"Although we would all like to believe that changes in diet or lifestyle can greatly improve our health, the likelihood is that, with few exceptions such as smoking cessation, many if not most such changes will produce only small effects. And the effects may not be consistent. A diet that is harmful to one person may be consumed with impunity by others." --New England Journal of Medicine editors, Drs. Jerome Kassirer and Marcia Angell
The World Health Organization’s MONICA project, which is a 10-year study that measured cardiovascular disease and risk factors among 10 million people in 21 countries, was also not included in the 2007 AHA evidence review. This WHO study continues to reveal no statistical connections between standard risk factors (obesity, smoking, blood pressure or cholesterol levels) and heart disease.
clinical studies probably ever conducted to examine risk factors and deaths was not included among the 2007 AHA evidence. It studied 149,600 men and women followed for over 15 years and involved 454,448 medical examinations which included blood pressures, BMI measurements, fasting cholesterol panels and blood glucose levels. After age 50, when most heart disease deaths occur, only a borderline association between cholesterol and CVD mortality was found in men, while in women, low cholesterols were significantly associated with higher mortality.
In many countries, there is enthusiasm for “Healthy Heart Programmes” that use counseling and educational methods to encourage people to reduce their risks for developing heart disease. These risk factors include high cholesterol, excessive salt intake, high blood pressure, excess weight, a high-fat diet, smoking, diabetes, and a sedentary lifestyle. This updated review of all relevant studies found that the approach of trying to reduce more than one risk factor - multiple risk factor intervention - advocated by these Programmes do result in small reductions in blood pressure, cholesterol, salt intake, weight loss, etc. Contrary to expectations, these lifestyle changes had little or no impact on the risk of heart attack or death." -- Cochrane review