So another piece of the jigsaw slipped into place. It wasn't just rabbits who died of high blood cholesterol levels. Humans did too. Other researchers looking further back in time noted that rationing was introduced during WWII in Norway and the UK, and in both countries the rate of heart disease fell. (Although the rate of having bombs fall on your head rose rapidly, which could have had something to do with a rapid alteration in the causes of death.)

It was then found that there were some people with a genetic condition known as familial hypercholesterolaemia (FH), basically, an inherited condition of high levels of blood cholesterol (LDL). Children inheriting the condition from both parents could die as young as five from heart disease. By golly, it was all beginning to look like an openand-shut case. leaping ahead in time somewhat; in the 1970s Brown and Goldstein identified that people with FH had a problem with their production of lDl receptors. With fewer LDl receptors the LDl level skyrocketed and this was the basic 'fault' in FH, which, as you will now recognize, should actually be called 'hyper low density lipoproteinemia.

It was at this time that the concept of a raised blood cholesterol started to fragment into a constellation of different lipoproteins, and LDL was fingered as 'bad' cholesterol.. And so it seemed, although I am leaping about a bit in time and space, that all the pieces of the jigsaw puzzle were falling into place. and the diet-heart hypothesis was really flying. As early as 1956 the American Heart Association (AHA), somewhat jumping the gun in my opinion, had launched the concept of the 'prudent diet'.

A prudent diet consisted of replacing butter with margarine, beef with skinless chicken, bacon and eggs with cold cereal, warm baths with cold showers and chocolate by a smack on the back of the neck with a cold kipper. In the 1960s and 1970s, huge trials on dietary modification were set up. The biggest was probably the MR-FIT trial, involving hundreds of thousands of people. What were the results of this trial? I think it would spoil things to let you know that at this point all will be revealed later on.



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