Cholesterol: A scientific, medical, and social history, 1908--1962

The aim of this dissertation is to examine scientific, medical, and social perceptions of cholesterol and its relation to heart disease. The dissertation is divided into three parts. The first part examines the body of basic science research on cholesterol, focusing on experimental atherosclerosis and cholesterol biosynthesis research. Experimental animals including the rabbit, mouse, and chicken provided researchers with a new form of physiological material with which to interpret the relationship between health and disease, trace a pathological process---atherogenesis---in a living organism, and guide the practice of disease definition. Experimental atherosclerosis and cholesterol biosynthesis research formed the scientific and technological base upon which a nascent cardiovascular epidemiology research community built its body of research on cholesterol metabolism.;The second part traces the development of cardiovascular epidemiology in the late 1940s and early 1950s. Combating coronary heart disease became an increasingly prominent issue in postwar America as rising mortality rates suggested that the United States was in the midst of a serious cardiac crisis. Prevention required prediction, prompting epidemiologists and physiologists to design a series of predictive equations and statistical correlations in order to determine a patient's future risk of developing atherosclerosis and coronary heart disease. These predictive equations revised medical conceptions of risk and transformed physiological data into products of complex statistical analysis by replacing discrete and measurable physiological phenomena with increasingly elaborate statistical and mathematical relationships. Serum cholesterol and lipoprotein levels became input variables for complex equations rather than simple, straightforward measurements of a patient's physiological state.;The third part of the dissertation examines the emergence of dietary prevention programs intended to control coronary heart disease by controlling cholesterol. This social story traces the contestations and intersections between scientific, medical, and social perceptions of cholesterol, diet, and coronary heart disease. For the remainder of the twentieth century, cholesterol would remain a topic of perpetual debate as epidemiologists and physicians continued to grapple with how best to quell increasing incidence of coronary heart disease in American society. By the end of the twentieth century, cholesterol had left a distinguishable mark on American society, continually informing and re-forming public perceptions of nutrition, diet, and health.