The epidemiologic study evaluated the effect of nutrition on disease in rural China and US. In the study of more than 10,000 individuals, the US fat intake was twice as high, fiber intake was 3 times lower, and animal protein intake was 90% higher. The heart disease death rate was 17-fold greater for men and 6-fold greater for women in US than China. However, Asian immigrants to the US reached the US level of heart diseases within 2 generations (Campbell et al., 1998).
Fats and carbohydrates are the major macronutrients affecting cardiovascular health. Fats are broken down into saturated, mono-unsaturated, and poly-unsaturated fatty acids. Saturated fatty acids contain no double bonds in their fatty acid chains. They are the predominant fats in dairy products, red meat, and tropical oils, such as coconut oil. Saturated fats increase total cholesterol and low-density lipoprotein (LDL)-cholesterol. Overall, the intake of saturated fat is associated with an increase in the incidence of cardiovascular disease (Ascherio, 2002).
Mono-unsaturated fatty acids contain only 1 double bond in their fatty acid side chains. Replacement of saturated fat with mono-unsaturated or poly-unsaturated fats is associated with 10-fold greater decrease in risk (Hu et al., 1997).
Foods rich in mono-unsaturated fat include olive oil, canola oil, many types of nuts, and avocados. This is best illustrated by the Mediterranean diet, which contains high in mono-unsaturated fats, namely olive oil. The Mediterranean diet group experienced 49% fewer cardiovascular events, 62% fewer sudden deaths, and 51% fewer non-fatal myocardial infarctions, in comparison to the National cholesterol education program diet group (Singh et al., 2002).