The lipid-heart hypothesis from the Seven Countries Study of Cardiovascular Diseases.

Purpose of review: To summarize and comment recent analyses from the Seven Countries Study of Cardiovascular Diseases (SCS) on the role of Atherogenicity (ATI) and Thrombogenicity (THI) indexes (created by combining several types of dietary fatty acids) in predicting major cardiovascular disease (CVD) and mainly coronary heart disease (CHD) mortalities in a long follow-up observation of ecological procedures involving 16 cohorts of middle-aged men.

Recent findings: In a chain of steps, a dietary score [Mediterranean Adequacy Index (MAI)] was inversely correlated with the ATI (R = -0.91). ATI directly correlated with serum cholesterol (R = +0.73) and serum cholesterol directly correlated with 50-year CHD mortality (R = +0.78). Moreover, MAI was inversely correlated (R = -0.91) and ATI was directly correlated with CHD mortality (R = +0.93). THI produced comparable results. In 10 cohorts reaching the extinction after 60 years of follow-up, results were similar. The same dietary and metabolic indicators were instead unrelated to other major types of CVD fatalities (heart diseases of uncertain etiology and stroke) or even inverse.

Summary: ATI and THI indices assembled by pooling several types of dietary fatty acids are strongly associated with long-term CHD mortality but not with other major CVD types.