My understanding is that they've done a wide variety of studies continuously over decades.

They observed only, people with higher cholesterol were more likely to die.

They fed various animals high fat diets, the animals died sooner than control groups. The animals who are a lot of fat had higher serum cholesterol.

They tried diet interventions, no medicine, just getting people to eat different, those who ate less saturated fat tended to live longer. Saturated fat is correlated with cholesterol levels, as shown in other observational studies.

They created medicines, did trials, some of the medicines tended to lower cholesterol and extend life, others lowered cholesterol and didn't extend life.

It's complicated, but there's a wide variety of studies that have looked at cholesterol from different angles and taken all together paint a crude but coherent picture.

Today, we know that total cholesterol is quite crude, looking at LDL is better, and there's other blood markers that are even better than LDL.

It's complex and beyond what can be discussed effectively on HN, but there's a lot behind the conventional wisdom on cholesterol. Dismissing it all as "bunk science" is dismissing a strawman.

Furthermore, mainstream recommendations are completely reasonable. Eat a variety of food, avoid processed foods, limit saturated fat but some is ok, only give statins when cholesterol is very high or their risk for heart disease is high. If more people followed the guidelines, the net effect would mostly be people eating more whole fruits and vegetables, hardly the great evil the industry is sometimes accused of.