Changes in Retail Market Food Supplies in the United States in the Last Seventy Years in Relation to the Incidence of Coronary Heart Disease, with Special Reference to Dietary Carbohydrates and Essential Fatty Acids

Changes in the American diet over the last seventy years have been analyzed with particular emphasis on the sources of fats and carbohydrates in the light of the increasing incidence of coronary heart disease. The main changes have been (1) a considerable decrease in the consumption of total carbohydrates with a greater progressive decline in the intake of complex carbohydrate from flours, cereals, and potatoes, and a concurrent dramatic increase of simple sugars, especially in the first part of this century; and (2) a slight increase in total fat consumption contributed mainly by the increase of unsaturated fatty acids. The increase in polyunsaturated fatty acids has surpassed the increase in the saturated ones and consequently the ratio has increased about 37 per cent since 1909. Obviously these data do not fit the hypothesis that low ratios of polyunsaturated to saturated fatty acids in the food supply contribute to the increased incidence of coronary heart disease in the United States. The changes which have occurred in the type of dietary carbohydrates, however, may be a factor.