In an earlier study of ambulatory humans, significant increases in the serum concentration of lipids and cholesterol were observed to correlate with emotionally stressful events in the life situation.' Other workers have also observed such changes.2-8 The changes seemed to occur independently of diet and exercise, but since it was not possible in ambulatory subjects to rule out such influences, the present study was undertaken while subjects were hospitalized, and with careful attention to maintaining diet and exercise constant.
METHODSFour subjects, three men and one woman, were admitted to the metabolic ward of the Oklahoma Medical Research Foundation and were maintained on balanced regimens for periods varying from four weeks to five months. Exercise was carefully regulated and maintained as uniform as possible. Three of the subjects had had a well-documented myocardial infarction. Two were hypertensive. The fourth had a mild hypertension and a hyperlipemia, which was presumed to be familial. As soon as each patient was admitted to the hospital a standard diet approximating his usual eating habits was begun. All four of the diets selected happened to be of the "average American" type, with approximately 40% of calories coming from fat, mainly animal fat. Calories were adjusted to the eating habits and size of the individual. The diet of one of the subjects is illustrated in Table I. Periodic blood samples were drawn at the same time of day. Cholesterol was determined in some instances by the method of Zak and in others by the technic of Schoenheimer and Sperry, and in others by the auto-analyzer. Frequent checks were carried out with two or more methods. Duplicate determinations were made in each instance. Checks were within 2.3 %, and recoveries were within 5 %.
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