In the 30+ years of my career as a heart surgeon, I’ve had conversations about cholesterol almost every day. I’ve spoken with countless medical professionals about cholesterol in that time. And even now, all these years down the line, I’m still met with some frankly shocking misunderstandings about how cholesterol works.
No, high cholesterol doesn’t instantly suggest you’ll have a heart attack. And dropping it doesn’t necessarily mean you’ll avoid — or survive — one, either.
But I’m getting ahead of myself.
Let’s take a look at some of the most common cholesterol myths so you can empower yourself at your doctor’s office and otherwise.
Article overview
- There are many popular myths surrounding cholesterol that are simply outdated.
- This includes dietary cholesterol, LDL ranges, heart attack risks, and lowering cholesterol for ‘better heart health.’
- Knowing the differences between fact and fiction can make conversations with your doctor more effective for your care.
The biggest cholesterol myths of 2026
I’ve heard just about every cholesterol myth there is. With the wealth of research and resources we have today, it’s easier than ever to fact-check them against modern studies.
Below are a few of the most common myths I debunk every single week.
“Eating too much cholesterol will give you heart plaque.”
Contrary to popular belief, dietary cholesterol is not the same thing as blood cholesterol. One study found that “challenges with dietary cholesterol do not increase the biomarkers associated with heart disease risk.”
It also found that eating eggs actually improves dyslipidemia, since it creates “more efficient reverse cholesterol transport.”
You might be familiar with the old dietary limit for cholesterol — 300 milligrams per day — which lasted from 1968 to 2015. Today, the upper limit has been removed. But again, there’s no evidence to suggest that dietary cholesterol alone will magically transform into heart plaque without oxidized LDL particles and inflammation. Quite the opposite, in fact, when looking at whole, real foods. Processed foods, heavy carbohydrates, and sugar are far more of a concern for heart disease.
So, please, never let a doctor tell you that you can’t eat eggs.
“The healthy range for LDL is 55 mg/dL.”
At least, that’s what it is today.
The range was below 100 mg/dL in the 1980s. Then, in 2004, it dropped to 70 mg/dL. 2018 guidelines for very high-risk patients dropped to below 55 mg/dL. Some European guidelines suggested below 40 mg/dL, which would be considered an extremely low number even a decade prior.
As you might imagine, this significantly increased the number of people eligible for statins. It also made perfectly ‘normal’ numbers ludicrously high, which scared many patients into a lifelong statin subscription.
And considering the LDL levels of the so-called “Blue Zones” range from 199.5 to 202.5 mg/dL, there’s very little reason for healthy populations to consider dropping to 55 or below.
So, what about high-risk populations? Will reducing your cholesterol levels to 55 or even 40 mg/dL help? According to research, it may actually raise your risks for an early death, as we’ll come to shortly.
“High cholesterol means you’re at high risk for a heart attack.”
Not necessarily. As many as 50% of the people admitted to the ER with a heart attack have an LDL within the normal range. So, having high cholesterol isn’t an immediate sign of serious heart risk.
Another great example includes lean mass hyperresponders, or people who see abnormally high cholesterol spikes in response to low-carb, high-protein, high-fat diets. Some of these people have LDL as high as 500 mg/dL.
We also know that losing weight causes your blood LDL to rise. That’s because your body is moving stored fat around the bloodstream. So, does that mean you’re more likely to have a heart attack because of weight loss?
Certainly not.
Another example is the Pooled Cohort Equations, or PCE, which doctors use to assess a patient’s 10-year risk of a heart attack or stroke. If the patient has an “elevated” risk probability of ≥ 7.5%, most doctors will automatically prescribe a statin, per AHA guidelines.
But you should know that age is the heaviest-weighted variable in the PCE — which means age alone could push your score over the treatment threshold, even if you have stellar metabolic health.
For women in their mid-to-late 70s specifically, age alone is enough to cross the 7.5% treatment threshold. Even if you have very healthy lab work, a doctor may still want to prescribe you statins ‘just in case.’
Learn more about how current heart health guidelines are failing women.
So, can very high cholesterol indicate you’re at risk for a heart attack? Sure, but it shouldn’t be viewed as an isolated metric. And it’s very rarely accurate, especially compared to other measures of heart disease risk.
“Lowering your cholesterol will help you avoid heart attacks.”
If cholesterol is such a big bad boogeyman, it would stand to reason that lowering it would make your heart healthier. Right?
Let’s look at the Minnesota Coronary Experiment, which ran from 1968 to 1973 inside Minnesota state mental hospitals and a nursing home. This allowed researchers to carefully control the diets of more than 9,500 people. To determine if unsaturated fats could lower cholesterol, the diets were randomized to either:
- A diet with saturated fat
- A diet with linoleic acid from corn oil and corn oil polyunsaturated margarine
As you might imagine, the corn oil group reduced their total cholesterol by 13.8%. So, by the logic of the times, they should have lived longer.
Except, they didn’t. The study concluded that “available evidence from randomized controlled trials shows that replacement of saturated fat in the diet with linoleic acid effectively lowers serum cholesterol but does not support the hypothesis that this translates to a lower risk of death from coronary heart disease or all causes.”
So, to summarize: not only will lowering your total cholesterol not always help you avoid heart attacks, but it may also increase your risk of an early death.
Which leads to my next point…
“Statins are the best way to lower cholesterol.”
If you do need to lower your LDL cholesterol, medication may not be the best way to do it.
I’ve written previously about what they don’t tell you about statins, and the reality is that their real-world benefits are smaller than many people realize, and meaningful improvements to metabolic health and reduced likelihood of a heart attack can be achieved with lifestyle changes.
Everything else you should know about cholesterol
I could cover dozens of other popular cholesterol myths here, but I have a feeling you get the point: the vilification of cholesterol as a whole has entirely overshadowed its usefulness and benefits in the body.
If there’s anything you should take away from this article, let it be this:
- Cholesterol isn’t the enemy
- You don’t need statins to lower it healthily
- Lowering it drastically could lead to long-term side effects such as Alzheimer’s and dementia
Of course, I highly recommend doing more research on the subject so you can reach your own conclusions. And if you don’t already have a doctor who ‘gets’ it, knowing the truth can help you engage in constructive conversation (and potentially begin the hunt for a more competent professional, barring a positive outcome).
I’d recommend starting here: