Abstract
This study is an ecological comparison of coronary heart disease (CHD) mortality trends and trends in food consumption in the United States population between 1909 and 1980. CHD mortality data were obtained from published vital statistics. National food disappearance data, compiled regularly by the US Department of Agriculture (USDA), were the primary source of dietary information used. Food balance sheets and USDA household survey data were used for corroborative purposes. Dietary data were analyzed to observe trends in the per capita consumption of calories and fat; to determine the contribution of major food groups to both calories and fat; and to determine the effect of substitutions within those food groups on consumption of calories and fat. Dietary substitutions towards less-saturated fatty acids support the hypothesized relationship between dietary fat and CHD. These changes preceded CHD mortality changes by 10–20 y.