Current Atherosclerosis Reports

, Volume 4, Issue 6, pp 419–424 | Cite as

Dietary fats and coronary heart disease pathogenesis

  • Serge Renaud
  • Dominique Lanzmann-Petithory


The intake of saturated fat seems to be the main environmental factor for coronary heart disease (CHD). However, decreasing the intake of saturated fat and replacing it in part with linoleic acid in primary or secondary intervention trials did not satisfactorily reduce CHD clinical manifestations. It is only when omega-3 fatty acids, alpha-linolenic acid (ALA), or eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were added to the diet that sudden cardiac death (ALA, EPA plus DHA) and nonfatal myocardial infarction (only ALA) were significantly lowered. The protective effect of omega-3 fatty acids occurs rapidly, within weeks. The mechanism for preventing ventricular fibrillation seems to be through a direct effect on myocytes. The additional effect of ALA on nonfatal myocardial infarction may be through thrombosis, at least partly caused by an effect on platelets.


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References and Recommended Reading

  1. 1.
    Kato H, Tillotson J, Nichaman JZ, Rhoads GG, Hamilton HB: Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California. Am J Epidemiol 1973, 97:372–385.PubMedGoogle Scholar
  2. 2.
    Yano K, Rhoads GG, Kagan A: Coffee, alcohol and risk of coronary heart disease among Japanese men living in Hawaii. N Engl J Med 1977, 297:405–409.PubMedCrossRefGoogle Scholar
  3. 3.
    Keys A: Coronary heart disease in seven countries. Circulation 1970, 41(suppl 1):1–211.Google Scholar
  4. 4.
    Hegsted DM: Serum cholesterol response to dietary cholesterol: a re-evaluation. Am J Clin Nutr 1986, 44:299–305.PubMedGoogle Scholar
  5. 5.
    Mensik RP, Katan MB: Effect of dietary FAs on serum lipids and lipoproteins. Arterioscler Thromb 1992, 12:911–919.Google Scholar
  6. 6.
    Martin MJ, Hulley SB, Kuller LH, Wentworth D: Serum cholesterol, blood pressure and mortality: implications from a cohort of 361,662 men. Lancet 1986, 2:933–936.PubMedCrossRefGoogle Scholar
  7. 7.
    Wissler RW, Vesselinovitch D: The effects of feeding various dietary fats on the development and regression of hypercholesterolemia and atherosclerosis. Adv Exp Med Biol 1975, 60:65–76.PubMedGoogle Scholar
  8. 8.
    Renaud S, de Lorgeril M: Dietary lipids and their relation to ischaemic heart disease: from epidemiology to prevention. J Intern Med 1989, 225(suppl 1):39–46.Google Scholar
  9. 9.
    Kromhout D, Menotti A, Blowmberg B, et al.: Dietary saturated and trans fatty acids and cholesterol and 25-year mortality from coronary heart disease: the Seven Countries Study. Prev Med 1995, 24:308–315.PubMedCrossRefGoogle Scholar
  10. 10.
    Mattson FH, Nolen GA, Webb MR: The absorbability of fats of various triglycerides of stearic and oleic acid and the effect of dietary calcium and magnesium. J Nutr 1973, 109:1682–1687.Google Scholar
  11. 11.
    Renaud S, Ruf JC, Petithory D: The position distribution of fatty acids in palm oil and lard influences their biologic effects in rats. J Nutr 1995, 125:229–237.PubMedGoogle Scholar
  12. 12.
    Wolfe MS, Sayer JK, Morgan TM, Bullock BC, Rudel LL: Dietary polyunsaturated fat decreases coronary artery atherosclerosis in a pediatric-aged population of African Green monkeys. Arterioscler Thromb 1994, 14:587–597.PubMedGoogle Scholar
  13. 13.
    Guidry MA, Wu WT: Suppression of experimental atherosclerosis in dogs by dietary linoleic acid. Proc Soc Exp Biol Med 1967, 124:973–976.PubMedGoogle Scholar
  14. 14.
    Nordoy A: The influence of saturated fats, cholesterol, corn oil and linseed oil on experimental venous thrombosis in rats. Thromb Diath Haemorrheol 1965, 13:244–256.Google Scholar
  15. 15.
    Renaud S, Godu J: Induction of large thrombi in hyperlipemic rats by epinephrine and endotoxin. Lab Invest 1969, 21:512–518.PubMedGoogle Scholar
  16. 16.
    Hornstra G, Vendelmans A: Induction of experimental arterial thrombi in rats. Atherosclerosis 1973, 17:369–382.PubMedCrossRefGoogle Scholar
  17. 17.
    Renaud S: Thrombotic, atherosclerotic and lipemic effects of dietary fats in the rats. Angiology 1969, 20:657–669.PubMedGoogle Scholar
  18. 18.
    Connor WE, Hoak JC, Warner FD: Massive thrombosis produced by fatty acid infusion. J Clin Invest 1963, 42:860–866.PubMedCrossRefGoogle Scholar
  19. 19.
    Gautheron P, Renaud S: Hyperlipemia induced hypercoagulable state in rat. Role of increased activity of platelet phosphatidyl serine in response to certain dietary fatty acids. Thromb Res 1972, 1:353–370.CrossRefGoogle Scholar
  20. 20.
    Renaud S, Morazain R, Godsey F, et al.: Nutrients, platelet function and composition in nine groups of French and British farmers. Atherosclerosis 1986, 60:37–48.PubMedCrossRefGoogle Scholar
  21. 21.
    Renaud S, Godsey F, Dumont E, Thévenon C, Ortchanian E: Influence of long-term diet modification on platelet function and composition in Moselle farmers. Am J Clin Nutr 1986, 43:136–150.PubMedGoogle Scholar
  22. 22.
    Emken EA, Adlot RO, Gulley RM: Dietary linoleic acid influences desaturation and acylation of deuterium-labeled linoleic and linolenic acids in young adult males. Biochem Biophys Acta 1994, 1213:277–288.PubMedGoogle Scholar
  23. 23.
    DeWood MA, Spores J, Notske R, et al.: Prevalence of total coronary occlusion during the early hours of transmural myocardial infarction. N Engl J Med 1980, 303:897–902.PubMedCrossRefGoogle Scholar
  24. 24.
    Zucker MB, Peterson J: Inhibition of adenosine diphosphate-induced secondary aggregation and other platelet functions by acetylsalicylic acid ingestion. Proc Soc Exp Biol Med 1968, 127:547–551.PubMedGoogle Scholar
  25. 25.
    Billman GE, Kang JX, Leaf A: Prevention of ischemia-induced cardiac sudden death by n-3 polyunsaturated fatty acids in dogs. Lipids 1997, 32:1161–1168.PubMedCrossRefGoogle Scholar
  26. 26.
    Siebert BD, McLennan PL, Woodhouse JA, Charnock JS: Cardiac arrhythmia in rats in response to dietary n-3 fatty acids from red meat, fish oil and canola oil. Nutr Res 1993, 13:1407–1418.CrossRefGoogle Scholar
  27. 27.
    McLennan PL, Dallimore JA: Dietary canola oil modifies myocardial fatty acids and inhibits cardiac arrhytmias in rats. J Nutr 1995, 125:1003–1009.PubMedGoogle Scholar
  28. 28.
    Kang JX, Leaf A: Effects of long-chain polyunsaturated fatty acids on the contraction of neonatal rat cardiac myocytes. Proc Natl Acad Sci U S A 1994, 91:9886–9890.PubMedCrossRefGoogle Scholar
  29. 29.
    Xiao YF, Gomez AM, Morgan JP, Lederer WJ, Leaf A: Suppression of voltage-gated L-type Ca2+ currents by polyunsaturated fatty acids in adult and neonatal rat ventricular myocytes. Proc Nat Acad Sci USA 1997, 94:4182–4187.PubMedCrossRefGoogle Scholar
  30. 30.
    Leren P: The Oslo diet heart study. Eleven year report. Circulation 1970, 42:935–942.PubMedGoogle Scholar
  31. 31.
    Morris JN, Ball KP, Antonis A, et al.: Controlled trial of soya bean oil in myocardial infarction. Lancet 1968, 2:694–700.Google Scholar
  32. 32.
    Frantz ID Jr, Dawson EA, Ashom PL, et al.: Test of effect of lipid lowering by diet on cardiovascular risk. The Minnesota Coronary Survey. Arteriosclerosis 1989, 9:129–135.PubMedGoogle Scholar
  33. 33.
    Hooper L, Summerbell CD, Higgins JP, et al.: Dietary fat intake and prevention of cardiovascular disease: systematic review. BMJ 2001, 322:757–763.PubMedCrossRefGoogle Scholar
  34. 34.
    Hjermann I, Holme I, Leren P: Oslo study diet and antismoking trial. Results after 102 months. Am J Med 1986, 80:7–11.PubMedCrossRefGoogle Scholar
  35. 35.
