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Suite 323
2600 Philmont Avenue
Huntingdon Valley, Pennsylvania 19006
Page 5
than 40 years. The primary goal of this study was to develop information about risk factors associated with coronary artery disease, one of the most important of the arteriosclerotic diseases. This is the heart disease responsible for "heart attack", usually referred to by doctors as coronary thrombosis, or myocardial infarction. A detailed analysis of the Framingham data has shown the following factors to be the most important in increasing the risk of coronary artery disease: Increasing Age, Male Sex, High Blood Pressure, Cigarette Smoking, Elevated Blood Cholesterol Level, Low Level of HDL Cholesterol, Severe Obesity (>30% overweight), Diabetes Mellitus, Family History of Hyperlipidemia or Premature Coronary Heart Disease, Sedentary Life Style, "Type A" Personality, Personal History of Cerebrovascular or Occlusive Peripheral Vascular Disease
A
number of research projects in addition to the Framingham
study have been done to shed light on the interactions of
various risk factors. It is commonly known that some smokers
live to ripe old ages without symptomatic heart disease. It
is also noted that some people with very high cholesterol
levels have little or no evidence of arteriosclerotic
changes. Others with low levels of cholesterol die young of
coronary artery disease. We now know that no one factor is
predictive of arteriosclerotic complications. Low
cholesterol may protect a smoker. High levels of high
density lipoprotein may protect the person with high blood
cholesterol. Neither a low cholesterol nor nonsmoking may
protect one from the effects of sustained, severe high blood
pressure. Since there are a number of factors that are
potentially controllable, it should be possible to prevent
or delay the complications of arteriosclerotic
disease.
Lipids
As Risk Factors
Saturated
Fats
Dietary
fat content is one measure of the affluence of a society.
Fatty foods are expensive to produce. Societies with limited
resources do not eat prime, marbled beef, and can't afford
to buy large quantities of meat, cheese, eggs, butter,
cream, shortenings, and cooking oils; nor do they have the
grain and other animal feeds to raise their own fattened
meat animals. North Americans, particularly in the United
States, eat a lot of fat. In this country we ingest more
than 130 pounds per person per year, although that amount
has been gradually decreasing over the past 40
years.
Fats,
including oils, which are fats that happen to be liquid at
room temperatures, are the most concentrated sources of
energy in the diet. There are "fat-soluble" vitamins which
are carried in dietary fats, including Vitamins A, D, E, and
K. Dietary fat is also the source of an essential fatty
acid, linoleic acid, which cannot be produced by the human
body. Fats that are not used for body heat and energy output
are easily converted to body fat. So a high-fat diet can
result in obesity, which in itself is a risk
factor.
All
animal and vegetable fats are composed of glycerol, attached
to fatty-acid chains made up of carbon, hydrogen, and oxygen
atoms. Fats are characterized by the number of hydrogen
atoms attached to the fatty acid molecular chain. A fat with
all possible hydrogen sites filled on the molecule is called
"saturated", and one with missing hydrogen atoms is called
"unsaturated". Unsaturated fats are further divided into
"monounsaturated" and "polyunsaturated", depending on the
number of hydrogen atoms missing along the molecular chain.
This explains the term "hydrogenated", as applied to solid
shortenings and margarines.
Saturated
fats in the diet will increase cholesterol and "bad" lipids
in the blood, while polyunsaturated fats tend to lower these
levels. Unfortunately, saturated fats are twice as efficient
in raising the cholesterol level as polyunsaturated fats are
in lowering cholesterol. Monounsaturated fats may have a
similar effect as polyunsaturated, or at least be
cholesterol neutral, neither lowering nor raising. Medical
studies indicate that ingestion of saturated fat and
elevated blood cholesterol are causally related to coronary
heart disease and other atherosclerotic diseases. It is
therefore wise to eliminate some fat from one's diet,
especially the saturated kind.
Fats
in the diet are in the form of both "invisible" and
"visible" fats. Invisible fats, in meat, poultry, fish,
dairy products, etc., comprise 55 to 60 percent of the fat
in a typical diet in the United States. It takes a radical
alteration of diet to get rid of these hidden, or invisible,
fats. It requires limits on meat and dairy foods. However,
visible fats, which appear mainly in fats and oils for
cooking, salad dressings, and spreads, can be reduced more
easily. One can modify the way food is prepared; avoid
frying, for example. One can also switch to different kinds
of fats and oils.
Animal
fats are the most saturated of fats; vegetable oils contain
more unsaturated fats. Since the initial Framingham data in
the 1950's, there has been a shift toward fats and oils of
vegetable sources. Lard, meat drippings, butter, and chicken
fat (schmaltz), are much less frequently used; vegetable
fats,
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