You Bet Your Life: An Epilogue to the Cholesterol Story
The first Dietary Goals for the United States (DGUS) were released in 1977 to not a lot of fanfare. At that time, the great unwashed masses hadn’t really heard much about the word cholesterol, a substance the DGUS recommended that we should limit to 300 mg per day. Doctors didn’t routinely screen for it, and if they did, they didn’t pay much attention to it. In fact, at that time – as I recall, anyway – the upper limit of normal for total cholesterol was 240 mg/dl. I was in medical school back then, and I don’t really remember any emphasis on cholesterol or blood lipids. I think we had one lecture on it in biochemistry, given by a nebbish little professor we called Mighty Manford (his first name was Manford), who labored away in the obscurity of the biochemistry department. It’s hard to believe in today’s world of lipophobia that as little as 30 years ago, no one much cared about cholesterol.
One of the major players in bringing cholesterol to the public’s awareness was Time magazine. Its piece on cholesterol in the March 26, 1984 issue was a devastating hit piece on both dietary cholesterol and dietary fat. Both – the article explained – were a main driving force behind the development of heart disease.
Reading this article today, it’s amazing how it drips with misinformation. At the time, however, most people – physicians included – accepted it as gospel. Sadly, even today, many physicians who should know better believe in and act in accordance to the bountiful misinformation contained in this piece.
A study appeared this week sure to drive members of the low-fat and vegan tribes sprinting for their Protexid.
Synchronicity strikes again. The seeds of this post were sown when Gary Taubes emailed me about a study published in early 2009 in the New England Journal of Medicine (NEJM) that I had seen at the time, briefly skimmed and tossed aside as worthless. Gary agreed that the study was of little value, but notice that it contained a peculiar statement by the authors, an interesting admission about HDL, the lipophobe’s favorite lipoprotein. And not only had the authors made this strange admission, but so had another prominent lipophobe who wrote the accompanying editorial.
In the early 1980s MD and I were laboring away in anonymity in our clinics in Little Rock, Arkansas. By that time I had gone through my thin-to fat-to thin again metamorphosis, and I was starting to treat patients for obesity. My own transformation had been fairly striking, a fact not lost on many of my overweight patients, a number of whom were seeking my professional advice on treating their own weight problems. I was still doing a fair amount of general primary care medicine, but more and more of my time was being diverted to helping people lose weight.












