Diet and atherosclerosis.

Everything in the diet can affect cholesterolemia and experimental atherosclerosis. Dietary cholesterol has relatively little effect on blood cholesterol. Saturated fat is a major factor in cholesterolemia. In rabbits, triglyceride structure affects atherosclerosis but not blood cholesterol. Protein and carbohydrate effects are secondary to those of fat. Soluble fiber lowers blood lipid levels. In the United States the mortality from heart disease (age adjusted cases per 100,000) has been falling since 1968. The "French Paradox" is attributed variably to red wine, exercise or other factors but no generally accepted explanation is available. One area of nutrition research that is almost untouched is that of interaction of nutrients which may explain some of the dichotomies. A new trend to study dietary patterns rather than specific dietary components may help to elucidate observed effects. For healthy people the most reasonable dietary advice is moderation, balance and variety.