Cholesterol Controversy

On the hazards of obesity and the necessity for counting calories, the medical profession is almost unanimous. On the dangers of cholesterol and its role in heart disease, doctors remain stubbornly divided. In fact, says Manhattan's Dr. Arthur M. Master, one of the foremost of U.S. cardiologists, the current preoccupation with cholesterol is one of the heart-health fads on which "the ablest and most reputable physicians and scientists have diametrically opposed views."

The problem has been oversimplified for the layman, Dr. Master complains. Men with a lot of cholesterol in their blood tend to have heart attacks earlier in life than others. Though some foods contain readymade cholesterol, the body manufactures more of it from saturated fats in meat and dairy products. So the argument runs: Cut down on saturated fats in the diet, thus lowering the cholesterol level in the blood and reducing the danger of artery disease and heart attacks.

Snacks or Squares? But the medical facts are not so straightforward as all that. Though cholesterol is found in diseased coronary arteries, it is not yet certain whether cholesterol is the original cause of damage or a secondary invader. Many high-cholesterol men never have heart attacks at all. While doctors use the cholesterol level as a guide to the amount of fat in the blood, it is a crude and unreliable measure: it varies with exercise and whatever drugs the patient may have taken; it depends on whether he has been nibbling snacks or eating three meals a day. It changes with his emotional ten sion (how worried is he about this test?), and even with the amount of tourniquet pressure on his arm when the nurse draws a blood sample.

"It cannot be taken for granted," Dr. Master told the American Medical Association, "as many physicians and lay persons do, that lowering the blood cholesterol will reduce the incidence and mortality of coronary disease and coronary thrombosis. There is as yet no proof that a diet low in saturated fats, or a drop in the blood cholesterol, will prevent or in fluence coronary disease." Although the medical profession cannot yet make up its collective mind on these matters, Dr. Master gave much credit for pioneer research to Dr. Ancel Keys (TIME cover, Jan. 13, 1961) and the late Dr. Norman Jolliffe, who founded New York City's Anti-Coronary Club (former and potential coronary cases).

Meanwhile the mere hope that a change in diet will prolong life is filling U.S. kitchens and men's stomachs with hitherto esoteric oils; housewives are chattering with superficial knowingness about polyunsaturated fats.* Americans get an average of 40% to 45% of their daily calories in fats, and before the cholesterol craze came along, most of the fat was saturated. Some doctors have urged simply cutting down fats, of whatever kind, to about 30% of the total caloric intake. Others have advocated substituting polyunsaturated fat for much of the saturated stuff, and worrying less about the total intake. Conservative Dr. Master adds a warning: "The ingestion of large amounts of polyunsaturated acids is unnecessary and may actually be harmful."

Claims that a few capsules of safflower oil taken daily will stave off heart disease are so misleading that they have fallen under Government ban. But polyunsaturates in moderate amounts may be beneficial, so many leading U.S. food processors are supplying new fats in new forms to meet a growing demand.

Because hydrogenation of vegetable oils--to keep spreads and shortenings fresh and solid at kitchen temperature--saturates them to varying degrees, Procter & Gamble Co. has spent millions of dollars on research and on revamping its manufacturing process to bring out the new Crisco, only 25% saturated, 44% to 50% neutral monounsaturated, and the rest polyunsaturated. New Crisco, says P. & G., has double the linoleic acid of the old formula and of competing brands as well. General Mills, Inc. is marketing a safflower cooking oil named "Saff-o-life" which, its ads say, is "38% higher in polyunsaturates than any leading oil, even corn oil."

Point of Desperation. Many factors beside the quantities of food and fats consumed are important in regulating the body's cholesterol level. So Dr. Master deplores overemphasis on diet. "We have encountered people who have deprived themselves of foods they crave, almost to the point of desperation," report Dr. Master and his colleague, Dr. Harry L. Jaffe. To avoid this situation, and to help their patients achieve "philosophical equanimity," they encourage people to relax and enjoy moderate amounts of butter and cream, meat and eggs. This is no different from Grandma's injunction to eat "everything in moderation." But today's doctors add this advice to their patients: leave the problems of cholesterol to the medical scientists.

* Food fats are classed by chemists as saturated if they have hydrogen atoms hooked onto the carbon atoms all along the molecular chain, as mono-unsaturated if hydrogen atoms are missing at one point in the chain, and as polyunsaturated if they are absent at two or more points. Most saturated fats are solid at room temperature, and come from meat or milk. The polyunsaturated fats, notably linoleic acid, are found mainly in fish, marine mammals, and such plant extracts as safflower, sunflower, cottonseed, soybean, corn and peanut oils. Only ten years ago, safflower oil was made mostly from imported seed for use in dyes. Today, hundreds of thousands of acres in California, Arizona and Utah grow the thistlelike plant.

This file is automatically generated by a robot program, so reader's discretion is required.