Over the course of the twentieth century, cardiovascular disease (CVD) has become the leading cause of death in the United States. CVD is also a significant cause of morbidity and mortality in many other industrialized countries and regions, such as Scandinavia, the United Kingdom, Australia, and Canada. Most CVD is manifested as coronary artery disease (CAD), usually based on atherosclerosis. This “epidemic” of CVD has been attributed to the poor lifestyle habits of members of late-twentieth-century industrialized, urban society, who smoke tobacco, exercise rarely, and indulge in fat-laden diets (Kannel 1987).

A striking similarity of these factors leading to disease is that each – in most cases – can be modified by an individual at risk for coronary disease, even without professional guidance and in the absence of public health initiatives. But risk factors are not always easily eliminated. Addiction to tobacco is difficult to overcome. Exercise may be problematic for some people, given constraints on time posed by other obligations. Everyone, however, must eat, and perhaps for this reason, of all the possible causes of heart-related diseases, diet has received the most attention.

This chapter explores the relationship between nutrition and heart-related diseases by describing selected nutrients that have been implicated in the pathogenesis, prevention, or treatment of CAD. Most of the available data come from population studies. It appears unlikely that any single nutrient will soon be identified as the specific dietary agent that causes atherosclerotic diseases. Moreover, any individual nutrient is but a small part of a larger group of chemicals that make up any particular “food”.