[ProCOR] Journal Club: Changes in dietary fat may contribute to declining coronary heart disease in Poland

["Robert Goldberg" <GoldberR@ummhc.org>]

[A national survey in Poland suggests encouraging declines in death due to CHD
in the Polish population that may be partially attributed to changes in the
ratio of dietary polyunsaturated to saturated fats.]

Title:  Changes in dietary fat and declining coronary heart disease in Poland:
population based study

Authors: Witold Zatonski, Walter Willett 

Reference: Br Med J 2005;331:187-188.

Reviewer: Robert Goldberg

What problem is being addressed? Nutrition and coronary heart disease.

Purpose of the study: To examine the association between national changes in
dietary fat consumption in Poland to declining death rates from CHD.

Location of the study:  Warsaw, Poland.

Study design: Cross-sectional.

Results/Findings:  Based on national death certificate data, death rates in
middle-aged (45-64 years) men and women declined by 38% (340 per 100,000 to 212
per 100,000) and 42% (76 to 44/100,000), respectively, between 1990 and 2002. In
terms of risk factors for CHD, consumption of saturated fat declined by 7%
between 1990 and 1999 while consumption of polyunsaturated fat increased by more
than 50% over the decade long study period. Annual consumption of imported fruit
also increased over time from approximately 5.5 pounds (per person) in 1990 to
slightly more than 22 pounds in 1999. Between 1990 and 1999, the prevalence of
smoking among men 40-59 years declined from 51% to 46% and from 34% to 28% in
men 60 years and older. During this period, the prevalence rates of smoking
increased from 23% to 35% among women 40-59 years old. 

Comments:  The results of this cross-sectional national survey suggest
encouraging improvements in several dietary risk factors for CHD and slight
declines, in men, in the prevalence of current cigarette smoking. Data for other
major coronary risk factors, such as physical inactivity, body mass index, blood
pressure, and serum cholesterol were unfortunately either not presented or
available in this study. The direct consumption of various dietary foods and
sources was also not assessed in this study, overall or in persons with as
compared to those without CHD. These ecologic data nonetheless suggest
encouraging declines in death due to CHD in the Polish population. These
declining death rates may be partially attributed to charges in the ratio of
dietary polyunsaturated to saturated fats as well as to other measured, or
unmeasured, nonnutritional factors. Trends in national CHD death rates, as well
as in the principal predisposing factors for CHD, warrant further monitoring in
this population.