Prevention of Coronary Heart Disease

This publication is organized in an exceptional way: Each chapter introduces several completed clinical trials and provides the original conclusions and discussions of the results. The authors then contribute their own comments and interpretations of the findings, challenging the prevailing belief that serum cholesterol is a mediator of disease which is increased by eating saturated fats and decreased by eating polyunsaturated fats. They argue that upon closer scrutiny, the diet recommendations based on the cholesterol hypothesis are essentially ineffective in reducing serum cholesterol levels in the long run. Instead, it is proposed that traditional cholesterol biomarkers are of different significance in short- and long-term interventions due to the feedback control mechanisms in the body. Even more important, the association of high serum cholesterol values with high coronary heart disease mortality is not consistent when different populations are compared: This mortality rate may simply reflect the incidence and severity of familial hypercholesterolemia cases.