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No More Controversy
Ironically, cholesterol has affected my own life over and over again during the past twenty years.
I first heard of cholesterol in college, when the professor simply described the substance as he would any other chemical covered in the course. Cholesterol, he said then and it remains true today, is an organic chemical compound in the family of alcohols. It looks and feels like soft wax. Cholesterol is just one of a whole group of compounds in the body known as sterols, all of which are essential to life. Cholesterol enters the body through the foods, specifically the animal foods, we eat. It is also manufactured by the body in the liver. On the one hand, if the body didn't have enough cholesterol to form vital hormones and metabolic products, we would not be able to survive. On the other hand, if the body has too much cholesterol, the excess begins to line the arteries, leading to atherosclerosis.
A long time ago, scientists noticed that in cultures where very little saturated fat and cholesterol were consumed, there was a parallel lessening of heart disease. But did the eating of cholesterol lead to the heart disease, or was it just another of the many aspects of the modem lifestyle that could be blamed?
Thus began the controversy, the so-called diet/heart debate that raged for many years.
On a holiday when I was home from college, my father mentioned that his doctor had noticed that his cholesterol level was elevated, and had advised staying away from certain foods that had a lot of cholesterol. Of course, not much was known about dietary modification back in 1965. Dadand I had a number of discussions about cholesterol. I pointed out that Eskimos eat a lot of blubber and they don't get heart disease. There just was no proof about the whole thing. Just to be on the safe side, Dad avoided oysters, then thought to be high in cholesterol, when we ate out in restaurants. He ate fish because he actually preferred seafood over steaks. But, without much guidance, he still ate a lot of cheese and drank whole milk, and his cholesterol level was affected not a bit. One day in 1969 1 got a phone call that Dad had died, at age fifty-seven, of a massive coronary.
Should I blame cholesterol? Well, Dad also had very high blood pressure. He was under a great deal of stress the year he died. And there was a family history of heart disease. Actually, I thought it was too bad that he had missed out on the oysters.
Two years later, while working for a medical association in Chicago, I attended a medical meeting where a new computerized blood-analyzing device was being unveiled. All of us attending the meeting got free blood tests, and I learned from mine that while everything was in the "normal" range my cholesterol level was a bit high. One of the doctors at the association said that 250 milligrams was too high for someone only twenty-nine years old.
I shrugged it off and went on with my normal, all American eating habits. There was no proof, I reasoned, that changing my diet would lower my cholesterol level.
My career path led, in 1973, to a job as a science writer at the National Dairy Council. Over the next seven years I became Director of Communications, managing a great number of projects designed to improve the public's nutrition in general, and to increase the consumption of dairy products in particular by stressing their high calcium content.
During that seven-year period of time I read extensively about the cholesterol issue and met most of the scientists conducting research on the topic. Of course a great deal of my time was spent defending dairy foods against those who brought up the cholesterol problem. Even though I knew I had an elevated cholesterol level myself, I still felt there was no proof that diet could affect cholesterol levels, no reason to recommend altering the eating patterns of the entire nation. It was a "controversy." There was room for "debate."
A number of research studies during those years swayed many individuals, including me, to believe that altering the diet was not the proper course of action to reduce cholesterol levels. First, those who did change their eating habits found that their cholesterol levels did not decrease significantly. Second, the "average" cholesterol level in adult men was in the low to middle range of 200 to 2 50 milligrams per 100 cubic centimeters of blood. If that was average, therefore "normal," why try to change anything? Third, studies showed that people with low levels of cholesterol did not increase those, levels when fed an extralarge load of cholesterol. Even the American Medical Association, after reviewing these data, concluded that there was no reason to give a blanket prescription of dietary modification to the general public. Many other medical and scientific organizations agreed.
Then, in 1978, at the age of just thirty-five years, I had that heart attack. After I recovered from the attack, the doctors recommended a triple coronary artery bypass; three of the arteries supplying blood to the heart were blocked and needed to be bypassed with bits of vein taken from my legs.
Yes, they took samples of my blood. Yes, the cholesterol levels were elevated. But even after the surgery I didn't really alter my diet. You might ask why.
The answer is very simple, or at least it appeared simple to me at the time. When I did try to alter my diet somewhat by cutting back on butter, whole milk, steaks, and the like, the results were so minimal that I concluded that I was just one of those unlucky people who didn't respond to dietary modification. This was the cholesterol level my body had "chosen" to maintain no matter how much or how little cholesterol I ate. Besides, the surgery had "cleaned up" my system and I was as good as new. So I thought. Six years later, I had my second bypass operation, this time a quadruple. I was only forty-one years old. Not a very good record, and not a very good omen for the future.The 8-Week Cholesterol Cure. Copyright � by Robert E. Kowalski. Reprinted by permission of HarperCollins Publishers, Inc. All rights reserved. Available now wherever books are sold.