Oslo Diet Heart Study Leren et al . The effect of plasma cholesterol lowering diet in male survivors of myocardial infarction. Bull N Y Acad Med. 1968 August; 44(8): 1012–1020. (does NOT contain detailed diet instrcutions) Published also as doctoral thesis in Acta Med Scand. 1966; Suppl 466; 1-9 (comprehensive version containing the detailed dietary instructions ) [Updated February 2015] Page 1
This study is the first one to show the effect of dietary intervention in the secondary prevention of CHD. It is meal pattern study even if very often labelled as sole fat modification study
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Oslo Diet Heart Study
Leren et al. The effect of plasma cholesterol lowering diet in male survivors of myocardial infarction. Bull N Y Acad Med. 1968
August; 44(8): 1012–1020.
(does NOT contain detailed diet instrcutions)
Published also as doctoral thesis in
Acta Med Scand. 1966; Suppl 466; 1-9
(comprehensive version containing the detailed dietary instructions )
Detailed dietary instructions can only be found in the long and
original paper version from 1966, not in the electronically available
version from 1968
2
Pronutritionist’s background
• In meta-analyses, saturated fat intake is not independently linked to coronary heart disease (CHD) incidence (Siri-Tarino et al. 2010, Skeaff & Miller J. 2009 and Mente et al. 2009)
• Another meta-analysis based on the randomized outcome trials, demonstrated a lower incidence of CHD if saturated fat was replaced by polyunsaturated fat (Mozaffarian et al. 2010)
• The results of Mozaffarian’s meta-analysis were heavily driven by two studies: a) Finnish Mental Hospital Study (FMHS) and b) Oslo Diet Heart Study
• Oslo Diet Heart Study is often perceived as a fat modification trial but this has been questioned by Ramsden et al. 2010
• Oslo Diet Heart Study is still a landmark trial, but how does it stand the test of time?
Leren et al. . Bull N Y Acad Med. 1968 August; 44(8): 1012–1020
Methods (patients)• Parallel randomized trial • Secondary prevention of CHD among myocardial infarction (MI)
survivors• Primary outcomes: Reinfarctions and serum total cholesterol• N=412, males, age 30-64 years• Active treatment was started 1-2 years after MI • Total cholesterol levels at baseline in both groups 7,6 mmol/L (296
mg/dl)• Subjects were free living• Length: 5 years per arm• Era: 1956 → (60 months follow up)
• “Dieters” = active treatment group”
Leren et al. . Bull N Y Acad Med. 1968 August; 44(8): 1012–1020
• Oslo Diet Heart Study is not a sheer SFA/PUFA modification trial but a dietary pattern studysuch as Lyon Diet Heart or Predimed studies
• Oslo Diet Heart dietary intakes were poorly reported. Only 4 % of participants provided any dietary data. In controls none provided dietary data.
• “Dieters” possibly received 5 grams of marine omega-3 fatty acids, 15 mcg vitamin D extra, and controls received 7 grams more of TFA due to different dietary patterns (Ramsden et al. 2010)
Leren et al. . Bull N Y Acad Med. 1968 August; 44(8): 1012–1020
Page 12
Pronutritionist’s discussion (2/3)Pursued dietary changes in Oslo Diet-Heart
Means Method of support
Increase in omega-6 fatty acids (linoleic acid)
Soybean Oil for cooking or “as medicine”Nuts
Free soybean oil
Encouraged
Increase in omega-3 fatty acids
Canned sardines in cod liver oil Nuts
Free canned sardine delivery twice during the studyEncouraged
Increase in Vitamin D Canned sardines in cod liver oil
Free canned sardine delivery twice during the study
Decrease in SFA intake Skim milk ↑, butter/margarine and meat restricted
Encouraged/banned
Decrease in trans fat intake
Margarine restricted Banned
Increase fiber and indigestible carbs
Increase in brown bread & vegetable, fruit, beans intake
Encouraged
http://www.facebook.com/pronutritionist
Leren et al. . Bull N Y Acad Med. 1968 August; 44(8): 1012–1020
Page 13
Pronutritionist’s discussion (3/3)
• Oslo Diet Heart Study produced very similar results to Lyon Diet Heart Study in which TFA-low margarine was the vehicle of n-3 and n-6 fatty acids in the context of Mediterranean dietary pattern
• Dietary pattern used in Oslo Diet Heart Study is very similar to what is recommended in many official dietary guidelines globally
– Higher than usual intake of both n-6 and n-3 FAs– High fiber intake – Low refined carbohydrate intake– Low intake of saturated fat and cholesterol– High consumption of vegetables, fruits, berries, whole grains, nuts and beans – More fish and seafood and possibly poultry instead of of red and processed meat– More vegetable oils or margarines low in TFA instead of butter and old-fashioned