A Few Kind Words for Cholesterol

A scientific panel says it is calories that really count

Should Americans cut their intake of cholesterol and saturated fats? For years, many health authorities have been strongly urging such reductions to stem the epidemic of coronary disease in the U.S. But last week, in a 20-page report that stirred instant controversy, a panel of scientists from the National Research Council, an arm of the National Academy of Sciences, challenged the prevailing wisdom. It said that there was no reason for healthy adults to decrease dietary cholesterol and, in a slap at diet faddists, added: "Good food . . . should not be reguarded as a poison, a medicine, or a talisman. It should be eaten and enjoyed."

Some critics, acting as if the report were an invitation to a national orgy of hamburgers, French fries and junk food, quickly denounced it with such words as "irresponsible," "conspiratorial" and "slipshod." Said Dr. Donald M. Berwick of the Harvard School of Public Health: "The council is not acting in the best interests of the American people." Representative Fred Richmond of New York, chairman of the House Agriculture Subcommittee on Domestic Marketing, Consumer Relations and Nutrition, even suggested that lobbyists for the food industry--particularly meat, dairy and egg producers--"must have been at work here."

But a closer look at the report, titled "Toward Healthful Diets," indicated that the criticism was not entirely justified. Far from giving American dietary habits a clean bill of health, the council's food and nutrition board made a major plea for moderation. Noting that millions of Americans are at least 20% overweight, it recommended that these people could cut down on dietary fats, which contain twice as many calories as equal amounts of carbohydrates and proteins. It also urged reduction in consumption of salt by as much as two-thirds in hopes of reducing high blood pressure, especially among those people susceptible to this life-threatening disorder. Despite the physical-fitness boom, the board emphasized the need for even more exercise as a way of burning up excess calories, curbing appetite and staying in trim. Finally, the panel advised Americans to limit their consumption of alcohol, a source of nutritionally "empty" calories, to no more than the equivalent of three mixed drinks a day.

Despite such cautionary notes, it was the panel's views on cholesterol that stirred critics. Since turn-of-the-century Russian researchers showed that rabbits fed a diet rich in saturated fats and cholesterol develop hardening of the arteries, some doctors have suspected that the same thing happens in humans. Indeed, in populations that consume more of these foods, there is a higher level of cholesterol in the blood--serum cholesterol--and a greater incidence of coronary disease. But the board found such statistical evidence no more than circumstantial (although it did accept similar studies for obesity's links with both heart disease and cancer). The panelists noted that when attempts were made to reduce serum cholesterol by dietary restrictions, there was only a "marginal" drop in the number of heart attacks and "no effect on overall mortality." The body continues to make its own cholesterol --an important component of hormones and other vital substances--even though it is not derived from outside sources; thus reducing the intake of fats may not do all that much good in reducing cholesterol levels.

Even so, the board hedged its bets. It emphasized that people with a family history of heart disease or otherwise at risk because of such factors as obesity, high blood pressure or diabetes should rely on polyunsaturated fats in their diet and have blood fat and serum-cholesterol levels checked. It also said that even healthy people should consume no more fats than necessary to maintain their proper weight.Noting that a high-cholesterol diet tends to be a high-calorie diet, Panelist Robert Olson of St. Louis University said, "we think that the emphasis should be put on calories."

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