Cholesterol: Misunderstood Villain or Lifesaving Ally?

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Issue #5: August 11, 2025

🔍 The Cholesterol Myth: What’s Actually Killing Us

We’ve been told for decades to fear cholesterol.

Like every egg yolk is a heart attack waiting to happen.

But here’s the thing: nearly half of all heart attacks occur in people with normal LDL levels.  And I’ve had enough casual conversations with friends and family to know that statins are being handed out way too often, sometimes based on a single number on a blood panel. It’s time to challenge the narrative.

💥 The Real Stats Behind Cholesterol

A 2009 study in the American Heart Journal analyzed over 136,000 heart attack patients:

• 75% had LDL below 130 mg/dL

• Nearly 50% were below 100mg/dL — what’s considered “optimal” by the American Heart Association

If LDL is the villain, why are so many heart attacks happening in people with “healthy” levels?

🛡️ Cholesterol Isn’t Just Safe, It’s Essential

Cholesterol builds every cell membrane in your body. It powers your brain, helps produce hormones, and is a key ingredient in vitamin D synthesis.

Your brain, just 2% of your body weight, holds 25% of your total cholesterol. That’s no accident.

Even LDL, the so called “bad” kind, plays a role in immune defense by neutralizing bacterial toxins (Nature Reviews Immunology, 2015). And longevity research keeps flipping the script:

• A 2023 GeroScience study found those with higher total cholesterol were more likely to reach 100

• In Sardina (2025), nonagenarians with LDL ≥130 mg/dL had better survival odds

🧬 Your Body Regulates Cholesterol, Not Just Your Diet

Here’s what most people (and many doctors) miss: Your liver makes the majority of your cholesterol. It also adjusts its production based on what you eat.

So if you eat more cholesterol (eggs, shrimp, etc.), your body makes less. If you eat less, your body makes more. This homeostatic loop is why dietary cholesterol usually impacts blood levels by just 10-15%.

The bigger drivers? Genetics, saturated fat, and fiber. Not that omelet you had this morning.

💊 Statins: Miracle Drug or Misused Crutch?

Statins are the most prescribed drugs in America.

Yes, they lower LDL by inhibiting its production in the liver. And yes, they reduce heart attack risks by ~22% per 1mmol/L drop (The Lancet, 2010).

But here’s the nuance:

• In people without heart disease, that reduction often translates to just a 1% absolute risk reduction

• Side effects include muscle pain, fatigue, and increased diabetes risk (The Lancet, 2011; Johns Hopkins, 2024)

The real issue? Too often, doctors prescribe statins based on one number, LDL, without looking at the full picture: inflammation, insulin resistance, metabolic health, lifestyle.

That’s not practicing medicine. That’s playing pharmacist.

🍭 Sugar: The Real Cardiovascular Wrecking Ball

A 2014 Jama Internal Medicine study found that people who got more than 25% of their calories from added sugar had 2.5x the risk of dying from heart disease.

Why? Because sugar:

• Raises triglycerides

• Lowers HDL

• Feeds chronic inflammation

All of which are stronger predicators of heart disease than LDL alone (JAHA, 2020).

🧪 The Tests That Actually Matter

If your doctor is quick to prescribe a statin, ask them if they’ve looked at:

• CRP (inflammation)

• HbA1c (blood sugar)

• Homocysteine (inflammation and vascular health)

• Triglycerides & HDL (actual risk indicators)

• LDL particle size (small, dense = worse)...Journal of Clinical Lipidology, 2014

Total LDL alone? That’s like judging a book by its cover.

✅ The Big Picture

• Cholesterol is not the enemy

• Sugar and inflammation are far more dangerous

• Satins help, but they’re overprescribed

• Ask better questions before you swallow the pill

Until next week. Stay vital.

-Jordan Slotopolsky

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🧠 References

• American Heart Journal, 2009: LDL levels in 136k heart attack patients

• GeroScience, 2023 & Sardinian Longevity Cohort, 2025: Higher LDL linked to longer life

• Nature Reviews Immunology, 2015: LDL’s immune function

• The Lancet, 2010 & 2011: Statins efficacy and side effects

• Johns Hopkins Medicine, 2024: Statins and diabetes risk

• Circulation, 2019: Dietary cholesterol’s modest impact

• Am J Clin Nutr, 1992: 100mg cholesterol → ~2.2 mg/dL serum rise

• Journal of Clinical Lipidology, 2015: Particle size matters

• JAMA Internal Medicine, 2014: Sugar & heart disease

• JAHA, 2020: Triglycerides & inflammation vs. LDL