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Narrowing of the arteries by these fatty deposits is called atherosclerosis. It is a slowly progressing disease that can begin early in life but not show symptoms for many years. In 1913, scientists identified the substance responsible for the fatty deposits in the rabbits' arteries as cholesterol.

In 1916, Cornelius de Langen, a Dutch physician working in Java, Indonesia, noticed that native Indonesians had much lower rates of heart disease than Dutch colonists living on the island. He reported this finding to a medical journal, speculating that the Indonesians' healthy hearts were linked with their low levels of blood cholesterol.

De Langen also noticed that both blood cholesterol levels and rates of heart disease soared among Indonesians who abandoned their native diet of mostly plant foods and ate a typical Dutch diet containing a lot of meat and dairy products. This was the first recorded suggestion that diet, cholesterol levels, and heart disease were related in humans. But de Langen's observations lay unnoticed in an obscure medical journal for more than 40 years.

After World War II, medical researchers in Scandinavia noticed that deaths from heart disease had declined dramatically during the war, when food was rationed and meat, dairy products, and eggs were scarce. At about the same time, other researchers found that people who suffered heart attacks had higher levels of blood cholesterol than people who did not have heart attacks.

Since then, a large body of scientific evidence has been gathered linking high blood cholesterol and a diet high in animal fats with an elevated risk of heart attack. In countries where the average person's blood cholesterol level is less than 180 mg/dl, very few people develop atherosclerosis or have heart attacks. In many countries where a lot of people have blood cholesterol levels above 220 mg/dl, such as the United States, heart disease is the leading cause of death.

High rates of heart disease are commonly found in countries where the diet is heavy with meat and dairy products containing a lot of saturated fats. However, high-fat diets and high rates of heart disease don't inevitably go hand-in-hand.

Learning from Other Cultures

People living on the Greek island of Crete have very low rates of heart disease even though their diet is high in fat. Most of their dietary fat comes from olive oil, a monounsaturated fat that tends to lower levels of "bad" LDL-cholesterol and maintain levels of "good" HDL-cholesterol.

The Inuit, or Eskimo, people of Alaska and Greenland also are relatively free of heart disease despite a high-fat, high-cholesterol diet. The staple food in their diet is fish rich in omega-3 polyunsaturated fatty acids.

Some research has shown that omega-3 fatty acids, found in fish such as salmon and mackerel as well as in soybean and canola oil, lower both LDL-cholesterol and triglyceride levels in the blood. Some nutrition experts recommend eating fish once or twice a week to reduce heart disease risk. However, dietary supplements containing concentrated fish oil are not recommended because there is insufficient evidence that they are beneficial and little is known about their long-term effects.

Omega-6 polyunsaturated fatty acids have also been found in some studies to reduce both LDL- and HDL-cholesterol levels in the blood. Linoleic acid, an essential nutrient (one that the body cannot make for itself) and a component of corn, soybean and safflower oil, is an omega-6 fatty acid.

At one time, many nutrition experts recommended increasing consumption of monounsaturated and polyunsaturated fats because of their cholesterol-lowering effects. Now, however, the advice is simply to reduce dietary intake of all types of fat. (Infants and young children, however, should not restrict dietary fat.)

The available information on fats may be voluminous and is sometimes confusing. But sorting through the information becomes easier once you know the terms and some of the history.

The "bottom line" is actually quite simple, according to John E. Vanderveen, Ph.D., director of the Office of Plant and Dairy Foods and Beverages in FDA's Center for Food Safety and Applied Nutrition. "What we should be doing is removing as much of the saturated fat from our diet as we can. We need to select foods that are lower in total fat and especially in saturated fat." In a nutshell, that means eating fewer foods of animal origin, such as meat and whole-milk dairy products, and more plant foods such as vegetables and grains.

Eleanor Mayfield is a writer in Silver Spring, Md.
Food and Drug Administration Publication No. (FDA) 99-2286