Ernährung und Atheroskleroseprävention

  • W. O. Richter
  • P. Schwandt


In der Bundesrepublik Deutschland sterben mehr als 50% der Menschen an Herzund Kreislauferkrankungen. Nach Angaben der WHO führte die Bundesrepublik Deutschland (588/100 000) zusammen mit Großbritannien (578/100000) 1985 die Mortalitätstatistik vor Italien, USA, Frankreich, Spanien, Kanada und Japan (247/100 000) an. Jährlich sterben allein in Deutschland etwa 80 000 Menschen akut am Herzinfarkt, weitere 80 000 an anderen Komplikationen der koronaren Herzkrankheit (KHK). Mit dieser Anzahl an Todesfällen durch die koronare Herzkrankheit (KHK) nahm die Bundesrepublik Deutschland unter den Ländern der OECD einen mittleren Rang ein (Tabelle 1).


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  1. Anderson JW, Gustafson NJ (1988) Hypocholesterolemic effects of oat and bean products. Am J Clin Nutr 48:749–753PubMedGoogle Scholar
  2. Angelin B, Einarsson K, Ewert S, Leijd B (1981) Biliary lipid composition in obesity. Scand J Gastroenterol 16:1015–1019PubMedCrossRefGoogle Scholar
  3. Arntzenius AC, Kromhout D, Barth JD et al. (1985) Diet, lipoproteins, and the progression of coronary atherosclerosis. N Engl J Med 312:805–811PubMedCrossRefGoogle Scholar
  4. Aro A, Kardinaal AFM, Salminen I et al. (1995) Adipose tissue isomeric trans fatty acids and risk of myocardial infarction in nine countries: the Euramic study. Lancet 345:273- 278CrossRefGoogle Scholar
  5. Ascherio A, Hennekens CH, Buring JE et al. (1994) Trans-fatty acids intake and risk of myocardial infarction. Circulation 89:94–101PubMedGoogle Scholar
  6. Assmann G, Schulte H (1986) Procam-Studie. Panscientia, Hedingen-ZürichGoogle Scholar
  7. Bak AA, Grobbe DE (1989) The effect on serum cholesterol levels of coffee brewed by filtering or boiling. N Engl J Med 321:1432–1437PubMedCrossRefGoogle Scholar
  8. Blackburn H, Jacobs D (1983) Coronary disease risk factors: a population view. In: Schettler G, Gotto AM, Middelhoff G (eds) Atherosclerosis VI. Springer, Berlin Heidelberg New YorkGoogle Scholar
  9. Carroll KK, Khor HT (1971) Effects of level and type of dietary fat on incidence of mammary tumors induced in female Sprague-Dawley rats by 7,i2-dimethylbenz(a)anthrace- ne. Lipids 6:415–420PubMedCrossRefGoogle Scholar
  10. Carter CA, Milholland RJ, Shea W et al. (1983) Effect of the prostaglandin synthetase inhibitor indomethacin on 7,i2-dimethylbenz(a)anthracene-induced mammary tumorige- nesis in rats fed different levels of fat. Cancer Res 43:3559–3562PubMedGoogle Scholar
  11. Consensus development conference (1985) Lowering blood cholesterol to prevent heart disease. JAMA 253:2080–2086CrossRefGoogle Scholar
  12. Cortese C, Levy Y, Janus ED et al. (1983) Modes of action of lipid lowering diets in man: studies of apolipoprotein B kinetics in relation to fat consumption and dietary fat composition. Eur J Clin Invest 13:79–85PubMedCrossRefGoogle Scholar
  13. Cristofori FC, Duncan GG (1964) Uric acid excretion in obese subjects during periods of fasting. Metabolism 13:303–311PubMedCrossRefGoogle Scholar
  14. Davidson MH, Dugan LD, Burns JH, et al. (1991) The hypocholesterolemic effect of b-glucan in oatmeal and oat bran. JAMA 265:1833–1839PubMedCrossRefGoogle Scholar
  15. Davis Conference (1991) Alcohol and atherosclerosis. Ann Int Med 114:967–976Google Scholar
  16. Dayton S, Pearce ML, Hashimoto S, Dixon WJ, Tomiyasu U (1969) A controlled clinical trial of a diet high in unsaturated fat in preventing complications of atherosclerosis. Circulation 40:1–63Google Scholar
  17. Dyerberg J (1986) Linolenate derived polyunsaturated fatty acids and prevention of atherosclerosis. Nutr Rev 44:125–130PubMedCrossRefGoogle Scholar
  18. Dyerberg J, Bang HO (1978) Dietary fat and thrombosis. Lancet I:152CrossRefGoogle Scholar
