Dietary patterns and coronary heart disease risk

This chapter describes and compares selected dietary patterns, each of which has been associated with reduced coronary heart disease (CHD) risk. The dietary patterns include those consumed by free-living persons (i.e., a traditional Mediterranean diet consumed in Crete, vegetarian diets, diets consumed in rural China, and a traditional Okinawan diet) and diets tested in clinical trials (i.e., Lyon Diet Heart Study, Indo-Mediterranean Diet Heart Study, and the DASH clinical trial). Several distinct dietary patterns are associated with lower CHD rates and with improved CHD risk factors. A common feature of these diets is an emphasis on plant-based foods. Accordingly, fibre intake is high while saturated fat intake is low, less than 10% kcal in all instances. When total fat intake is high, that is, over 30% kcal, the predominant fat is monounsaturated fats. N-3 polyunsaturated fats are frequently consumed in small quantities and in a variety of forms. Carbohydrate intake is typically high; the predominant forms appear to be complex carbohydrates, likely from whole grain products with minimal processing.