User:David.Throop/Atherosclerosis cause
There are several accounts of the main causes of atherosclerosis. Almost all commentators agree that smoking is a major factor and therefore that cessation is the most productive first step, for patients who smoke. Beyond that, there are several views.
The majority view[edit]
The majority view is that atherosclerosis is primarily caused by high serum cholesterol, especially LDL. This is, in turn, caused largely by dietary fat, especially saturated fat. HDL is a protective factor.
Reducing serum cholesterol is therefor the most important next step in avoiding or treating atherosclerosis and attendant coronary heart disease (CHD). Total dietary fat should be below 30% and saturated fat below 10%. LDL should be below 130 mg/dl; below 100 for vulnerable patients, such as those with established CHD or diabetes. Statins are to be used when dietary and lifestyle modifications do not get patients to these goals. In normal practice, there is no lower bound for desirable LDL - "Lower is better."
This view is set forth by the National Cholesterol Education Program, the American Heart Association, the American Diabetes Association.
Hegsted equation:
Hegsted D, McGandy R, Myers M, Stare F (1965). "Quantitative effects of dietary fat on serum cholesterol in man" (PDF). Am J Clin Nutr. 17 (5): 281–95. PMID 5846902.{{cite journal}}: CS1 maint: multiple names: authors list (link)
OTOH[edit]
- The benefit of MUFA or PUFA is only well-defined in comparison to some other nutrient. I.e, if 100 kcal/d of oleic acid is added to your diet, without anything being taken away, you're likely to start gaining about a pound a month. Not so good. If you add that oleic acid and take away 100 kcal/d of PUFA, that probably won't be so good for you.
- If you instead take away 100 kcal/d of corn syrup, probably pretty good. Etc. But is the effect really due to the oleic acid? or the decrease in fructose? Further, since virtually all sources of MUFA also have some satfat and PUFA, most studies have confounded changes in all three at once. For that reason, I'd prefer to see an article that reviews all the fats together. And the first source to use is
- G Taubes (2001-03-30). "The soft science of dietary fat". Science. l 291: 2536–2545. PMID 11286266. Retrieved 2007-01-16.
{{cite journal}}: Text "issue 5513" ignored (help) (subscriber link) - There was a popular version of the same article in [The New York Times].
Walter Willet
NFΚB elevated by high fat diet. [1]