In December, JAMA published a study by Dr. Ornish showing patients following a very low fat (<15%) near-vegetarian diet for 5 years continued to experience regression of their atherosclerosis without cholesterol-lowering medication. Patients following the AHA-type diet experienced progression even though most had also been taking cholesterol-lowering medications for the past 4 years.It?s becoming clear that science doesn?t support ?moderate? dietary guidelines for treatment or prevention of heart disease.Brown and Goldstein, Nobel Prize winners for their work on LDL receptors, state, ?If the LDL-receptor hypothesis is correct, the human receptor system is designed to function in the presence of an exceedingly low LDL level. The kind of diet necessary to maintain such a level would be markedly different from the customary diet in Western industrial countries and much more stringent than moderate low-cholesterol diets of the kind recommended by the American Heart Association. It would call for the total elimination of dairy products as well as eggs and for a severely limited intake of meat and other sources of saturated fats?.In the next paragraph of their Scientific American article (11/84), these authors state, ?We believe such an extreme dietary change is not warranted for the entire population.? Here are their stated reasons: ?First, such a radical change would have severe economic and social consequences. Second, it might well expose the population to other diseases now prevented by a moderate intake of fats. Third, experience shows most Americans will not adhere voluntarily to an extreme lowfat diet. Fourth, and most compelling, people vary genetically. Among those who consume the current high-fat diet ofWestern industrial societies, only 50 percent will die ofatherosclerosis...?The fact remains that only a diet that is drastically different from what most Americans consume is truly capable of preventing or reversing atherosclerosis. Claims that such a diet may pose health risks are more opinion than science. On the other hand, claims that the more moderate AHA-type diet prevents heart disease are without scientific merit. At best it appears to slow the progression of atherosclerosis.By Jay Kenney, PhD, RD, FACN.