A comprehensive new study on cholesterol, based on results from more than a million patients, could help upend decades of government advice about diet, nutrition, health, prevention, and medication. Just don't hold your breath.
The study, published in the Expert Review of Clinical Pharmacology, centers on statins, a class of drugs used to lower levels of LDL-C, the so-called "bad" cholesterol, in the human body. According to the study, statins are pointless for most people.
"No evidence exists to prove that having high levels of bad cholesterol causes heart disease, leading physicians have claimed" in the study, reports the Daily Mail. The Express likewise says the new study finds "no evidence that high levels of 'bad' cholesterol cause heart disease."
The study also reports that "heart attack patients were shown to have lower than normal cholesterol levels of LDL-C" and that older people with higher levels of bad cholesterol tend to live longer than those with lower levels.
This is probably news to many in government. But it's not news to everyone.
"In fact researchers have known for decades from nutrition studies that LDL-C is not strongly correlated with cardiac risk," says Nina Teicholz, an investigative journalist and author of The New York Times bestseller The Big Fat Surprise (along with a great recent Wall St. Journal op-ed highlighting ongoing flaws in federal dietary advice). In an email to me this week, she pointed out that "physicians continue focusing on LDL-C in part because they have drugs to lower it. Doctors are driven by incentives to prescribe pills for nutrition-related diseases rather than better nutrition—a far healthier and more natural approach."
Cholesterol in our diets comes from animals and animal products—including eggs, meat, fish, and dairy. The government told us for decades that these foods were, to varying degrees, dangerous.
Federal dietary policy is shaped by the Dietary Guidelines Advisory Committee (DGAC), which meets every five years to update its findings. The government touts the DGAC and the dietary guidelines it develops as "an important resource to help our Nation reach its highest standard of health."
The federal government's war on cholesterol, as early DGAC recommendations suggest, dates back decades. For example, the 1995 DGAC report stressed the dangers of dietary cholesterol.
"Most people are aware that high levels of saturated fat and cholesterol in the diet are linked to increased blood cholesterol levels and a greater risk for heart disease," it declares. "Choosing foods with less cholesterol and saturated fat will help lower your blood cholesterol levels."
"There's a growing consensus among nutrition scientists that cholesterol in food has little effect on the amount of cholesterol in the bloodstream," a Harvard Medical School blog post noted that same year. "And that's the cholesterol that matters."
"The government's new stance on dietary cholesterol is in line with that of other nations, which do not single out cholesterol as an issue," the Washington Post reported following the release of the most recent dietary guidelines in 2016. "Yet it should not be confused with officials' continued warning about high levels of 'bad' cholesterol in the blood—something that has been clearly linked to heart disease."
But this most recent study is throwing cold water on many of those continued government warnings about blood cholesterol.
What's more, if bad cholesterol isn't so bad, then the benefits of so-called good cholesterol are also under assault. Recently, *HDL, the so-called "good" cholesterol, was itself deemed suspect in some cases.
Dietary fat also appears not to be the danger the government says it is. Another new study, reported on by Ron Bailey this week, suggests, as he writes, that the federal government's warnings to avoid dairy products that are high in fat "is bunk."
I'm not a nutritionist. I don't know if the science on cholesterol is settled. But the federal government has warned us for decades about cholesterol in our bodies and in our food. The fact those warnings are now changing means the government has, despite what I'm sure are the good intentions of everyone involved, been handing out poor dietary advice and developing regulations that reflect that poor advice.
I'm one of many who has called out the DGAC and the federal government for foisting "decades of confusing and often-contradictory dietary advice" upon the American public. I also suggested, in a column last year, that one way the government might back up its claims to possess invaluable and unparalleled expertise in the areas of food policy and nutrition would be stop regularly reversing or altering its recommendations.
"The reason that we don't know about these huge reversals in dietary advice is that the nutrition establishment is apparently loathe to make public their major reversals in policy," Teicholz says. "The low-fat diet is another example: neither the AHA or the dietary guidelines recommend a low-fat diet anymore. But they have yet to announce this to the American public. And some in the establishment are still fighting to retain the low-fat status quo."
I am not your doctor, nor your nutritionist. I have no idea what you should eat. Maybe the government should adopt that mantra, too.
*Correction: This sentence initially referred to LDL as the "good" cholesterol. LDL is widely considered to be an unhealthy cholesterol, while HDL is conventionally considered good.
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