(Some think he had anorexia nervosa. If so, it would corroborate what I noticed here about anorexic girls eating almost exclusively carbs and no sort of animal products, other than the odd container of sugar-loaded yoghurt.)
Heart disease is caused by inflammation, and certain types of cholesterol transporters -- low-density lipoproteins -- are more easily damaged and can get lodged into the arterial walls more easily than other types. There are basically two shapes that an LDL particle comes in (there's a spectrum in between, but it's mostly one side or the other): a small, dense BB shape, and a large, fluffy cotton ball shape.
Having high total cholesterol, or even having high LDL cholesterol (so-called "bad" cholesterol), doesn't predict whether you'll get heart disease. It is the shape of these LDL particles -- the transporters that cholesterol rides on -- that matters. The BB-shaped ones are more likely to cause heart disease, probably because they're small and dense size allows them to get embedded in the arterial walls more easily, and because they are more easily oxidized (turning into the kind of thing that anti-oxidants go after) and cause an inflammatory response. This just sends more of these LDL particles to the site of inflammation, and they begin to get stuck and get oxidized, eventually forming a plaque. To reiterate, it's not cholesterol that is the culprit -- it's the shoddy construction of the its transporter that is to blame.
Well, what causes you to have the atherogenic BB-shaped LDL particles rather than the protective cotton ball-shaped ones? Carbs in the diet. I'll try to explain the mechanism later on, but for now I'll just quote one of the pioneering researchers in the study of HDL, LDL, heart disease, diet, etc., Ronald Krauss (from Gary Taubes' Good Calories, Bad Calories, p. 176):
"I am now convinced it is the carbohydrate inducing this atherogenic [profile] in a reasonable percentage of the population," says Krauss. "...we see a quite striking benefit of carbohydrate restriction."
Both Taubes and Krauss appeared on this Talk of the Nation show, which was very good, and they at some point discuss the relationship between how rich your diet is in carbs and how likely you are to have an atherogenic -- i.e., heart disease-causing -- LDL shape.
LDL particle size is not something that is routinely tested, by the way, so just because your LDL is low doesn't mean anything. You have to request the doctor to test your particle size. You could have low LDL but have most of it in the harmful BB shape. We can be pretty sure that Michael Jackson did after 25 years of a vegetarian diet. Switching to such a diet is unlikely to make you drop dead at age 50, but if you compound it with a high-endurance activity level, which puts more stress on the body than brief interval-burst activities, you're asking for trouble.
Just to emphasize how little the standard blood lipid tests tell you about your heart's health, ignoring as they always do the LDL particle size test, here's a brief news item on Jackson's health and performance from only 3 months ago:
Chief executive [of promoter AEG Live] Randy Phillips said he isn't worried.
"The insurance brokers sent doctors and they spend five hours with him, taking blood tests. He's a vegetarian, he's in great shape," he said.
"We would be prepared to self-insure to make up the dates. It's a risk we're willing to take to bring the King of Pop to his fans."
When a rock star dies of a drug overdose, everyone holds him at least partially responsible, as much as they may sympathize with his addiction. But when a pop star dies from heart disease after being anorexic and vegetarian -- knowing pretty well that human beings aren't designed to be that way -- everyone treats it like he was struck by lightning. Don't get me wrong, I love the Jackson Five and Michael Jackson's own work (at least up through the "Smooth Criminal" days), so I'm not going on about his diet to trash someone I don't like. I'm just pissed that the guy who sang "I Want You Back" and "Billie Jean" decided to destroy his health the way he did.
In the same way that kids should learn not to try drugs when their favorite rock star dies with a needle in his arm, everyone who ever got down to "Beat It" should take note and view vegetarianism as the cooky and harmful diet that it is.