    Burr ML, Fehily AM, Gilbert JF, et al.: Effects of changes in fat, fish, and fiber intakes on death and myocardial reinfarction: diet and reinfarction trial (DART). Lancet 1989, 2:757–761.PubMedCrossRefGoogle Scholar
  36. 36.
    Gissi Prevenzione Investigators: Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the Gissi Prevenzione trial. Lancet 1999, 354:447–453.CrossRefGoogle Scholar
  37. 37.
    Albert CM, Hennekens CH, O’Donnell CJ, et al.: Fish consumption and risk of sudden cardiac death. JAMA 1998, 279:23–28.PubMedCrossRefGoogle Scholar
  38. 38.
    Albert CM, Campos H, Stampfer MJ, et al.: Blood levels of long-chain n-3 fatty acids and the risk of sudden death. N Engl J Med 2002, 346:1113–1118.PubMedCrossRefGoogle Scholar
  39. 39.
    De Lorgeril M, Renaud S, Mamelle N, et al.: Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet 1994, 343:1454–1459.PubMedCrossRefGoogle Scholar
  40. 40.
    Renaud S, de Lorgeril M, Delaye J, et al.: Cretan Mediterranean diet for prevention of coronary heart disease. Am J Clin Nutr 1995, 61:1360S-1367S.PubMedGoogle Scholar
  41. 41.
    Sandker GN, Kromhout D, Aravanis C, et al.: Serum cholesteryl ester fatty acids and their relation with serum lipids in elderly men in Crete and the Netherlands. Eur J Clin Nutr 1993, 47:201–208.PubMedGoogle Scholar
  42. 42.
    Singh RB, Niaz MA, Sharma JP, et al.: Randomized, double-blind, placebo-controlled trial of fish oil and mustard oil in patients with suspected acute myocardial infarction; the Indian experiment of infarct survival. Cardiovasc Drugs Ther 1997, 11:485–491.PubMedCrossRefGoogle Scholar
  43. 43.
    Ascherio A, Rimm EB, Giovannucci EL, et al.: Dietary fat and risk of coronary heart disease in men: cohort follow up study in the United States. BMJ 1996, 313:84–90.PubMedGoogle Scholar
  44. 44.
    Hu FB, Stampfer MJ, Morison JE, et al.: Dietary intake of alpha-linolenic acid and risk of fatal ischemic heart disease among women. Am J Clin Nutr 1999, 69:890–897.PubMedGoogle Scholar
  45. 45.
    Dolecek TA: Epidemiological evidence of relationships between dietary polyunsatured fatty acids and mortality in the Multiple Risk Factor Intervention Trial. Proc Soc Exp Biol Med 1992, 200:177–182.PubMedGoogle Scholar
  46. 46.
    Djousse L, Pankow JS, Eckfeldt JH, et al.: Relation between dietary linolenic acid and coronary artery disease in the National Heart, Lung, and Blood Institute Family Heart Study. Am J Clin Nutr 2001, 74:612–619.PubMedGoogle Scholar
  47. 47.
    Oomen CM, Ocke MC, Feskens EJ, Kok FJ, Kromhout D: Alpha-linolenic acid intake is not beneficially associated with 10-y risk of coronary artery disease incidence: the Zutphen Elderly Study. Am J Clin Nutr 2001, 74:457–463.PubMedGoogle Scholar
  48. 48.
    Pietinen P, Vartiainen E, Steppanen R, Aro A, Puska P: Changes in diet in Finland from 1972 to 1992: impact on coronary heart disease risk. Prev Med 1996, 25:243–250.PubMedCrossRefGoogle Scholar
  49. 49.
    Hulshof KF, van Erp-Baart MA, Anttolainen M, et al.: Intake of fatty acids in western Europe with emphasis on trans fatty acids: the TRANSFAIR Study. Eur J Clin Nutr 1999, 53:143–157.PubMedCrossRefGoogle Scholar
  50. 50.
    Jula A, Marniemi J, Huupponen R, et al.: Effects of diet and simvastatin on serum lipids, insulin, and antioxidants in hypercholesterolemic men: a randomized controlled trial. JAMA 2002, 287:598–605.PubMedCrossRefGoogle Scholar
  51. 51.
    Bemelmans WJ, Broer J, Feskens EJ, et al.: Effect of an increased intake of alpha-linolenic acid and group nutritional education on cardiovascular risk factors: the Mediterranean Alpha-linolenic Enriched Groningen Dietary Intervention (MARGARIN) study. Am J Clin Nutr 2002, 75:221–227.PubMedGoogle Scholar

Copyright information

© Current Science Inc 2002

Authors and Affiliations

  • Serge Renaud
    • 1
  • Dominique Lanzmann-Petithory
    • 1
  1. 1.INSERMBordeaux cedexFrance

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