Diet and hyperlipidemia: a justifiable debate.

The current debate regarding a national "diet-heart" policy has many roots: questions regarding the effectiveness of a "prudent diet" in reducing plasma lipid levels, whether such reductions will decrease cardiovascular mortality, and whether there are potential long-term side effects of such a diet remain unanswered. These uncertainties are amplified by the fact that individual patients vary markedly in their responses to dietary management of hyperlipidemia and by our ignorance of the relative frequencies of these responses in the general population. Considering the uncertainties, it would seem that specific dietary rules for the American public are premature at this time in our search for the causes of cardiovascular disease and the discovery of safe and effective preventive measures.