Social Worlds, Actor-Networks and Controversy: The Case of Cholesterol, Dietary Fat and Heart Disease

Knowledge which links dietary fat and cholesterol to coronary heart disease (CHD) has been controversial for more than forty years. While policies advocating fat and cholesterol restriction are now deeply ingrained in affluent western societies, the scientific `facts' on which they are supposedly based are highly contested. Applying concepts from actor-network theory and the symbolic interactionist social worlds approach, I argue that knowledge and dietary recommendations relating to cholesterol, fat and CHD are the outcome of complex social negotiations which can only be understood in their cultural, commercial and political contexts. Policies were framed in the 1960s before `proof' of their efficacy was available. Since then, ambiguous experimental results have been shaped to support the policies. I argue that, despite its many attractive features, actor-network theory cannot adequately deal with protracted controversies. Social worlds theory provides a much more useful framework for investigating long debates in which the `facts' remain elusive.