American Fitness Professionals & Associates

Copyright © 1996 by Jack Challem. Reproduced from The Nutrition Reporter™ newsletter.
All rights reserved.

Simply reducing blood levels of cholesterol is not enough to reduce the risk of coronary heart disease (CHD). People could further reduce their risk of heart disease by eating a diet high in “good” fats, vitamin E, beta-carotene, and flavonoids.

That’s the conclusion of re-searchers who analyzed 25 years of dietary and health data from 12,773 men in seven countries. The study was published in the Journal of the American Medical Association (July 12, 1995;274:131-6).

Lead researcher W.M. Monique Verschuren, MSc, of the National Institute of Public Health and Environmental Protection, Netherlands, reported that higher cholesterol levels were associated with heart disease in the United States, Finland, the Netherlands, Italy, Greece, Croatia and Serbia (formerly part of Yugoslavia), and Japan.

A cholesterol level of 210 mg/dL corresponded to a 4 to 5 percent increase in the death rate from heart disease in Japan and Mediterranean Europe (Greece and Italy). However, the same cholesterol level was far more dangerous elsewhere. It translated to a 10 percent increase in the death rate in central Europe, 12 percent in the United States, and 15 percent in Northern Europe.

According to the researchers, men with a cholesterol level generally considered safe-190 mg/dL-were twice as likely to die of heart disease in Northern Europe than in the Mediterranean.

The difference in heart disease risk vis-a-vis cholesterol may very well be related to other aspects of the diet, suggested Verschuren. “Com-pared with the Northern European and US diets, the Mediterranean diet at baseline contained less meat but more fish fruits, vegetables, and ethanol,” she wrote. “The fatty acids consumed in Northern Europe and the United States were pre-dominantly saturated but in the Mediterranean predominantly monounsaturated. Intake of the antioxidant vitamins beta-carotene and alpha-tocopherol [vitamin E] was highest in Mediterranean Southern Europe. Flavonoid intake was twice as high in Southern Europe…as in Northern Europe and the United States, but was highest in Japan. Intake of flavonoids, polyphenolic substances with antioxidant properties, has been shown to protect against CHD.”

Verschuren cited previously published research indicating that oxidized low-density lipoprotein (LDL) cholesterol promotes heart disease more than does cholesterol protected by antioxidant nutrients. In addition, polyunsaturated fats (common vegetable oils) are more prone to oxidation than are monounsaturated fats (such as olive oil).

“These results indicate that the relationship between diet and cholesterol explains only a part of the relationship between diet and CHD. Dietary factors that influence LDL oxidation and thrombotic [clot-causing] factors are also of great importance.”

She concluded, “from a public health perspective it is not enough to focus solely on serum cholesterol levels to decrease the burden of CHD in populations. It appears that reductions in serum total cholesterol levels are not likely to bring cultures with a high CHD risk, such as the United States and Northern Europe, back to a CHD mortality characteristic for the Mediterranean and Japanese cultures unless other factors are also changed.”

The information provided by Jack Challem and The Nutrition Reporter™ newsletter is strictly educational and not intended as medical advice. For diagnosis and treatment, consult your physician.