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What You Might Not Know About Cholesterol


50 years ago most people wouldn't think twice about having a big portion of bacon and eggs for breakfast, but then in the 60s doctors started telling us that we need to watch our cholesterol, that we need to keep it as low as possible. "The lower the better" has been the standard ever since and cholesterol has been named as the main cause of atherosclerosis, which is when fatty deposits, including cholesterol, build up in your arteries, causing them to harden and narrow and blocking the flow of blood to the heart. This made sense to most people; eat less cholesterol and less cholesterol is able to clog your arteries.

However, since the 1960s we have learned a lot about cardiovascular diseases and we know that cholesterol is only one small part of the equation and that there are other more important risk factors. Nevertheless, the battle against cholesterol has become more intense than ever. In fact, some of the most commonly sold drugs in North America are statins, which are prescribed to lower cholesterol levels in sometimes otherwise healthy individuals.

Despite popular medical opinions about cholesterol there is a growing number of doctors and scientists who are speaking out and saying that we need to bring focus away from cholesterol because it is distracting us from making new advances in other, possibly more productive, areas of cardiovascular health and medicine. It is important to remember that cholesterol is not some foreign poison but a nutrient needed by your body for both important cellular functions and hormone balance. Many doctors even believe that our efforts to lower cholesterol levels have the potential to do more harm than good, and there have been a growing number of cases where reducing cholesterol has had unintended negative consequences.

Cholesterol is found in the highest concentrations in the brain where it is needed by nerve cells to form connections between synapses, and insufficient cholesterol in the brain as a result of statin use may cause thinking and memory problems. Cholesterol also forms the basis for many important hormones such as estrogen, testosterone, progesterone, and cortisol, and as if that wasn't enough, cholesterol is also needed for the production of bile acids used to digest food and make vitamin D.

So if cholesterol is needed for so many important processes in the body, then how did it get such a bad reputation?

In the 1950s, one third of all men in the united states would develop some sort of cardiovascular disease by the age of 60. This left researchers scrambling to find a cause. They discovered that blood vessels of heart disease victims were often clogged with fatty deposits and debris, and at the centre of it all was cholesterol. This led to the hypothesis that cholesterol must be the cause of the arterial build-up, and so cholesterol's bad reputation was born.

The hypothesis that cholesterol caused cardiovascular diseases gained popular support after Ancel Keys published papers interpreting population studies. Keys focused on studies that showed heart disease was more prevalent in some, but not all, countries where cholesterol levels were high. His first paper compared heart disease and nutritional data from six countries and clearly showed that higher levels of cholesterol corresponded to more cases of heart disease. There was just one problem. Keys only used data from six countries even though data was available for 22 countries, and he did this because the data from those six countries matched his hypothesis. However, if you look at the data from all 22 countries, there is no consistent link between cholesterol levels and incidences of cardiovascular diseases.

Despite his critics, Keys' papers were widely read and accepted, and his recommendations for a low-fat diet were even incorporated into the American Heart Association's 1961 dietary guidelines.

Another highly influential study was the Framingham Heart Study. Their 1977 report showed a correlation between high cholesterol levels and death from heart disease, and these results were widely cited as further proof of the link between cholesterol and heart disease. But this was a very general interpretation of the results. The report did show an increased risk of death from heart disease in people with high cholesterol, but it was only for people under age 50. The under 50 age group accounts for only 5 percent of all deaths from heart disease, and the second Framingham report in 1987 showed that people over age 50 who had reduced their cholesterol levels over ten years had higher rates of death from heart disease as well as higher rates of death from other causes.

The Framingham Heart Study also popularized the differentiation of cholesterol into HDL and LDL. Cholesterol is categorized based on what it is being carried through the body in. Cholesterol is found in the body within either high-density lipoproteins(HDL) or low-density lipoproteins(LDL). Because the study showed more cases of heart disease in people with high levels of LDL, it has become commonly known as "Bad Cholesterol", whereas HDL is known as "Good Cholesterol". This in turn led to doctors recommending that you lower your LDL and raise your HDL, and many doctors encourage their patients to lower their LDL levels even if they have no other risk factors for heart disease.

