Food pontiffs see the cuisines of the world as a continual provocation. A typical example is the Mediterranean diet, which doctors believe to be good for the heart. What a shame that it includes almost everything that the most intransigent health gurus attempt to exclude from their clients' eating habits. A couple of glasses of Pastis or Ouzo as an aperitif, followed by the first course: instead of a bowl of raw salad, an onion soup, possibly topped with high cholesterol cheese au gratin.

As a main course perhaps succulent fatty grilled meat. The vegetables served in Greek tavernas ooze olive oil, are well-salted and flavored with garlic. Moreover, gastronomy would be a non-event around these parts without a good glass of Retsina, Rioja or Beaujolais.

North of the Alps, where there are no olive trees glittering in the hot summer sun, but in their stead dew glistening on the lush grass of pasture land, butter is the time-honored basic ingredient. At least this was the case until the margarine factories declared that such ancient customs were responsible for the rise in heart attacks: butter contains cholesterol, which according to the latest research, attacks the heart and cardio-circulatory system. It remains a mystery why experts did not warn us against the dangers of breast feeding, since breast milk is particularly rich in this insidious substance which new born babies cannot produce themselves, but which they need for the development of the brain.

For all that advertising would have us believe, cholesterol is not a dangerous external substance which enters our bodies through what we eat. On the contrary, it's a fundamental element in all the cells of our organism and is of vital importance for our metabolism. Leaving aside water content, about half the content of adrenal glands is pure cholesterol, which also accounts for about 10-20% of the brain. In a healthy person, even the heart, the organ considered to be most at risk from this selfsame substance, is made up of roughly 10% cholesterol. Not that this is really so surprising: the body needs cholesterol to produce sexual and stress hormones, vitamin D and bilious acids; without it the nervous and immune systems could not function.

Not even vitamins play such a significant and multifarious role. The very fact that cholesterol is so important explains why the body does not rely on a sufficient supply from diet: the body must be, and is, able to produce its own. In a healthy person the body produces from one to one and a half grams a day, according to need. If diet does not provide enough cholesterol, the body produces more. This the reason why, for the majority of people, a low-cholesterol diet is not successful in reducing levels of the substance in the blood.

Statistics
Where does the cholesterol theory spring from? The answer is simple: from statistical figures. In countries where greater quantities of animal fats are eaten, myocardium heart attacks are more frequent than elsewhere. If one delves further, the artifice becomes clear: in developing countries people have less to eat and die from diseases that differ from those afflicting the well-fed populations of industrialized countries. This however means nothing. Developing counties differ from rich western societies in many other ways: suffice it to mention the number of cars, sales of dog food or television ownership.

Juggling numbers has long been a specialty of marketing experts, whose power to scare has even infected a number of doctors. As a result, there are plenty of members of the medical profession who make up for what they lose through cuts in the national health system by treating those hitherto considered healthy and now deemed subject to excessive cholesterol levels.

Yet the cholesterol theory is essentially so shaky that sooner or later it was bound to be modified The focus has now moved from the quantity of cholesterol in food to fatty acids. It has been said that only unsaturated fats, such as those in margarine, can protect the heart. Saturated fats, found for example in butter and animal suet, are thought to be the main causes of the diseases of prosperity.
What appeared to be decisive proof of the fact that the right diet lowers cholesterol and guards against heart attack was provided by the famous study carried out in the northern Finnish province of Carelia. Finland has one of the highest levels of heart disease anywhere, and the statistics for Carelia used to break all records. A widespread campaign succeeded in stopping the region's inhabitants from smoking, in introducing dietary margarine and eliminating butter. Comparisons were then made with the inhabitants of the nearby province of Kuopio, which also had similar levels of heart disease.

Over the years a decrease in cholesterol levels was noticed alongside a reduction in deaths from heart attack. The success was widely celebrated. It was a shame that doctors were not shown the results of studies conducted on the inhabitants of Kuopio, where the number of deaths due to cardio-circulatory diseases decreased more than in northern Carelia despite the fact that people continued to smoke, eat and drink in peace. The results of a study carried out in Great Britain were even clearer: a conspicuous number of people who died from heart attacks were found to have eaten more margarine and less animal fats than those who died in road accidents.

