Dietary intake and coronary heart disease: a variety of nutrients and phytochemicals are important.

Until quite recently, the dietary focus on prevention of coronary heart disease (CHD) has been almost exclusively centered on reducing intake of cholesterol, total fat, and saturated fat. The food industry responded vigorously with low-fat products, some of which are helpful, particularly low-fat dairy products, but others that are less so, due to increases in refined carbohydrate content. Recent research shows that a variety of foods contribute to protection against CHD, including certain types of fatty acids, and a variety of components in fruit and vegetables, whole grains, and nuts. In particular, there is now an emphasis on reducing not only saturated fat, but also trans fat, whereas mono and omega-3 fatty acids have been shown to be protective. Many new studies have shown a link between intake of fruit and vegetables and whole grains and protection against CHD. This has been ascribed to their fiber, vitamin, mineral, and phytochemical content. In particular, there is accumulating evidence of protective effects for folate, vitamin B(6), vitamin B(12), vitamin E, vitamin C, flavonoids, and phytoestrogens. New recommendations to prevent heart disease require a greater focus on total dietary pattern with a return to the use of a variety of minimally processed foods.