I believe it to be an equal part gallows humor for those who fear high cholesterol numbers, and mocking the entire concept for those who don't believe in the lipid hypothesis at all.

In my opinion it may established, but what to make of the numbers and what they really mean is well over the heads of the average physician who has been educated about cholesterol primarily by statin sales reps.

But some of the Doctors are so "under-informed"! My doc saw a total cholesterol of 220 and was writing a 'scrip for statins. This is with an HDL over 100, trigs under 35, and c-reactive protein that was "not measurable"..... so yes, it is fun to have such a doctor shocked and in horror that my TC went from 180 to 220.....

A physician friend and I were discussing cholesterol a few weeks ago and we shared similar viewpoints regarding the importance of discerning between different lipoprotein fractions rather than taking the position that "TC below 200 is good" and "TC above 200 is bad".

We also agreed that a cholesterol reading higher than the currently accepted "healthy" level absent elevated blood sugar, blood pressure, and other markers of metabolic disease is likely not a reason for concern.

This is not to say that cholesterol results should be disregarded. I am of the opinion that extremely elevated levels are like the "canary in the coal mine" and indicate some underlying issue whether it be nutrient deficiency, inflammation, etc.

There is, however, a clear economic incentive for pharmaceutical companies to "educate" doctors about the benefits of widespread statin prescriptions and this is evidenced by the fact that they are one of the most widely used, and profitable, products in recent history. It would be naive to think otherwise.

I have heard through various sources within the medical community that doctors also get bonuses or kickbacks from drug companies if they reach a certain quota on prescriptions. For example, one such kickback I was told about when I was pregnant and contemplating the flu shot was that doctors receive large bonusus from the drug companies if they reach a certain number of doses. I'm not saying that every doctor is like this, but I definately believe that the doctors work more for the big drug companies than they do for us. My nephew had drainage, so they gave me an antibiotic. Really? Doesn't make sense to me... My family never gets the flu shot. Maybe someday we will suffer for it, but as of now, I believe that feeding my family a balanced diet, getting enough sleep, and generally taking good care of our selves will reep better benefits than taking vaccinations and prescription drugs. My children are 2 1/2 and 4 1/2. Neither have ever had a serious illness and I can count on one hand how many times the two of them combined have been given any kind of prescription drug. I do regular vaccinations, like MMR and TB, but no additionals, like flu shots. It's just my personal opinion, but I think that a lot of doctors make it their business to scare the shi*t out of people so they will sign up for a long list of prescription drugs...

You use the term "common sense" in an ironic manner in your question.

I think the whole idea with the Paleo diet is that it's a response to this type of "common sense" thinking that has led our country down a steep path of chronic disease and malnutrition.

As far as medical practice goes, it's slowly becoming apparent to many physicians that total cholesterol is a useless number when determining someone's health status. So if your doctor tries to prescribe statins based on your total cholesterol being higher than 200, because that's what they were taught in medical school 15+ years ago, then I'd say the doctor's advice should be disregarded.

Laughing about disregarding your doctor's advice may be haughty and unnecessary. Being educated about blood lipid results and following the most current scientific recommendations rather than blindly following one doctor's prescription is simply proactive.

As a final thought, most doctors are not adequately educated in nutrition:

"Researchers from the University of North Carolina at Chapel Hill asked nutrition educators from more than 100 medical schools to describe the nutrition instruction offered to their students. While the researchers learned that almost all schools require exposure to nutrition, only about a quarter offered the recommended 25 hours of instruction, a decrease from six years earlier, when almost 40 percent of schools met the minimum recommendations. In addition, four schools offered nutrition optionally, and one school offered nothing at all. And while a majority of medical schools tended to intersperse lectures on nutrition in standard, required courses, like biochemistry or physiology, only a quarter of the schools managed to have a single course dedicated to the topic."

http://www.nytimes.com/2010/09/16/health/16chen.html?_r=2&ref=health

You're loading the question by saying these are "established measures of health." The whole point is that they haven't been established by science, but by poor logic and peer pressure, and some of us don't consider them to be measures of health at all.

Many people, maybe a majority, believe in astrology, carry something around for luck, forward chain letters, or put real credence in other kinds of magical thinking. If I go outside on a day my horoscope said to stay home, and intentionally walk under a ladder and step on a crack in the sidewalk, is that hubris?

I asked if there were people out there with "normal" panels last year http://paleohacks.com/questions/25606/who-here-has-normal-cholesterol#axzz1iM4vYv6z

Turns out there are a lot of us. It seems like a lot of the people with numbers that would make your average doc's head explode are kind of new to the diet. I'd be curious if their numbers are a little more normal after a few years for the reasons outlined by Masterjohn here. The panel I posted in that thread was after doing ancestral-type diets for three years when systems have healed and malnutrition has been abated.