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This Cholesterol Thing Sounds Like Some Kind of a Cold War Intrigue

November 26, 1987|Joseph N. Bell

I was never much for the conspiracy theory until last week. That's when I learned how fiendishly clever the Russians are. I know now why they're willing to dismantle their nuclear weapons. They have something much better, a psychological warfare ploy that will do us in slowly but certainly.

They announced it last week under the guise of medical research. A doctor named Anatoli N. Klimov of the Academy of Medical Sciences in Leningrad said an eight-year study of 7,815 (note the odd number to lend credence) Russian men has shown conclusively that high levels of the so-called "good cholesterol" (HDL), instead of preventing heart disease, actually increases it.

Now what are we supposed to believe?

We older Americans spent most of our lives totally ignorant of cholesterol. Never even heard of it. Then about 10 years ago, a growing group of doctors began telling us that the eating habits we had established 30 or 40 years earlier and thoroughly enjoyed were probably killing us. We were given a choice of kicking the over-easy eggs in the morning and the medium-rare steak in the evening or leaving this world prematurely via a heart attack. Some choice. How deeply those habits were ingrained was illustrated by the fact that most of us thought it over. Weighed the odds. How many days of life was a Cheddar cheese omelet worth?

I reluctantly cut down on eggs and cheese on the advice of my doctor, who said my cholesterol showed up as "normal" in my physical examinations but that nevertheless I should cut back on cholesterol-forming foods. He gave me a diet sheet that was about as appetizing as a hospital lunch--especially because I don't eat fish.

I didn't question what he meant by "normal." I've learned after six-plus decades not to rock boats. If some authority figure--and especially a doctor--tells me I'm normal, I accept it and go from there. It did occur to me to ask why if I was normal I should change my eating habits. But I didn't. Subconsciously, I wanted to quit while I was ahead.

Then I was asked to write an article about a group of physicians who were traveling through industrial plants testing employees' cholesterol in a mobile laboratory. In the process of researching the article, I read a lot about cholesterol--including charts of figures showing cholesterol danger levels at various ages. That's when I realized I had never been given a number to identify my cholesterol level; just a label, "normal."

So I violated one of my own precepts about boat rocking. I called the clinic where my doctor practices and asked the young woman who answered the phone whether she would mind getting out my file and telling me my numerical cholesterol level. I have a feeling she shouldn't have done it, but she did.

The number startled me. According to my charts, I was in big trouble. So I called a doctor friend in another town, and he also seemed alarmed. Told me to consult with my own doctor about it immediately. Now, having set all this in motion, I was stuck with it. A little learning is a dangerous thing.

My doctor was patient with me. He got out the breakdown of my blood test and explained meticulously about the two kinds of cholesterol: bad (LDL), which causes narrowing of the arteries, and good (HDL), which reduces this accumulation. I was labeled "normal," he said, because even though I had a very high LDL, I also had a high HDL, and it was the ratio between the two that doctors looked at in determining danger levels.

Your ratio is OK, he said, but stay off the eggs anyway.

So I left, feeling pretty good about my HDL. I presume that millions of other older Americans brought up on mashed potatoes and gravy have been told the same thing. God bless our HDL.

Now along come the Russians with their study, spreading anxiety and confusion among us all.

Frankly, I'm getting fed up with this whole cholesterol thing. I'm not at all sure that medical researchers know what they're talking about. I could go back to my doctor, but I know what he'd tell me. Probably the same thing other American doctors are saying about the Russian study: that the conflict between the effects of HDL on Americans and Russians may well be explained by environmental or dietary or genetic differences. Or then again, maybe it can't.

One U.S. physician (Dr. Robert Levy of Columbia University's College of Physicians and Surgeons) was quoted in news stories as saying: "It gives one pause. If our HDL's were raised by whatever raises them in the Soviet Union, it would clearly not be beneficial."

If all this gives Dr. Levy pause, what are 30 million older Americans supposed to do? What am I supposed to do?

Should I figure I'm sunk anyway, and go out in a debauchery of cheese omelets and rare steaks and avocado dips and thick gravy? Or take up a monastic diet that tastes like cardboard and leaves me hungry all the time? Or figure that the medical people are going to come up with a new theory next year in which gravy and meat fat are going to be seen as the most certain route to a long and vigorous life?

Damned if I know. But I'm not going to let the Russians in on that uncertainty. Thing is, we have to keep all the studies in mind. And maybe have the omelet without cheese.

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