Day 279 - 12 Jul 96 - Page 20


     
     1        individuals; about 45 per cent of the 1,500,000 Americans
     2        who have heart attacks each year are under age 65.  (1)
     3
     4             The effects of dietary cholesterol and dietary fat can
     5        be separated for purposes of discussion, although many
     6        McDonald's products contain substantial amounts of both.
     7
     8             Dietary Cholesterol.
     9
    10             According to Bowes and Church's Food Values of
    11        Portions Commonly Used (1989) by JAT Pennington, a Big Mac
    12        contains 83 mg of cholesterol, a cheeseburger contains 41
    13        mg of cholesterol, and a hamburger holds 29 mg of
    14        cholesterol.
    15
    16             The mathematical relationship between dietary
    17        cholesterol and heart disease was summarised in an American
    18        Medical Association Journal, called the Archives of
    19        Pathology and Laboratory Medicine, in October, 1988, by
    20        Jeremiah Stamler, MD, of North-western University Medical
    21        School in Chicago, Illinois, and Richard Shekelle, PhD, of
    22        the University of Texas School of Public Health in Houston,
    23        Texas:
    24
    25             "In humans, ingestion of dietary cholesterol raises
    26             serum cholesterol, largely through its effect on
    27             low-density lipoprotein-cholesterol.  Over the
    28             range of intake in usual American diets, this
    29             effect is substantial, eg with 30 mg of
    30             cholesterol intake per 1000 kcal rather than
    31             100, serum cholesterol is on average about 6 per
    32             cent to 7 per cent higher, equivalent to a 12
    33             per cent to 14 per cent greater risk of coronary
    34             heart disease." (2)
    35
    36             The Lipid Research Clinics Trial, one of the
    37        best-known multi-centre research studies on heart disease,
    38        showed that on average every one per cent increase in the
    39        serum cholesterol level is associated with an increase in
    40        the risk of a heart attack of two per cent or more. (3)
    41        The relationships between the dietary cholesterol and
    42        cholesterol levels, and between cholesterol levels and
    43        heart disease risk, as I have described them here, are
    44        commonly accepted by researchers and clinicians.
    45
    46             Dietary cholesterol also contributes to heart disease
    47        apart from its effect on serum cholesterol levels, as the
    48        article by Stamler and Shekelle describes:
    49
    50             "In addition, since 1981, four prospective
    51             within-population studies have shown that
    52             dietary cholesterol intake of individuals is
    53             significantly related to their long-term CHD
    54             risk, independent of and in addition to serum
    55             cholesterol, blood pressure, and cigarette use.
    56             On average, a 200 mg/1000 kcal higher intake of
    57             cholesterol at baseline was associated with a 30
    58             per cent higher CHD rate (95 per cent confidence
    59             interval, 1.1 to 1.5).  Conversely, lower
    60             intakes of cholesterol were associated with

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