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Author(s)
The lipid hypothesis of coronary heart disease
proposes that a high total cholesterol level has a causative role in
coronary heart disease (CHD), specifically in the development of
atherosclerosis. It forms the basis for formulating target levels of
serum cholesterol and hence the widespread use of statins for lowering
cholesterol. An extension of the lipid hypothesis is the diet/heart
hypothesis of coronary heart disease. This theory combines two
ideas—that saturated fat raises cholesterol levels, and that a reduced
saturated fat intake will lower cholesterol levels, thereby inhibiting
the development of atherosclerosis and manifestations of CHD. Those who
make diet recommendations or prescribe medication to reduce cholesterol
may be unaware of the underpinning science. The original research behind
these recommendations has given us “healthy heart” guidelines and
preventive measures we assume to be true. While the lipid and diet/heart
hypotheses are often presented as fact, they remain inadequately proven
theories that have little agreement from experts. Historical
perspectives can help us understand the basis of current-day beliefs. In
the lipid hypothesis case, research from the 1950s and 60s was
instrumental in its formation. This early work should not be considered
irrelevant, outdated or obsolete because current recommendations from
national heart associations in many countries continue to be shaped by
these studies. This paper examines evidence used to formulate the lipid
hypothesis and, subsequently, the diet/ heart hypothesis. By critically
evaluating steps in the formation of the theory, inconsistencies,
mistakes and alternate explanations become apparent and cast doubt on
its validity.
KEYWORDS
Cite this paper
Elliott, J. (2014) Flaws, Fallacies and Facts:
Reviewing the Early History of the Lipid and Diet/Heart Hypotheses. Food and Nutrition Sciences, 5, 1886-1903. doi: 10.4236/fns.2014.519201.
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