Rifkind and his collaborators also concluded that the cholesterol-lowering benefits of a drug applied to diet as well. Although the trial included only middle-aged men with cholesterol levels higher than those of 95 percent of the population, Rifkind and his colleagues concluded that those benefits “could and should be extended to other age groups and women and…other more modest elevations of cholesterol levels.” As Rifkind told Time magazine, “It is now indisputable that lowering cholesterol with diet and drugs can actually cut the risk of developing heart disease and having a heart attack.”

Pete Ahrens called this extrapolation from a drug study to a diet “unwarranted, unscientific and wishful thinking.” Thomas Chalmers, an expert on clinical trials who would later become president of the Mt. Sinai School of Medicine in New York, described it to Science as an “unconscionable exaggeration of all the data.” In fact, the LRC investigators acknowledged in their JAMA article that their attempt to ascertain a benefit from diet alone had failed.

Rifkind later explained the exaggerated claims. For twenty years, he said, those who believed in Keys’s hypothesis had argued that lowering cholesterol would prevent heart attacks. They had spent hundreds of millions of dollars trying to prove it, in the face of extreme skepticism. Now they had demonstrated that lowering cholesterol had reduced heart-disease risk and maybe even saved lives. They could never prove that cholesterol-lowering diets would do the same—that would be too expensive, and MRFIT, which might have implied such a conclusion, had failed—but now they had established a fundamental link in the causal chain from lower cholesterol to cardiovascular health. With that, they could take the leap of faith from cholesterol-lowering drugs to cholesterol-lowering diets. “It’s an imperfect world,” Rifkind said. “The data that would be definitive is ungettable, so you do your best with what is available.”

With publication of the LRC results, the National Heart, Lung, and Blood Institute launched what Robert Levy called “a massive health campaign” to convince the public of the benefits of lowering cholesterol, whether by diet or drug, and the media went along. Time reported the LRC findings in a story headlined “Sorry, It’s True. Cholesterol Really Is a Killer.” The article about a drug trial began, “No whole milk. No butter. No fatty meats. Fewer eggs…” In March, Time ran a follow-up cover story quoting Rifkind as saying that the LRC results “strongly indicate that the more you lower cholesterol and fat in your diet, the more you reduce your risk of heart disease.” Anthony Gotto, president of the American Heart Association, told Time that if everyone went along with a cholesterol-lowering program, “we will have [atherosclerosis] conquered” by the year 2000.