AbstractEpidemiological studies show that coronary heart disease is more common in wealthier countries than in poorer. Such studies cannot, however, isolate which of the dietary or nondietary characteristics of affluence help to cause the disease; they provide only clues that need to be subjected to experimental study. Experiments should be designed on the basis of their ability to produce the multiple abnormalties associated with coronary heat disease (CHD) and not only hypercholesterolemia. They should also explain the association of CHD with obesity, diabetes mellitus, cigarette smoking, and physical inactivity. These considerations suggest that the underlying abnormality that produces CHD is a disturbed hormonal balance. Experiments have shown that a high consumption of sucrose produces not only the wide range of abnormalities seen in CHD but also an increased blood concentration of insulin and cortisol. Since a low intake of sucrose confers many other health benefits, it is a more logical dietary recommendation than that of substituting polyunsaturated fat for saturated fat.