Starting in the 1950s, physicians and researchers began to debate the exact nature of the relationship among blood cholesterol, diet, and cardiovascular risk. Using professional medical, public health, and scientific journals, this article examines the history of a series of intense and sustained debates regarding the credibility of the diet-heart hypothesis, which proposed that diet was causally linked to coronary artery disease. Brought about by intellectual disagreements and illuminated by personal quarrels, these debates created a profound professional rift among researchers who debated whether observational data could be used to prove that dietary intake caused heart disease and who sought to differentiate between "good" and "bad" science. But while the debate persisted into the early 1980s, Americans had begun to adopt the diet-heart hypothesis as public health truth as early as the 1960s, embracing cookbooks promoting "heart healthy" diets that promised to prevent coronary artery disease. Although critics and advocates of diet-heart continued to debate the theory's finer points, the widespread adoption of diet-heart in American homes meant that the debate had become almost moot by the time the National Heart, Lung, and Blood Institute officially endorsed the hypothesis in the 1980s.

After World War II, the National Institutes of Health (NIH) emerged as a major patron of biomedical research. In the succeeding decades, NIH administrators sought to determine how best to disseminate the findings of the research it supported and manage their relationship with clinicians in the national community. This task of bridging research and practice fell to the Office of Medical Applications of Research (OMAR), which administered the NIH Consensus Development Program (CDP) between 1978 and 2012. This article argues that the CDP represented an unusual attempt to depoliticize biomedical research and medical practice at a particularly controversial time in American medicine. Throughout the program's existence, administrators sought ways to bring new knowledge to the medical community without creating the appearance of regulating clinical practice. For an agency with a mandate to promote the production of new biomedical knowledge, the question remained open as to how far this responsibility extended from the bench to the bedside. In striking this balance, the leadership sought to refine their understanding of the role and mission of the NIH. The history of the CDP has much to tell us about postwar biomedical research, health politics, and the institutional development of the NIH.

In 1910, James Bryan Herrick published the first clinical and laboratory description of sickle cell anemia. Two years later, he published a case report on coronary thrombosis. Together, these case reports solidified his reputation as one of the premier diagnosticians of his generation. Now regarded as a central figure in the history of American medicine, Herrick played an integral role in the clinical adoption of the electrocardiograph and the professionalization of cardiology in the United States. Although a full decade passed before the medical profession recognized his clinical description of coronary thrombosis and myocardial infarction, it has had profound implications for cardiovascular medicine and prevention over the past hundred years. As a consultant physician, Herrick advocated in favor of incorporating chemistry and laboratory evaluation into clinical practice.

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