Changes in Retail Market Food Supplies in the United States in the Last Seventy Years in Relation to the Incidence of Coronary Heart Disease, with Special Reference to Dietary Carbohydrates and Essential Fatty Acids

Antar, Mohamed A.; Ohlson, Margaret A.; Hodges, Robert E.

doi:10.1093/ajcn/14.3.169

Cited by 150 publications

(20 citation statements)

References 6 publications

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“…This higher increase of sugar compared with fat is similar to that reported occurring in America since the 1890s (Antar, Ohlson & Hodges, 1964), and supports the suggestion that sugar rather than fat is involved in the causation of ischaemic heart disease and other 'diseases of affluence' (Yudkin, 1963).…”

Section: I4asupporting

confidence: 85%

Abstracts of communications

1969

Proc. Nutr. Soc.

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ReadingThe treatment of chronic renal failure presents unique problems in nutrition and the patients, maintained on closely restricted diets, are eminently suitable for nutritional studies. Conventional treatment involves the use of high-calorie diets providing 18-20 g proteinjday (Giovannetti & Maggiore, 1964) which, although maintaining a precarious nitrogen balance, are deficient in vitamins and iron. With the advent of regular dialysis treatment (RDT) it became possible to allow a more generous protein intake (50-70 g) but the prolonged cooking times and the leaching effect of large volumes of water necessary to rid the diet of excess sodium and potassium reduced the content of most vitamins to well below the accepted daily requirements. I n addition, there was a significant dialysis loss of vitamins during treatment. I n six patients established on RDT, thiamine, nicotinic acid, pantothenic acid, biotin and vitamin R, were all lost during dialysis, in amounts approximately equal to the 24 h urine loss in healthy adults. Folic acid and riboflavine were lost in considerably greater amounts, but there was no detectable loss of vitamin BIZ. All the patients had low plasma folate, averaging 3-9 ng/ml as compared with the normal range of 6-18 ng/ml, and indeed megaloblastic marrow changes, attributed to folate deficiency, have been reported in chronic renal failure. T h e R D T diet supplied daily only 74 pg free folate, compared with about ZOO pg in normal diets. Loss of folate during 14 h dialysis averaged 80 pg, calculated from the drop in plasma folate across the dialyser, or 30 pg from direct assay of folate in the dialysing fluid.Studies with tritiated folk acid showed normal absorption from the gut, and so the low plasma folate presumably reflects an adverse equilibrium between dietary intake of the vitamin, the losses during dialysis and the requirements for metabolism. Nevertheless there was no progressive depletion of tissue stores as indicated by the red cell folate, which remained within the normal range during the period of this study. Furthermore, early megaloblastic marrow changes observed in the patients did not respond to saturation doses of folic acid.

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Section: I4asupporting

confidence: 85%

Abstracts of communications

1969

Proc. Nutr. Soc.

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“…9 Using food supply, Antar and Kahn each concluded that there had been a rise in fat content of the American diet but that the rise was too small to alone explain the rising IHD mortality in the early part of the 20 th century (rather, Antar hypothesised a role for the replacement of complex carbohydrates by processed ones). 128,129 Similar analyses using data on food supply or dietary surveys associated reductions in saturated and animal-source fats as a driver of IHD decline in the last few decades of the 20 th century in Finland, Germany, New Zealand, Poland, Sweden, the UK, and the US (with some also documenting a decline in salt intake and a rise in consumption of fruits). 19,26,130–135 Addressing a longer period, Stephen and colleagues fitted a quadratic relationship to all available nutrition surveys and concluded that fat intake increased in the US until the 1960s before declining; the peak in the UK was in the 1970s.…”

Section: Trends In Cvd Risk Factorsmentioning

confidence: 97%

Contributions of risk factors and medical care to cardiovascular mortality trends

et al. 2015

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Ischaemic heart disease, stroke, and other cardiovascular diseases (CVDs) are responsible for an estimated 17.5 million annual deaths in the world. If account is taken of population aging, death rates from CVDs are estimated to be steadily decreasing in the world as a whole, and in regions with reliable trend data. The declines in high-income countries and some countries in Latin America have been ongoing for decades with no indication of slowing. In high-income countries, these positive trends have broadly coincided with, and benefited from, declines in smoking and physiological risk factors like blood pressure and serum cholesterol. Improvements in medical care, including effective primary prevention through management of physiological risk factors, better diagnosis and treatment of acute CVDs, and post-hospital care of those with prior CVDs, are also likely to have contributed to declining CVD event and death rates, especially in the past 40 years. However, the measured risk factor and treatment variables neither explain why the decline began when it did, nor much of the similarities and differences in the start time and rate of the decline across countries or between men and women. There have been sharp changes and fluctuations in CVDs in the former communist countries of Europe and the Soviet Union since the fall of communism in the early 1990s, with changes in volume and patterns of alcohol drinking, as a major cause of the rise in Russia and some other former Soviet countries. The challenge of reaching more definitive conclusions concerning the drivers of what constitutes one of the most remarkable international trends in adult mortality in the past half-century in part reflects the paucity of time trend data not only on disease incidence, risk factors, and clinical care, but also on other potential drivers, including infection and associated inflammatory processes throughout the lifecourse.

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“…As one of the typical trends of dietary changes in economically developed populations is a rise of sugar consumption (Yudkin, 1956, Antar et al, 1964, Greaves and Ilollingsivorth, 1964 attention should be paid to the problem M'liether the effect of sucrose in the diet and the effect of infrequent food intake may not also act synergically in human pathology. …”

Section: Discussionmentioning

confidence: 99%