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Coronary heart disease: dietary links and pathogenesis

Published online by Cambridge University Press:  27 September 2007

Serge Renaud  and
Dominique Lanzmann-Petithory
Serge Renaud*
Affiliation:
INSERM, Unity 330, University Bordeaux 2, 146, rue Léo Saignat, 33076 Bordeaux Cedex, France
Dominique Lanzmann-Petithory
Affiliation:
Department of Internal Medicine, Nutrition and lipid metabolism. Henri Mondor Hospital, 51. Avenue, Marechal de Lattre deTassigny, 94010 Creteil Cedex, France
*
*Corresponding author: Email serge.renaud@bordeaux.inserm.fr
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Abstract

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For decades it has been postulated that the main environmental factor for coronary heart disease (CHD) was the intake of saturated fatty acids (SFA). Nevertheless, confirmation of the role of SFA in CHD through intervention trials has been disappointing. It was only when the diet was enriched in n-3 fatty acids that CHD was significantly prevented, especially cardiac death.

In addition to n-3 fatty acids, many other foodstuffs or nutrients such as fibers, antioxidants, folic acid, calcium and even alcohol contribute to prevent CHD. Thus the relationship between diet and CHD morbidity and mortality appears to be much more complex than formerly suspected considering as key factors only SFA, linoleic acid, cholesterol and atherosclerosis. Some of the mechanisms are briefly described, but many additional nutrients (or non nutrients) may also play an important role in the pathogenesis of CHD.

Finally, as a result of the most recent epidemiologic studies the ideal diet may comprise: 8% energy from SFA, 5% from polyunsaturated fatty acids with a ratio 5/1 of linoleic/alpha-linolenic acid+longer chains n-3, oleic acid as desired, large intake of cereals, vegetables, legumes and fruits, fish twice a week, cheese and yogurt as dairy products, rapeseed and olive oils as edible fat. Without side effects, such a diet can be highly palatable, easily enjoyed by many populations and may prevent effectively and rapidly (within a few weeks or months) CHD.

Keywords

Coronary heart diseaseDietSaturated fatty acidsLinoleic acidAlphalinolenic acidTrans fatty acidsAntioxidantsFibersCalciumAlcohol
Type
Research Article
Information
Public Health Nutrition , Volume 4 , Issue 2b , April 2001 , pp. 459 - 474
Copyright
Copyright © CABI Publishing 2001

References

1Keys, A.Coronary heart disease in seven countries. Circulation 1970; 41(Suppl 1): 1–211.Google Scholar
2Kato, H, Tillotson, J, Nichaman, JZ, Rhoads, GG, Hamilton, HB. Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California. Am. J. Epidemiol. 1973; 97: 372–85.CrossRefGoogle ScholarPubMed
3Renaud, S, de Lorgeril, M.Dietary lipids and their relation to ischaemic heart disease: from epidemiology to prevention. J. Intern. Med. 1989; 225(Suppl 1): 39–46.CrossRefGoogle Scholar
4Kromhout, D, Menotti, A, Blowmberg, B, et al. Dietary saturated and trans fatty acids and cholesterol and 25-year mortality from coronary heart disease: the Seven Countries Study. Prev. Med. 1995; 24: 308–15.CrossRefGoogle ScholarPubMed
5Caggiula, AW, Mustad, VA. Effects of dietary fat and fatty acids on coronary artery disease risk and total and lipoprotein cholesterol concentrations: epidemiologic studies. Am. J. Clin. Nutr. 1997; 65(Suppl): 159–610S.CrossRefGoogle ScholarPubMed
6Joossens, JV, Geboers, J, Kesteloot, H.Nutrition and cardiovascular mortality in Belgium. Acta Cardiol 1989; 44: 157–182.Google ScholarPubMed
7Shekelle, RB, Shryock, AM, Paul, O, et al. Diet, serum cholesterol, and death from coronary heart disease. The Western Electric Study. N. Engl. J. Med. 1981; 304: 65–70.CrossRefGoogle ScholarPubMed
