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(Circulation. 2003;107:10.)
© 2003 American Heart Association, Inc.

Special Review

Diets and Clinical Coronary Events

The Truth Is Out There

William S. Yancy, Jr, MD; Eric C. Westman, MD; Patricia A. French, BS; Robert M. Califf, MD

From the Divisions of General Medicine (W.S.Y., E.C.W.) and Cardiology (R.M.C.), Department of Medicine, Duke University Medical Center, and the Duke Clinical Research Institute (P.A.F., R.M.C.), Durham, NC.

Correspondence to Robert M. Califf, MD, Duke Clinical Research Institute, PO Box 17969, Durham, NC 27715. E-mail calif001@mc.duke.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Perhaps no question is asked more often of physicians, and particularly of cardiologists, than, "What should I be eating to prevent heart disease?" Over recent years, vast amounts of literature have been produced on this topic, and fortunes have been made from books offering advice and programs offering supervision. Even one of the most respected nutritional epidemiologists has written a lay-press book, recognizing the critical need for improved dietary habits in the general population.¹

Despite the glut of dietary advice, however, the direction that Americans are taking is discouragingly clear. Although lipid levels and the age-adjusted incidence of coronary artery disease (CAD) are declining gradually, rates of obesity and diabetes (two risk factors for CAD) are skyrocketing,² threatening a reversal of the gains achieved to date.

Information about the "best diet" is incomplete, unscientific, and often conflicting. On one hand, people wishing to avoid CAD or prevent its progression are told to eat less fat. Some undoubtedly interpret this as a recommendation to eat a high-carbohydrate diet instead, contributing to epidemics in diabetes and obesity, and placing them at risk for CAD. On the other hand, many overweight or obese Americans attempt to lose weight through one of the popular weight-reducing diets, many of which severely restrict carbohydrates. The resulting increase in proportional calories from protein (and fat) may pose a risk; a recent Science Advisory from the American Heart Association has expressed concern about weight-loss diets recommending a high proportion of calories from protein.³ According to the Advisory, the . . . [Full Text of this Article]

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