Form and Function

I just cannot get on the bandwagon that says that we know what's going on with the relationship between diet, cholesterol, and heart disease to a level that allows us to dramatically reduce the rate of cardiac disease and resulting death in our population as a whole. The "Homeostatic Imbalance" entry on cholesterol levels on page 981 of the text seems like a good representation of how little we know. To rephrase its content:

1. We used the think that high total cholesterol levels and LDL to HDL ratios were the predictors of heart disease but now we think only LDL levels and other risk factors are better predictors.

2. Half of people with heart disease have "normal" (as defined by the AHA or whoever) cholesterol levels.

3. Many people with "bad" cholesterol levels do not have heart disease.

4. Still, statins are prescribed (supposedly only) to those people who a) are cardiac patients and b) have LDL levels over 130.

5. The number of people who meet those 2 criteria apparently number 10 million, because that's the number of people taking statins.

6. Everyone should change their diet, regardless of total cholesterol or HDL levels, despite the fact that only 15% of cholesterol in the body comes from diet, and that dietary restriction of cholesterol may result in deficiencies of other essential nutrients found in cholesterol-containing foods.

Good grief.