8Kromhout, D, de Lezenne Coulander, C.Diet, prevalence and 10 year mortality from coronary heart disease in 871 middle-aged men. The Zutphen Study. Am. J. Epidemiol. 1984; 119: 733–741.CrossRefGoogle ScholarPubMed
9De Lorgeril, M, Renaud, S, Mamelle, N, et al. Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet 1994; 343: 1454–1459.CrossRefGoogle ScholarPubMed
10Renaud, S, de Lorgeril, M, Delaye, J, et al. Cretan Mediterranean diet for prevention of coronary heart disease. Am. J. Clin. Nutr. 1995; 61(Suppl): 1360–7S.CrossRefGoogle ScholarPubMed
11Kritchevsky, D.Role of cholesterol vehicle in experimental atherosclerosis. Am. J. Clin. Nutr. 1970; 23: 1105–10.CrossRefGoogle ScholarPubMed
12Mattson, FH, Nolen, GA, Webb, MR. The absorbability of fats of various triglycerides of stearic and oleic acid and the effect of dietary calcium and magnesium. J. Nutr. 1973; 109: 1682–7.CrossRefGoogle Scholar
13Renaud, S, Ruf, JC, Petithory, D.The position distribution of fatty acids in palm oil and lard influences their biologic effects in rats. J. Nutr. 1995; 125: 229–37.Google ScholarPubMed
14Kritchevsky, D, Moyer, AW, Tesar, WC, et al. Effect of cholesterol vehicle in experimental atherosclerosis. Am. J. Physiol. 1954; 178: 30–2.CrossRefGoogle ScholarPubMed
15Wolfe, MS, Sayer, JK, Morgan, TM, Bullock, BC, Rudel, LL. Dietary polyunsaturated fat decreases coronary artery atherosclerosis in a pediatric-aged population of African Green monkeys. Arterioscler Thromb. 1994; 14: 587–97.CrossRefGoogle Scholar
16Nordoy, A.The influence of saturated fats, cholesterol, corn oil and linseed oil on experimental venous thrombosis in rats. Thromb Diath Haemorrheol 1965; 13: 244–56.Google ScholarPubMed
17Nordoy, A, Hamlin, JT, Chandler, AB, Newland, H.The influence of dietary fats on plasma and platelet lipids and ADP induced platelet thrombosis in the rat. Scand J. Haematol. 1968; 5: 458–73.CrossRefGoogle ScholarPubMed
18Renaud, S, Godu, J.Induction of large thrombi in hyperlipemic rats by epinephrine and endotoxin. Lab. Invest. 1969; 21: 512–518.Google ScholarPubMed
19Hornstra, G, Vendelmans, A.Induction of experimental arterial thrombi in rats. Atherosclerosis 1973; 17: 369–82.CrossRefGoogle ScholarPubMed
20Renaud, S.Thrombotic, atherosclerotic and lipemic effects of dietary fats in the rats. Angiology, Baltimore 1969; 20: 657–69.CrossRefGoogle Scholar
21Connor, WE, Hoak, JC, Warner, FD. Massive thrombosis produced by fatty acid infusion. J. Clin. Invest. 1963; 42: 860–6.CrossRefGoogle ScholarPubMed
22Gautheron, P, Renaud, S.Hyperlipemia induced hypercoagulable state in rat. Role of increased activity of platelet phosphatidyl serine in response to certain dietary fatty acids. Thromb. Res. 1972; 1: 353–70.CrossRefGoogle Scholar
23Billman, GE, Kang, JX, Leaf, A.Prevention of ischemiainduced cardiac sudden death by n-3 polyunsaturated fatty acids in dogs. Lipids 1997; 32: 1161–8.CrossRefGoogle ScholarPubMed
24Siebert, BD, McLennan, PL, Woodhouse, JA, Charnock, JS. Cardiac arrhythmia in rats in response to dietary n-3 fatty acids from red meat, fish oil and canola oil. Nutr. Res. 1993; 13: 1407–18.CrossRefGoogle Scholar
25McLennan, PL, Dallimore, JA. Dietary canola oil modifies myocardial fatty acids and inhibits cardiac arrhytmias in rats. J Nutr. 1995; 125: 1003–9.Google Scholar
26Xiao, YF, Gomez, AM, Morgan, JP, Lederer, WJ, Leaf, A.Suppression of voltage-gated L-type Ca2+ currents by polyunsaturated fatty acids in adult and neonatal rat ventricular myocytes. Proc. Nat. Acad. Sci. USA 1997; 94: 4182–7.CrossRefGoogle ScholarPubMed
27Hunter, JE, Applewhite, TH. Reassessment of trans fatty acid availability in the US diet. Am. J. Clin. Nutr. 1991; 54: 363–9.CrossRefGoogle ScholarPubMed
28Hulshof, K, Van Erp Baart, MA, Anttolainen, M, et al. Intake of fatty acids in Western Europe with emphasis on trans fatty acids: the TRANSFAIR study. Europ. J. Clin. Nutr. 1999; 53: 143–57.CrossRefGoogle ScholarPubMed
