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It is clear that elevated cholesterol, LDL and triglyceride levels are a bad thing, as are low HDL levels. What isn't clear is whether the lipid levels themselves are the problem, or, as seems more likely, that they are markers of the underlying problem. Consequently, it is unclear whether interventions that affect lipid levels alter clinically relevant end-points such as coronary heart disease, strokes, peripheral vascular disease and survival.

If lipid values of concern are not threats in themselves but markers for the underlying problem, then taking a statin to lower total cholesterol and LDL doesn't make much sense, becauase the statins specifically inhibit the cholesterol synthesis pathway. Period. So they would be addressing the marker, not the problem. And screwing up CoQ10 synthesis into the bargain. (Among other issues.)

With macadamia nuts, on the other hand -- for all we know, they ARE targeting the underlying pathology (if we consider high cholesterol as a marker for the actual problem). Studies simply showed that they consistently reduce levels of LDL and total cholesterol levels. And as I recall, they also raise HDL levels, which statins don't do.

Obviously, further study is needed before claims can be made. But until then, I'll take macadamias over a statin any day! ;-) Especially with super dark dark chocolate added.

=sheila
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