By the late 19th century, pathologists knew that people who had died of heart attacks and strokes tended to have a lot of softy, fatty material stuck to the inner walls of their arteries. This material eventually hardens with the buildup of scar tissue and calcium deposits. The presence of this material is called atherosclerosis, which means hardening of the arteries. The material itself is called plaque.
In its early stages, atherosclerotic plaque looks and feels like cheesecake. In 1910, a German chemist named Adolf Windaus showed that like real cheesecake, atherosclerotic plaque is rich in cholesterol. Because of his work on the chemistry of sterols, Windaus won the Nobel Prize in chemistry in 1928.
As soon as Windaus published his findings about the cholesterol in plaque, Nikolai Anitschkow started an important series of experiments at the Military Medical Academy in St. Petersburg. Anitschkow dissolved some purified cholesterol in sunflower oil and fed it to some rabbits. Control rabbits got some sunflower oil without added cholesterol. The rabbits that got cholesterol in their sunflower oil got atherosclerotic plaque, but the control rabbits did not. To the naked eye and under a microscope, the plaque from rabbit arteries looked a lot like the plaque from human arteries.
Anitschkow and his coworkers discovered a lot of important things about atherosclerosis in those early experiments. As cholesterol researcher Jon Gofman argued,
Why were Anitschkow’s findings ignored? Because they couldn’t be repeated in dogs. As a result, many scientists assumed that the findings wouldn’t apply to human beings, either. That's an idiotic assumption, because atherosclerosis is rare in dogs, which are natural carnivores. Anitschkow guessed correctly that dogs and other carnivores are good at excreting excess cholesterol. Human beings and rabbits are not. Tragically, no one listened, probably because they'd rather eat meat than rabbit food.If the full significance of his findings had been appreciated at the time, we might have saved more than 30 years in the long struggle to settle the ‘cholesterol controversy’ and Anitschkow might have won a Nobel Prize. Instead, his findings were largely rejected or at least not followed up. Serious research on the role of cholesterol in human atherosclerosis did not really get underway until the 1940s.