ABSTRACT
However, substituting fish (oily or not) for meats high in saturated fat is to be encouraged.
In this chapter, obesity will be discussed first, before the effects of individual macronutrients and other dietary components on cholesterol are described. In the previous editions of this book, obesity was included in the chapter on secondary hyperlipoproteinaemia. This is no longer a tenable arrangement, because in most of the ‘primary’ hyperlipoproteinaemias discussed in earlier chapters, obesity and other aspects of nutrition make a major contribution. The more extreme dyslipoproteinaemias, it is true, represent an interaction between genes and diet. However, the more common and less severe (though causing most CVD events) have even more to do with nutritional abuse per se (often confusingly called ‘the environment’) and much less to do with genes. Logically, to regard the dyslipidaemia of obesity as a secondary hyperlipidaemia is to confine primary hyperlipoproteinaemia to a few patients with strongly inherited conditions, such as familial hypercholesterolaemia (FH)and familial lipoprotein lipase deficiency, and even then nutrition contributes to their consequences.
