Cumulative evidence suggests that dietary and lifestyle modifications may help prevent cardiovascular disease and should be considered as a primary treatment before cholesterol-lowering or blood pressure–lowering drugs are used. A major area of uncertainty for the past 50 years has been the relationship among the type of dietary fat, CHD, and associations with well-known CHD risk factors (e.g, serum cholesterol, hypertension, obesity, and inflammation). Based on the higher life expectancy associated with a MDP (where olive oil is the key fat source) and subsequent epidemiologic evidence, in 2004 the United States Food and Drug Administration authorized the use of health claims for olive oil; however, a recent appraisal based on a large body of experimental evidence suggests that MUFA might not be the proper substitute for SFA [25]. The debate continues on the optimal dietary fatty acid composition, but the evidence supporting MUFA as the healthy dietary fatty acid is weak. Even when considering the food source of MUFA (plant vs animal), there is little evidence to support recommendations to increase dietary MUFA for CHD prevention. On the other hand, increasing dietary PUFA consistently appears to provide benefit.