29Willett, WC, Stampfer, JM, Manson, JE. Intakes of trans fatty acids and risk of coronary heart disease among women. Lancet 1993; 341: 581–6.CrossRefGoogle ScholarPubMed
30Hu, FB, Stampfer, MJ, Manson, JE, Rimm, E, Colditz, GA, Rosner, BA, Hennekens, CH, Willett, WC. Dietary fat intake and the risk of coronary heart disease in women. N. Engl. Med. 1997; 337: 1491–9.CrossRefGoogle ScholarPubMed
31 Editorial. Trans fatty acids and coronary heart disease: weighing the evidence against hardened fat. Lancet 1995; 345: 269–270.CrossRefGoogle Scholar
32Nicolosi, RJ. Trans fatty acids and coronary heart disease risk. Experimental mechanism: formation of atheroma. Am. J. Clin. Nutr. 1995; 62(Suppl): 689S–92S.Google Scholar
33Kritchevsky, D, Davidson, LM, Weight, M, Kriek, NPJ, du Plessis, JP. Effect of trans-unsaturated fats on experimental atherosclerosis in Vervet monkeys. Atherosclerosis 1984; 51: 123–33.CrossRefGoogle ScholarPubMed
34Toda, T, Toda, Y, Yamamoto, VK, Kummerow, FA. Comparative study of atherogenicity of dietary trans, saturated and unsaturated fatty acids on swine coronary arteries. J Nutr. Sci. Vitaminol. 1985; 31: 233–41.CrossRefGoogle ScholarPubMed
35Weigensberg, BI, McMillan, GC, Ritchie, AC. Elaidic acid: effect on experimental atherosclerosis. Arch. Pathol. 1961; 72: 358–66.Google ScholarPubMed
36Katan, MB. Commentary on the supplement trans fatty acids and coronary heart disease risk. Am. J. Clin. Nutr. 1995; 62: 518–9.Google Scholar
37Crawford, MA. The balance between alpha-linolenic and linoleic acid. The role of fats in Human Nutrition. In: Brun, JP, et al. , eds. Chichester: Ellis Horwood, 1985: 62.Google Scholar
38Gautheron, P, Dumont, E, Renaud, S.Clotting activity of platelet phospholipids in rats and man. Thromb Diath Haemor 1974; 32: 382.Google ScholarPubMed
39Sellmayer, A, Danesh, U, Weber, PC. Modulation of the expression of early genes by polyunsaturated fatty acids. Prostagland Leukot EFA 1997; 57: 353–7.CrossRefGoogle ScholarPubMed
40Renaud, S, Godsey, F, Dumont, E, Thévenon, C, Ortchanian, E.Influence of diet modification on platelet function and composition in Moselle farmers. Am. J. Clin. Nutr. 1986; 43: 136–50.CrossRefGoogle ScholarPubMed
41Emken, EA, Adlot, RO, Gulley, RM. Dietary linoleic acid influences desaturation and acylation of deuterium-labeled linoleic and linolenic acids in young adult males. Biochem. Biophys. Acta. 1994; 1213: 277–88.CrossRefGoogle ScholarPubMed
42Frantz, ID Jr, Dawson, EA, Ashom, PL, et al. Test of effect of lipid lowering by diet on cardiovascular risk. The Minnesota Coronary Survey. Arteriosclerosis 1989; 9: 129–35.CrossRefGoogle ScholarPubMed
43Leren, P.The Oslo diet heart study. Eleven year report. Circulation 1970; 42: 935–42.CrossRefGoogle ScholarPubMed
44Morris, JN, Ball, KP, Antonis, A, et al. Controlled trial of soya bean oil in myocardial infarction. Lancet. 1968; 2: 694–700.Google Scholar
45Burr, ML, Fehily, AM, Gilbert, JF, et al. Effects of changes in fat, fish, and fiber intakes on death and myocardial reinfarction: diet and reinfarction trial (DART). Lancet 1989; 2: 757–61.CrossRefGoogle ScholarPubMed
46Ascherio, A, Rimm, EB, Giovannucci, EL, Spiegelman, D, Stampfer, MJ, Willett, WC. Dietary fat and risk of coronary heart disease in men: cohort follow up study in the United States. BMJ 1996; 313: 84–90.CrossRefGoogle ScholarPubMed
47Guallar, E, Aro, A, Jimenez, FJ, et al. Omega-3 fatty acids in adipose tissue and risk of myocardial infarction: the Euramic study. Arterioscler Thromb Vasc. Biol. 1999; 19: 1111–8.CrossRefGoogle ScholarPubMed
48Hu, FB, Stampfer, MJ, Morison, JE, et al. Dietary intake of alpha-linolenic acid and risk of fatal ischaemic heart disease among women. Am. J. Clin. Nutr. 1999; 69: 890–7.CrossRefGoogle ScholarPubMed
49Renaud, S, Nordoy, A.Small is beautiful: α-linolenic acid and eicosapentaenoic acid in man. Lancet 1983: 1169.CrossRefGoogle Scholar
