All of us feel culpable, accountable and guilty after devouring a yummy fried snack. Those who are confiscated while eating a triple chocolate fudge cake or that delicious lip-smacking cookie usually makes an ignominious excuse and feel blameworthy. The primary explanation for this disposition is the relentless preaching for decades about detrimental effects of cholesterol by the cardiologists. It is believed that blood cholesterol is directly responsible for heart disease and stroke. It is assumed that those who have high cholesterol levels are at higher risk of getting a heart attack and stroke. However, as was discovered with time, the majority of patients who develop heart attack have normal levels of cholesterol. In addition, many of those who have high cholesterol levels never develop heart disease. Clearly either we are missing a bit or there is something more than the cholesterol in the development of this deadly disease.

Cholesterol controversy

Fats are as essential to our body as water. Cholesterol is an integral component of all cells of our body, is essential for brain function, helps form wall of all cells, contributes to a healthy immune system and is needed for making body hormones and vitamins. For very long cardiologists believed that lowering cholesterol by drugs such as statins, mortality due to heart disease would be lowered. However, partially true it is, there is a growing body of evidence now that apart from the cholesterol there are equally significant factors which are contributing to the menace of this deadly disease. Gradually it started to become clear that majority of benefits of statins, the wonder drugs, are due to their loads of properties other than cholesterol lowering. Further, the quantity of cholesterol we get from food usually constitutes up to one-fourth of the blood cholesterol, while the rest coming from the internal body metabolism. This is the reason that some people who eat foods high in fats continue to have low blood cholesterol levels while those who eat foods low in cholesterol have high levels. It was also learned that it is the type of fat and not the amount of fat which is important. While certain fats such as trans fats and saturated fats are harmful, others such as omega-3 fatty acids, monounsaturated and polyunsaturated are actually good and should be consumed in required amounts.

Beyond cholesterol

It is increasingly being recognized that inflammation plays an important role not only in the genesis of heart disease but in a host of other diseases including cancer. A biomarker called C-reactive protein (CRP) is a convenient measure of inflammation and its raised values signify ongoing inflammation. CRP is increasingly being endorsed and recommended by important world cardiology forums as an initial investigation for risk assessment of patients at risk for heart disease. Cholesterol legacy is perhaps drawing to a close and cardiologists are looking beyond it. Translated in clinical terms, perhaps in coming years it would neither be too unfashionable nor unhealthy to eat those alluring deep fried Pizzas with onion rings and French fries

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