Margarine
So how can all this be explained? New types of fatty acids, which do not occur naturally, are used in the production of margarine. The nub of the matter is the so-called partial hardening, during which only part of the unsaturated fatty acids are transformed in saturated fats, while those that remain change their structure. It is still not known how many new substances develop during this process nor what biological effects they may have, yet a link between arteriosclerosis and heart attack has often been observed. Margarine manufacturers obviously assure the public that their products no longer contain fatty transacids, yet independent tests have shown that the fats used in the food industry, particularly by bakeries, are rich in them.

It wouldn't actually be difficult to obtain solid scientific proof of the truth of the cholesterol theory. A long-term study, for example over a ten-year period, would soon reveal whether lovers of butter were at greater risk of heart attack than margarine enthusiasts. No biochemical theory, however sophisticated, could be more convincing. So why have proponents of the theory resisted this to date? Perhaps because the results would be wrong? The large-scale independent survey known as the Nurse-Health-Study involved 80,000 American nurses on the project and demonstrated that the risk of heart attack is higher among margarine eaters than among those who eat butter.

Even Ancel Keys, the mind behind the famous fat theory, had to admit that his studies had not shown a significant relationship between diet and cholesterol levels in the blood on the one hand and the appearance of coronary heart disease on the other. Some years ago the Suddeutsche Zeitung wrote: The margarine industry is today suspected of having simply bought many of the leading dietary scientists.

How is it possible that even those who read the specialist medical literature failed to see these links? In addressing this question, the Swedish scientist Uffe Ravnskov discovered that the majority of studies refute the fats theory. However, since such papers were at odds with doctors' preconceived ideas, they were simply not cited. Ravnskov concluded: It is probable that human diet contains important substances for the blood vessels and heart, but there is almost no proof that the group of saturated fatty acids is harmful whereas the polyunsaturated group has beneficial effects.

Olive oil
At this point another theory looms into focus. Perhaps it is not fatty acids which are responsible for the effects of fats, but some complementary substances. Let us take olive oil as an example. Until just a few years ago, public opinion north of the Alps considered olive oil to be pure poison for the heart: indeed, like butter, it contains few polyunsaturated fatty acids. However a series of epidemiological studies in the Mediterranean proved the exact opposite: the more olive oil is consumed the lower the death toll from heart attack. This finding spawned a new theory: the beneficial effects were attributed to precisely those hitherto denigrated simple unsaturated fatty acids found in olive oil.

However, perhaps the most plausible explanation is as follows: besides fats, olive oil contains other complementary substances with pharmacological effects, for example oleuropein. This belongs to the group of iridoids, which are found in many medicinal plants such as valerian, veronica and gentian. Experiments on animals have shown that even small quantities (10 milligrams per kilo of body weight) of oleurpein reduce blood pressure by 60%. It also stimulates blood flow in the heart, increases the coronary flow, has an anti-arhythmic action on the heart and has anti-spastic properties. It is a highly reactive substance that can be transformed into a wide range of other powerful active substances, such as dihydroxyphenylethanol.

How come this pharmacological treasure was not discovered earlier? Perhaps lack of interest in the subject is a result of the fact that the medicinal substances in olives cannot be used commercially: the heart-protecting qualities of olive oil are so well-known that no patents can be issued; and besides, oleuropeina can be found in supermarkets and pizzerias. Pills containing oleuropein would therefore have no market.

In the end the heated debate about the right fats, the constant changes in theories, the hideous consequences threatening anyone silly enough to ignore these theories and the millions that are made from the fear thus engendered all boil down to one simple truth: our traditional fats are as tolerable and healthy as any typical ingredient pertaining to local traditions, whether these be bread, wine or pomegranates. However, this only holds true if the fats are not refined. The products which satisfy this condition are only two to date: butter and olive oil. Clearly every cultural environment is fully justified in developing its own cuisine, and this will have its devotees regardless of the dictates of passing theories.