THE “WHOLE POPULATION” APPROACH TO REDUCING CHOLESTEROL

Apr
02
2009

THE “WHOLE POPULATION” APPROACH TO REDUCING CHOLESTEROL

Among the early studies was the Los Angeles Veterans Administration Study, which took place between 1959 and 1967. This followed 846 men aged between fifty-four and eighty-eight years, of whom a quarter initially had evidence of coronary heart disease (mainly angina). Half were allocated to a diet in which the ratio of polyunsaturated fats to saturated fats was two to one. Vegetable and fish oils were used instead of animal fats. Half were left as the control group. After eight years, fewer deaths from heart disease and nonfatal heart attacks had occurred in the treatment group (85 in 424) than in the control group (119 in 422). The benefit of cholesterol lowering was greatest in the men under sixty-five years old.

Diet also seemed to work in seven hundred men and six hundred women in the Finnish Mental Hospitals Study, which was undertaken from 1959 to 1971. For six years, those in one hospital were on the same polyunsaturated/saturated two-to-one diet as in the Los Angeles study, whereas those in the other hospital were left alone. After six years, the positions were reversed. Although the patient populations changed greatly during the twelve years, and there were many problems with the data analysis, the diet was linked with a moderate benefit in reduction of heart attack and stroke for both men and women (though less so for women).

The North Karelia Study described in chapter 4, which targeted a whole community, produced a similar benefit, in that heart attacks became fewer after the low cholesterol educational project started.

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