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Coronary heart disease: dietary links and pathogenesis

Published online by Cambridge University Press:  27 September 2007

Serge Renaud  and
Dominique Lanzmann-Petithory
Serge Renaud*
Affiliation:
INSERM, Unity 330, University Bordeaux 2, 146, rue Léo Saignat, 33076 Bordeaux Cedex, France
Dominique Lanzmann-Petithory
Affiliation:
Department of Internal Medicine, Nutrition and lipid metabolism. Henri Mondor Hospital, 51. Avenue, Marechal de Lattre deTassigny, 94010 Creteil Cedex, France
*
*Corresponding author: Email serge.renaud@bordeaux.inserm.fr
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Abstract

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For decades it has been postulated that the main environmental factor for coronary heart disease (CHD) was the intake of saturated fatty acids (SFA). Nevertheless, confirmation of the role of SFA in CHD through intervention trials has been disappointing. It was only when the diet was enriched in n-3 fatty acids that CHD was significantly prevented, especially cardiac death.

In addition to n-3 fatty acids, many other foodstuffs or nutrients such as fibers, antioxidants, folic acid, calcium and even alcohol contribute to prevent CHD. Thus the relationship between diet and CHD morbidity and mortality appears to be much more complex than formerly suspected considering as key factors only SFA, linoleic acid, cholesterol and atherosclerosis. Some of the mechanisms are briefly described, but many additional nutrients (or non nutrients) may also play an important role in the pathogenesis of CHD.

Finally, as a result of the most recent epidemiologic studies the ideal diet may comprise: 8% energy from SFA, 5% from polyunsaturated fatty acids with a ratio 5/1 of linoleic/alpha-linolenic acid+longer chains n-3, oleic acid as desired, large intake of cereals, vegetables, legumes and fruits, fish twice a week, cheese and yogurt as dairy products, rapeseed and olive oils as edible fat. Without side effects, such a diet can be highly palatable, easily enjoyed by many populations and may prevent effectively and rapidly (within a few weeks or months) CHD.

Keywords

Coronary heart diseaseDietSaturated fatty acidsLinoleic acidAlphalinolenic acidTrans fatty acidsAntioxidantsFibersCalciumAlcohol
Type
Research Article
Information
Public Health Nutrition , Volume 4 , Issue 2b , April 2001 , pp. 459 - 474
Copyright
Copyright © CABI Publishing 2001

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