Dietary prevention of coronary heart disease: the lyon diet heart study

Comment on
Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. [Circulation. 1999]

This issue of Circulation contains an article that I believe deserves special attention from cardiologists and physicians. It reports the 46-month mean follow-up findings on the original report of the study on “Mediterranean α-linolenic acid–rich diet in secondary prevention of coronary heart disease,” the so-called Lyon Diet Heart Study. This study was undertaken because of the interest of the investigators in explaining the very much lower mortality from cardiovascular disease, mainly coronary heart disease, in the countries bordering the Mediterranean compared with that in northern Europe. The initial report2 was published in Lancet in 1994 after the study was terminated by its Scientific and Ethics Committee at 27 months mean follow-up time of what had been planned as a 5-year study, because the benefits in the experimental group at that time were so favorable. Despite the striking findings in the first report of a 70% reduction in all-cause mortality due to a reduction in coronary heart disease (CHD) mortality and comparable large reductions in nonfatal sequelae, I have encountered few cardiologists here who are aware of that study. […]