Mutants, hyperlipoproteinaemia, and coronary artery disease.

This week America was recommended a diet that some may find hard to digest.The occasion was a report of the Inter- society Commission for Heart Disease Resources, a group sponsored by the Federal Government's Regional Medical Program (Atherosclerosis Study Group, 1970).The Commis- sion was originally created to survey the nation's resources for treating circulatory diseases.Quite probably appalled by the rising demand for acute coronary care, it has instead dedicated this one of its several reports to suggestions for eliminating some of the need through preventive action.These are impeccable motives, and the goal will have unanimous support.All the interested parties, however, will not agree with all of the Commission's present recommendations.On the dietary side the Commission urges three precautions on all Americans from infancy to the grave.The first, to maintain optimal weight, will inspire no opposition, but perhaps will always fail to obtain maximal participation.The second, a requiem for the egg, is to eat less than 300 mg of cholesterol each day.The third is to consume what comes to about 30' of total calories from fat, to be equally divided between saturated, monounsaturated, and polyunsaturated sources.The last two strictures are sure to be controversial.The Commission offers some praiseworthy suggestions for implementing its advice.These include several directed at the cholesterol-raising elements in cows' milk, shortcomings that this animal doubtless would gladly overcome if she could, but which seem to be locked into the changeless biochemical programme of her rumen.The Commission advocates upsetting the general use of butter fat content to set the wholesale prices of dairy products, ending the prohibition against adding vegetable fats to meat products, a process now declared "adulteration," and revcrsing the regulations of some states and of certain federal *Thc St. Cyres Lccture of the National Heart Hospital presented at the Royal College of Physicians