[seewhydee]

From Fig. 2, it looks like the "hazard ratio" is minimized at a total cholesterol level of around 230 mg/dL, with both higher and lower total cholesterol levels associated with higher mortality. However, medical advice (see e.g. Cleveland Clinic page below) routinely asserts 200 mg/dL as the maximum for the normal range, with 230 mg/dL being "borderline high" and approaching the "high" band.

https://my.clevelandclinic.org/health/articles/11920-cholest...

In the discussion section of the paper, the authors write:

"The current cholesterol guidelines are heavily based on heart disease risk and recommend a TC range of <200 mg/dL as desirable. TC range <200 mg/dL, however, may not be necessarily a sign of good health when other diseases are considered. The diseases associated with lower TC levels and potential mechanisms have not been conclusively identified."

Time to eat more cheeseburgers?

[cuchoi]

This doesn't mean you should increase your cholesterol.

Low cholesterol (hypocholesterolemia) is commonly observed in critically ill patients. This could be driving the correlation and doesn't mean that if you lower your cholesterol you will increase your risk of dying.

[noobermin]

So the data is interesting and speaks for itself, but of course, let's ask the ancillary but potentially relevant questions: why sci rep? Why isn't this in a higher impact journal? Is sci rep even read in medicine?

[deugtniet]

Scientific reports is read in many places, including in medicine.

Regarding your 'low-impact' comment I have a few thoughts. 1. Although this is a large study, they do not find any world shocking new insights that are otherwise found in other studies. Cholesterol phenotypes are very well studied. Changing a guideline is usually not done based on a study of a single population. 2. They do not account for medication usage which confounds results. 3. They do not find a causal relationship between cholesterol and mortality, only provide an association.