The fall of the traditional lipid hypothesis

Abstract

The Finnish recommendation "Diagnosis and treatment of hypercholesterolaemia and other hyperlipidaemias in adults"(6) is mainly based on the traditional lipid hypothesis. The expediency of the recommendation should be reviewed in the light of the latest studies on diet, blood serum cholesterol and mortality. According to this information: 1. The mortality of the population increases both at high and at low cholesterol levels. The U-shape (Fig. 1) illustrating mortality vs. blood cholesterol level is different for men and women. Hence, the optimum blood cholesterol range should be set for men and for women separately. The present target value, below 5 mmol/1 for the entire Finnish population, is not reasonable. 2. The trans fatty acids formed in the catalytic hydrogenation process of polyunsaturated fatty acids have an unfavourable effect on blood cholesterol and may contribute to the occurrence of CHD. Thus the Finnish recommendation to increase the use of margarines is not well-founded. There are considerably better alternatives on the Finnish yellow fat market (Table 1).