The best approach to reducing incidence of coronary heart disease, which kills millions every year, is by lowering cholesterol early on, according to University of California researchers. Pioneering lipid researcher Daniel Steinberg, professor emeritus of medicine, University of California and colleagues Christopher Glass and Joseph Witztum, dismissed current approaches to lowering cholesterol as "too little, too late".
With a large body of evidence proving that low cholesterol levels equate with low rates of heart disease, "our long-term goal should be to alter our lifestyle accordingly, beginning in infancy or early childhood" and "instituting a low-saturated fat, low-cholesterol diet in infancy is perfectly safe, without adverse effects..."
According to Steinberg, progress has been made in the treatment of coronary heart disease (CHD) in adults with cholesterol lowering drugs like statins.
However, while studies show a 30 percent decrease in death and disability from CHD in patients treated with statins, 70 percent of patients have cardiac events while on statin therapy.
Promising new therapies are under development, but with an alarming rate of CHD in the US today, action to curtail the epidemic is needed urgently.
In fact, the researchers propose that lowering low-density lipoproteins ("bad cholesterol") even in children and young adults is a safe and potentially life-saving standard, through diet and exercise changes if possible. Drug treatment may also be necessary in those at very high risk.
"Our review of the literature convinces us that more aggressive and earlier intervention will probably prevent considerably more than 30 percent of CHD," said Steinberg.
"Studies show that fatty streak lesions in the arteries that are a precursor to atherosclerosis and heart disease begin in childhood, and advanced lesions are not uncommon by age 30.
"Why not nip things in the bud? Such early signs of heart disease should be taken as seriously as early signs of cancer or diabetes," he said.
The UC San Diego team noted that studies of Japanese men in the 1950s showed that consuming a low-fat diet from infancy resulted in lifelong low cholesterol levels, and their death rate from heart disease was only 10 percent of the rate of cardiac-related death in the US
These findings were published in Tuesday’s issue of the American Heart Association journal Circulation.
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