Diet and atherosclerosis: Epidemiologic evidence and public health implications
1983
Blackburn, Henry
Evidence for the effect of habitual diet on mass hyperlipidemia and atherosclerosis is illustrated in a review of a study of coronary heart disease in 7 countries. Wide discrepancies are found in hypercholesterolemia incidence between whole population groups (e.g., south Japan vs. east Finland), with group diet and lipid values being highly correlated. In contrast, a model of individual diet-cholesterol relationships indicates the high significance of intrinsic factors which determine individual cholesterol levels (and, perhaps, dietary responses). This microscopic model is extended to whole population groups, assuming an approximately equal distribution of polygenic susceptibility. When applied to the population diets, experimental data on the effects of different diets on cholesterol level give estimated means and ranges of serum cholesterol which were consistent with the observed values in all 7 country areas, suggesting that the diet is the main determinant of serum lipid population differences. The implications of these findings for public health strategy are discussed. (wz)
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