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5. The Myth of Cholesterol - Part II: Who can Benefit from Lowering Cholesterol

Updated: Jun 9, 2023

Continue from Part I to summarize Dr. David Diamond's talk at the 2019 CrossFit Health Conference titled "Deception of Cholesterol Research: Separating Truth from Profitable Fiction".

  • Since the 1950s, a lot of money and effort had been poured into finding solutions to lower cholesterol, especially LDL-C, to prevent coronary heart diseases (CHD). The first attempt was using corn oil to treat hypercholesterolemia. In the paper shown below, an oil supplement of 80g/day was prescribed. Indeed, it lowered the LDL-C of the test group comparing to the control group. However, there is a catch here. After three years, there were less number of people remaining in the study in the test group than in the control group. The people who remained in the study were the ones who did not die and did not have a heart attack. Although the test group had their cholesterol lowered, they had higher advense events happening. Ah ha! Is corn oil healthy for our heart after all? I guess not. John Abramson, M.D. of Harvard University made a very good comment: dying with "corrected" cholesterol is not a successful outcome.

  • Statins are the most commercially successful drugs for lowering serum cholesterol. Billions of dollars was made from statin sales. They were considered as "wonder drugs". Lipitor (atovastatin) claimed to reduce the risk of heart attack by 36%. Sounds so wonderful. Again, this is the relative risk. The absolute risk number, which was 1%, was hidden in the blue fine print. Although It did reduce the CHD risk, if the absolute number was presented, would it still be as commercially successful as it is now?

  • Of course, statins do decrease CHD risk by a small percentage. Who are these small group of people that can benefit from taking statins? There was a famous 4S study which showed a 4% reduction in total mortality of taking Simvastatin. People reanalyzed the raw data and re-plotted them into subgroups. It shows people who have high LDL, high TG and low HDL do benefit from taking statin. While people who have high LDL, low TG and high HDL do not see any positive effect. In order to raise HDL and lower TG, we need to change our lifestyles by eating less sugar and carbs. Stain is really just for people who do not want to bother to change their lifestyles, but simply to take pills.


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