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Cholesterol's slippery slope.

Analysis of six years of data on 356,222 men shows that the heart disease-blood cholesterol relationship is not a "threshold phenomenon." Instead, the risk of heart disease rises with increasing cholesterol. People with cholesterol levels as low as 180 milligrams per deciliter are at increased risk, but not to the degree of people with cholesterol levels over 220, says Jeremiah Stamler of Northwestern University Medical School in Chicago.

In the 40- to 44-year-old age group of MRFIT (Multiple Risk Factor Intervention Trial), for example, the six-year heart attack rate in the 20 percent of men with the lowest cholesterol levels was 1.3 deaths per 1,000 men. For the next 20 percent, with levels of 182 to 202, the rate was 2.3 and it steadily climbed to 8.6 in the highest 10 percent.

Though there are still many researchers who do not appreciate the strength of the relationship, the MRFIT data should nail it down, Stamler says. "It was a strong and unequivocal relationship of serum cholesterol to risk, for both cigarette smokers and nonsmokers, for both men with normal blood pressure and men with high blood pressure," he says. "In every one of those groups, this relationship held consistently, systematically and without contradiction -- and in every one of them it was continuous, strong and graded."

You don't need to become a complete ascetic in order to lower your cholesterol levels. Scott M. Grundy of the University of Texas Health Science Center at Dallas and his colleagues rotated nine men through two-month stints on each of three diets -- the American Heart Association diet, in which a maximum of 30 percent of the calories come from fat; a 40 percent fat diet; and a 20 percent diet. The subject's average cholesterol level was 210 mg/dl on entry.

In all the men, the blood levels of total cholesterol and of the "bad" form of cholesterol, LDL-cholesterol, fell to around 175. "There were no significant differences [in cholesterol levels of the men] on these three diets," Grundy says. "Perhaps there is more flexibility in substituting dietary constituents for staturated fat in the diet. At least for the general public it would seem that severe fat restriction is not necessary to achieve an optimal reduction in levels of LDL-cholesterol and an optimum change in lipoprotein levels." Grundy has previously reported that monounsaturated fat, the primary constituent of peanut oil and olive oil, is better than polyunsaturated fat in holding cholesterol levels down (SN:4/6/85, p. 216).

What to eat? A suggestion from Stamler is bound to please the folks in Little Italy and Chinatown -- "a combination of the best of the Mediterranean and the Far East."
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Title Annotation:heart disease-blood cholesterol phenomenon
Author:Silberner, Joanne
Publication:Science News
Date:Nov 30, 1985
Previous Article:Bypassing women.
Next Article:If I only had a heart.

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