Cholesterol is a fat and an essential component of living matter, because it is an element present in the wall of all cells. Without cholesterol there is no life. For example, there is a large amount of cholesterol in the brain and in the spinal cord, where it is essential for the functions of the nervous system either for the transmission of the nerve impulse and, consequently, for sensory, motor and intellectual activity).
Cholesterol is also essential in the synthesis of sex hormones (testosterone, oestrogens, progesterone) and adrenal corticosteroids (cortisol, aldosterone), vitamin D and many other vital components. Considering cortisol the stress hormone, we can confirm cholesterol is necessary for survival.
Cholesterol is produced in all cells, and there is a homeostasis that adjusts production to intake. For instance if meals are taken with more cholesterol, less is synthesized in the cells, and vice versa. We call endogenous cholesterol the one produced in the cells, and exogenous the one incorporated with food.
Without cholesterol, we would die. Plain and simple. Thus, children have serious developmental problems if their blood cholesterol levels are low. In the elderly low cholesterol levels are associated to higher mortality, including suicides.
The first scientific study released worldwide proving the harmful effects of cholesterol was back 1948 in the American town of Framingham which demonstrated a statistical association between the levels of lipids (mainly cholesterol) in the blood and the incidence of cardiovascular disease. Therefore, there was an hypothesis that assumed the existence of a causal chain between the increase in lipid content in blood plasma and the appearance of clinical manifestations of cardiovascular disease. But such a hypothesis was just that, an hypothesis, since the association between high level of LDL cholesterol and myocardial infarction (aka heart attack) is only one risk factor.
It is important to define concepts too. A risk factor is a statistical association, a factors statistically associated with the disease under consideration. However it is neither necessary nor sufficient. Many people have high cholesterol and do not suffer from heart attack, and vice versa, as many of those suffering from a heart attack do not have high levels of cholesterol.
Therefore risk factors are not cause, but a statistical associations based on population statistics. Therefore, the factor figures of risk in patients say little about the problem of cardiovascular mortality in the population. That’s why it is worth seeing the figures in perspective (e.g not only about cholesterol but all kind of figures including the studies coming from herbal medicine, nutritional supplements or complementary medicines) and you would not use to justify the inappropriate use of statins and other therapeutics. Because risk factors can lead to confusion.
Since the beginning of the seventies of the last century, the lipid hypothesis has justified the use of lipid-lowering agents which are drugs to lower the level of cholesterol in the blood. They’re called statins with different commercial names; which inhibit endogenous cholesterol synthesis (inhibit its formation in cells), and for this reason they are used in the treatment of dyslipidaemia (basically against the “increase in cholesterol” due to polygenic essential hypercholesterolemia). Therefore they modify the way your body metabolize cholesterol instead of decreasing its absorption through diet. It is an invasive therapy with a huge impact on clinical practice as statins are the best-selling drugs in the world.
Therefore we can say we first go from statistical association to a cause, so that the level of cholesterol (LDL) becomes “the problem”, and then the use of dietary and pharmacological treatments is justified to decrease it.
Statins are used to reduce high levels of “bad cholesterol” in the blood in healthy people. Naturally, cardiologists and experts are the ones who define normal cholesterol figures, and often lower the levels considered normal as it’s been happening for the last 20-30 years.
Now the key question here is: Is it worthy measuring and treating cholesterol in healthy people?
Based on research done on my own plus considering that I’m not a doctor, the answer is no. At least based on the studies that I’ve found which are not conclusive. I mean, primary prevention of hypercholesterolemia in men and women seems to have almost zero efficacy. That is, it neither delays nor decreases deaths from myocardial infarction (nor mortality).
Regarding children and adolescents, it is absurd to measure cholesterol as it does not predict their adult levels or the incidence of cardiovascular disease. There are plenty of clinical trials comparing statins to placebo that repeatedly point to the lack of efficacy of statins, as mentioned by Dr. James M. Wright is a professor at the University of British Columbia.
In addition, we need to consider that the diagnosis falsely “labels” the healthy person with a constant worry, introducing fragility and vulnerability into his life, forcing him to an abnormal behaviour on its new life because it complies with appointments and diets, taking medications, analytical controls, performing electrocardiograms etc; and entails a significant waste of time and money.
Statins are not only sold as a remedy for cholesterol and to prevent myocardial infarctions, since its association with the decrease in the prevalence and incidence of various cancers, various mental disorders, sepsis, fractures and ictus.
Statins have very little impact and do not decrease or they delay myocardial strokes (neither they modify their severity), nor do they reduce deaths in total. Statins also do not decrease incidence of cancer, mental disorders, falls, infections, wounds, burns and so on.
Of course, statins achieve the intermediate result; that is, they lower cholesterol levels (LDL). But the goal is not to go down cholesterol itself, but reduce the number of deaths from diseases associated with high cholesterol and lower over all mortality. These ultimate goals are not achieved with primary prevention, lowering cholesterol in people without previous cardiovascular diseases. Primary prevention of hypercholesterolemia produces harm.
Feel free to verify these information on your own doing some basic Google search (as I did).
Photo by Michelle @New Layer