Macro partitioning
Replacing saturated fat with polyunsaturated fat to lower serum cholesterol does not reduce the incidence of cardiovascular events, sudden death, or all-cause mortality in institutionalized populations.
This large, long-term study of institutionalized patients found that while a diet high in polyunsaturated fats successfully lowered blood cholesterol levels, it did not reduce the risk of heart attacks, sudden death, or overall mortality compared to a standard diet. This suggests that simply lowering cholesterol through fat substitution may not be sufficient to prevent cardiovascular death in all populations, particularly those with lower baseline cholesterol or shorter life expectancies.
For the entire study population, no differences between the treatment and control groups were observed for cardiovascular events, cardiovascular deaths, or total mortality.
Why this rating
Large sample size (n=9057), double-blind, randomized design, long duration (4.5 years), though conducted in a specific institutional population.
Source
Test of effect of lipid lowering by diet on cardiovascular risk. The Minnesota Coronary Survey.
Ivan D. Frantz et al. · Arteriosclerosis An Official Journal of the American Heart Association Inc · 1989
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