Zukel concludes that it is unlikely that any relationship between diet and CHD can be established while measuring fat.
December 1, 1959
A Short-Term Community Study of the Epidemiology of Coronary Heart Disease
"Despite the limitations of the tools and procedures used in this study some provocative findings have been produced. There appears to be a real difference in risk of developing severe manifestations of CHD for farmers as contrasted with other occupations as a group. The explanation for this difference deserves more intensive study. Some comments should be made on the lack of apparent differences in recent dietary patterns of coronary cases in comparison with controls. This does not necessarily mean that dietary factors may not be important in the development of coronary heart disease. Mean dietary intake will have to be assessed in relation to height-weight-activity characteristics. Even this may not reveal differences between coronary cases and controls since the fat consumption in the population studied was surprisingly uniform. As is shown in Table 6, the calories from fat ranged only between 40 and 50 per cent in two-thirds of the men studied. Under such conditions, considering the potential inherent error in dietary interview procedures, it seems unlikely that any relationship between diet and CHD can be established. These dietary findings suggest the probable importance of factors other than diet in determining why, in populations on relatively high fat diets, some males develop CHD and others do not."