Life Extension Magazine®

The Great Cholesterol Myth: Why Lowering Your Cholesterol Won’t Prevent Heart Disease – And the Statin-Free Plan That Will

Coauthors Stephen Sinatra, MD, and Jonny Bowden, PhD, have concluded that the traditional protocol of low-fat diets and statin drugs do not inhibit cardiovascular disease. As they reveal in their new book, The Great Cholesterol Myth, the real culprits behind heart disease are sugar, inflammation, stress, and high-carbohydrate diets.

Scientifically reviewed by Dr. Gary Gonzalez, MD, in August 2023. Written by: Jonny Bowden, PhD, CNS & Stephen Sinatra, MD, FACC.

Cholesterol and Saturated Fat Don’t Cause Heart Disease

Senior Couple Power Walking In The Park  

Heart disease is the #1 killer. However, traditional heart disease protocols have gotten it all wrong. Science is showing that cholesterol and saturated fat are not a direct path to heart disease – and that the standard prescription of low-fat diets and statin drugs are contributing to a health crisis of monumental proportions.

The Great Cholesterol Myth reveals the shoddy science, manipulated research, and corporate greed that has perpetuated the myth and displays the true culprits of heart disease – including sugar (not fat), inflammation, stress, and high-carb diets full of processed foods.

LE: Big Pharma has spent tens of millions of advertising dollars to create the $30 billion-a-year industry of cholesterol-lowering drugs. What is the most disturbing fallout from this misinformation campaign?

TGCM: The real tragedy is that by putting all of our attention on cholesterol, we’ve virtually ignored the real causes of heart disease: inflammation, oxidation, sugar, and stress.

LE: And sadly, the government has gone in lockstep with this false narrative.

TGCM: Many of the general dietary guidelines accepted and promoted by the government and by major health organizations such as the American Heart Association are either directly or indirectly related to cholesterol phobia. As you’ll learn in our book, cholesterol numbers are a pretty poor predictor of heart disease; more than half the people hospitalized with heart attacks have perfectly normal cholesterol levels, and about half the people with elevated cholesterol levels have perfectly normal, healthy tickers.

LE: The book references a report in the New England Journal of Medicine about the Nurses’ Health study involving 120,000 women since the 1970s. Their findings support your research.

Cholesterol plaque in artery 

TGCM: The authors of that study wrote: “Eighty-two percent of coronary events in the study…could be attributed to lack of adherence to (these five factors).” One, don’t smoke. Two, drink alcohol in moderation. Three, engage in moderate-to-vigorous exercise for at least half an hour a day on average. Four, maintain a healthy weight (BMI under 25). Five, eat a wholesome, low-glycemic (low-sugar) diet with plenty of omega-3 fats and fiber. Where’s the part about lowering cholesterol? It’s not there.

LE: Another myth you tackle is the idea of “good” and “bad” cholesterol.

TGCM: Knowing you have a “high” LDL level is pretty much a useless piece of information unless you know how much of that LDL is the small, dense kind (harmful) and how much is the big, fluffy kind (not harmful in the least). Unfortunately, most doctors are behind the times on this one. They look at that total LDL number – not the size and type – and if that number is even slightly higher than the lab says it should be, out comes the prescription pad. LDL, the imprecisely named “bad” cholesterol, has several different subtypes, and not all of them are bad at all – quite the contrary. Sadly, most doctors do not perform the easily available tests – often covered by insurance- that determine your LDL.

LE: Since cholesterol so often plays “the bad guy”, how do we benefit from cholesterol?

TGCM: Cholesterol is a hormone factory. Cholesterol is used by the body to synthesize bile acids. Cholesterol is an essential component of all the cell membranes in the body. Cholesterol is important for the immune system. We make vitamin D from cholesterol. Understanding the functions of this much maligned molecule will help you understand why so many things can go wrong when we pursue lower and lower cholesterol numbers.