It is odd for 30 and 40 year old men to be using medications to lower their cholesterol when the single most important risk factor for heart disease is age: 82 percent of all heart disease related deaths occur in people over the age of 65. There are other significant risk factors to consider too. Smoking, family history, gender, obesity, hypertension, a sedentary lifestyle, and diabetes are noteworthy.

There have been more recent studies into risk factors that put cholesterol low if not last on the list for good predictors of cardiovascular diseases. A 2003 study in the Journal of the American Medical Association performed an analysis on three large studies that had followed participants for more than 20 years and concluded that the best predictors for heart attack were smoking and hypertension while cholesterol was named one of the least predictive.

Cholesterol and Statins: is it worth it?

Statin usage is typically a life-long prescription, considering that around 76 percent of patients who begin taking statins end up taking them indefinitely. As of 2006, nearly 8 percent of Canadians (2.5 million people) were taking statins to lower cholesterol and since most of them will never stop taking the drugs, you can see how profitable statins are. The question still remains though: do the benefits of statins outweigh the cost and the risk?

We have established that statin use often comes with a lifelong financial burden, but what about the burden of side effects which can reduce quality of life or lead to other diseases? The most common and immediate side effects of statins are muscle pains and weakness, headaches, and nausea. Muscle pains are sometimes just symptomatic of a more serious disease called rhabdomyolysis, which is an actual breakdown or degeneration of muscle tissue. Other reported side effects are memory loss and cognitive decline resulting from insufficient cholesterol in the brain, and sexual dysfunction resulting from insufficient cholesterol to produce hormones like testosterone. Statins are also known to cause liver and kidney damage.

The adverse effects of statins are a direct result of how they lower cholesterol. Statins inhibit the production of enzymes in the liver that are required to make cholesterol, but statins also stop or inhibit the production of other important substances like steroid hormones and co-enzyme Q10, which is ironically needed to maintain healthy heart muscles. Although statins are proven to lower cholesterol, it seems ridiculous to use them for the long-term regulation of a relatively unimportant risk factor when their usage also interferes with the body's ability to manufacture critical substances. Over time, a lack of cholesterol in the brain, a lack of co-enzyme Q10, and a lack of important steroid hormones can cause serious health problems and issues with quality of life, and why would anyone want to go through such an ordeal when there are much safer and effective ways to lower your risk of cardiovascular disease.

Leading alternative health expert Dr. Brownstein recommends weight loss, smoking cessation, vitamin C therapy, and fish oil supplementation as several effective therapies for lowering your risk of heart disease without side effects. This list should also include regular exercise and eating a balanced whole foods diet.

Basically, we should not focus overmuch on cholesterol levels, especially in otherwise healthy people, and spend more time trying to reduce heart disease risk through lifestyle changes and a whole body approach.

Recommended Further Reading:

The Great Cholesterol Con

Healthy Fats for Life: Preventing and Treating Common Health Problems with Essential Fatty Acids

Is Your Cardiologist Killing You?

Reversing Heart Disease: A Vital New Program to Help, Treat, and Eliminate Cardiac Problems Without Surgery

The Inflammation Syndrome: The Complete Nutritional Program to Prevent and Reverse Heart Disease, Arthritis, Diabetes, Allergies, and Asthma


Brownstein D. Drugs That Don't Work and Natural Therapies That Do!. Medical Alternatives Press, West Bloomfield. 2007.

Dugliss P, Fernandez S. The Myth of Cholesterol. Century Publications, Ann Arbor. 2005.

Ellis M. Statins May Play Dual Role in Preventing Heart Attack and Stroke. Health News. November 10, 2008.

Golomb BA, Evans MA. Statin adverse effects : a review of the literature and evidence for a mitochondrial mechanism. American Journal of Cardiovascular Drugs. 8(6):373-418, 2008.

Jackevicius CA, Tu JV, Ross JS, et al. Use of Ezetimibe in the United States and Canada. New England Journal of Medicine. 358:1819-1828, 2008.

Kauffman JM. Malignant Medical Myths. Self-published. 2006.

Moller J. Cholesterol: Interactions with Testosterone and Cortisol in Cardiovascular Diseases. Springer-Verlag, Berlin. 1987.

Neutel CI, Morrison H, Campbell NR, de Groh M. Statin use in Canadians: trends, determinants and persistence. Canadian Journal of Public Health. 98(5):412-6, 2007.

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