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J Am Coll Cardiol, 2004; 43:731-733, doi:10.1016/j.jacc.2003.10.034
© 2004 by the American College of Cardiology Foundation
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VIEWPOINT AND COMMENTARY

The diet–heart hypothesis: a critique

Sylvan Lee Weinberg, MD, MACC*,*

* Dayton Heart Hospital, Dayton, Ohio, USA

Manuscript received September 23, 2003; revised manuscript received October 6, 2003, accepted October 14, 2003.

* Reprint requests and correspondence: Dr. Sylvan Lee Weinberg, Director of Medical Education, The Dayton Heart Hospital, 4555 Southern Blvd., Dayton, Ohio 45429, USA.
slwjal{at}aol.com

The low-fat "diet–heart hypothesis" has been controversial for nearly 100 years. The low-fat–high-carbohydrate diet, promulgated vigorously by the National Cholesterol Education Program, National Institutes of Health, and American Heart Association since the Lipid Research Clinics-Primary Prevention Program in 1984, and earlier by the U.S. Department of Agriculture food pyramid, may well have played an unintended role in the current epidemics of obesity, lipid abnormalities, type II diabetes, and metabolic syndromes. This diet can no longer be defended by appeal to the authority of prestigious medical organizations or by rejecting clinical experience and a growing medical literature suggesting that the much-maligned low-carbohydrate–high-protein diet may have a salutary effect on the epidemics in question.

Abbreviations and Acronyms
  AHA = American Heart Association
  CAD = coronary artery disease
  Carb = carbohydrate
  HDL = high-density lipoprotein
  LCarb-HP = low-carbohydrate–high-protein
  LCR-CPPT = Lipid Research Clinics–Primary Prevention Trial
  LDL = low-density lipoprotein
  LF-HCarb = low-fat–high-carbohydrate
  NCEP = National Cholesterol Education Program
  NIH = National Institutes of Health
  SC = serum cholesterol
  USDA = U.S. Department of Agriculture




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