Finland, Belgium, and Israel."' All cause mortality has fallen in these countries at the same time. By contrast, the countries of eastern Europe-for example, Hungary, Poland, and Czechoslovakiahave suffered large increases in coronary deaths accompanied by rises in total mortality. In an intermediate group of countries-for example, Sweden, Denmark, Ireland, England and Wales, Scotland, and Northern Ireland-changes in coronary mortality have been small or late. Those who have examined these changes in contrasting countries conclude that dietary change seems to have been the most consistent variable in lifestyle-notably an increase in (o-6 polyunsaturated fatty acids in countries with falling mortality" and an increase in animal fat in countries with rising coronary and total mortality. 12 In England and Wales coronary mortality started to move downwards in about 1977"; this coincided with the start of an increase in the ratio of polyunsaturated to saturated fatty acids in the average household's diet. 4 Oliver's group in Edinburgh found significant inverse and progressive relations between the linoleic acid content of adipose tissue and the risk ofangina and myocardial infarction in a population based case-control study. "I Four other case-control studies have yielded similar findings. Other components of the dietary package first recommended for preventing coronary disease at the end of the 1950s may play important parts as well-namely, reduced total fat, reduced saturated and hydrogenated fats, and increased vegetable, fruit, and fibre intakes.