Cholesterol is a type of lipid (fat) called a sterol, made by the liver and present in every cell in an animal’s body, including human animals. Cholesterol is only found in foods of animal origin – meat, dairy, eggs, fish, shrimps, prawns and shellfish. Plant foods contain none. As our liver makes all the cholesterol we need there is no dietary need for cholesterol at all (WHO) and vegetarians have much lower levels than meat eaters (17, 18, 19, 20).

Cholesterol is a well-known risk factor for heart disease and exists in two forms. So-called bad cholesterol (low-density lipoproteins or LDL) is dumped on the artery wall, reduces blood flow and causes heart attacks and strokes. Good cholesterol (high-density lipoproteins or HDL) is carried to the liver so the body can get rid of it. Around 70 per cent of the UK have been shown to have bad cholesterol levels above the recommended levels (21). Saturated fats, found mainly in animal fats and many processed foods, raise cholesterol levels in the body. This type of fat is found principally in the fatty portion of meat, eggs and milk products.

The process through which cholesterol damages arteries is thought to be caused by oxidation – the action of molecules called free radicals (see p15). They can only be destroyed by other molecules called antioxidants (also see p16), found largely in fruit and vegetables. Taking vitamin supplements and looking for magic cures to counter high cholesterol levels hasn’t worked. According to Dr Lori Mosca of Michigan University (and many other researchers): “The best scientific evidence we have is that eating a diet rich in fruits and vegetables is protective against heart disease” (24).

In rural China, cholesterol levels are between 2.5 and 4.0 (a measurement based on mmol per litre) and heart attacks are almost unknown. In England, it is recommended that people reduce their levels down to 5.0 even though the level to avoid heart attacks entirely is 3.9.

Despite this welter of evidence that a vegetarian diet is the best way to avoid high cholesterol levels and the diseases which go with them, amazingly the official advice is not to go vegetarian but to switch to a lower fat diet – avoiding fatty cuts of red meat, favouring white meat and fish and swapping butter for margarine. Research from the US shows this advice to be largely ineffective. Cholesterol levels of people on this ‘official’ diet tend to drop by only about five per cent while changing to a vegetarian diet reduces levels to a much greater degree (25, 26, 27, 28).