Dietary lipids and arteriosclerosis

A great deal of attention has been given to the question of whether dietary fats in general and certain fats in particular play an important part in such arteriosclerotic complications as heart attacks and strokes. Milk fats have been widely accepted as desirable nutritional fats. Cow milk fat, or butter, contains a wide variety of fatty acid derivatives, including the important, medium chain acids. The structural configuration of butter triglycerides facilitates absorption of the palmitate present in butter. However, there have been objections to the use of butter and other forms of milk fat because of the preoccupation of many investigators with the unproven lipid theory of arteriosclerosis, and because serum cholesterol levels are relatively high after the intake of milk fat. Reevaluation of the lipid theory suggests that cholesterol can hardly be an atherogenic factor. Cholesterol occurs under conditions of tissue repair, and it may well be that the high serum levels in arteriosclerotic conditions are a consequence of such processes. The low serum levels occurring after the consumption of polyunsaturated vegetable oils are often associated with high tissue levels of cholesterol. Long term clinical studies and population surveys suggest that this century’s changes in mortality and morbidity are much less related to dietary factors (other than over‐eating) than is claimed. New insights in the fields of immunology and microbiology may be vastly more important for an understanding of some etiological factors in arteriosclerosis.