Fredrick J. Stare

Diet and 20-year mortality from coronary heart disease: the Ireland-Boston Diet-Heart Study.

In a prospective epidemiologic study of 1001 middle-aged men, we examined the relation between dietary information collected approximately 20 years ago and subsequent mortality from coronary heart disease. The men were initially enrolled in three cohorts: one of men born and living in Ireland, another of those born in Ireland who had emigrated to Boston, and the third of those born in the Boston area of Irish immigrants. There were no differences in mortality from coronary heart disease among the three cohorts. In within-population analyses, those who died of coronary heart disease had higher Keys (P = 0.06) and modified Hegsted (P = 0.02) dietary scores than did those who did not (a high score indicates a high intake of saturated fatty acids and cholesterol and a relatively low intake of polyunsaturated fatty acids). These associations were significant (P = 0.03 for the Keys and P = 0.04 for the modified Hegsted scores) after adjustment for other risk factors for coronary heart disease. Fiber intake (P = 0.04) and a vegetable-foods score, which rose with increased intake of fiber, vegetable protein, and starch (P = 0.02), were lower among those who died from coronary heart disease, though not significantly so after adjustment for other risk factors. A higher Keys score carried an increased risk of coronary heart disease (relative risk, 1.60), and a higher fiber intake carried a decreased risk (relative risk, 0.57). Overall, these results tend to support the hypothesis that diet is related, albeit weakly, to the development of coronary heart disease.

Serum Lipid Levels in Normal Persons Findings of a Cooperative Study of Lipoproteins and Atherosclerosis

Measurements of Sf 12-20, Sf 20-100, and total serum cholesterol made on 10,690 men and 3,404 women are reported and the relation of lipid level to race, source, age, sex, blood pressure, and weight is described. Distributions for men 40 to 59 are reported in detail. The groups studied, while not selected as representative of the population at large, were remarkably similar in their lipid levels. The lipid levels of only 2 of the 33 groups—Los Angeles and the prisoners—differed significantly from the average. No convincing explanation for either of these exceptions was discovered. The data in this study were mainly from a white population. Data for nonwhites came primarily from 2 aberrant groups and were too meager to allow a clear characterization of lipid levels. The levels for nonwhites from these 2 sources were closer to those of the white members of these groups than to the levels of the general population. Cholesterol levels for men and women were found to be about the same at age 20. For both sexes the level rises with age but at first the rise is much greater for men than women. Above age 50, however, the level is higher for women than men and the level for women continues to rise after that age—at least within the age series for this study. The level for men reaches a peak at age 55, after which it declines. The relation of age and sex with lipid level for Sf 12-20 and Sf 20-100 appeared to be similar to that for cholesterol. Correlations of lipid levels with blood pressure and weight were positive but very low. Hypertension or obesity, however, is associated with some elevation of lipid levels. Sf 20-100 was found to be the most sensitive of the 3 lipid measures to sex and race differences. In the age group 40 to 59 it was the only one that exhibited a definite race and sex differential. In addition, it had the highest correlation with weight and with blood pressure.

Atherosclerosis and the Fat Content of the Diet

A report to the American Heart Association and to the American Society for the Study of Arteriosclerosis the Nutrition Committee of the Council on Community Service and Education of the American Heart Association and others.

Dietary Fats, Carbohydrates and Atherosclerotic Vascular Disease

THERE is considerable evidence relating nutrition, presumably through its influence on the levels of circulating lipids, to the relentless progression of atherosclerotic vascular disease and to the...

Coronary heart disease and behavior patterns. An examination of method.

&NA; The methods of research used in relating a behavior pattern to coronary heart disease, elevated serum cholesterol levels, decreased clotting time, and increased norepinephine secretion was examined, and an independent study using the earlier procedures was done. One hundred and eighty‐nine men, 35–55 years old, were examined in three hospitals. Three groups were selected: (1) patients with clinical coronary heart disease, (2) those with peptic ulcer, and (3) controls having neither of these diseases. Ratings of behavior pattern were obtained without prior knowledge of medical diagnosis. Cholesterol determinations were made on 87 men in two hospitals. The polygraph procedure reported by Friedman and Rosenman was used with 65 patients in a third hospital. Among coronary patients only half were designated as the Friedman and Rosenman behavior type, although noncoronary patients were more closely associated with an inverse behavior pattern. Serum cholesterol levels were not found to be related to behavior type. The polygraph method, likewise, did not differentiate coronary patients from others. With younger patients, 35–44 years of age, interview ratings identified two‐thirds of coronary victims. At 45–49 years, however, only one‐third were correctly classified. When coronary patients were divided into those with angina pectoris and those having myocardial infarction, angina patients were much more closely related to the behavior type described. The high relation of interview ratings with education indicated the influence of socioeconomic status on judgments.

Diet, blood lipids and health of Italian men in Boston.

Excerpt INTRODUCTION The hypothesis that ingestion of excess dietary fat leads to coronary arterial and heart disease is man is supported by much suggestive evidence but has yet to be demonstrated ...

Serum Lipoprotein and Cholesterol Concentrations Comparison of Rural Costa Rican, Guatemalan, and United States Populations

A previous study indicated that Guatemalan Indians, both male and female, tended to maintain low levels of serum cholesterol throughout adulthood but that beta-lipoprotein fractions increased with age, as is usually the case in populations in the United States. To investigate whether race was of importance in this unexpected dissociation between these lipid fractions, a similar study was done with a rural group in Costa Rica, which was comparable in the diet consumed and in many other environmental factors, but of pure European origin. At all ages the cholesterol values were slightly higher but the same type of dissociation was observed.

The physiologic and clinical significance of plasma proteins and protein metabolites.

PROTEIN is an essential component of protoplasm. Both structure and function of bodytissues are dependent on specific proteins, such as enzymes and hormones. Fluid balance, hemostasis, many hormone...

Preparation of fat emulsions for intravenous alimentation

SummaryDescriptions are given of the high pressure homogenization equipment used and of the actual procedure followed in the preparation of fat emulsions suitable for intravenous nutrition. Such emulsions contain 10–15% oil (w/v) dispersed in particles less than one micron in diameter. They are made under nitrogen and subsequently autoclaved to ensure sterility.Procedures are also given for screening each batch of emulsion by means of tests performed on rats, dogs, and rabbits. Emulsions of the type described have found extensive application in the clinic with a low incidence of unfavorable reactions.

An institutional approach to the dietary regulation of blood cholesterol in adolescent males

Abstract This study presents in detail an acceptable effective approach to initiate dietary modification to lower serum cholesterol in institutionalized, nonmotivated adolescent males. In order to simulate the traditional school menu pattern, considerable use was made of specially prepared food items to replace the ordinary market counterparts. During the Modified Diet periods, dietary fat intake was estimated to decrease from 39 (baseline) to 33% (modified diet) of total calories; saturated fatty acids decreased from 15 to 10% of total calories; and polyunsaturated fatty acids increased from 3 to 10% of total calories. The ratio of polyunsaturated to saturated fatty acids rose from 0.2 in the baseline diets to 1.0 on the modified diets, and mean daily intake of dietary cholesterol was reduced from 540 to 300 mg, a decrease of about 44%. Initial mean serum cholesterol level was 178 mg/100 ml. This was decreased promptly by about 15% upon introduction of the Modified Diet and returned to baseline levels after a short midterm vacation period and again after the summer vacation. Thus, an interrelationship between diet and level of blood cholesterol does exist in males as early as the second decade of life. Recognition and alteration of this environmentally determined risk factor during the adolescent years may result in lessened atherosclerotic vascular disease in later life.