"...doctors know that [DELC] is only one of a number of risk factors associated with heart disease. They know that an association does no prove causation and that focusing on one risk factor is unproductive and unlikely to yield much benefit."

When I speak at different venues around the country, telling people about the benefits of a diet rich in healthy animal fats, the inevitable question always comes up. "Yeah, but what about cholesterol?" Imagine telling a roomful of wide-eyed preschool innocents, the day before Christmas, that Santa Claus is a myth and you can imagine the effect that hearing the truth about cholesterol can have on an unsuspecting audience. For some people, the prospect that what they've believed about cholesterol all their lives is wrong, is simply unimaginable. I've found that it is impossible to convince anyone in the span of a 30 second reply that they need to rethink their position on cholesterol.

Honestly, I believe some people are more accepting of the claimed existence of Big Foot or an undead Elvis than they are of the idea that cholesterol isn't the killer it's been made out to be.

While most people only think of cholesterol when it comes to heart disease, there are a number of known markers or risk factors associated with the disease. These risk factors include high blood pressure, smoking, diabetes, physical inactivity, obesity, so-called high cholesterol (although people with low to normal cholesterol suffer heart disease too) and, oh yes, diagonal earlobe creases.

Say what? Diagonal earlobe creases?

That's right. There is a well-established area of study which shows that the presence of DELC (diagonal earlobe creases) may be a reliable marker for heart disease. More than 25 studies have shown an association between DELC and an increased risk of heart disease. A quick search at PubMed turns up the following studies:

1. Bilateral diagonal earlobe crease and coronary artery disease: a significant association.
Dermatology. 2004;209(4):271-5. PMID: 15539887

2. Evaluation of diagonal earlobe crease as a marker of coronary artery disease: the use of this sign in pre-operative assessment.
Anaesthesia. 2001 Dec;56(12):1160-2. PMID: 11736771

3. More on the diagonal earlobe crease as a marker of coronary artery disease.
Am J Cardiol. 1993 Oct 1;72(11):861. PMID: 8213534

So why haven't we heard more about DELC from the pharma/medical establishment? That's anyone's guess, but one reason worth considering is that the known risk factors for heart disease can be sorted into two treatment categories: those that generate revenue and those that don't. Let's look at a more comprehensive table of risk factors organized in this manner.

Positive Revenue	Negative Revenue
High (so-called) cholesterol levels	Increasing age
High blood pressure	Gender (men are more prone to heart disease)
Smoking cessation	Family history
Physical inactivity	Diagonal Earlobe Creases
Obesity treatment
Diabetes treatment
Substance abuse treatment
Alcohol abuse treatment
Poor Diet

When you tally up the consumer costs and the industry profit for the treatment of the risk factors on the left, you're talking quite a bit of money. The list on the right, however, generates zero revenue when it comes to preventing heart disease. There's little you can do about getting older for instance. And while gender transformations are possible, they're not very popular. Likewise, there's no drug that can alter your family's health history and therefore no profit potential. DELC, the last item on the list is another profit generating dead-end. Sure, with enough marketing hype and fear-mongering it might be possible to build DELC into a big-enough bogeyman to generate sufficient profits in cosmetic reconstruction. The marketing campaign might look something like this:

MEDICAL NEWS JOURNAL --The American Heart Association and NELEP (the National Earlobe Education Program) have jointly announced the latest recommendations for heart disease prevention. Dr. Alex Pinna, NELEP chairman and Baltimore cardiologist, announced today that "Creaseless is better." The once controversial opinion that deep DELC (Diagonal Earlobe Creases) are the primary causative factor for heart disease has given way to full acceptance in the medical community. This acceptance comes on the heels of the development of a blockbuster class of new drugs called auristatins, which have been shown to reduce diagonal earlobe creases by up to 85 percent. Dr. Pinna noted that, "This breakthrough will go down in history as a pivotal moment & a milestone in the prevention and, I believe the eradication, of heart disease." Wall Street analysts say that auristatins represent a money-machine for the drug industry that could quickly become a trillion-dollar cash cow over the next three years.

Ah, but we're just dreaming as it would be ludicrous to believe that cosmetic modification of your ears could have any beneficial effect on your heart. Right?

Besides the fact that treatment of DELC yields a negative cash flow, the other reason we don't hear about it is because doctors know that it is only one of a number of risk factors associated with heart disease. They know that an association does no prove causation and that focusing on one risk factor is unproductive and unlikely to yield much benefit. The truth is that the true cause(s) of heart disease are quite complex and given the number of new cases that turn up each year, mortality rates notwithstanding, we still don't know as much about the disease as you might think.

So what can this tell us about the efficacy of cholesterol lowering, a multi-billion dollar bonanza for the drug industry and arguably the most profitable 'treatment' for the prevention of heart disease? Given the sorry track record for cholesterol lowering, the utter lack of scientific evidence that cholesterol causes heart disease, the profit-motivated push to make statins available over the counter and even put them in our drinking water, a case can be made that worrying about your cholesterol makes about as much sense as worrying about the shape of your ears.

Get the real facts on cholesterol. Read Anthony Colpo's The Great Cholesterol Con, Dr. Uffe Ravnskov's, The Cholesterol Myths, Shane Ellison's M.Sc. Hidden Truths about Cholesterol Lowering Drugs and Dr. Duane Graveline's Lipitor: Thief of Memory, Statin Drugs and the Misguided War on Cholesterol. Educate yourself and maybe, just maybe we'll start to see stories in the media like this:

PHOENIX DISPATCH --- More evidence in the form of secret documents, emails and unpublished research reports surfaced today in the ongoing wave of new revelations about what is being called, the greatest medical scam in history. Among other findings, it has been determined that drug-induced cholesterol lowering is actually associated with an increased death rate from other causes, such as cancer. And in an astounding revelation, proof is emerging that statins, the class of cholesterol lowering drugs that have reaped trillions of dollars for the drug industry, have never been shown to have any beneficial effect in women. Increases in the incidence of memory loss, depression and a muscle wasting disorder has also been linked to cholesterol lowering drugs. Wall Street analysts have begun advising drug industry investors to proceed with caution, especially with regard to companies that generate much of their revenue from the sale of cholesterol lowering drugs.