Prevention

using diet modification: ^a encourage patients to eat less fat ^a (particularly cholesterol) ^a and more oats ^a , fish ^a and soy protein. ^b

Why?

• Diet modification can lower cholesterol levels slightly, but there is no clear effect on blood pressure levels. ^a
• Low fat diets help reduce cholesterol levels ^a - on average by 0.6 mmol/l. Triglycerides fall on average by 0.2 mmol/l. ^a
• Patients who eat oat products have a small fall in cholesterol levels (0.13 mmol/l: 95% CI: 0.017 to 0.19) ^a
• Eating around 50g of soy protein a day reduces cholesterol level by roughly 0.6 mmol/l, and triglyceride levels by 0.2 mmol/l ^b
• Patients who eat more fish (at least 2 weekly portions of fatty fish) are less likely to die. ^a

Eating more fish reduces mortality

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
myocardial infarction a	increased fish intake	usual diet	death at 2 years	13%	27% (7% to 44%)	28 (16 to 130)