50Renaud, S.Linoleic acid, platelet aggregation and myocardial infarction. Atherosclerosis 1990; 80: 255–6.CrossRefGoogle ScholarPubMed
51De Lorgeril, M, Salen, P, Martin, JL, Monjaud, I, Boucher, P, Mamelle, N.Mediterranean dietary pattern in a randomized trial. Prolonged survival and possible reduced cancer rate. Arch. Intern. Med. 1998; 158: 1181–7.CrossRefGoogle Scholar
52Watanabe, S, Sakai, N, Yasui, Y, et al. A high α-linolenate diet suppresses antigen-induced immunoglobin E response and anaphylactic shock in mice. J. Nutr. 1994; 124: 1566–73.CrossRefGoogle Scholar
53Bang, HO, Dyerberg, J, Sinclair, HM. The composition of Eskimo food in north western Greenland. Am. J. Clin. Nutr. 1980; 33: 2657–61.CrossRefGoogle ScholarPubMed
54Kromhout, D, Bosschieter, EB, de Lezenne Coulander, C.The inverse relation between fish consumption and 20 year mortality from coronary heart disease. N. Engl. J. Med. 1985; 312: 1205–9.CrossRefGoogle ScholarPubMed
55Norell, SE, Ahlbom, A, Feychting, M, Pedersen, NL. Fish consumption and mortality from coronary heart disease. BMJ 1986; 293: 426.CrossRefGoogle ScholarPubMed
56Gissi Prevenzione Investigators. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the Gissi Prevenzione trial. Lancet 1999; 354: 447–53.CrossRefGoogle Scholar
57Leaf, A, Weber, PC. Cardiovascular effects of n-3 fatty acids. N. Engl. J. Med. 1988; 318: 549–57.CrossRefGoogle ScholarPubMed
58Sensaki, H, Iwamoto, S, Ogura, E, et al. Dietary effects of fatty acids on growth and metastasis of KPL-1 human breast cancer cells in vivo and in vitro. Anticancer Res. 1998; 18: 1621–8.Google Scholar
59Weyman, C, Berlin, J, Smith, AD, Thomson, RSH. Linoleic acid as an immunosuppressive agent. Lancet 1975; 2: 33–4.CrossRefGoogle ScholarPubMed
60Keys, A.Serum cholesterol response to dietary cholesterol. Am. J. Clin. Nutr. 1984; 40: 351–9.CrossRefGoogle ScholarPubMed
61Grundy, SM. Influence of stearic acid on cholesterol metabolism relative to other long-chain fatty acids. Am. J. Clin. Nutr. 1994; 60(Suppl): 986–90S.CrossRefGoogle ScholarPubMed
62Kris-Etherton, PM, Yu, S.Individual fatty acid effects on plasma lipids and lipoproteins: human studies. Am. J. Clin. Nutr. 65(Suppl)1997; : S1628–44.CrossRefGoogle ScholarPubMed
63Jacotot, B, Sola, R, Motta, C.Dietary monounsaturated fats and serum HDL. Europ. J. Clin. Nutr. 1991; 45(Suppl): 66–69.Google Scholar
64Tsimikas, S, Philis-Tsimikas, A, Alexopoulos, S, Sigari, F, Lee, C, Reaven, PD. LDL isolated from Greek subjects on a typical diet or from American subjects on an Oleate-supplement diet induces less monocyte chemotaxis and adhesion when exposed to oxidative stress. Arterioscler Thromb. Vasc. Biol. 1999; 87: 403–406.Google Scholar
65Sola, R, Motta, C, Maille, M, et al. Dietary monounsaturated fatty acids enhance cholesterol efflux from human fibroblasts. Relationship to fluidity, phospholipid fatty acid composition, overall composition and size of HDL 3. Arterioscler Thromb 1993; 13: 958–66.CrossRefGoogle Scholar
66Roche, H, Zampelas, A, Knapper, JME, et al. Effect of longterm olive oil dietary intervention on postprandial triacylglycerol and factor VII metabolism. Am. J. Clin. Nutr. 1998; 68: 552–60.CrossRefGoogle ScholarPubMed
67Ruddock, V, Meade, TW. Factor VII activity and ischeamic heart disease: fatal and non fatal events. Q. J. Med. 1994; 87: 403–6.Google Scholar
68Connor, WE. Dietary fiber. Nostrum or critical nutrient? N. Engl. J. Med. 1990; 322: 193–5.CrossRefGoogle ScholarPubMed
69Anderson, JW, Story, L, Sieling, B, Chen, WJ, Petro, MS, Story, J.Hypocholesterolemic effects of oat bran or bean intake for hypercholesterolemic men. Am. J. Clin. Nutr. 1984; 40: 1146–55.CrossRefGoogle ScholarPubMed
70Khaw, KT, Barrett Connor, E.Dietary fiber and reduce ischemic heart disease mortality rates in men and women: a 12 year prospective study. Am. J. Epidemiol. 1987; 126: 1093–102.CrossRefGoogle ScholarPubMed
