(Circulation. 1999;99:733-735.)
© 1999 American Heart Association, Inc.
Editorials |
Dietary Prevention of Coronary Heart Disease
The Lyon Diet Heart Study
From the Departments of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston.
Correspondence to Alexander Leaf, MD, Massachusetts General Hospital, East, Bldg 149, 4th Floor, 13th St, Charlestown, MA 02129. E-mail leaf.alexander1@mgh.harvard.edu
Key Words: Editorials • fatty acids • trials • coronary disease
This issue of
Circulation contains an article1 that
I believe deserves special attention from cardiologists and physicians.
It reports the 46-month mean follow-up findings on the original report
of the study on "Mediterranean 
-linolenic acid–rich diet
in secondary prevention of coronary heart disease," the
so-called Lyon Diet Heart Study. This study was undertaken because of
the interest of the investigators in explaining the very much lower
mortality from cardiovascular disease, mainly
coronary heart disease, in the countries bordering the
Mediterranean compared with that in northern Europe. The initial
report2 was published in Lancet in
1994 after the study was terminated by its Scientific and Ethics
Committee at 27 months mean follow-up time of what had been planned as
a 5-year study, because the benefits in the experimental group at that
time were so favorable. Despite the striking findings in the first
report of a 70% reduction in all-cause mortality due to a reduction in
coronary heart disease (CHD) mortality and comparable large
reductions in nonfatal sequelae, I have encountered few cardiologists
here who are aware of that study.
It is much to the credit of Dr de Lorgeril and associates that
they persisted in following the original enrollees despite the official
termination of the study and publication of the initial findings so
that they are now able to report their more extended observations. With
the mean follow-up time of 46 months per patient, the initial
remarkably beneficial effects of the experimental dietary program
persisted compared with the control group consuming
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