Lowering of Cholesterol Absorption and Blood Levels by Ileal Exclusion

THE general association of high blood cho-lesterol levels with atherosclerosis has been almost universally accepted. Because of this association, doctors attempting to treat the disease have sought means to lower circulating cholesterol and thereby, possibly, to arrest or perhaps even to reverse the process of vascular deposition and narrowing. Numerous drugs employed to the present have achieved limited success at best, and have, at times, caused serious side effects. Dietary programs of low cholesterol and low saturated fat intake, with a relative increase in polyunsaturated fats, are harmless, but are not too successful. Cholesterol enters the intestinal tract by in-gestion and by endogenous secretion via the bile and the intestinal mucosa.1 It is absorbed exclusively in the small intestine, and preferen-tially in the distal half.2 With the use of radio-actively labeled cholesterol, it has been deter-mined that there is a delay of 24 to 72 hours before the appearance of peak blood levels.- Three independent experiments have been carried out in the research laboratories of Dr. Ivan D. Frantz, Jr., to study the role of ileal bypass in cholesterol absorption and to de-termine the accompanying effect on blood cholesterol levels. The first experiment was carried out with matched groups of rabbits. The second was performed with eight pigs, used as their own controls; the omnivorous pig was chosen because his dietary habits resemble those of human subjects better than do those of the herbivorous rabbit or of the primarily carnivorous canine. The third experi-