  19. Egusa G, Beltz WF, Grundy SM, Howard BV (1985) Influence of obesity on the metabolism of apolipoprotein B in humans. J Clin Invest 76:596–603PubMedCrossRefGoogle Scholar
  20. Forsythe WA, Green MS, Anderson JJB (1986) Dietary protein effects on cholesterol and lipoprotein concentrations. J Am Coll Nutr 5:533–549PubMedGoogle Scholar
  21. Fox JC, McGill Jr HC, Carey KD, Getz GS (1987) In vivo regulation of hepatic LDL receptor mRNA in the baboon - differential effects of saturated and unsaturated fat. J Biol Chem 262:7014–7019PubMedGoogle Scholar
  22. Frankel EN, Kanner J, German JB et al. (1993) Inhibition of oxidation of human low-density lipoprotein by phenolic substances in red win. Lancet 341:454–456PubMedCrossRefGoogle Scholar
  23. Fried RE, Levine DM, Kwiterovich PO et al. (1992) The effect of filtered-coffee consumption on plasma lipid levels. JAMA 267:811–815PubMedCrossRefGoogle Scholar
  24. Fry MM, Spector AA, Connor SL (1973) Intensification of hypertriglyceridemia by either alcohol or carbohydrate. Am J Clin Nutr 26:798–802PubMedGoogle Scholar
  25. Gaddi A, Ciarrocchi A, Matteucci A et al. (1991) Dietary treatment for familial hypercholesterolemia - differential effects of soy protein according to the apolipoprotein E phe- notypes. A J Clin Nutr 53:1191–1196Google Scholar
  26. Garrison RJ, Feinleib M, Castelli WP, McNamara PM (1983) Cigarette smoking as a con- founder of the relationship between relative weight and long-term mortality: the Fra- mingham heart study. J Am Med Ass 249:2199–2203CrossRefGoogle Scholar
  27. Ginsberg H, Olefsky J, Farquhar JW et al. (1974) Moderate ethanol ingestion and plasma triglyceride levels - a study in normal and hypertriglyceridemic persons. Ann Intern Med 80:143–149PubMedGoogle Scholar
  28. Ginsberg HN, Le NA, Gibson JC (1985) Regulation of the production and catabolism of plasma low density lipoproteins in hypertriglyceridemic subjects. Effects of weight loss. J Clin Invest 75:614–623PubMedCrossRefGoogle Scholar
  29. Gordon T, Doyle JT (1986) Alcohol consumption and its relationship to smoking, weight, blood pressure, and blood lipids. The Albany Study. Arch Int Med 146:262–265CrossRefGoogle Scholar
  30. Grundy SM, Vega GL (1988) Plasma cholesterol responsiveness to saturated fatty acids.Am J Clin Nutr 47:822–824Google Scholar
  31. Grundy SM, Mok HYI, Zech L, Steinberg D, Berman L (1979) Transport of very low density lipoprotein triglycerides in varying degrees of obesity and hypertriglyceridemia. J Clin Invest 63:1274–1283PubMedCrossRefGoogle Scholar
  32. Grundy SM, Nix D, Whelan MF, Franklin L (1986) Comparison of three cholesterol-lowering diets in normolipidemic men. JAMA 256:2351–2355PubMedCrossRefGoogle Scholar
  33. Hubert HB, Feinleib M, McNamara PM, Castelli WP (1983) Obesity is an independent risk factor for cardiovascular disease: A 26-year follow-up of participants in the Framingham heart study. Circulation 67:968–977PubMedCrossRefGoogle Scholar
  34. Hegsted DM, Ausmann LM (1988) Diet, alcohol and coronary heart disease in men. J Nutr. 118:1184–1189PubMedGoogle Scholar
  35. Hegsted DM, McGandy RB, Myers ML et al. (1965) Quantitative effects of dietary fat on serum cholesterol in man. Am J Clin Nutr 17:281–295PubMedGoogle Scholar
  36. Hennekens Ch, Rosner B, Cole DS (1978) Daily alcohol consumption and coronary heart diesease. Am J Epidemiol 107:196–200PubMedGoogle Scholar
  37. Hillyard LA, Abraham S (1979) Effect of dietary polyunsaturated fatty acids on growth of mammary adenocarconomas in mice and rats. Cancer Res 39:4430–4437PubMedGoogle Scholar
  38. Kagan A, Hains BR, Winkelstein W, Johnson KG, Tillotson J (1974) Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: demographic, physical, dietary and biochemical characteristics. J Chron Dis 27:343–351CrossRefGoogle Scholar
