Western diets coronary heart disease

Amounts of dietary sodium in excess of the kidney s ability to dilute and to excrete it in the urine leads directly to hypertension and indirectly to coronary heart disease and stroke. Although sodium chloride is required at about 1 g day, a typical Western diet, in fact, may contain from 8 to 12 g day. If renal transport is impaired, sodium ion accumulates and the osmotic pressure of the blood rises. Dietary reduction of salt can ameliorate some but not all of the problems. A wide variety of low-salt food products is now available. 

Recent research also indicates an association between tomato consumption (fresh and processed) and protection against cardiovascular disease. Coronary heart disease (CHD) has a high prevalence in western countries and is increasing in Asian countries due to changes in socioeconomic conditions, lifestyle, and diet. The link between LDL oxidation and atherosclerosis is hypothesized to be the basis for a beneficial effect of antioxidants in general on the incidence of subclinical and clinical CHD. 

Shekelle RB, Shryock AM, Paul O, et al. Diet, serum cholesterol, and death from coronary heart disease The Western Hectric Study. N Engl J Med. 1981304 65-70. 

One positive outcome of the cultural presence of cholesterol has been a high level of public education in the area of lipid metabolism—millions of people know the difference between LDL and HDL. This level of public sophistication in details of biochemistry is unprecedented and demonstrates that scientific literacy in other fields is also possible and achievable. During the past 30 years, people in many Western nations have adopted healthier diets and lifestyles, leading to a dramatic drop in the rate of coronary heart disease. 

Chronic diseases caused by physical inactivity and inappropriate diet consumption are epidemic in modem Western society. Chronic diseases develop over a lifetime, with clinical sequelae occurring many years after the underlying pathogenesis of the disease has occurred. As we move ahead in the 21st century, cardiovascular diseases (i.e., coronary artery disease, hypertension, stroke, and heart failure), type 2 diabetes, metabolic syndrome, and cancer are the leading killers in Western society and are increasing dramatically in developing nations. 

In the past half a century, scientists and public health officials have gradually come to realize that the two leading causes of mortality in Western nations, heart disease and cancer, are associated to a certain though unknown extent with life style, including dietary factors. This association is somewhat better established for coronary artery disease than it is for cancer. Based on current knowledge, many organizations have offered dietary advice to the public (1-9). However, the scientific community has reached no clear consensus about the nature of the association between diet and chronic diseases and the extent to which dietary modification can decrease the risk, especially cancer risk (5 6 10 U). 

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