Prevention of coronary heart disease

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This publication is organized uniquely, with each chapter presenting completed clinical trials alongside original conclusions and discussions. The authors challenge the widely held belief that serum cholesterol mediates disease, suggesting that dietary recommendations based on the cholesterol hypothesis are largely ineffective in the long term. They argue that traditional cholesterol biomarkers have varying significance in short- and long-term interventions due to the body's feedback control mechanisms. Furthermore, the link between high serum cholesterol and increased coronary heart disease mortality is inconsistent across different populations, indicating that this association may stem from familial hypercholesterolemia cases. Notably, higher serum cholesterol levels are correlated with lower cancer and all-cause mortalities in populations with fewer instances of this disorder. This suggests that there may be no advantage to restricting dietary cholesterol or lowering serum cholesterol below certain thresholds. Additionally, evidence points to health risks arising from excessive calorie intake, exacerbated by an imbalance of omega-6 and omega-3 polyunsaturated fats. The authors propose new directions for lipid nutrition aimed at the primary and secondary prevention of coronary heart disease, cancer, and overall mortality, potentially transforming current dietary practices.