71Kromhout, DBosschieter, EB and de Lezenne Coulander, C.Dietary fiber and 10 year mortality from coronary heart disease, cancer and all causes: the Zutphen Study. Lancet II 1982; 2: 518–21.CrossRefGoogle ScholarPubMed
72Pietinen, P, Rimm, EB, Korhonen, P, et al. Intake of dietary fiber and risk of coronary heart disease in a cohort of Finnish Men. Circulation 1996; 94: 2720–7.CrossRefGoogle Scholar
73Rimm, EB, Ascherio, A, Giovannuci, E, Spiegelman, D, Stampfer, MJ, Willett, W.Vegetable, fruit and cereal fiber intake and risk of coronary heart disease among men. JAMA 1996; 275: 447–51.CrossRefGoogle ScholarPubMed
74Hallfrisch, J, Scholfield, DJ, Behall, KM. Diets containing soluble oat extracts improve glucose and insulin responses of moderately hypercholesterolemic men and women. Am. J. Clin. Nutr. 1995; 61: 379–84.CrossRefGoogle ScholarPubMed
75Simpson, HCR, Mann, JL, Chakrabarti, R.Effect of high fiber diet on hemostatic variables in diabetes. BMJ 1982; 284: 1608–15.CrossRefGoogle ScholarPubMed
76Halliwell, B.Currents status review: free radicals, reactive oxygen species and human disease: a critical evaluation with special reference to atherosclerosis. Br J. Exp. Pathol. 1989; 70: 737–57.Google Scholar
77Witztum, JL, Steinberg, D.Role of oxidized low density lipoprotein in atherogenesis. J. Clin. Invest. 1991; 88: 1785–92.CrossRefGoogle ScholarPubMed
78Henning, JL, Chow, CK. Lipid peroxidation and endothelial cell injury: implications in atherosclerosis. Free Radic Biol. Med. 1988; 4: 99–106.CrossRefGoogle Scholar
79Regnström, J, Nilsson, J, Tornvall, P, Landou, C, Hamsten, A.Susceptibility to low-density lipoprotein oxidation and coronary atherosclerosis in man. Lancet 1992; 339: 1183–6.CrossRefGoogle ScholarPubMed
80Reaven, PD, Grasse, BJ, Trible, DL. Effects of linoleate enriched and oleate enriched diets in combination with alpha-tocopherol on the susceptibility of LDL and LDL subfraction to oxidative modification in humans. Arterioscler Thromb 1994; 14: 557–66.CrossRefGoogle ScholarPubMed
81Shahar, E.A putative role of dietary omega 3 polyunsaturated fatty acids in oxidative modification of low density lipoprotein. Prostag Leuk Ess Fatty Acids 1993; 48: 397–9.CrossRefGoogle ScholarPubMed
82Rimm, EB, Stampfer, MJ, Ascherio, A, Giovannucci, E, Colditz, GA, Willett, WC. Vitamin E consumption and the risk of coronary heart disease in men. Engl. J. Med. 1993; 328: 1450–6.CrossRefGoogle ScholarPubMed
83Stampfer, MJ, Hennekens, CH, Manson, JE, Colditz, GA, Rosner, B, Willett, WC. Vitamin E consumption and the risk of coronary heart disease in women. N. Engl. J. Med. 1993; 328: 1444–9.CrossRefGoogle Scholar
84Gey, KF, Stähelin, HB, Eichholzer, M.Poor plasma status of carotene and vitamin C is associated with higher mortality from ischemic heart disease and stroke. Clin. Invest. 1993; 71: 3–6.CrossRefGoogle ScholarPubMed
85Kok, FJ, de Bruyn, AM, Vermeeren, R, et al. Serum selenium, vitamin antioxidants and cardiovascular mortality: a 9 year follow-up in the Netherlands. Am. J. Clin. Nutr. 1987; 45: 462–8.CrossRefGoogle ScholarPubMed
86Hense, HW, Stender, M, Bors, W, Keil, U.Lack of an association between serum vitamin E and myocardial infarction in a population with high vitamin E levels. Atherosclerosis 1993; 103: 21–8.CrossRefGoogle Scholar
87Stephens, NG, Parsons, A, Schofield, PM, et al. Randomized controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study (CHAOS). Lancet 1996; 347: 781–6.CrossRefGoogle ScholarPubMed
88Rapola, JM, Virtamo, J, Haukla, JK, et al. Effect of vitamin E and beta carotene on the incidence of angina pectoris. J. Am. Med. Ass. 1996; 275: 693–8.CrossRefGoogle ScholarPubMed
89Nagaoka, S, Okauchi, Y, Urano, S, Nagashima, U, Mukai, R.Kinetic and ab initio study of the pro-oxidant effect of vitamin E. Hydrogen abstraction from fatty acid esters and egg yolk lecithin. J. Am. Chem. Soc. 1990; 112: 8921–4.CrossRefGoogle Scholar