  39. Kagawa Y, Nishizawa M, Suzuki M et al. (1982) Eicosapolyenoic acids of serum lipids of Japanese islanders with low incidence of cardiovascular disease. J Nutr Sei Vitaminol 28:441–453CrossRefGoogle Scholar
  40. Kahn HA, Philips RL, Snowden DA, Choi W (1984) Association between reported diet and all-cause mortality. Twenty-one year follow-up on 27,530 adult Seventh-Day Adventists. Am J Epidemiol 119:775–787PubMedGoogle Scholar
  41. Katan MB, Beynen AC, DeVries JHM, Nobels A (1986) Existence of consistent hypo- and hyperresponders to dietary cholesterol in man. Am J Epidemio 123:221–234Google Scholar
  42. Katan MB, Berns MAM, Glatz JFC, Knuiman JT, Nobels A, deVries JHM (1988) Congruence of individual responsiveness to dietary cholesterol and to saturated fat in humans. J Lipid Res 29:883–892PubMedGoogle Scholar
  43. Kendler BS (1987) Garlic and Onion: A review of their relationship to cardiovascular disease. Prev Med 16:670–685PubMedCrossRefGoogle Scholar
  44. Kesäniemi YA, Grundy SM (1983) Increased low density lipoprotein production associated with obesity. Arteriosclerosis 3:170–177PubMedCrossRefGoogle Scholar
  45. Kesäniemi YA, Beltz WF, Grundy SM (1985) Comparisons of metabolism of apolipoprotein B in normal subjects, obese patients, and patients with coronary heart disease. J Clin Invest 76:586–595PubMedCrossRefGoogle Scholar
  46. Keys A, Anderson JT, Grande F (1960) Diet type (fat constant) and blood lipids in man. J Nutr 70:257–266PubMedGoogle Scholar
  47. Keys A, Anderson JT, Grande F (1965) Serum cholesterol response to changes in the diet. Metabolism 14:747–787CrossRefGoogle Scholar
  48. Kimura N (1983) Changing patterns of coronary heart disease, stroke and nutrient intake in Japan. Prev Med 12:222PubMedCrossRefGoogle Scholar
  49. King ME, Spector AA (1978) Effect of specific fatty acyl enrichments on membrane physical properties detected with a spin-label probe. J Biol Chem 253:6493–6501PubMedGoogle Scholar
  50. Kinsella JE (1987) Effects of polyunsaturated fatty acids on factors related to cardiovascular disease. Am J Cardiol 60:23–32CrossRefGoogle Scholar
  51. Knuiman JT, West CE, Katan MB, Hautvast JGAJ (1987) Total cholesterol and high density lipoprotein cholesterol levels in populations differing in fat and carbohydrate intake. Arteriosclerosis 7:612–619PubMedCrossRefGoogle Scholar
  52. Kramer K, Kuller LH, Fisher R (1968) The increasing mortality attributed to cirrhosis and fatty liver in Baltimore (1957 - 1966). Ann Int Med 69:273–282Google Scholar
  53. Kromhout D, Boschieter EB, de Lezenne Coulander C (1985) The inverse relation between fish consumption and 20-year mortality from coronary heart disease. New Engl J Med 312:1205–1209PubMedCrossRefGoogle Scholar
  54. Kuschi LH, Lew RA, Stare FJ (1985) Diet and 20-year mortality from coronary heart disease.New Engl J Med 312:811–818CrossRefGoogle Scholar
  55. Lecocq FR, McPhaul JJ (1965) The effect of starvation, high fat diets, and ketone infusions on uric acid balance. Metabolism 14:186–197PubMedCrossRefGoogle Scholar
  56. Leijd B (1980) Cholesterol and bile acid metabolism in obesity. Clin Sei 59:203–206Google Scholar
  57. Lewis B, Katan M, Merkx I et al. (1981) Towards an improved lipid-lowering diet: additive effects of changes on nutrient intake. Lancet II:1310–1313CrossRefGoogle Scholar
  58. Lissner L, Odell P, Agostino RD, Stokes III J, Kreger B, Belanger A, Brownell K (1988a) Weight cycling and coronary heart disease in the Framingham population, ist European Congress on Obesity StockholmGoogle Scholar
  59. Lissner L, Bengtsson C, Lapidus L, Larsson B, Bengtsson B, Brownell K (1988b) Body weight variability and mortality in the Göteborg prospective studies of men and women. 1st European Congress on Obesity StockholmGoogle Scholar
