July 17

The lipid hypothesis


The lipid hypothesis of heart disease is, as Dickens wrote of Scrooge’s partner, Jacob Marley, dead as a doornail, yet, like Marley’s ghost, it continues to haunt us. Why? Because the idea that cholesterol causes heart disease–the lipid hypothesis–has been so frequently repeated for so many years that doctors have forgotten that it is only a hypothesis, not a fact.
In simplistic terms the lipid hypothesis is as follows:
a) cholesterol and/or fat in the diet leads to cholesterol and/or fat in the blood;
b) cholesterol and/or fat in the blood causes plaque formation in the arteries and, consequently, heart disease; and, therefore
c) cholesterol and/or fat in the diet causes heart disease.
Sounds simple enough, but problem is there is no hard science behind it. There is a bit of weak, but not fully convincing science that purports to prove a. Less science yet that proves b. Yet we’re all to believe a leads to b and, therefore, causes c.
One scientifically verified fact disproves the whole lot: only about half the people who have heart attacks have elevated cholesterol levels.
Let’s look at the above statement, which is absolutely true, in view of how we determine the causes of other diseases. We know that the measles virus causes measles–there is no doubt about it. Doctors can find the evidence of measles virus infection in anyone who has measles; and there is no instance that I’m aware of in which an individual is teeming with the measles virus, yet doesn’t ultimately manifest the symptoms of measles.
If half the time that people were diagnosed with measles they were found to have no evidence of the measles virus, and half the time they were swarming with an infection of measles virus yet never developed measles, would we still say that the measles virus caused measles? I don’t think so. Infectious disease specialists starting with Dr. Koch, the German physician who derived the eponymous postulates that define an infective disease back in the nineteenth century, have specific criteria to determine whether a specific bacteria or virus causes a specific disease.
Not so with those wedded to the lipid hypothesis as is apparent from an article from the Science section of last Tuesday’s New York Times.
The gist of the article is thus: a 51 year old male has had cholesterol levels that have hovered at around 300 mg/dl for the past couple of decades. A physician had persuaded this man to take Lipitor (a “statin”? drug) in the past, but he had experienced side effects and stopped it. Since that time all his physicians had been after him to go on some kind of “statin”? drug to get his cholesterol down. In his latest blood test, his cholesterol levels zoomed up to 380 mg/dl, so he finally agreed to go on a “statin”? if his doctor could give him some kind of objective evidence that his “arteries were actually clogging.”? His physician sent him for an Ultrafast CT scan of the heart, an X-ray type of test that can actually see the coronary arteries and determine the degree of calcification in those arteries. The more calcification, the worse the disease. After the radiologist examined the scan he declared the guy free of coronary arteries disease with his arteries clean as a whistle. (You can see pictures of his scan in the article along with pictures of diseases arteries.)
You would think that his clean arteries would have his physicians saying something along the lines of, “Well, you’re one of the lucky ones, so we’ll just watch and maybe re-evaluate a little later on.”?
His doctor said:

“I still want you on a statin. And Burt [the radiologist] agrees. You got lucky. But you still shouldn’t walk around with those numbers.”

Remember, doctors are supposed to treat diseases not numbers. Pharmaceutical companies have succeeded in persuading most physicians that the lipid hypothesis is a fact, and that numbers should be treated. If Lipitor and other “statin”? drugs were innocuous, this zeal to treat numbers would just be an expensive chimera. But these drugs are far from innocuous. Take a look at the book Lipitor, Thief of Memory: Statin Drugs and the Misguided War on Cholesterol by Duane Graveline, M.D.
Not only can Lipitor steal your memory, it can do in your liver and cause a lot of other problems as well. Side effects of drugs are tolerable when the drug in question treats a disease, but elevated numbers are not a disease. Beware.

