January 1, 1985
Consensus Conference has ended debate on the diet-heart hypothesis.
National Cholesterol Education Program (NCEP)
The consensus conference spawned an entirely new administration at the NIH, called the National Cholesterol Education Program (NCEP), whose job it remains to advise doctors about how to define and treat their “at-risk” patients, as well as to educate Americans themselves about the apparent advantages of lowering their cholesterol. In the following years, the NCEP’s expert panels became infiltrated by researchers supported by pharmaceutical money, and cholesterol targets were ratcheted ever lower, thereby bringing greater and greater numbers of Americans into the category that qualified for statins. And the low-fat diet, even though it had never been properly tested in a clinical trial to ascertain whether it could prevent heart disease, became the standard, recommended diet of the land.
For longtime critics of the diet-heart hypothesis such as Pete Ahrens, the consensus conference was also significant because it marked the last time they could speak openly. After this conference, Ahrens and his colleagues were forced to fold their case. Although members of the nutrition elite had, over the previous two decades, been allowed to be part of the debate, in the years following the consensus conference, this was no longer true. To be a member of the elite now meant, ipso facto, supporting the low-fat diet. So effectively did the NHLBI-AHA alliance silence its antagonists, in fact, that among the tens of thousands of researchers in the worlds of medicine and nutrition over the next fifteen years, only a few dozen would publish research even gingerly challenging the diet-heart hypothesis. And even then, they worried about putting their careers on the line. They saw Ahrens, who had risen to the very top of his field and yet found himself having a hard time getting grants, because there was “a price to pay for going up against the establishment, and he was well aware of that,” as one of his former students told me.
No doubt this is why Ahrens, in looking back on the conference, which came to be his swan song, spoke with an uncharacteristic lack of reserve. “I think the public is being hosed by the NIH and the American Heart Association,” he declared. “They desire to do something good. They’re hoping to God that this is the right thing to do. But they are not acting on the basis of scientific evidence, but on the basis of a plausible but untested idea.” Plausible or even probable, however, that untested idea had now been launched.