The 2012 University of Cape Town Faculty of Health Sciences centenary debate: “Cholesterol is not an important risk factor for heart disease, and the current dietary recommendations do more harm than good”

  • Timothy David Noakes University of Cape Town
Keywords: diet heart hypothesis, lipid hypothesis, Ancel Keys, carbohydrate resistance, low-carbohydrate diet, Woman’s Health Initiative, cholesterol, ancestral diet, dietary guidelines


Our human ancestors thrived on a diet high in fat and protein of animal or fish origin for at least 2.5 million years. Foods with a high-energy content and nutritional density were required for the development of the large, energy-expensive human brain. A reduction in human height and deterioration in our health followed the introduction of agriculture 2 000-12 000 years ago. In 1977, the United States Department of Agriculture (USDA) introduced novel dietary guidelines based on an untested hypothesis of Keys that dietary fat, especially of animal origin, increases the blood cholesterol concentration, “clogging” the coronary arteries and causing heart attacks, i.e. the diet-heart hypothesis.

Author Biography

Timothy David Noakes, University of Cape Town
MBChB, MD, DSc, PhD (hc), FACSM, (hon) FFSEM (UK) Emeritus Professor Department of Human Biology and Sports Science Institute of South Africa University of Cape Town Cape Town