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VIEWPOINT AND COMMENTARY

The diet–heart hypothesis: a critique

^* 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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