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  1. Just so you know, we cannot read the entire article from NY Times. It implies that you can read it with a “free” membership. I signed up for the free membership, it showed me the first paragraph and then wanted $3.95 for me to purchase the article. I wanted to see the picture, actually. =)
    Hi Teresa–
    Yeah, when the NY Times articles get more than a couple of weeks old they start charging for them. I went back and looked (I have a print subscription, so I get the online subscription free) and the picture was no longer there, so you didn’t miss anything.
    I rescued you from the ‘junk comments’ pile. I do go through the ‘junk comment’s file because it’s a lot easier for me to pick the one or two legitimate comments from the 20 or 30 that are junk than it is to weed out the 20 or 30 from the legitimate comment file.

  2. It seems to me that sometimes the anti-statin lobby makes a conflicting argument ie that a diet rich in saturated fat will bring down LDL levels, and that high LDL is good for you (I therefore draw the conclusion that animal fat is bad because it lowers LDL). Can you please clear up my confusion? Thanks Fred
    Hi Fred–
    Uh, I don’t know anyone who says that saturated fat brings down LDL levels.  It, in fact, does just the opposite: it raises LDL levels a little.  I also don’t know anyone who says that high LDL is good for you.  I, myself, don’t think it’s particularly harmful, but I wouldn’t go around telling people to make an effort to raise their LDL levels.

  3. >One scientifically verified fact disproves the whole lot: only about half the people who have heart attacks have elevated cholesterol levels.
    This is untrue. We need to know the proportion of low to high cholesterol in the general population (the population that this statement refers to). If high cholesterol is rare this would mean that high cholesterol is an important risk factor. If equally as common then you’re right – it undermines the lipid hypothesis. Also the statement does not distinguish between HDL and LDL or specify the reference population. It would be far better to quote the proportion of those with low cholesterol who “have” heart disease (does this mean dying of it? This is unspecified too) and the proportion of those with high cholesterol who do. Then we would want to know the sample size for each proportion, following it up with a logistic regression analysis.
    Your statement is a perfect example of the half truths that are floating about on this subject, and every other damned subject
    To cite measles is to mislead where the phenomenon is multifactorial. The CVD question is like smoking and lung cancer. There are plenty of non-smokers who die of lung cancer, but no-one seriously doubts that the risk is higher if you smoke.
    Hi Fred–
    Don’t confuse statistics with science.
    If more than 50 percent of the people who developed lung cancer had never smoked, I would be hard pressed to say that smoking causes lung cancer.  As it is, a small fraction of people who have never smoked develop lung cancer.
    BTW, I accidently ditched one of your other comments moments ago.  It somehow got caught in the spam filter, and when I went to rescue it, I hit the wrong button and deleted your comment along with all the spam.  Sorry.  Please repost.


  4. >only about half the people who have heart >attacks have elevated cholesterol levels.
    As I explained, this does not disprove the lipid hypothesis. On balance I don’t believe the lipid hypothesis either but we must be accurate in our statements.
    I’m a statistician and a scientist and find
    >Don’t confuse statistics with science.
    a quite incredible remark
    Hi Fred–
    Why don’t you enlighten me and show me how the fact that half the people who have heart attacks have low-cholesterol ‘proves’ the lipid hypothesis.

  5. I’ve since found that 2/3 of the people in the US “need” statin treatment according to current guidelines. So the fact that half the people who have heart disease do not have elevated cholesterol sure makes it look as if low cholesterol is a risk factor for heart disease. Except for one other fact that confuses the issue. Apparently a myocardial infarction (MI) causes a drop in cholesterol. So were the readings for cholesterol taken after the MI? In which case we still haven’t proved that there’s no link between high cholesterol and heart attack.
    As I see it there isn’t a correlation between cholesterol levels – high or low – and risk for developing heart disease.  The Framingham study data (among others) seems to bear this out.

  6. MRE
    Have you seen the mistake in the Scandinavian study? It looks like seven all-cause deaths in the statin treated group were swapped to the placebo group. The conclusions of this oft quoted study hangs on one graph and it’s wrong. Without the mistake the placebo and treated groups would be approximately equal. Whether this swapping was deliberate or an accident who knows?
    Re: item 4 I’ve done my best. The explanation is there
    Hi Fred–
    Are you talking about the 4S study?  I haven’t looked at it in a while but I will when I get back from Europe.