90Kagan, VE, Serbinova, EA, Forte, T, Scita, G, Packer, L.Recycling of vitamin E in human low-density lipoproteins. J. Lip. Res. 1992; 33: 385–97.CrossRefGoogle ScholarPubMed
91Sharma, MK, Buettner, GR. Interaction of vitamin C and vitamin E during free radical stress in plasma: an ESR study. Free radical Biology and Medicine 1993; 14: 649–56.CrossRefGoogle ScholarPubMed
92Hertog, MGL, Feskens, EJM, Hollman, PCH, Katan, MB, Kromhout, D.Dietary antioxidant flavonoids and risk of coronary heart disease: the Zutphen elderly study. Lancet. 1993; 342: 1007–11.CrossRefGoogle ScholarPubMed
93Knekt, P, Järvinen, R, Reunanen, A, Maatela, J.Flavonoids intake and coronary mortality in Finland: a cohort study. BMJ 1996; 312: 478–81.CrossRefGoogle ScholarPubMed
94Hertog, AG, Kromhout, D, Aravanis, C, et al. Flavonoid intake and long-term risk of coronary heart disease and cancer in the Seven Countries Study. Arch. Intern. Med. 1995; 155: 381–6.CrossRefGoogle ScholarPubMed
95Mc Cully, KS. Vascular pathology of homocysteinemia: implications for pathogenesis of arteriosclerosis. Am. J. Pathol. 1969; 56: 111–28.Google ScholarPubMed
96Clarke, R, Daly, L, Robinson, K, et al. Hyperhomocysteinemia: an independent risk factor for vascular disease. N. Engl. J. Med. 1991; 321: 1149–55.CrossRefGoogle Scholar
97Mayer, EL, Jacobsen, DW, Robinson, K.Homocysteine and coronary arteriosclerosis. J. Am. Coll. Cardiol. 1996; 27: 517–27.CrossRefGoogle Scholar
98Torbek, M, Kopeiczna-Grezebieniak, E, Drozdz, M, Wieczorek, M.Increased lipid peroxidation as a mechanism of methionine induced atherosclerosis in rabbits. Atherosclerosis 1995; 115: 217–24.Google Scholar
99Brattstrom, LE, Israelsson, B, Norrving, B, et al. Impaired homocysteine metabolism in early onset cerebral and peripheral occlusive arterial disease: effects of pyridoxine and folic acid treatment. Atherosclerosis 1990; 81: 51–60.CrossRefGoogle ScholarPubMed
100Ubbink, JB, Vermaak, WJH, Van Der Merwe, A, et al. Vitamin requirements for treatment of hyperhomocysteinemia in humans. J. Nutr. 1994; 124: 1927–33.CrossRefGoogle ScholarPubMed
101Rimm, EB, Willett, WC, Hu, FB, et al. Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women. JAMA 1998; 279: 359–64.CrossRefGoogle ScholarPubMed
102Olszewski, AJ, Mc Cully, KS. Fish oil decreases serum homocysteine in hyperlipemic men. Coron Art Dis 1993; 4: 53–60.CrossRefGoogle ScholarPubMed
103Masironi, R, Pisa, Z, Clayton, D.Myocardial infarction and water hardness in the WHO myocardial registry network. Bull WHO 1979; 57: 291–9.Google ScholarPubMed
104Shaper, AG, Packham, RF, Pocock, SJ. The British Regional Heart study. J. Environm. Pathol. Toxicol. 1980; 4: 89.Google ScholarPubMed
105Comstock, GN. The epidemiologic perspective Water hardness and cardiovascular disease. J. Environm. Path. Toxicol. 1980; 4: 9.Google ScholarPubMed
106Bhattacharyya, AK, Thera, C, Anderson, JT, Grande, F, Keys, A.Dietary calcium and fat. Effects on serum lipids and fecal excretion of cholesterol and its degradation products in man. Am. J. Clin. Nutr. 1969; 22: 1161.CrossRefGoogle ScholarPubMed
107Yacowitz, H, Fleischman, AI, Raichelson, RI. Effects of oral calcium upon serum lipids in man. BMJ 1965; 1: 1352.CrossRefGoogle ScholarPubMed
108Renaud, S, Morazain, R, Godsey, F, et al. Nutrients, platelet function and composition in nine groups of French and British farmers. Atherosclerosis 1986; 60: 37–48.CrossRefGoogle ScholarPubMed
109Renaud, S, Ciavatti, M, Thevenon, C, Ripoll, JP. Protective effects of dietary calcium and magnesium on platelet function and atherosclerosis in rabbits fed saturated fat. Atherosclerosis 1983; 47: 187.CrossRefGoogle ScholarPubMed
110Renaud, S. Dietary fatty acids and platelet reactivity in relation to coronary heart disease. Proc on the Effects of Dietary Fatty Acids on Serum Lipoproteins. In: Nicolosi, RJ, ed. Washington: American Heart Association, 1989: 125.Google Scholar
