It is interesting to compare the World Health Organization dietary recommendations for saturated fat (< 10% of total energy) with actual intakes in France. Furthermore, the average population intake of saturated fat was strongly related to 10 and 25 year CHD mortality rates.
5 The average consumption of animal food groups, with the exception of fish, was positively associated with 25 year CHD mortality rates. Information on diet was collected by use of seven day food records. In the seven countries study, 12 763 men from 16 cohorts in seven countries were examined for CHD risk factors in 1958. Reproduced from Artaud-Wild et al, 2 with permission. Plot of death rate from coronary heart disease (1977) correlated with daily dietary intake (from 1976 to 1978) of cholesterol and saturated fat as expressed by the cholesterol fat index (CSI) per 1000 kcal. France had a CSI of kcal and a CHD mortality rate of 198, whereas Finland had a CSI of kcal and a CHD mortality rate of 1031. 2 After having defined a cholesterol–saturated fat index (CSI), they studied the relation between the CSI and CHD mortality (per 100 000 men aged 55–64 years) for all 40 countries (fig 1 1). 1, 2 In one of the most interesting ones, Artaud-Wild and colleagues examined the relation of CHD mortality to the intake of foodstuffs and nutrients in 40 countries. Numerous correlation studies have been carried out in various countries concerning the relation between consumption of fat and CHD mortality.
Limitations of correlational studies are the inability to link exposure with disease in particular individuals, the lack of ability to control the effects of potential confounding factors, and the use of average exposure levels rather than actual individual values. In correlation studies, measures that represent characteristics of an entire population (consumption of animal fat, daily milk, and alcohol) are used to describe disease (CHD mortality).
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