Skip to main content
NCBI home page
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 1989 Jun;43(2):162–167. doi: 10.1136/jech.43.2.162

Changes in diet and coronary heart disease mortality among social classes in Great Britain.

M Morgan 1, R F Heller 1, A Swerdlow 1
PMCID: PMC1052819  PMID: 2592905

Abstract

Coronary heart disease (CHD) mortality has declined in Britain since the early 1970s and followed a reduction in dietary fat intake in the population. We attempted to determine whether there have been changes in dietary fat intakes by social classes and to see whether they correspond to social class changes in CHD mortality, where the greatest reduction has been in the upper social class groups. Dietary fat intake was specially obtained by social class on a household basis from the National Food Survey (NFS) for 1974 and 1981. The decline in saturated fat intake and increase in polyunsaturated fat is shown to have occurred in each social class group, although it was not possible to examine the data separately for men and women. In contrast, the decline in the proportion of current smokers between 1974 and 1980 (from the General Household Survey) was greatest in the higher social classes. Rates of CHD mortality showed the greatest decline among men in social classes I & II over the period 1969/73 to 1979/83. However, despite some problems in the interpretation of the data collected by the NFS, this study shows that recent social class trends in dietary fat intakes are unlikely to account for the differential changes in CHD mortality. Changes in the prevalence of smoking among social classes are more consistent with the change in CHD mortality.

Full text

PDF
162

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barker D. J., Osmond C. Infant mortality, childhood nutrition, and ischaemic heart disease in England and Wales. Lancet. 1986 May 10;1(8489):1077–1081. doi: 10.1016/s0140-6736(86)91340-1. [DOI] [PubMed] [Google Scholar]
  2. Cade J. E., Barker D. J., Margetts B. M., Morris J. A. Diet and inequalities in health in three English towns. Br Med J (Clin Res Ed) 1988 May 14;296(6633):1359–1362. doi: 10.1136/bmj.296.6633.1359. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Dwyer T., Hetzel B. S. A comparison of trends of coronary heart disease mortality in Australia, USA and England and Wales with reference to three major risk factors-hypertension, cigarette smoking and diet. Int J Epidemiol. 1980 Mar;9(1):65–71. doi: 10.1093/ije/9.1.65. [DOI] [PubMed] [Google Scholar]
  4. Heller R. F., Hayward D., Hobbs M. S. Decline in rate of death from ischaemic heart disease in the United Kingdom. Br Med J (Clin Res Ed) 1983 Jan 22;286(6361):260–262. doi: 10.1136/bmj.286.6361.260. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Heller R. F., Williams H., Sittampalam Y. Social class and ischaemic heart disease: use of the male:female ratio to identify possible occupational hazards. J Epidemiol Community Health. 1984 Sep;38(3):198–202. doi: 10.1136/jech.38.3.198. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Jackson R., Beaglehole R. Trends in dietary fat and cigarette smoking and the decline in coronary heart disease in New Zealand. Int J Epidemiol. 1987 Sep;16(3):377–382. doi: 10.1093/ije/16.3.377. [DOI] [PubMed] [Google Scholar]
  7. Lewis B., Chait A., Wootton I. D., Oakley C. M., Krikler D. M., Sigurdsson G., February A., Maurer B., Birkhead J. Frequency of risk factors for ischaemic heart-disease in a healthy British population. With particular reference to serum-lipoprotein levels. Lancet. 1974 Feb 2;1(7849):141–146. doi: 10.1016/s0140-6736(74)92438-6. [DOI] [PubMed] [Google Scholar]
  8. Mann J. I., Lewis B., Shepherd J., Winder A. F., Fenster S., Rose L., Morgan B. Blood lipid concentrations and other cardiovascular risk factors: distribution, prevalence, and detection in Britain. Br Med J (Clin Res Ed) 1988 Jun 18;296(6638):1702–1706. doi: 10.1136/bmj.296.6638.1702. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Marmot M. G., McDowall M. E. Mortality decline and widening social inequalities. Lancet. 1986 Aug 2;2(8501):274–276. doi: 10.1016/s0140-6736(86)92085-4. [DOI] [PubMed] [Google Scholar]
  10. Marmot M. G., Rose G., Shipley M., Hamilton P. J. Employment grade and coronary heart disease in British civil servants. J Epidemiol Community Health. 1978 Dec;32(4):244–249. doi: 10.1136/jech.32.4.244. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Morgan M. Measuring social inequality: occupational classifications and their alternatives. Community Med. 1983 May;5(2):116–124. [PubMed] [Google Scholar]
  12. Pocock S. J., Shaper A. G., Cook D. G., Phillips A. N., Walker M. Social class differences in ischaemic heart disease in British men. Lancet. 1987 Jul 25;2(8552):197–201. doi: 10.1016/s0140-6736(87)90774-4. [DOI] [PubMed] [Google Scholar]
  13. Rose G., Marmot M. G. Social class and coronary heart disease. Br Heart J. 1981 Jan;45(1):13–19. doi: 10.1136/hrt.45.1.13. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Stamler J. George Lyman Duff Memorial Lecture. Lifestyles, major risk factors, proof and public policy. Circulation. 1978 Jul;58(1):3–19. doi: 10.1161/01.cir.58.1.3. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES