Diet composition in the Pacific area in relation to cardiovascular disease.

Abstract

The present status of knowledge of how dietary constituents may be related to the development of cardiovascular disease has been generally reviewed and discussed. The factors other than diet are not included in this paper.Dietary patterns and composition of many Pacific countries have also been reviewed. They were arbitrarily classified into the following four groups.(1) The Caucasian diet: It contains characteristically high energy (around 3, 100-3, 300 Cal. per capita daily), high fat (37.5% of total Cal.) with a ratio between saturated and unsaturated fat (S/U ratio) of 9.5, high animal protein and relatively low but refined carbohydrate. This is the typical dietary pattern of North American countries (excluding Mexico), White Australia, part of USSR and of Caucasian immigrants to the other Pacific regions.(2) The Latin American diet: It offers a moderate amount of energy around 2, 500-2, 700 Cal. per capita daily, derived about 20% or less from fat with a S/U ratio of 1.3, and high carbohydrate content. Such a diet pattern covers an area of the Pacific Coast of Latin American countries and a part of Central American countries.(3) The Oriental diet: It can be considered as a high carbohydrate, high protein, mainly vegetable, and low fat diet with a total energy value of 2, 200-2, 500 per capita daily. Only 11.4% of total calorie is derived from fat, of which the S/U ratio is 0.2. It is composed mainly of rice and other cereals, fair amount of legumes and vegetables, with a small amount of meat, poultry, fish and egg and practically no dairy products. Vegetable oil is the main cooking fat. This diet pattern covers rice eating countries of the West Pacific Region.(4) The South Pacific Islands diet: It is composed mainly of starchyVol. 3 No. 2 DIET COMPOSITION AND CARDIOVASCULAR DISEASE 143roots, sago and taro, some coconuts and sea foods and a very little fat. So it is high in carbohydrate and fiber but low in protein and fat. This dietary pattern covers the population groups who live on less-technically developed small islands of the South Pacific Region.Thus, the Caucasian diet may favor the development of cholesterolemia and of degenerative cardiovascular disease most readily than the other three Pacific diets. The Latin American diet may stand next and then the Oriental and South Pacific Islands diets. The actual situation runs parallel with this trend, as the ratios between Caucasian-Latin American-Oriental diet countries on death rate of degenerative cardiovascular disease and its percentage in all types of heart diseases are approximately 5:1.5:1 and 6:4:2 respectively. So the correlation between diet composition and cardiovascular diseases does exist.From the study of correlation between the caloric percentage of consumed dietary constituents and the death rate of arteriosclerotic and degenerative heart diseases of many Pacific countries, it may be safe to say that, the dietary fat, particularly saturated fat is the most important factor in the development of these diseases.But the reverse order may be true for infectious and nutritional heart diseases, though supporting data are incomplete.Relevant data for the South Pacific Islanders are insufficient, therefore, whether the above statements hold true or not requires further proof.