WHO and US Dept of Health and Human Services advocate a fat-modified, fruits and vegetable-enriched diet in conjunction with mode-rate physical activity for fitness and health. The Diet and Moderate Exercise Trial (DAMET) is a randomized and controlled study and has provided scientific proof, possibly for the first time, to the above hypothesis (based on epidemiologic studies, short clinical trials and experimental studies) that the new approach can cause modulation of risk factors of coronary heart disease (CHD) as well as improve fitness. In the DAMET, 231 group A and 232 group B patients with risk factors of CHD were administered a prudent diet for 4 weeks, group A patients in addition were also given at least 400 g/day of fruits and vegetables that are rich in dietary fibre and antioxidants such as vitamins A, C, E, carotene and copper, selenium and magnesium. Fruits and vegetables were administered in a foods-to-eat approach by asking the patients to eat these foods before meals when they were hungry to allow better nutrient adequacy. After 4 weeks, group A patients also did moderate exercise such as brisk walking and spot running compared to no such advice to group B for another 20 weeks. After a follow-up period of 24 weeks, adding exercise to diet was associated with a significant decrease in blood total cholesterol (8.9%) and LDL-cholesterol (6.7%) and triglycerides (11.9%) and a marked increase in HDL-cholesterol (16.5%). Mean blood pressures, fasting blood glucose, body weight, body mass index, waist-to-hip ratio and subcutaneous fat also showed a significant decrease in group A, leading to a significant decrease in 12-year CHD risk. A long-term follow-up may be necessary to demonstrate the role of this new approach in decreasing cardiovascular morbidity and mortality.

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