The latest Recommended Dietary Allowances state that changes in diet only, without consideration of measures to alter other risk factors, will probably have minimal desirable effects toward reducing risk of this disease. Many experts do find the evidence linking fats, cholesterol, and heart disease convincing enough to warrant changes in diet; many others do not. One of the seemingly most impressive studies in this area was a long-term analysis of 1,900 middle-aged American men, the results of which were published in a January 1981 issue of the New England Journal of Medicine, and which was taken to task in a May 1981 issue of the same journal.
This study claimed that the consumption of large amounts of cholesterol increased the risk that these men would die prematurely from heart attack, and that a higher intake of polyunsaturated fats helped to protect against this early death, without increasing the risk of dying from cancer or other causes. Between 1957, when these men were first examined, and 1977, when the study was concluded, the men in the group with the lowest dietary intake of saturated fats and cholesterol had a 33 percent lower death rate from coronary heart disease than the men in the group with the highest intakes. Contrary to expectations, however, the lowest death rate from coronary heart disease occurred among the group of men with the middle intake of cholesterol.