  7. If I can intrude upon your columns again; if 2/3 of Americans have high cholesterol (whatever “high” is as they keep lowering the bar) and for simplicity 1 person has a heart attack in the low cholesterol group and 1 in the low, that means the risk for a low cholesterol person is 1/33, but 1/66 for someone with high cholsterol. Which means that high cholesterol protects against heart attacks. But as I said, if the cholesterol is measured after an MI then you’ll get a low cholesterol reading as it’s said to drop after an MI
    Hi Fred–
    Feel free to intrude any time.  That’s what the comment section is for.
    According to Uffe Ravnskov, a high cholesterol might well be protective against heart disease, especially in older individuals.

  8. MRE I’m unable to take exercise apart from short walks because of myopathy (from simvastatin?) – or is it arthritis? Recently I went on a high fat low carb diet. In the first week I lost 1.8 Kg (probably water?) but then started putting it on again until I was 2 Kg over what I was at the start. Perhaps it would have oscillated back down, but what it tells me is, given the exercise I take, my body seems to know what weight it should be. This is not affected in any way by diet. Have I been a bit slow in reaching this epiphany?
    Hi Fred–
    I can’t give you an answer unless I have a few more details.  What was your carb intake when you lost the 1.8 kg (and if you lost 1.8 kg in the first week, a good portion of it was probably water), and did you change the diet or carb level when you gained the wt back?  Are you on any medications?

  9. MRE thanks for replying. Most importantly I take Nardil, which is famous for weight gain. I left out potatoes, bread, cereals and pasta all the time, but perhaps the few beers at weekends screwed it up. I also ate 3 pieces of fruit per day. A delicious breakfast I discovered is 3 hard-boiled eggs, with 2 great dollops of mayonnaise , laced with single cream. Yum
    Hi Fred–
    Nardil is absolutely famous for making people gain weight, and lots of it. Given your diet as you described it, I would tend to lay much of the blame at the doorstep of the medication. I have seen patients gain enormous amounts of weight while taking Nardil. You sound like you’ve kept yours in pretty good check – at least you’re not gaining.

  10. MRE thanks for your reply. Is there anyone else on this blog? I had a blood test when I was on the high fat diet and my Dr says it’s the highest total cholesterol he’s ever seen and mostly LDL. Perhaps I’d better leave high fat diets alone
    Hi Fred–
    I can assure you that your experience is atypical. Most people (virtually all, in my experience with many thousands of patients) have just the opposite effect: their cholesterol levels go down. At least their triglycerides do markedly and their HDL levels go up. If triglycerides are low and HDL high, then it indicates that LDL – even if present in amounts higher than normal – is composed of the non-harmful large particle variety.
    I would be curious to know how high your total cholesterol was. And your triglyceride and HDL numbers as well.

  11. MRE I don’t know what the units are but my total cholesterol was 8.2 with HDL as somewhat less than half of that. No mention of triglycerides. I drink kava in the evenings. I wonder if that is responsible. Anyway I’m now being pressurised to take a statin even though I still have sore muscles
    Hi Fred–
    An 8.2 total cholesterol calculates out to about 317 mg/dL, which would be regarded as high by most physicians. However, if your HDL is “somewhat less than half of that” it could mean that your HDL was around 100 or so mg/DL, which would be protective. If you’ve had muscle soreness from one round of statins, your likely to have them from another. You should consider taking some CoQ10 and maybe getting a second opinion.

    1. Dear Dr Eades as I still have generalised weakness long after stopping statins, my Dr sent me for a Doppler Ultra Sound scan. This showed “exemplary” arteries. My Dr seemed angry about this since I’m 63, diabetic with high cholesterol and won’t take my statins

      1. I might consider changing doctors. I would also seriously consider taking some CoQ10 to see if it helps with the post-statin muscle weakness. Good luck. I hope you get better.

