Changes of plasma lipids and biochemical markers for coronary artery disease in Korea.

The average Korean diet is low in total fat, cholesterol, animal protein, and sugar, and high in total carbohydrate, and adequate in total protein. More foods are derived from vegetables than in any comparable Western countries. The nutritional status of Korean is good without evidence of any gross nutritional deficiency. The leading causes of death, currently, form a unique ranking of malignancies, accidents, and cerebrovascular diseases. Korean diet may account for the strikingly low incidence of heart disease. Studying the relationship between diet and these diseases may greatly aid our understanding of their pathogenesis and lead to improved prevention and treatment. Current changes in the Korean diet are a decreasing proportion of carbohydrates with increasing proportions of fat and animal protein and an increased content of cholesterol. The ratio of polyunsaturated to saturated fatty acid of Korean diet seems to fall in desirable range. The changes in plasma cholesterol levels and CAD mortality among Korean in the past 20 years seem to be a reflection of changes in diet. Similar changes could be seen in the Japanese population. In Korea, the incidence of CAD is still low compared with that in western countries. Recently, a slightly increased incidence of CAD has been observed in Korea. Thus, establishment of reliable biochemical markers and their cut-off values are needed for the Korean population. Several methods including TC, TG, HDL-C, LDL-C, HDL-C/TC, LDL-C/TC, LDL-C/HDL-C, Apo A-I, Apo B and Apo A-I/B for CAD were examined and found that Apo A-I/B ratio was a good biochemical marker for CAD in Korea. In the future, the Korean diet will probably continue to change. The changes are being influenced by economic development that have been emerging and growing stronger since 1980 and that will probably continue to be potent. The effect of these changes upon CAD is not clear at the present time. To detect a changing incidence of CAD and to evaluate the significance of diet will require continued close observation and use of more specific and sensitive methods. The Korean experience with diet and plasma lipids will be potentially valuable in appraising CAD of both developing and technically developed countries.