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October 31, 1977

Dietary Management in the Coronary Care Unit

JAMA. 1977;238(18):1914. doi:10.1001/jama.1977.03280190016011

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To the Editor.—  This is in regard to the answer to the question of "Dietary Management in the Coronary Care Unit" (237:2645, 1977).In the penultimate paragraph, Richard Jones, MD, states that there should be "a reasonable balance between carbohydrate, protein, and fat, in a proportion of 40%:20%:30% of calories." I would like to know what happened to the other 10%? As a dietitian who has worked with coronary patients for five years and also as a member of the Michigan Heart Association Nutrition Committee, I would like to correct Dr Jones and recommend that a more reasonable balance of carbohydrate, protein, and fat would be 45%:20%:35% of calories. In addition to being concerned about the ratio of polyunsaturated fat to saturated fat and the cholesterol content of the diet, clinicians should also be concerned with the ratio of simple to complex carbohydrate. A ratio of 30% sugar to 70%