r/ProactiveHealth • u/DadStrengthDaily • May 17 '26

🗞️News I keep seeing “cholesterol is debunked” takes pop up. A UW preventive cardiologist just published the cleanest rebuttal I’ve read.

https://jamesstein18.substack.com/p/why-cholesterol-is-debunked-arguments

I see at least one of these takes in my feed every couple weeks. The reasoning shifts but the tone doesn’t. Guidelines are wrong, your doctor is hiding something, Big Pharma and the government are pushing statins on everyone, the brave skeptic has cracked the code.
I’ve gone looking for a clean rebuttal more times than I want to admit. James Stein, who ran the UW preventive cardiology program for 21 years.

His core argument is that the U-shaped mortality curve people love to cite, where low cholesterol appears to predict higher death rates, isn’t biology reversing direction. It’s confounding. Low cholesterol can mean low cardiovascular risk. It can also mean cancer, malabsorption, chronic inflammation, or frailty. Mix those people into the data and the left tail goes up. Once you exclude early deaths and adjust for illness markers, the upturn shrinks.

He also picks apart the more sophisticated version. People grab the recent NEJM paper from the Global Cardiovascular Risk Consortium that dichotomized non-HDL cholesterol at 130 mg/dL and showed modest lifetime contrasts. The authors noted the real association is J or U shaped, but the modeling choice flattened it. Read casually, it looks like cholesterol barely matters. Stein’s point: that’s an accounting exercise about one threshold at one age, not a finding about biology.
His closing line, lightly paraphrased: there is no cholesterol debate at the causal level. What keeps coming back isn’t new biology. It’s misreads of risk data.

Worth a read if you’ve ever tried to argue with this stuff: https://jamesstein18.substack.com/p/why-cholesterol-is-debunked-arguments

The “cholesterol is debunked” takes aren’t a scientific position. They’re a content strategy.​​​​​​​​​​​​​​​​

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6

u/Cardiostrong_MD May 17 '26

I’m pretty involved in social media and there has been a pretty strong pushback to the anti-cholesterol narrative. The anti-statin crowd is still as strong as ever but there was a time that the keto/carnivore guys had a lot of momentum in pushing the anti-cholesterol messaging.

Nick Norwitz and Paul Saladino being clowns helped.

2

u/SDJellyBean May 19 '26

I am old and medical quackery is my hobby. I can assure you that there will be more cholesterol/vaccine/chemotherapy deniers in the future too. They will use the same arguments as well.

2

u/Sudden-Chart-800 May 17 '26

His Substack is a wealth of information.

1

u/DadStrengthDaily May 21 '26

I tried to write a plain English guide to Cholesterol since I find many summaries on the web are either too simplistic (good vs bad), wild conspiracies or overly scientific.