Can a very-low-fat diet achieve cholesterol goals in CAD?

We enrolled 126 male nonsmoking coronary artery disease (CAD) outpatients to determine if a very-low-fat diet with or without an accompanying 10-mg daily dose of simvastatin could achieve a low-density lipoprotein (LDL) cholesterol level of 2.5 mmol/L or lower. Compliance was ensured with a highly simplified diet regimen. No patients reduced LDL to the target value with diet alone, whereas 33% achieved the goal with diet plus drug. Thus, diet alone, even when based on restricted lipid content and a simplified regimen, cannot achieve cholesterol goals in CAD.