A Controlled Clinical Trial of a Diet High in Unsaturated Fat in Preventing Complications of Atherosclerosis
Abstract
This report describes a clinical trial, with domiciled male veterans, designed to determine whether a diet which lowers serum cholesterol concentration can prevent overt complications of coronary heart disease and other manifestations of atherosclerosis. Volunteers were allocated randomly to control and experimental groups. Participants numbered 422 in the control group and 424 in the experimental group. The two groups were indistinguishable at the outset of the study in almost all observations. These included age, racial characteristics, and religious affiliation; height, weight, and blood pressure; electrocardiographic findings; prevalence of pre-existing anginal syndrome, myocardial infarction, peripheral atherosclerosis, cerebral ischemia, or cerebral infarction; cardiac decompensation; utilization of relevant medications; serum cholesterol and serum total lipid levels; and prevalence of corneal arcus and xanthelasma. One significant difference between the groups in regard to a possibly influential characteristic was that they differed slightly in patterns of cigarette smoking habits. The control diet was similar to the regular institutional diet, which is a standard American diet. It provided, by analysis, 40.1% of calories as fat, having a mean iodine value of 53.5; cholesterol intake was 262 mg/1,000 calories (653 mg/day). The experimental diet provided 38.9% of calories as fat, with an iodine value of 102.4, and had a cholesterol content of 146 mg/1,000 calories (365…
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Five included studies were conducted in European countries, 2 in the USA, 1 in Australia, and 1 in India.
“Five studies were conducted in European countries (15), (18), (19), (21), (23), 2 in the USA (20), (22), 1 in Australia (24), and 1 in India (25).”
From Saturated Fat Restriction for Cardiovascular Disease Prevention: A Systematic Review and Meta-analysis of Randomized Controlled Trials (2025) · cites this paper as [20]
Only 2 included studies were primary prevention trials from the USA; the remaining 7 were secondary prevention trials.
“Only 2 studies were primary prevention trials from the USA (20), (22); the remaining 7 were secondary prevention trials.”
From Saturated Fat Restriction for Cardiovascular Disease Prevention: A Systematic Review and Meta-analysis of Randomized Controlled Trials (2025) · cites this paper as [20]
Only 3 included studies were on stroke, and the incidence of stroke was almost zero in 2 of those studies.
“Only 3 studies were on stroke (20), (23), (25), and the incidence of stroke was almost zero in 2 of those studies (23), (25).”
From Saturated Fat Restriction for Cardiovascular Disease Prevention: A Systematic Review and Meta-analysis of Randomized Controlled Trials (2025) · cites this paper as [20]
Several studies included in our meta-analysis reported positive results with SFA reduction (15), (19), (20), (23).
“Although we did not observe statistically significant CVD prevention due to SFA reduction, several studies included in our meta-analysis reported positive results with SFA reduction (15), (19), (20), (23).”
From Saturated Fat Restriction for Cardiovascular Disease Prevention: A Systematic Review and Meta-analysis of Randomized Controlled Trials (2025) · cites this paper as [20]
In previous studies showing positive outcomes (15), (19), (20), (23), statins were not prescribed to the participants.
“Furthermore, in previous studies showing positive outcomes (15), (19), (20), (23), statins were not prescribed to the participants.”
From Saturated Fat Restriction for Cardiovascular Disease Prevention: A Systematic Review and Meta-analysis of Randomized Controlled Trials (2025) · cites this paper as [20]
In the 8 trials of established nonstatin therapies that ultimately act predominantly via upregulation of LDL receptor expression, each 1-mmol/L reduction in LDL-C was associated with an RR of 0.75 (95% CI, 0.66-0.86; P = .002) for major vascular events.
“Specifically, each 1-mmol/L reduction in LDL-C was associated with an RR of 0.75 (95% CI, 0.66-0.86;P = .002)in major vascular events”
From Association Between Lowering LDL-C and Cardiovascular Risk Reduction Among Different Therapeutic Interventions: A Systematic Review and Meta-analysis (2016) · cites this paper as [49]
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- Authors
- DAYTON, S., PEARCE, M. L., HASHIMOTO, S., DIXON, W. J., & TOMIYASU, U.
- Affiliations
- United States Department of Veterans Affairs (US)
- Venue
- Circulation
- Published
- 1969-07
- Volume
- 40
- Issue
- 1s2
- Pages
- 1237-42
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W1991289303
- Cited by
- 595
- References
- 0
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 9 · 2023: 4 · 2022: 2 · 2021: 6 · 2020: 8 · 2019: 4 · 2018: 11 · 2017: 9 · 2016: 7 · 2015: 9 · 2014: 3 · 2013: 6 · 2012: 8
- FWCI
- 15.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- dietary fat, serum cholesterol, atherosclerosis, coronary artery disease, linoleic acid, dietary cholesterol, dietary adherence, dietary fat saturation, adipose tissue fatty acid composition, veterans, dietary intervention, cholesterol-lowering diet
- MeSH terms
- Aged, Cerebrovascular Disorders, Cholesterol, Clinical Trials as Topic, Coronary Disease, Dietary Fats, Fats, Unsaturated, Humans, Male, Middle Aged
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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