frame our words to be applicable to most people, most of the
time. We posit that dietary cholesterol intake, on the whole,
has minimal impact on blood cholesterol levels. As a dietary
villain, it’s been exonerated, pure and simple. But, and
there’s always a but, there are specific individuals and
genetic variants who are wired differently from most. Most
of us synthesize our own cholesterol–but a few people do
absorb more cholesterol from food! In specific and special
cases, especially when managing inexplicably high
cholesterol markers surrounding a cardiac event, we can
measure blood markers for people with very high internal
cholesterol production, or abnormally high cholesterol
absorption from food. This can guide therapy when
considering why a statin, which blocks cholesterol
production, may not be working to lower blood cholesterol
levels in a given patient–that person may be absorbing
cholesterol from food instead! The specific tests are beyond
the scope of this book, but for you citizen-scientists out
there, those with elevated lathosterol tend to be
overproducers who respond better to statins, whereas
elevations in campesterol and beta-sitosterol, plant sterols,
indicate overabsorption from the diet.
And yet there’s a nontrivial percentage of the population
still being told to substitute nutritious egg yolks for
alternatives like sugary cereals, instant oatmeal, or worse—
the dreadful egg white omelet! A recent Credit Suisse survey
exploring consumer perceptions around fat found that 40