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March 13, 1996

The Effect of Low-Fat Diet on Lipid Levels-Reply

JAMA. 1996;275(10):759-760. doi:10.1001/jama.1996.03530340023023

In Reply.  —Drs Siguel and Lerman indicate that two of 29 patients in our study developed evidence of heart disease while on a low-fat diet. One of these two subjects was a 70-year-old woman who developed an acute myocardial infarction and after having angiography was documented to have severe diffuse coronary atherosclerosis. The other patient was a 77-year-old man who had asymptomatic minor electrocardiographic changes during the course of the study. For patients to qualify for our study, they had to have a mean low-density lipoprotein cholesterol level of more than 3.36 mmol/L (130 mg/dL) at the time of screening. In fact, the mean low-density lipoprotein cholesterol level of our study subjects was 4.68 mmol/L (181 mg/dL). Such subjects are known to be at increased risk for coronary heart disease. It has been our experience that elderly patients with established risk factors for heart disease, even though they are asymptomatic