Cholesterol is a lipid substance found in foods of animal origin. The idea that dietary cholesterol is the cause of cardiovascular disease is based on the premise that dietary cholesterol is able to affect blood cholesterol levels. In turn high blood cholesterol levels are claimed by some to be the cause of atherosclerosis, which is in turn the cause of cardiovascular disease. There are a number of problems with this theory which call into question its validity. One such problem is the fact that cholesterol levels of populations change through time in a natural cyclical pattern. If blood cholesterol was the cause of cardiovascular disease, cardiovascular disease would mirror these changes in blood cholesterol. However, this is not the case. In addition, if diet was able to influence plasma cholesterol levels, populations with different dietary patterns would have quite different cholesterol levels. For example the dietary patterns and blood cholesterol levels have been studies in populations from the North and South of India1.
Indians living in Southern India consume fewer calories from fat and protein compared to the north. In contrast in the south of the country more energy is derived from carbohydrates, mainly rice. In the south, the fibre intake is also 4 % lower than anywhere in the rest of the country. Analysis of inhabitants of the Southern Indian state of Andhra Pradesh showed that in males, the mean cholesterol levels increased until the age of 40, and then remained stable. In females the patterns was different as cholesterol levels rose until the age of 20 years, declined until 35 years and then rose again. Before the age of 20 years, females had higher cholesterol levels that males. After the age of 40 years, there was no significant difference between the cholesterol levels of the sexes. These results were similar to those in the north of the country and are comparable to other countries. Such patterns are rarely considered during cholesterol testing in clinical settings. Further, cardiovascular risk does not follow these cholesterol patterns.
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