Cholesterol too, like fat, has many other important functions. Far from being an enemy to the body, as conventional thinking holds, cholesterol is a valuable substance made by the body itself. Little of the cholesterol in our blood comes directly from food; most of it is made in the liver. That's because cholesterol strengthens cell membranes and intestinal walls, makes bile, and is vital for hormone and vita-min production. It may even act as an antioxidant and boost immunity.

Small wonder that "people with high cholesterol live the longest," says medical researcher Dr Uffe Ravnskov. "This statement seems incredible, but its truth emerges clearly from many scientific papers-particularly studies of the elderly." One was done by Yale University, and found that old people with high cholesterol had half the number of deaths from heart attack as their low-cholesterol peers (JAMA, 1994; 272: 1335-40).

In another first-class study, doctors from London's Imperial College found that high cholesterol levels protected people with chronic heart failure, leading to dramatic reductions in death rates. "The chance of survival increases by 25 per cent for each mmol/L [38.6 mg/dL] increment in total cholesterol," they reported (J Am Coll Cardiol, 2003; 42: 1933-40).

In Holland, scientists have been studying the 200-year-long records of two families with genetically high levels of cholesterol, and found no increase in deaths compared with those without the condition (BMJ, 2001; 322: 1019-23).

So, is there no connection between heart disease and cholesterol levels? Yes, there is, but the data are not nearly as consistent as the established view makes out, with a substantial minority of clinical studies showing an inverse relationship: less cholesterol, more heart attacks. In fact, over 60 per cent of all heart attacks occur in people with normal cholesterol, and most of those with high cholesterol never suffer heart attacks at all. "Consider the fact that more than 90 per cent of all cardiovascular disease occurs in people above age 60," says Dr Ravnskov, " and that almost all studies have found that high cholesterol is not a risk factor for either women or old people. This means that high cholesterol is only a risk factor for less than 5 per cent of those who die from a heart attack."

And yet, CHD is increasing, and has been for nearly a century. So, if neither fat nor cholesterol is the culprit, then what is?

A Processing Problem
Many nutritionists are now pointing the finger at modern processed food. "It's a little known fact that, before 1920, coronary heart disease was rare in developed countries like America," says pioneering nutritionist Dr Mary Enig, of the Weston Price Foundation, "but it rose dramatically over the next 40 years. If, as we have been told, heart disease results from the consumption of saturated fats, one would expect to find a corresponding increase in animal-fat consumption. Actually, the reverse is true. In America, for example, during the period from 1910 to 1970, there was a significant decline in the proportion of traditional animal fat in the national diet."

Enig has shown that the rise of heart disease corresponds with the introduction of polyunsaturated plant oils into foodstuffs. Invented in 1916, margarine was the earliest and best-known example, but thousands of common foods soon followed suit. "One reason the polyunsaturates cause health problems is that they become oxidized when subjected to heat, as in food processing, and produce free radicals," says Enig. "These are extremely reactive chemically, causing damage to blood vessels and initiating atherosclerosis."