Science, policy, and controversy in the cholesterol arena

This article investigates the relationships between scientific knowledge and dietary policy in the cholesterol arena, a site of controversy for over 40 years. It draws on the concepts and methods of Anselm Strauss, especially social worlds/arenas theory, to analyze the negotiations and conflicts through which both scientific knowledge and public health policy were created. Science/policy interactions were shaped by shifting distributions of power and legitimacy among many interested social worlds. These shifts reflected changing cultural, commercial, and political conditions which, over the decades, favored the entrenchment of initially provisional and tentative dietary recommendations. The cultural foundations of policy interventions can be as salient as scientific research. They can also contribute to ongoing instability in controversial arenas.