        1. BTW I got no relief from fatigue, sore muscles and joints etc from taking ubiquinone. However after a few weeks on ubiquinol, I feel a new man

  12. Dr. Eades,
    First, I’d like to say how much I enjoyed reading your book Protein Power. I’ve been following the diet for a few months now, and as a type II diabetic I am pleased to report thay it is helping me to improve my blood glucose control.
    However, I am a little confused by some of your blog remarks regarding cholesterol control because on the surface they seem to contradict the advice given in your book.
    In your book you stated that under certain circumstances elevated cholesterol levels could lead to clogged arteries. You went on to describe that a number of metrics should be considered regarding cholesterol health issues. Total cholesterol levels ideally should be in the 180 to 200 mg/dl range. Total cholesterol divided by HDL should be below 4, and LDL divided by HDL should be below 3.
    Do you still adhere to these metrics, or has your understanding of the issue evolved from when you published the book?
    If you still recommend some sort of cholesterol metrics, either the above or a revised set, in the event that diet and exercise was unsuccessfull in reducing total cholesterol into your recommended ideal range, would there be circumstances where you would prescribe low dosages of statins?
    For diabetics would you recommend these same metrics as non-diabetics?
    Hi Lawrence–
    Protein Power was published over 10 years ago, and I’ve learned a little since then. I don’t get as wrapped up in lipid numbers now as I did then. Typically the ones I look at are triglycerides, HDL and LDL particle size. All of these move in the direction I like to see them move when patients go on low-carb diets. Even when these patients are type II diabetic. In fact, they usually move more in diabetics because they’re typically farther from ‘normal’ values to start.

  13. Dr. Eades,
    Thanks very much for your response.
    So from your response is it correct to infer that you would now never prescribe statins, regardless of how high the patient’s total cholesterol was, provided the triglycerides, HDL and LDL particle size were in what you consider healthy ranges or ratios?
    Would you mind telling us what those healthy
    ranges/ratios are?
    Thanks again.
    Hi Lawrence–
    I probably wouldn’t prescribe statins no matter what. If the triglycerides, HDL and LDL particle size were out of range I would correct them with diet. I have yet to find a patient who didn’t respond to dietary changes.
    I like to see triglycerides below 100, HDL of at least 50 (higher is better), and a preponderance of Type A (large) LDL particles (there is no specific number here).

  14. I’m type II diabetic (although my readings always seem to be normal) and after several weeks on a high fat/low carb diet my total cholesterol was the highest my Dr had ever seen (he’s never heard of ratios). I now eat more or less what I want and, perhaps thanks to CoQ10, my myopathy has improved and I’m exercising. I believe that was the missing ingredient.
    Hi Fred–
    I’m glad the CoQ10 is working. Myopathies are the most frequent side effect of statins, often lasting for long after statin use has been discontinued. I find that people with these statin-induced myopathies respond well to CoQ10.

  15. Dr Firstly thank you for your free expert advice. I’m still getting muscle weakness and pain after quitting simvastatin for about 4 months and supplementing with CoQ10. The pain seems strongly linked to extreme fatigue and sleepiness and even depression. Walking can be very difficult, although some days I temporally recover. At 95Kg am I taking enough Q10? I was taking 200mg in the evening. Perhaps 200 night and morning would be better. I’ve heard it could be 2 years before recovery. I’m 61 so don’t produce much Q10 of my own. Many thanks for your advice
    Hi Fred–
    I would certainly take at least 300 mg per day of CoQ10. And you’ve got to make sure that you’re taking it in the correct form. CoQ10 is lipid soluble so it must be taken with fat to be absorbed. If you take the kind that comes in a capsule filled with oil – the expensive kind – you’re okay taking it alone. If you take the less expensive kind, you’ve got to take it with a fatty meal or you won’t benefit from it much at all. There is another kind, which dissolves in your mouth, and which is also expensive. I don’t know if that is available where you live or not. At any rate, before you change the amount, make sure you’re actually absorbing the stuff. If you’re taking the inexpensive kind on an empty stomach, then you’re actually getting very little.

