A person of sense knows that high cholesterol per se is not the cause of atherosclerosis. Three facts prove it beyond a reasonable doubt. Some people with high cholesterol never develop atherosclerosis; some people with normal cholesterol do, and if high serum cholesterol were the cause, we would expect disseminated disease at first presentation, and that is definitely not the case. Like caries and ulcers, and in my model, ALL DISEASES, the disease first presents as being positionally specific. Disseminated disease is a disease with a lot of positionally specific loci, but all disseminated disease began at ONE locus with MULTIPLE LOCAL deficiencies in chemical activities (and often with normal systemic concentrations), sometimes driven by various excesses (such as alcohol), and the deficiencies are usually exploited by one or more agents (including physical, chemical, and biological agents).
One reason that some doctors continue to believe – against common sense – that high cholesterol causes atherosclerosis is that people with the genetic disease of familial hypercholesterolemia (roughly 0.2% of the population) tend to develop atherosclerosis at an accelerated pace.
Seems logical, does it not? Yet it is a false analogy for two reasons. One, people with high cholesterol typically have cholesterol levels about 30-50% above average, while people with this genetic disease have cholesterol levels that are hundreds of percentage points higher. The circulating levels of molecules that protect serum cholesterol from damage (examples: uric acid, vitamin C, vitamin E and bilirubin) do not increase in these people to the same level as their cholesterol. Their cholesterol is way too high for the body to protect adequately.
False analogy reason two: those with this genetic disease have a serious problem with cholesterol uptake (this too has pathological consequences since membrane structure is suboptimal) that the average person does not have and thus does not suffer the consequences of. Rather the reverse – the average person has problems not with cholesterol but with cholesterol’s DADME network, and those problems are almost all deficiencies, and almost all would be correctible if we ate a sensible diet, exercised sensibly, and if we could fix our psychological problems and their attendant sleep quality deficits.