Cholesterol - fact or fiction

Rather let us suffer for speaking the truth, than that truth should suffer for want of speaking.

Eliza Cook, Diamond Dust



Conventional wisdom has it that cholesterol is an enemy to our health and we should take every means

to lower it.


But, says Dr Aseem Malhotra, Honorary Consultant Cardiologist, author of The Pioppi Diet, ‘That is plain

wrong, cholesterol is our friend.’


You DO need cholesterol.


Cholesterol, a fatty, wax-like substance, is found not only in your bloodstream, but also in every cell in your body,

where it helps to produce cell membranes, hormones, vitamin D and bile acids that help you to digest fat.


Cholesterol also helps in the formation of your memories and is vital for neurological function. In particular, it has many vital functions:


● Aiding the immune system to fight infections.

● Connecting brain cells; the links between the nerve cells in our brains are made almost entirely of cholesterol.

● Helping to produce bile acids, which enable the absorption of fat-soluble vitamins.

● Maintaining cell membranes, the coating that keeps our cells intact.

● Producing the sex hormones oestrogen, testosterone and progesterone.

● Producing vitamin D, needed for strong bones.


So why should the nation be mass “statinised” to lower our cholesterol, with evidence that is weak, and the need to treat level for a statin drug shows little evidence of gain.  See Statins – Why not! page.


The Number Needed to Treat (NNT) is the number of patients you need to treat to prevent one additional bad outcome (death, stroke, etc.). For example, if a drug has an NNT of 5, it means you have to treat 5 people with the drug to prevent one additional bad outcome.

If you are interested in the Number Needed to Treat for statins, here is the website

Here are the results for primary prophylaxis. 

“In Summary, for those who took the statin for 5 years:

·        98% saw no benefit

·        0% were helped by being saved from death

·        1.6% were helped by preventing a heart attack

·        0.4% were helped by preventing a stroke

·        1.5% were harmed by developing diabetes*

·        10% were harmed by muscle damage


In Other Words:

·        None were helped (life saved)

·        1 in 60 were helped (preventing heart attack)

·        1 in 268 were helped (preventing stroke)

·        1 in 67 were harmed (develop diabetes*)

·        1 in 10 were harmed (muscle damage)”


Here are the results for secondary prophylaxis. 

“In Summary, for those who took the statin for 5 years:

·        96% saw no benefit

·        1.2% were helped by being saved from death

·        2.6% were helped by preventing a repeat heart attack

·        0.8% were helped by preventing a stroke

·        0.6% were harmed by developing diabetes*

In Other Words:

·        1 in 83 were helped (life saved)

·        1 in 39 were helped (preventing non-fatal heart attack)

·        1 in 125 were helped (preventing stroke)

·        1 in 167 were harmed (develop diabetes*)”


If anything, the side effects (harm) are understated and the authors acknowledge this because many of the studies do not adequately report side effects and complications. (The studies were funded in part or in totality by the pharmaceutical company that makes the drug and given that vested interest, that is problematic but nonetheless, the results are cause sufficient to question your need to take a statin and to first do your research.)


The association between low-density lipoprotein (LDL), the so-called ‘bad’ cholesterol, and heart disease is weak. For those older than 60 (when people are more likely to suffer a heart attack), there is no link. In fact, the higher your LDL, the less likely you are to die from any cause. This does not apply with familial hypercholesterolaemia, a genetic condition that causes high cholesterol.


The large-scale US Framingham study, which monitored three generations, revealed little difference in cholesterol levels between the majority of those who did and did not develop heart disease. Further research found that of more than 130,000 patients hospitalised with a heart attack, 75 per cent had normal total cholesterol and LDL levels


You can reduce your risk of coronary artery disease most effectively by stopping smoking, following a Mediterranean diet, reducing stress and taking moderate exercise


For a more detailed analysis, read here.   



The Great Cholesterol Con

Cholesterol myths to stop believing