  60. Loscalzo J, Freedman J, Rudd MA, Barsky-Vasserman I, Vaughan DE (1987) Unsaturated fatty acids enhance low density lipoprotein uptake and degradation by peripheral blood mononuclear cells. Arterioslerosis 7:450–455CrossRefGoogle Scholar
  61. Mahley RW, Innerarity TL, Bersot TP, Lipson A, Margolis S (1978) Alterations in human high-density lipoproteins, with and without increased plasma cholesterol, induced by diets high in cholesterol. Lancet II:807–809CrossRefGoogle Scholar
  62. Martin MJ, Browner WS, Hulley SB, Kuller LH, Wentworth D (1986) Serum cholesterol, blood pressure, and mortality: implications from a cohort of 361662 men. Lancet 11:933- 936CrossRefGoogle Scholar
  63. Mattson FH, Grundy SM (1985) Comparison of effects of dietary saturated, monounsatu- rated, and polyunsaturated fatty acids on plasma lipids and lipoproteins in man. J Lipid Res 26:194–202PubMedGoogle Scholar
  64. Mattson FH, Erickson BA, Kligman AM (1972) Effect of dietary cholesterol on serum cholesterol in man. Am J Clin Nutr 25:589–594PubMedGoogle Scholar
  65. McGee DL, Reed DM, Yano K, Kagan A, Tillotson J (1984) Ten-year incidence of coronary heart disease in the Honolulu Heart Program: the relationship to nutrient intake. Am J Epidemiol 119:667–676PubMedGoogle Scholar
  66. McNamara DJ (1987) Effects of fat-modified diets on cholesterol and lipoprotein metabolism. Ann Rev Nutr 7:273–290CrossRefGoogle Scholar
  67. Miettinen TA (1971) Cholesterol production in obesity. Circulation 44:842–850PubMedGoogle Scholar
  68. Myers MG, Basinsky A (1992) Coffee and coronary heart diesease. Arch Int Med 152:1767- 1772CrossRefGoogle Scholar
  69. NIH Consensus Development Conference (1985) Health implications of obesity. Ann Int Med 103:1073–1077Google Scholar
  70. Olefsky J, Reaven GM, Farquahar JW (1974) Effects of weight reduction in obesity. Studies of lipid and carbohydrate metabolism in normal and hyperlipoproteinemic subjects. J Clin Invest 53:64–76PubMedCrossRefGoogle Scholar
  71. Ornish D, Brown SE, Schwerwith LW et al. (1990) Can lifestyle changes reverse coronary heart diesease? Lancet 336:129–133PubMedCrossRefGoogle Scholar
  72. Packard CJ, McKinney L, Carr K, Shepherd J (1983) Cholesterol feeding increases low density lipoprotein synthesis. J Clin Invest 72:45–51PubMedCrossRefGoogle Scholar
  73. Pyöräla K (1987) Dietary cholesterol in relation to plasma cholesterol and coronary heart disease. Am J Clin Nutr 45:1176–1184PubMedGoogle Scholar
  74. Richter WO (1988) Gewichtsreduktion - wie? Fortschr Med 106:363–364 Richter WO, Schwandt P (1983) Ballaststoffe bei Hyperlipoproteinämien. Münch Med Wo- chenschr 125:407–410Google Scholar
  75. Richter WO, Schwandt P (1989) Verbesserte Lebenserwartung durch Prävention der Atherosklerose - Ergebnisse von Interventionsstudien zur Behandlung von Fettstoffwechselstörungen. Lebensversicherungsmedizin 41:162–165Google Scholar
  76. Roberts TL, Wood DA, Riemersma RA, Gallagher PJ, Lampe FC (1995) Transisomers of oleic and linoleic acids in adipose tissue and sudden cardiac death. Lancet 345:278–282PubMedCrossRefGoogle Scholar
  77. Schuler G, Hambrecht R, Schlierf G et al. (1992) Myocardial perfusion and regression of coronary artery disease in patients on a regimen of intensive physical exercise and low fat diet. J Am Coll Cardiol 19:34–42PubMedCrossRefGoogle Scholar
  78. Schwandt P, Janetschek P, Weislweiler P (1982) High density lipoproteins unaffected by dietary fat modification. Atherosclerosis 44:9–17PubMedCrossRefGoogle Scholar
  79. Seely S (1988) Diet and coronary arterial disease: a statistical study. Int J Cardiol 20:183–192PubMedCrossRefGoogle Scholar
  80. Shaper AG, Wannamethee G, Walker M (1988) Alcohol and mortality in British men:explaining the U-shaped curve. Lancet II:1267–1273CrossRefGoogle Scholar
  81. Steinberg D (1993) Antioxidant vitamins and coronary heart disease. N Engl J Med 328:1487–1489PubMedCrossRefGoogle Scholar
