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If you read articles on natural health, you have heard of the "cholesterol myth." The truth is, cholesterol really does have a lot to do with heart disease, but the kind of cholesterol that clogs your arteries isn't the kind of cholesterol tested.

By now, just about everyone has heard of the "cholesterol myth." Dozens of natural health commentators, research scientists, and a few doctors have published articles and books on the simple fact that cholesterol doesn't, all by itself, cause heart disease. And there is a lot of room to believe that the common understanding of cholesterol is just plain wrong.

A Fallacious Understanding of Cholesterol Originating in the 1950's

The common misconception of the role of cholesterol in heart disease originated in autopsies of American soldiers who died in the Korean War. Many of the young men killed in battle were found to have advanced coronary artery disease. They had cholesterol-laden plaques that would have soon killed them had they not died on the front.

To the minds of cholesterol researchers of the time, such as the increasingly infamous Ancel Keys, this could only mean one thing. Even "healthy" youth had arteries clogged with cholesterol. The damage caused by cholesterol could start as early as age 18, and the only thing to do was to eat less meat.

The 1950's-era cholesterol researchers, however, overlooked a very important explanation of the American troops' deaths. The soldiers were killed by bullets and grenades and rockets, not by heart disease. They simply could not run as fast as their comrades and they were more likely to fall on the battlefield. Whether the surviving troops had severe atherosclerosis, mild atherosclerosis, or no atherosclerosis, or whether they had high cholesterol, low cholesterol, or "healthy" cholesterol was not known. Nor did researchers know the relationship between the amount of cholesterol in food and the amount of cholesterol in the bloodstream, or how it was deposited into plaques.

A Fallacious Understanding of Cholesterol Originating in the 1990's

If you fast-forward cholesterol research to the 1990's, you begin to see numerous examples of how the accepted theory of cholesterol and heart disease just couldn't be right. Most studies found that the "average" cholesterol level of people who had heart attacks was just 150-160 mg/dl, meaning that most people who had severe heart disease not only didn't have high cholesterol, they likely had low cholesterol. 

Studies of cholesterol-lowering drugs showed that getting total cholesterol levels down did not reduce the risk of dying from heart disease, or reduced the risk of dying from heart disease by increased the risk of dying from other causes. The largest study that found a benefit from cholesterol-lowing statin drugs, the Air Force/Texas Coronary Atherosclerosis Prevention Study, conducted in San Antonio, Texas, found that taking a statin drug for five years really did lower the risk of a "coronary event," from about 3% to about 2% in the healthy people in the study.

From this and mountains of other evidence, some critics came to believe that cholesterol doesn't really matter, but that is wrong, too. Cholesterol does matter to cardiovascular health, but it is a very specific kind of cholesterol called lipoprotein A, or Lp(a).

Continue reading after recommendations

  • Downs JR, Clearfield M, Weis S, Whitney E, Shapiro DR, Beere PA, Langendorfer A, Stein EA, Kruyer W, Gotto AM Jr. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS/TexCAPS. Air Force/Texas Coronary Atherosclerosis Prevention Study. JAMA. 1998 May 27. 279(20):1615-22.
  • Riches K, Porter KE. LIpoprotein (a): Cellular Effects and Molecular Mechanisms. Cholesterol. 2012
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  • von Dryander M, Fischer S, Passauer J, Müller G, Bornstein SR, Julius U. Differences in the atherogenic risk of patients treated by lipoprotein apheresis according to their lipid pattern. Atheroscler Suppl. 2013 Jan.14(1):39-44. doi: 10.1016/j.atherosclerosissup.2012.10.005.
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