The last word on cholesterol. (interview with Dr. Dean Ornish) (interview)

The Last Word on Cholesterol

CAN DIET CAUSE OR PREVENT A HEART ATTACK? IN A WORD. YES.

With all of the claims and counter-claims about cholesterol being pressed upon the public these days, it's little wonder that many of us are having difficulty separating the myths from the realities. We are warned, for example, that cholesterol is directly responsible for many of the 500,000 fatal heart attacks that strike Americans each year. But we're also told that only one form of cholesterol is harmful (low-density lipoprotein, or LDL), while another form is actually good for us (high-density lipoprotein, or HDL). And the line is blurred even further when talk turns to the kind in our blood (serum cholesterol), as opposed to the kind we ingest (dietary cholesterol).

About the only thing that seemed clear-cut, at least until recently, was that cholesterol had been targeted as the leading culprit in the development of heart disease--the No. 1 cause of death in the United States. An all-out national effort aimed at lowering America's collective cholesterol level was launched by the National Heart, Lung and Blood Institute with much fanfare in 1987. Since then, practically everyone even remotely aligned with health or nutrition concerns, from physician to pharmaceutical company to food manufacturer, has enthusiastically boarded the anti-cholesterol bandwagon.

Support never has been unanimous, however. A smattering of opponents--from medical circles as well as the public at large--persistently maintained that focusing exclusively on cholesterol in the battle against heart disease was both incorrect and ill-advised. This minority position surfaced periodically, and each time it was quickly dismissed by those who considered the dangers of LDL cholesterol largely beyond debate.

Then came "The Cholesterol Myth" in the September 1989 issue of The Atlantic Monthly. In that lengthy article and the book from which it was excerpted, journalist Thomas Moore alleged that …