Dietary fats and coronary heart disease: unfinished business

In the scientific and lay press, dietary recommendations that are aimed at prevention of coronary heart disease in the general public are appearing more and more frequently. The dietary pattern that is now most widely advocated is a low-fat, low cholesterol diet with a polyunsaturated/saturated ratio of 1. The argument for such a dietary change is supported mainly by extrapolations from epidemiological data and from animal experimentation. Reasons are given for concluding that the recommendations are unwise, impractical, and unlikely to lead to a reduced incidence of arteriosclerotic disease. Sinc complacency is equally inappropriate, a few practical questions are outlined that should be settled before the public is assured that a low-fat diet will lead to a reduced risk of coronary heart disease.