  16. Thanks MRE I take the oil capsules and I take them with my (fatty) evening meal. Do you know if it can take a long time before recovery? Is it possible I’ll never recover? I have slight arthritis in my hip and back and therefore some sciatica. But by leg pain is mostly in the buttocks, the front of the thighs and the calfs. Also deltoids and arms. Is extreme fatigue also a feature? I complained of it to my Dr about 3-4 years ago but she ignored my complaints. the kind of sudden fatigue where I wasn’t sure I’d reach the other side of the road. The next thing is, if I have to give up work, where do I start to look for compensation? I understand the UK are mounting some big petition. Meanwhile my Dr is strongly urging me to take up a statin again. I’m in New Zealand by the way
    All the best and thanks
    Hi Fred–
    It can sometimes take years for a complete recovery, assuming, of course, that your myalgias are caused by the statin drugs you took. If I were you I would crank up my CoQ10 to at least 300 mg per day. And, BTW, make sure yours doesn’t come from China.

  17. The articles & comments on the lipid hypothesis have been very interesting but I still find it hard to come to a conclusion about it. I had a MI in 2002 after about 6 weeks of angina symptoms. I had always been reasonably fit, a non smoker & exercised, my total cholesterol was ‘normal’ as was my weight for height. I had also for many years followed a low fat diet only eating saturated fat on rare occasions. No family history of heart trouble.
    I had however been taking a beta-blocker for about 5 years as a heart protector & to counter what was diagnosed as extra systoles (which I found uncomfortable but was assured were not a problem in themselves)
    After the MI I had triple CABG as my arteries were so blocked. Since the operation I have felt pretty good & keep fit & all my readings cholesterol etc are good though I take statins which I did not previously.
    So I have a few questions
    If the lipid hypothesis is not a valid one what caused the blockages?
    Does the emphasis on the lipid hypothesis mean that other causes of cardio vascular disease are not given due attention?
    Is it as has been suggested purely a matter of age – I was 65 when I had the MI?
    This is way too complex a question to be addressed in the comments section. Use the search function and go back and look at some of the old posts on the lipid hypothesis and heart disease and statins, and I think you’ll get a pretty good picture of my thoughts.
    If the lipid hypothesis were valid, then you shouldn’t have had an MI. You wrote that your cholesterol was normal, you followed a low-fat diet and you avoided saturated fat. You are the poster child for what to do to avoid a heart attack (assuming the lipid hypothesis is valid), yet you had one. My bet is that it is an inflammatory problem, and inflammation can be encouraged by a low-fat, high-carb diet.

  18. Am 83…male… after taking zocor for 8 years I suddenly have rather severe leg and thigh and buttock muscles.. also upper arms, both, near shoulders.. am quitting zocor cold..TODAY.. how long will it take to see if muscle problems due to zocor actually are fact… or is it something else?
    You need to talk to your doctor about this and at least get a lab test to see what’s going on to make sure the pain you’re describing is due to the Zocor.

  19. Dear MRE 7 months on and CoQ10 didn’t help my myopathy. I’m worse than ever. I know this because I had an MRI scan. The results were in fluent Martian, each phrase starting with the word “severe”. Stenosis for example. So I have allowed myself to be misled by the anti-statin lobby and the well-meaning “health professionals” in the health store
    Hi Fred–
    Who said your myopathy was from statin drugs? One of the most common side effects from statin drugs is myopathy, but it’s not the only cause of myopathy.
    I don’t know where you have stenosis, but I don’t know (and you don’t know) if it’s from your stopping a statin drug or not. The medical literature is pretty clear on the fact that the only group of people shown to receive any all-cause-mortality reduction from statin drugs is men under the age of 65 who have had a diagnosis of heart disease. That’s not high cholesterol – high cholesterol isn’t a disease; it’s a lab finding. Only those men who have had a heart attack or otherwise been diagnosed as suffering from heart disease were helped by statins. For the rest there was no benefit. I didn’t make this up – this is what the medical literature shows.

  20. Thanks so is it possible that those who have statin-induced myopathy, would, if they had an MRI scan, find they had stenosis? In my case lumbar spinal stenosis. I suffer loss of balance. My GP says it’s due to stenosis, but the specialist says it’s probably diabetes. I don’t agree with the specialist
    Hey Fred–
    I don’t think statin-induced myopathy has anything to do with lumbar spinal stenosis. Usually lumbar spinal stenosis, if not congenital, is secondary to arthritis or some other inflammatory process. Hope you get it all sorted out.

