CHD (diet to tackle atherosclerotic disease)

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  • there is evidence from population data that a diet high in saturated fat, low in fruit and vegetables, and high in salt is associated with a risk of developing atherosclerotic disease (1)
    • of note is the Seven Countries Study
      • this showed that total fat, and specifically saturated fat, are both positively associated in these populations with 25 year coronary mortality (2)
  • to reduce the risk of cardiovascular disease, it has been recommended that adults should adopt a balanced diet that includes: less fat, especially saturated fat; five portions or more of fruit and vegetables per day; a third less sodium (from about 150 mmol to about 100 mmol); and two or more portions of fish per week (one oily) (3)

NICE state that (1):

  • advise people at high risk of or with CVD to eat a diet in which:
    • total fat intake is 30% or less of total energy intake, saturated fats are 7% or less of total energy intake, intake of dietary cholesterol is less than 300 mg/day and where possible saturated fats are replaced by mono-unsaturated and polyunsaturated fats
  • if a person at high risk of or with CVD:
    • advise them that reducing their saturated fat intake from animal sources also reduces their mono-unsaturated fat levels
    • advise them to replace their saturated and mono-unsaturated fat intake with olive oil, rapeseed oil or spreads based on these oils
    • advise them to use olive oil, rapeseed oil or spreads based on these oils in food preparation

  • if person at high risk of or with CVD to then advise to do all of the following:
    • choose wholegrain varieties of starchy food
    • reduce their intake of sugar and food products containing refined sugars including fructose
    • eat at least 5 portions of fruit and vegetables per day
    • eat at least 2 portions of fish per week, including a portion of oily fish
    • eat at least 4 to 5 portions of unsalted nuts, seeds and legumes per week
  • advise pregnant women to limit their oily fish to no more than 2 portions per week and to avoid marlin, shark and swordfish


Last reviewed 10/2021