The Queen of Fats: Why Omega-3s Were Removed from the Western Diet and What We Can Do to Replace Them

4. MONSIEUR CHOLESTEROL

FOUR MONSIEUR CHOLESTEROL A man is only as old as his arteries. DR. WILLIAM OSLER, 1892 RALPH HOLMAN WASN’T INTERESTED IN CHOLESTEROL WHEN HE WAS looking for a new research project in 1941. But there was someone at the University of Minnesota who would be taken by this waxy substance, the stuff of plaques, as well as normal tissues, hormones, and vitamins. That was Ancel Keys, the charismatic physiologist who turned cholesterol into a household name and who even earned the nickname “Monsieur Cholesterol” because of his decades of work linking fat in the diet to elevated levels of cholesterol in the blood. “Keys had a beneficial effect because he focused people’s attention on lipids,” says Holman, who had known Keys since the physiologist sat on his dissertation committee. “But he was dogmatic about the part fats played in heart disease long before the nature of different fats was understood. Everywhere I went with my essential fatty acids, he went with his serum cholesterol. I couldn’t compete in terms of personality, but I could compete in terms of data.” Keys established a seemingly irrefutable link between fat consumption and heart disease. But ever since his first pronounce45 ments in the 1950s, the guilty fats—all fats, saturated fats, animal fats, tropical fats, cholesterol, trans fats—have kept changing as research has revealed how the different fats behave. Some people have been tolerant of these frequent changes. Others have become so frustrated that they have thrown the baby out with the bathwater and rejected all advice about fat. The baby, in this case, is the importance of diet and exercise in the prevention of heart disease, a point that Keys, inarguably, was one of the first to make. It’s hard to imagine there was ever a time when diet wasn’t thought of as a risk factor for heart disease, but Keys appreciated this connection long before most other scientists and physicians. Americans have Sunday dinner every day, he told Time magazine in 1959. In the late 1950s, he spearheaded the large and influential Seven Countries Study to follow the health and diets of 12,763 men in Yugoslavia, Finland, Italy, the Netherlands, Greece, the United States, and Japan. After earning his Ph.D. in physiology from the University of Cambridge in England, Keys taught at Harvard for several years; then, in 1940, he came to Minnesota to found the Laboratory of Physiological Hygiene. This laboratory, which was located underneath the University of Minnesota’s Memorial Stadium, Gate 27, quickly became a center for research in nutrition, preventive medicine, and epidemiology. At the beginning of the Second World War, Keys served as a special assistant to the secretary of war and was in charge of developing the eponymous K ration, which started out, he once said, as little more than a bag lunch. Toward the end of the war, it became clear to Keys that starvation would be a major problem in occupied countries such as Holland and Norway, and he began researching the effects of prolonged food deprivation. He reduced the caloric intake of thirty-six conscientious objectors (males who had volunteered for the project as a form of alternative service) to half the normal 46 MONSIEUR CHOLESTEROL intake for six months. Predictably, these men lost much of their body weight and became food obsessed. Three months after the Minnesota Starvation Experiment ended, none had regained his former weight or physical capacity. Keys learned that effective rehabilitation requires that starved individuals take in far more calories than normal for several months, as well as vitamin supplements and a higher proportion of protein in their diet, all of which he recommended to national and international relief agencies . “Starved people cannot be taught democracy,” the physiologist observed later. “To talk about the will of the people when you aren’t feeding them is perfect hogwash.” As Keys had predicted, some populations in war-torn Europe suffered from starvation. But others experienced a positive bene- fit from the conflict that no one had foreseen. Health professionals in Finland, Sweden, Norway, and Holland all observed and reported on a sudden drop in the number of people dying from heart disease, the condition that the doctors in the different countries variously diagnosed as angina pectoris, myocardial infarction , chronic myocarditis, arteriosclerosis, myocardial degeneration , pericarditis, emboli, and thrombosis. This steep decline in deaths occurred even in areas where...