  82. Study Group, European Atherosclerosis Society (1988) The recognition and management of hyperlipidemia in adults: A policy statement of the European Atherosclerosis Society. Eur Heart J 9:571–600Google Scholar
  83. Suh II, Shaten BJ, Cutler JA, Kuller LH (1992) Alcohol use and mortality from coronary heart disease: the role of high-density lipoprotein cholesterol. Ann Intern Med 116:881- 887PubMedGoogle Scholar
  84. Taskforce for the prevention of coronary heart disease. European Atherosclerosis Society (1992) Prevention of coronary heart disease - Scientific background and new clinical guidelines. Nutr Metab Cardiovasc Dis 2:113–154Google Scholar
  85. Taskinen MR, Nikkilä EA, Välimäki M, Sane T, Kuusi T, Kesaniämi A, Ylikahri R (1987) Alcohol-induced changes in lipoproteins and in their metabolism. Am Heart J 113:458- 464PubMedCrossRefGoogle Scholar
  86. The alpha-tocopherol, beta-carotene cancer prevention study group (1994) The effect of vitamin E and beta-carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 330:1029–1035Google Scholar
  87. The Treatment of Mild Hypertension Research Group (1993) The Treatment of Mild Hypertension Study: a randomized, placebo-controlled trial of a nutritional-hygienic regimen along with various drug nonotherapies. Arch Int Med 151:1413–1423Google Scholar
  88. The Trials of Hypertension Prevention Colloborative Research Group (1992) The effects of nonpharmacologic interventions on blood pressure of persons with high normal levels: results of the Trials of Hypertension Prevention. Phase I. JAMA 267:1213–1220CrossRefGoogle Scholar
  89. Tuomilehto J, Silvasti M, Aro A et al (1988) Long term treatment of severe hypercholesterolemia with guar gum. Atherosclerosis 72:157–162PubMedCrossRefGoogle Scholar
  90. Wasserteil-Smoller S, Oberman A, Blaufox MD et al. (1992) the Trial of Antihypertensive Interventions and Management (TAIM) Study: final results with regard to blood pressure, cardiovascular risk, and quality of life. Am I Hypertension 5:37–44Google Scholar
  91. Watts GF, Lewis B, Brunt JNH et al. (1992) Effects on coronary artery disease of lipid-lo- wering diet, or diet plus cholestyramine, in th St Thomas atherosclerosis regression study (STARS). Lancet 339:563–569PubMedCrossRefGoogle Scholar
  92. Weisweiler P, Janetschek P, Schwandt P (1985) Influence of polyunsaturated fats and fat restriction on serum lipoproteins in humans. Metabolism 34:83–87PubMedCrossRefGoogle Scholar
  93. Willet WC, Stampfer MJ, Manson JE et al. (1993) Intake of trans fatty acids and risk of coronary heart disease among women. Lancet 341:581–585CrossRefGoogle Scholar
  94. Yamori Y, Nara Y, Iritani N, Workman RJ, Inagami T (1985) Comparison of serum phospholipid fatty acids among fishing and farming Japanese populations and American Islanders. J Nutr Sei Vitaminol 31:417–422CrossRefGoogle Scholar
  95. Yang YT, Williams MA (1978) Comparison of unsaturated fatty acids in reducing fatty acids synthesis in rat hepatocytes. Biochem Biophys Acta 531:133–140PubMedGoogle Scholar
  96. Zock PL, Katan MB (1992) Hydrogenation alternatives: effects of trans fatty acids and stearic acid versus linolic acid on serum lipids and lipoproteins in human. J Lipid Res 33:399–410PubMedGoogle Scholar
  97. Zock PL, Katan MB, Merkus MP, van Dusseldorp M, Harryvan JL (1990 Effect of a lipid-rich fraction from boiled coffee on serum cholesterol. Lancet 335:1235–1237PubMedCrossRefGoogle Scholar
  98. Zürcher HU, Meier HR, Huber M, Lämmli J, Wick A, Binswanger U (1977) Akutes Nierenversagen als Komplikation von Fastenkuren. Schweiz Med Wochenschr 107:1025–1028PubMedGoogle Scholar

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  • W. O. Richter
  • P. Schwandt

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