Headline December29,2012


Indeed, what had started as a simple and plausible idea -that too much fat in the diet leads to heart disease- had turned into a stalking horse for the promotion of powerful drugs, a market estimated to be between $15 billion to $25 billion, and which in return only promised to increase the average US life expectancy by between three days and three months.

In Britain, one slogan went ''cholesterol could break your heart.'' Another urged ' Britain take heart' and and promised a breakthrough in cholesterol control. And it is important to mention that by then tens of thousands of people were trapped into taking drugs for life in anticipation of a benefit that never materialised.

''When we summon the wisest of doctors to our aid,'' the celebrated hypochondriac Marcel Proust once observed, ''the chances are they will be relying on scientific truths, the error which will be recognised in a few years tie.'' This, it would seem, has been the case with cholesterol.

There remains then one final and intriguing question : what, after all, is the role of cholesterol in heart disease? Perhaps we may find the answer by looking at the pattern of heart disease in the western world over the last 50 years. In each country, and in the same way, deaths from heart disease, which were insignificant in the early Twenties, rose exponentially year by year until the mid-Sixties. Since then, however, they have dramatically declined.

It is very difficult to explain this pattern, particularly the recent decline, in terms of the adoption of a 'healthy lifestyle' -less fat, more exercise, no smoking. Rather the rise and fall suggests there must be an underlying explanation which, for the moment, remains unknown. What is known, however, is that the role of cholesterol is marginal; it is at best an additional but not a determinant cause. It increases the risk of heart disease in a minority. For everyone else it is irrelevant.

Good Night & God Bless!


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