End of the road for the diet-heart theory?

Abstract

A personal account of the diet-cholesterol-heart hypothesis during the last sixty years, from its start with Jeremiah Stamler and Ancel Keys, its rapid rise and progressive fall during the last years. It is pointed out that the clinical picture of a heart attack is not synonymous with atherosclerotic changes in the coronary arteries. Special emphasis is given to the repeat publication of the results with the MRFIT screenees that have been used to obscure the negative results of the randomized multifactorial trials MRFIT in the US and The Gothenburg preventive trial in Sweden.

A part addresses the treatment or prevention of CHD with medicines, where the mode of action and side-effects of the statin group of medicines have been more or less been neglected in the large amount of clinical trials. A better analysis of these features of the family of statins has to be done in order to limit their use to patients who really need them.