Public-Health Campaigns: Do They Go Too Far?

March 16, 1990

Report Outline
Special Focus

Introduction

The cholesterol controversy has brought to the surface an ongoing debate within the scientific community over how to judge conflicting scientific evidence in drawing up recommendations for medical treatment. It has raised serious questions about the way expert panels develop consensus opinions, about how those opinions are translated into advice to patients, and about government's role in public-health campaigns.

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Overview

Responding to scientific reports linking cholesterol to heart disease, many Americans have changed their eating habits, markedly reducing their consumption of red meat, whole milk, eggs and other foods high in fat and cholesterol. But most of these Americans are unaware of the sharp differences of opinion in the medical and scientific communities over whether lowering blood cholesterol levels will actually save lives by reducing the incidence of coronary artery disease.

In fact, the cholesterol controversy has been going strong for years. Passions run high on both sides, and the opposing factions have been fighting it out at medical conferences and congressional hearings and in the pages of scientific journals. The controversy didn't break into the public's consciousness until last fall, when The Atlantic published an in-depth article by investigative reporter Thomas J. Moore attacking “the cholesterol myth.” Moore argued that diet has little effect on an individual's cholesterol level; that the drugs that can lower it can have serious or fatal side effects; and that there is little evidence to support the theory that lowering cholesterol will lengthen one's life.

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