In the US coronary mortality increased about ten times between 1930 and 1960, leveled off during the sixties and has since decreased. In Japan coronary heart disease is uncommon, allegedly due to the lean Japanese diet. If dietary fats were important this should obviously be reflected in the diet of patients who have had a heart attack. The following table gives the results from 13 studies, where the diet of patients with coronary heart disease was compared with the diet of healthy control individuals of the same age and sex. The amounts of dietary fats are given in percent of total calories.
Asterisks means that the difference found was statistically significant.
NS means that no absolute figures were given in the report, but that the difference was not statistically significant. As you see, the differences were very small and in most cases due to chance. In only one study patients ate more saturated fatty acids than did healthy controls, but in the same study and in a further three, patients ate more polyunsaturated fatty acids, contrary to what was predicted from the message we have heard for so many years. The prudent diet is thought to operate by lowering serum cholesterol and a low serum cholesterol is thought to prevent premature atherosclerosis. Logically, degree of atherosclerosis at autopsy should reflect the diet, but again, findings are contradictory.