111Me Carron, DA, Morris, CD, Henry, HJ, Stanton, JL. Blood pressure and nutrient intake in the United States. Science 1984; 224: 1392–8.CrossRefGoogle Scholar
112Witteman, JCM, Willett, WC, Stampfer, MJ, et al. A prospective study of nutritional factors and hypertension among US women. Circulation 1989; 80: 1320–1327.CrossRefGoogle ScholarPubMed
113Witteman, JCM, Willett, WC, Stampfer, MJ, et al. A prospective study of nutritional factors and hypertension among US women. Nutrition 1985; 11: 409–17.Google Scholar
114Vartiainen, E, Puska, P, Pekkanen, J, Tuomilehto, J, Jousilahti, P.Changes in risk factors explain changes in mortality from ischaemic heart disease in Finland. BMJ 1994; 309: 23–27.CrossRefGoogle ScholarPubMed
115Grobbe, DE, Rimm, EB, Keil, U, Renaud, S. Alcohol and the Cardiovascular System. In Macdonald, I ed. Healt issues related to alcohol consumption. ILSI. Blackwell Science 1999:125–179.Google Scholar
116Suhonen, O, Aromas, A, Reunanen, A, Knekt, P.Alcohol consumption and sudden coronary death in middle-aged Finnish men. Acta. Med. Scan. 1987; 221: 335–341.CrossRefGoogle ScholarPubMed
117Kauhanen, J, Kaplan, GA, Goldberg, DE, et al. Beer binging and mortality: results from the Kuopio ischemic heart disease risk factor study, a prospective population based study. BMJ 1997; 315: 846–851.CrossRefGoogle ScholarPubMed
118Rimm, EB, Giovannucci, E, Willet, WC, et al. Alcohol and mortality. Lancet. 1991; 338: 1073–1074.Google Scholar
119Renaud, S, Gueguen, R, Siest, G, Salamon, R.Wine, beer and mortaltiy in middle-aged men from Eastern France. Arch. Intern. Med. 1999; 159: 1865–1870.CrossRefGoogle Scholar
120Gronbaek, M, Dels, A, Sorensen, TIA, Becker, U, Schnohr, P, Jensen, G.Mortality associated with moderate intakes of wine, beer or spirits. BMJ 1995; 310: 1165–9.CrossRefGoogle ScholarPubMed
121Gronbaek, M, Becker, U, Johansen, D, Tonneson, H, Jensen, G, Sorensen, TIA. Population based cohort study of the association between alcohol intake and cancer of upper digestive tract. BMJ 1995; 317: 844–8.CrossRefGoogle Scholar
122Jang, M, Cal, L, Udearl, GO, et al. Cancer chemopreventive activity of resveratrol, a natural product derived from grapes. Science 1997; 275: 218–20.CrossRefGoogle ScholarPubMed
123Williams, PT. Interactive effects of exercise, alcohol and vegetarian diet on coronary artery disease risk factors in 9242 runners: The National Runner's Health Study. Am. J. Clin. Nutr. 1997; 66: 1197–206.CrossRefGoogle ScholarPubMed
124Langer, RD, Criqui, MH, Reed, DM. Lipoproteins and blood pressure as biologic pathways for the effect of moderate alcohol consumption on coronary heart disease. Circulation 1992; 85: 910–5.CrossRefGoogle ScholarPubMed
125Yano, K, Rhoads, GG, Kagan, A.Coffee, alcohol and risk of coronary heart disease among Japanese men living in Hawaii. N. Engl. J. Med. 1977; 297: 405–9.CrossRefGoogle ScholarPubMed
126Renaud, S, Ruf, JC. Effects of alcohol on platelet functions. Clin. Chim. Acta. 1996; 246: 77–89.CrossRefGoogle ScholarPubMed
127Hillbom, M, Kangasaho, M, Hjelm-Jäger, M.Platelet aggregation and thromboxane B2 formation after ethanol abuse: is there a relationship to stroke? Acta. Neurol. Scand. 1984; 70: 432–7.CrossRefGoogle Scholar
128Ruf, JC, Berger, JL, Renaud, S.Platelet rebound effect of alcohol withdrawal and wine drinking in rats. Relation to tannins and lipid peroxidation. Arterioscler Thromb. Vasc. Biol. 1995; 1: 140–4.CrossRefGoogle Scholar
129Renaud, S, Beswick, AD, Fehily, AM, Sharps, DS, Elwood, PC. Alcohol and platelet aggregation: the Caerphilly Prospective Heart Disease Study. Am. J. Clin. Nutr. 1992; 55: 1012–7.CrossRefGoogle ScholarPubMed
130Rand, ML, Packham, MA, Kinlough-Rathbone, RL, Mustard, JF. Effects of ethanol on pathways of platelet aggregation in vitro. Thromb Haemost 1988; 59: 383–7.Google ScholarPubMed
