Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: diet and reinfarction trial (DART)

Lancet. 1989 Sep 30;2(8666):757-61. doi: 10.1016/s0140-6736(89)90828-3.


A randomised controlled trial with a factorial design was done to examine the effects of dietary intervention in the secondary prevention of myocardial infarction (MI). 2033 men who had recovered from MI were allocated to receive or not to receive advice on each of three dietary factors: a reduction in fat intake and an increase in the ratio of polyunsaturated to saturated fat, an increase in fatty fish intake, and an increase in cereal fibre intake. The advice on fat was not associated with any difference in mortality, perhaps because it produced only a small reduction (3-4%) in serum cholesterol. The subjects advised to eat fatty fish had a 29% reduction in 2 year all-cause mortality compared with those not so advised. This effect, which was significant, was not altered by adjusting for ten potential confounding factors. Subjects given fibre advice had a slightly higher mortality than other subjects (not significant). The 2 year incidence of reinfarction plus death from ischaemic heart disease was not significantly affected by any of the dietary regimens. A modest intake of fatty fish (two or three portions per week) may reduce mortality in men who have recovered from MI.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Actuarial Analysis
  • Aged
  • Animals
  • Cholesterol / blood
  • Dietary Fats / administration & dosage*
  • Dietary Fiber / administration & dosage*
  • Edible Grain
  • Evaluation Studies as Topic
  • Fatty Acids / blood
  • Fish Oils / administration & dosage
  • Fishes*
  • Follow-Up Studies
  • Humans
  • Male
  • Multicenter Studies as Topic
  • Myocardial Infarction / blood
  • Myocardial Infarction / diet therapy
  • Myocardial Infarction / mortality
  • Myocardial Infarction / prevention & control*
  • Patient Compliance
  • Random Allocation
  • Recurrence
  • Regression Analysis
  • Risk Factors


  • Dietary Fats
  • Dietary Fiber
  • Fatty Acids
  • Fish Oils
  • Cholesterol