Am J Clin Nutr. 1994 May; 59(5 Suppl): 1117S-1123S.

Diet and coronary heart disease: beyond dietary fats and low-density-lipoprotein cholesterol.

Fraser GE.

Center for Health Research, Loma Linda University, School of Public Health, CA.

Traditionally, the effects of diet on coronary heart disease have been attributed to the effects of medium-chain fatty acids, soluble fiber, and dietary cholesterol on serum low-density-lipoprotein (LDL) cholesterol concentrations. We review evidence here that many other dietary substances may affect risk, often via mechanisms not involving LDL-cholesterol concentrations directly. Such substances include phytosterols, tocotrienols, arginine, and antioxidant vitamins. The effects of diet on high-density-lipoprotein-cholesterol concentrations, triglycerides (fasting and postprandial), oxidized LDL particles, prostaglandins, and endothelium-derived relaxing factor are described. Finally, an illustration of some epidemiologic associations between diet and coronary disease events is made from the Adventist Health Study data.