  21. I was taking Krill Oil for a week and had horrible nightmares every night. So I stopped it and they went away. So I thought because I took it at night that I would start taking it in the morning that that might work….well it didn’t. I still had bad nightmares. I have read that Krill Oil breaks through the brain barrier so now I am wondering what exactly does that mean? This is very disturbing and causes me sleepless nights. I only took one Swanson’s Krill Oil 500 mgs. I don’t want to stop it because I need it to bring my HD cholesterol levels up and this seems the most natural way. What would you suggest?
    Thank you so much,
    The blood-brain barrier is the means that the brain has to keep substances in the blood that might be toxic to the brain from making it into the brain. Medicines that are designed to treat the brain are formulated in such a way as to be able to cross this barrier. Fatty substances, of which krill oil is one, make it across the barrier as well. Krill oil is a more potent form of omega-3 fats than fish oil, but both cross the barrier. The krill oil is just more potent. I suspect that the nightmares will subside with time. If not, or if you want to avoid them now, try switching to fish oil. Or reducing your dosage of krill oil (find softgels with a lower dose).

  22. Anxious to hear your thoughts about JUPITER and the New Orleans PR offensive for statins.
    I’ll get my thoughts up just as soon as I have some.

  23. Dr. Mike,
    I am also anxious to hear your thoughts on JUPITER. I was reading an article on the AP about the study.
    I found it very interesting that the person who led the study is a co-inventor of the blood test that tests CRP levels…
    “One is high-sensitivity C-reactive protein, or CRP for short. It is a measure of inflammation, which can mean clogged arteries as well as less serious problems, such as an infection or injury. Doctors check CRP with a blood test that costs about $80 to have done.
    A co-inventor on a patent of the test, Dr. Paul Ridker of Harvard-affiliated Brigham and Women’s Hospital in Boston, led the new study. It involved 17,802 people with high CRP and low LDL cholesterol (below 130) in the U.S. and 25 other countries.”
    A little Conflict of interest?
    When I heard this study on the National news last night, I could only cringe. Especially when they were talking about how many “new” patients could now be prescribed Crestor and/or other statins. Especially women. They are saying that now this proves there is a reason for women to take statins. Like they were telling women to stay away before this study!!!
    I had to mute the volume when my husband came in the room because he still believes in the cholesterol hypothesis. His total chol is 156, with LDL at 71, at 50 y/0, without statins (too low for my liking). He is insisting that I get my numbers at my physical in Jan. (1st physical in 15 years, except for gyno, I only see Doctors when sick or emergency). I am going for the exam to keep him happy.
    I am 39 y/o, eat low-carb (10%) protein 35%, fat 55% on average. I am curious to see my numbers, but afraid we will get into quite an argument if my numbers are “high”, since I eat differently than him, (butter, steak, eggs, liver etc.), and I am overweight, but steadliy dropping since going low carb.
    Well, got a little off-subject here. Can’t wait to hear your take on the study.
    My thoughts are up!

  24. Dr, Mike-
    Sorry, one more point. Why do you suppose they stopped the study early? Could it be because they would have been dying from something else if continued? Cancer perhaps? That would be my guess.
    Or diabetes. The group taking Crestor developed diabetes at greater rates than did the group taking placebo.

  25. Hey Dr. Mike,
    Great article. I have been reading up on the lipid hypothesis ever since I was diagnosed with high cholesterol.
    You see, I am a healthy 31 yr old man who maintains a reasonable diet (5’10” 175lbs). I try to stay away from Trans and Sat Fats and I also try to stay active. However, my doctor wants to put me on statins because of my cholesterol. My HDL is 55, and my LDL was around 140 if I recall correctly. I can’t remember what my triglyceride levels were at.
    The trouble is, my parents both have high cholesterol and warn me about statins because of the muscle soreness they encountered. Now, however, I’m EXTREMELY paranoid about my arteries slowly being clogged. Is there any advice you could give me? Any encouraging words? I’m not on any medication, and like I said (other than the high cholesterol) I’m strong and healthy.
    Just do a search in the search function on ‘statins’ and you’ll find plenty to keep you reading. The short answer is that if you are male and under 65 (which you are) and have never had a heart attack, there is no evidence that taking a statin will increase your longevity. If you haven’t tried a low-carb diet to deal with your cholesterol, that would be the first step I would recommend.

