. The recommendations of The Netherlands Health Council are: saturated fatty acids < 10 % energy intake; trans-fatty acids < 1 % energy intake; fish consumption (an indicator of n-3 PUFA) once or twice weekly. Implementation of this recommendation could reduce the incidence of CHD in The Netherlands by about 25 000/year and the number of CHD-related deaths by about 6000/year and increase life expectancy from age 40 years onwards by 0 . 5 year. These projections indicate the public health potential of interventions that modify the fatty acid composition of the diet.

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“…The greatest potential for reducing the societal burden of CHD, particularly premature CHD, is to adopt the principles outlined for nondrug therapy in Table 4. In the US, efforts have been sustained over many years to encourage the public to modify life habits that raise the long-term risk for CHD [48].…”

Section: Life-time (Long-term) Preventionmentioning

confidence: 99%

“…These reports form the basis of recommendations to the American public for advocating modification of eating and exercise habits. Foremost amongst these are recommendations coming from the American Heart Association [48], the National Research Council [54], the Surgeon General of the US [55], joint federal government agencies [56], and the National Cholesterol Education Program (NCEP) [47]. The various dietary guidelines for the general public contain considerable consistency.…”

Section: Life-time (Long-term) Preventionmentioning

confidence: 99%

Primary prevention of coronary heart disease: role of cholesterol control in the United States

Grundy

1997

Journal of Internal Medicine

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The benefit of cholesterol‐lowering drug therapy in patients with existing coronary heart disease (CHD) is well established through clinical trials. Prevention of recurrent coronary morbidity and mortality in CHD patients is called secondary prevention. In contrast, primary prevention is delaying or preventing altogether new‐onset CHD. There are three categories of primary prevention: high‐risk, moderate‐risk, and long‐term (life‐time). A recent clinical trial has documented benefit of cholesterol‐lowering drugs for prevention of coronary morbidity and mortality and total mortality in hypercholesterolemic, middle‐aged men. This trial lends support for including aggressive cholesterol reduction in high‐risk primary prevention. However, for such therapy to be cost effective at present‐day prices of cholesterol‐lowering drugs, only those patients in the higher ranges of risk can be selected for treatment. This leaves a large number of people at moderately high risk for premature CHD because of high cholesterol levels. These persons deserve increased professional attention to risk reduction. In general the nondrug approach is indicated. The latter approach includes eliminating other risk factors, e.g. cigarette smoking and hypertension, and reducing serum cholesterol levels by decreased intakes of saturated fatty acids, cholesterol, and excess total calories. Some moderate‐risk patients may require low doses of cholesterol‐lowering drugs to achieve the goals for cholesterol reduction. Finally, public health strategies need to be developed for applying the same nondrug approach for the general population for reducing the overall incidence of CHD.

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Rationale of the Diet-Heart Statement of the American Heart Association | Report of Nutrition Committee

Cited by 69 publications

References 0 publications

Low-carbohydrate and high-fat intake among adult patients with poorly controlled type 2 diabetes mellitus

Low-carbohydrate and high-fat intake among adult patients with poorly controlled type 2 diabetes mellitus

Fatty acids and CHD

Primary prevention of coronary heart disease: role of cholesterol control in the United States

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