131Zucker, MB, Peterson, J.Inhibition of adenosine diphosphate-induced secondary aggregation and other platelet functions by acetylsalicylic acid ingestion. Proc. Soc. Exp. Biol. Med. 1968; 127: 547–551.CrossRefGoogle ScholarPubMed
132Steering Committee of the Physician's Health Study Research Group. Final report on the aspirin component of the ongoing Physician's Health Study. N. Engl. J. med. 1989; 3212: 129–35.Google Scholar
133Report of the Dietary Guidelines Advisory Committes on the Dietary Guidelines for Americans, to the Secretary of Agriculture and the Secretary of Health and Human Services. Springfield, VA: US Dept of Commerce, National Technical Information Service 1995.Google Scholar
134Woollett, LA, Dietshy, JM. Effect of long-chain fatty acids on low-density lipoprotein cholesterol metabolism. Am. J. Clin. Nutr. 1994; 60(Suppl): 991–6S.CrossRefGoogle ScholarPubMed
135Keys, A, Anderson, JT, Grande, F.Serum cholesterol response to changes in diet IV Particular saturated fatty acids in the diet. Metabolism 1965; 14: 776–86.CrossRefGoogle ScholarPubMed
136Hegsted, DM, Ausman, LM, Johnson, JA, Dollal, GE. Dietary fat and serum lipids: an evaluation of the experimental data. Am. J. Clin. Nutr. 1993; 57: 875–83.CrossRefGoogle ScholarPubMed
137Mensik, RP, Katan, MB. Effect of dietary fatty acids on serum lipids and lipoproteins. Arterioscler Thromb 1992; 12: 911–9.CrossRefGoogle Scholar
138Derr, J, Kris-Etherton, PM, Pearson, TA, Seligson, FH. The role of fatty acid saturation on plasma lipids, lipoproteins and apolipoproteins: II The plasma total and low-density lipoprotein cholesterol response of individual fatty acids. Metabolism 1993; 42: 130–4.CrossRefGoogle ScholarPubMed
139Hjermann, I, Holme, I, Leren, P.Oslo study diet and antismoking trial. Results after 102 months. Am. J. Med. 1986; 80(suppl 2A): 7–11.CrossRefGoogle ScholarPubMed
140Blackburn, H.The low risk coronary male. Am. J. Cardiol. 1986; 58: 161.CrossRefGoogle ScholarPubMed
141Sandker, GN, Kromhout, D, Aravanis, C, et al. Serum cholesteryl ester fatty acids and their relation with serum lipids in elderly men in Crete and the Netherlands. Eur. J. Clin. Nutr. 1993; 47: 201–8.Google ScholarPubMed
142De Lorgeril, M, Salen, P, Martin, JL, Monjaud, I, Delaye, J, Mamelle, N.Mediterranean diet, traditional risk factors and the rate of cardiovascular complications after myocardial infarction. Circulation 1999; 99: 779–85.CrossRefGoogle ScholarPubMed
143Kagawa, Y, Nishizawa, M, Suzuki, M, et al. Eicosapolyenoic acid of serum lipids of Japanese islanders with low incidence of cardiovascular diseases. J. Nutr. Sci. Vitaminol. 1982; 28: 441–53.CrossRefGoogle ScholarPubMed
144Innis, SM. Sources of omega 3 fatty acids in arctic diets. In: Galli, C, Simopoulos, AP, eds. Dietary omega 3 and omega 6 fatty acids. Biological effects and nutritional essentially. New York: Plenum Press, 1989: 135–46.Google Scholar
145Owren, PA, Hellem, AJ, Odegnard, A.Linolenic acid for the prevention of thrombosis and myocardial infarction. Lancet 1964; 2: 975–9.CrossRefGoogle ScholarPubMed
146Singh, RB, Rastogi, SS, Verma, R, et al. An Indian experiment with nutritional modulation in acute myocardial infarction. Am. J. Cardiol. 1992; 69: 879–85.CrossRefGoogle ScholarPubMed
147Singh, RB, Niaz, MA, Sharma, JP, Kumar, R, Rastogi, V, Mashiri, M.Randomized, double-blind, placebo-controlled trial of fish oil and mustard oil in patients with suspected acute myocardial infarction; the Indian experiment of infarct survival. Cardiovasc. Drugs. Ther. 1997; 11: 485–91.CrossRefGoogle ScholarPubMed
148Beaglehole, R.International trends in coronary heart disease mortality and incidence rates. J. Cardiol. Risk. 1999; 6: 63–8.Google ScholarPubMed
149Woodhill, JM, Palmer, AJ, Leelarthaepin, B, McGilchrist, C, Blacket, RB. Low cholesterol in secondary prevention of coronary heart disease. Adv. Exper. Med. Biol. 1978; 209: 317–31.CrossRefGoogle Scholar