Raw salmon steak with herbs  

LE: You write about how strong the cholesterol-vitamin D connection is and even mention a Life Extension Foundation® study from 2010 about the level of vitamin D in our members. Can you elaborate?

TGCM: It’s impossible to overstate how important the cholesterol-vitamin D connection is. There is compelling research that links less than optimal levels of vitamin D with heart disease, poor physical performance, osteoporosis, depression, cancer, difficulty in losing weight, and even all-cause mortality.

LE: Switching gears, your book labels sugar “the real demon in the diet.” What led you to that conclusion?

TGCM: Sugar is a far greater danger to your heart than fat ever was. Sugar is directly responsible for one of the most damaging processes in the body, something called glycation. Glycation is what happens when sticky sugar molecules glom onto structures where they don’t belong, essentially gumming up the works. What does this have to do with cholesterol and heart disease? Everything. [In our book] we discuss one primary way in which LDL cholesterol gets damaged – through oxidative stress generated by free radicals. Can you guess the other way it gets damaged? Glycation. Sugar is at the scene of several crimes, all related to heart disease. A 1992 study examined the blood work of healthy centenarians in an effort to find out whether there were any commonalities among the members of this unusually long-lived demographic. It found three: low triglycerides, high HDL cholesterol, and – wait for it – low fasting insulin. Your diet affects two of these blood measures – triglycerides and fasting insulin – and both meaures will fall like a rock when you reduce or eliminate sugar and processed carbs in your diet.

LE: Why has “fat” been taking the fall for so many years while “sugar” has been skating by without much coverage?

TGCM: Well, there’s no political lobby for “fat”, but there’s a powerful one for sugar. In 2003, the World Health Organization published a conservative, reasonable report called Diet, Nutrition and the Prevention of Chronic Diseases. In it, the WHO made a statement that it would be a good idea for people to derive no more that 10 percent of their daily calories from added sugars. The report suggested that people could lower their risk of obesity, diabetes, and heart disease simply by curbing some of the sugar they were consuming. Following the report, a reporter for the Washington Post quoted a letter from the Sugar Association’s president, Andrew Briscoe, to the general director of WHO in which he stated, “We will exercise every avenue available to expose the dubious nature of the Diet, Nutrition and the Prevention of Chronic Diseases report.” Two senators wrote a letter to the then Health and Human Services Secretary Tommy G. Thompson, stating that, “evidence that soft drinks are associated with obesity is not compelling.”

LE: And that’s where the danger of high fructose corn syrup comes in.

TGCM: In humans, a high-fructose diet raises triglycerides almost instantly. Fructose found in whole foods, such as in fruits, however, is a different story. There’s not all that much fructose in, for example, an apple. But fructose extracted from fruit, concentrated into a syrup, and then inserted into practically every food we buy at the supermarket, that’s a whole different animal. If you want a bunch of lab animals to become insulin resistant, all you have to do is feed them fructose.

LE: What are some supplements that you feel can have a heart-protecting effect?

Jonny Bowden, PhD, CNS, a best-selling nutritionist
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TGCM: CoQ10 is a kind of “energy fuel” for the heart. Magnesium relaxes the artery walls, reduces blood pressure, and makes it easier for the heart to pump blood and for the blood to flow freely. Niacin will lower both triglycerides and the “bad” kind of LDL cholesterol. Other supplements worth considering include vitamin C, curcumin, resveratrol, and cocoa flavanols. D-ribose is one of the components of the energy molecule ATP, which the body uses to power all activity.

To order The Great Cholesterol Myth, visit

Stephen Sinatra, MD, FACC, is an internationally known and sought-after cardiologist, educator, and author who created the Manchester, CT-based Heart MD Institute as an educational platform focused on prevention and proactive lifestyle changes to live a healthier life. For more information visit

Jonny Bowden, PhD, CNS, a best-selling nutritionist with a master’s degree in psychology, is a nationally known expert on nutrition, weight loss, and health. He is the author of several bestselling titles. For more information visit

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