  26. I will give the low-carb diet a shot. BTW, I found my Lab Results. Is there any area I should be more/less concerned about?
    Triglycerides – 60mg/dl
    Cholesterol, Total – 241 mg/dl
    HDL Cholesterol 48 mg/dl
    LDL Cholesterol 181 mg/dl
    Total Cholesterol/HDL Ratio – 5.0
    Thyroid Stimulating Hormone – 2.151 mU/L
    Thanks for the quick response!

  27. Viruses don’t cause disease, neither do germs, bacteria, parasites or fungus. They can only cause harm if the internal environment supports their existence and promulgation.
    Pasteur got it dead wrong, and admitted it on his deathbed. Antoine Bechamp was the real genius, but he was not lauded by European aristocracy like Louis was.
    So we live in the germ theory paradigm. Fiction.

  28. I realize I’m very late to the game here, but according to http://www.answers.com/topic/cholesterol-high, the FDA says half the adult population has “high cholesterol”. If, in accordance with Dr. Eades statistic, half of the people who have heart attack also have “high cholesterol”, this means that cholesterol is effectively irrelevant in predicting heart attacks.

  29. Sara at last someone who understands the point I was making. BTW it’s not much use saying statins treat a number not a disease; hypertension is a number as well (well 2 numbers). So is high blood sugar. Neither usually gives symptoms. Is it being suggested we ignore high blood pressure and high blood sugar?

  30. Fred, that’s not my point at all. What I was saying is that unless the 50% of the general population who has high cholesterol and the 50% of the general population who have heart attacks are the same 50% (which they are not, because only 50% of people who have heart attacks also have high cholesterol), the relationship between high cholesterol and heart attacks is likely spurious, not causal. It proves nothing about cholesterol causing heart attacks.

  31. Dear Dr. Mike, I’m a plastic and reconstructive surgeon practicing in Chicago, and I also write a blog on my website which discusses many different things most of which are not related to plastic surgery directly, but I’m trying to achieve a life well lived. I think in our current society, most of us don’t live by the philosophy, life will live but rather we rely on who has the most toys wins, and that translates into making money being skinny being popular and all the vacuous accoutrements of this lifestyle. I think all this numbers jockeying with the lipid hypothesis is simply an extension of that, in addition it makes an enormous amount of money on behalf of pharmaceutical companies or products that may ultimately be very harmful. After all we always have to remember as doctors that we as humans have been around with our doctors and pharmaceutical companies and hospitals for at least 99% of our existence on earth. Mother nature in short doesn’t make that many mistakes if any at all. That’s why I look to nature to find answers, and I think science but is well done can help us unlock some of those mysteries. I appreciate your blog very much because I myself, am very concerned that we are missing the point in Western medicine about what health and beauty and fitness are all about, they’re about feeling good at living well. I ran across the movie by Fat-Head by Tom Naughton, and I wrote a review on it on my blog. I have subsequently looked for resources to discuss the lipid hypothesis, and also really try to expose the hidden incentives and what I feel is the politicized approach to health that is all too common in Western medicine. You have an excellent blog, and intend to link to your blog from my blog, and if you would like to write a short blurb about the lipid hypothesis as a guest blogger that would be fabulous and I would appreciate that very much.

    1. Hi Dr. Ostric–
      I’m flattered to be asked, but as you can see from the limited posting I’m doing on my own blog, time is at a premium for me right now. I can’t find the time to write the many posts I’ve got planned for this site, so I can hardly commit to writing for others. Thanks much, though, for the request. If things ever settle down for me in my new day job as an appliance salesman, I’ll maybe have time to write for others. But until then, I can’t do it. Feel free to excerpt any of my posts whenever you want, just be sure to link back to this site and give me credit.

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