alt Hacker NewsWhat is the current state of understanding on high cholesterol as a leading or trailing indicator of poor health? I vaguely remember reading one theory that cholesterol was used by the body to mitigate arterial damage from other causes?
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the literature is very clear about the relationship between high LDL and Atherosclerosis. Are you referring to poor health in general, separate from Cardiovascular Disease?
cholesterol is one of the most crucial molecules for survival. It's used to create and maintain cell membranes, and other critical functions. The vast majority is created by the liver, and there are a lot of regulating signals for how much, which is where usually things go off. Low cholesterol production is an extremely serious condition. The "only" problem with high cholesterol is that it builds up inside artery walls, which eventually may or may not dislodge and may or may not cause a heart attack or an embolic stroke. (I'm not a doctor. I just get medication for high cholesterol and have done some research)
It turns out LDL has different subfractions based on size. Normally, the liver produces large ones which shuttle fat around the bloodstream, lose their payload and shrink then the liver reabsorbs them and the cycle continues.
The problem appears to begin when these LDL molecules hang around for too long. They are damaged by external factors in the bloodstream (eg. glycation due to high blood glucose, oxidation due to fragile polyunsaturated fats) and not recognized anymore for recycling. That's when they can start forming macrophages.
tl;dr LDL by itself is an incorrect measure of cardiovascular risk. Big pharma still profits by selling everyone LDL reducing drugs.
one authentic source: https://www.youtube.com/watch?v=fVLZA0qp-wc
Peter Attia had a great series of blog posts on this before his fall from grace:
https://peterattiamd.com/the-straight-dope-on-cholesterol-pa...
He also had a series of podcast interviews about this with Tom Dayspring.
I believe his explanations are all mainstream, except he favors treating LDL and LP(a) more aggressively than normal doctors
You should check which part of your body has the most cholesterol.
All the answers are smart sounding and completely avoid to address your main point. Same with most doctors I asked it to.
It (Particularly ApoB/Combining LDL-C and Lp(a) is one of the single largest leading indicators of health risk we have.
If anything, the data we have is suggesting we've gotten wrong what the upper limits should be for what is considered OK.
https://www.lipidjournal.com/article/S1933-2874(25)00317-4/f...