Lipid hypothesis

The lipid hypothesis (also known as the cholesterol hypothesis) is a medical theory postulating a link between blood cholesterol levels and the occurrence of cardiovascular disease. A summary from 1976 described it as: "measures used to lower the plasma lipids in patients with hyperlipidemia will lead to reductions in new events of coronary heart disease". It states, more concisely, that "decreasing blood cholesterol [...] significantly reduces coronary heart disease". An accumulation of evidence has led to the acceptance of the lipid hypothesis by most of the medical community. In 1856, the German pathologist Rudolf Virchow first described lipid accumulation in arterial walls, however the initial connection between arteriosclerosis and dietary cholesterol would not be established until the research of Russian pathologist Nikolay Anichkov, prior to World War I. In 1913, a study by Anichkov showed that rabbits fed on cholesterol developed lesions in their arteries similar to atherosclerosis, suggesting a role for cholesterol in atherogenesis. Dutch physician Cornelis de Langen noted the correlation between nutritional cholesterol intake and incidence of gallstones in Javanese people in 1916. de Langen showed that the traditional Javanese diet, poor in cholesterol and other lipids, was associated with a low level of blood cholesterol and low incidence of cardiovascular disease (CVD), while the prevalence of CVD in Europeans living in Java on a Western diet was higher. Since de Langen published his results only in Dutch, his work remained unknown to most of the international scientific community until the 1940s and 1950s. By 1951, it was accepted that, although the causes of atheroma were still unknown, fat deposition was a major feature of the disease process. "The so-called fatty flecks or streaks of arteries are the early lesions of atherosclerosis and... may develop into the more advanced lesions of the disease." Ancel Keys With the emergence of CVD as a major cause of death in the Western world in the middle of the 20th century, the lipid hypothesis received greater attention.