> What do the meta-studies have to say about statins and life expectancy? For long term maintenance, they're definitely recommended. Near EOL is a bit differen

> What do the meta-studies have to say about statins and life expectancy? For long term maintenance, they're definitely recommended. Near EOL is a bit different, but I don't know the guidelines. > Also, why isn't dietary adjustment the first-line treatment for high cholesterol? It is, but only in conjunction with medication. It seems that having a poor diet (e.g. high saturated fats) has long-lasting effects on cholesterol levels, and short-term dietary changes do little to "repair the damage", so to speak. Additionally, we know very little about what other factors affect HDL/LDL levels. For example, for a long time, there was concern that dietary cholesterol had an impact on serum levels, but I believe now the consensus is that this is false. Cholesterol is complex, and while its role in disease is what gets attention, it's a vital compound with a number of downstream effects. In most cells, it acts as a modulator of membrane structure and function: absolutely crucial aspects of every cell's job, regardless of what tissue they're in. My point is twofold: first, statins likely have unknown "off-target" effects on cholesterol synthesis throughout the body (which potentially speaks to the life expectancy issue); and second, the comorbidity of high cholesterol and obesity is likely more complex than "bad diet." Of course, keep in mind that having a "good diet" in the cholesterol sense (low saturated fats, possibly low dietary cholesterol) has been shown to be a good idea regardless. It's temporary changes to diet that seem ineffective, at a population level.