*34 Although, as we noted earlier (Chapter 1), the amount of animal fat Americans ate decreased during this period, and so the increased total fat consumption was entirely due to the increased consumption of vegetable fats.
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*35 There is even a plausible biological mechanism to explain how refined carbohydrates and sugars could cause or exacerbate cancer. See Chapter 13.
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*36 John Higginson, director of the World Health Organization’s International Agency on Cancer Research, later described Non-infective Diseases in Africa as a “brilliant review” that had been “regrettably ignored.”
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*37“The title Western diseases is preferred to that of the diseases of civilization,” they explained, “for it proved obnoxious to teach African and Asian medical students that their communities had a low incidence of these diseases because they were uncivilized.”
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*38 According to records from the local trading ships, this increase was nearly tenfold between 1961 and 1980: from seven pounds per person per year to sixty-nine pounds.
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*39 Although Reaven deserves much of the credit for identifying the syndrome and compelling the diabetes and heart-disease research communities to take notice, I will refer to it as metabolic syndrome, because that is now the preferred public-health terminology, rather than Syndrome X, except when discussing Reaven’s work in particular.
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†40 The first time the Washington Post mentioned metabolic syndrome or Reaven’s research was in 1999, in an article about popular weight-loss diets. The second time was in 2001, in an article that actually discussed metabolic syndrome as a risk factor for heart disease. By that time, the paper had published a couple of thousand articles that at least touched on the issue of cholesterol and heart disease.
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*41 A triglyceride molecule is composed of three fatty acids—hence, the “tri”—linked together by a glycerol molecule.
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*42 To be precise, Gofman’s Science paper identified IDL—i.e., intermediate-density lipoproteins—as the class associated with heart disease. He would later decide that LDL was more important than IDL. For the sake of simplicity, I’ve used LDL throughout.
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*43 One notable case was Theodore Cooper, who was assistant secretary for health in 1976, when he testified about “diet and killer diseases” to the Senate Select Committee on Nutrition and Human Needs. Cooper said that his personal dietary concern was with carbohydrates rather than fats. “If I have a problem, it is a tendency to gain weight,” Cooper explained. “I am classified Type IV. As a Type IV, my lipid levels are much more subject to elevation if I consume large amounts of carbohydrates or alcohol.”
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*44 This was not because the NIH had any interest in testing the HDL/heart-disease relationship, according to Gordon, but only because Fredrickson, Levy, and Lees’s new measurement technique required that the amount of cholesterol in HDL be known so that the amount in LDL could be calculated.
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