The 5-year experience of modified fat diets on younger men with coronary heart disease.

This is a study of 100 men, 30 to 50 years old, with documented coronary artery disease and past myocardial infarction who were placed under dietary management with a 28% fat diet. One hundred men whose diets were not managed were matched with regard to age at entry to the study, age at infarction, number of infarctions, blood pressure level, degree of angina, and serum cholesterol level among other factors. Over a period of 5 years the diet-managed group experienced and maintained a significant reduction in serum cholesterol level which the nondiet-managed group did not. Under the diet and experimental conditions employed, with saturated fat content below 9% of calories, and cholesterol intake below 400 mg per day, the degree of unsaturation of the fats in the experimental diets did not appear to influence serum cholesterol value or mortality. The serum triglyceride level was significantly lower in the diet-managed group than in the nondiet-managed group; this was presumably related to weight reduction. In the group under dietary management, fatal and nonfatal myocardial reinfarction rates were lower but were statistically significantly so only for the fatal infarction rates in men under age 45. Serum phospholipids above 220 mg/100 ml were associated with a significantly lower rate of recurrent infarction.