By Marie Leonard
High vs Low Cholesterol? Is this the real question?
If I were to say that people with high cholesterol will outlive those that have low levels, you would quickly come back with “You’re full of it! Haven’t you been listening to what the medical association has been saying, ad nauseaum?”
That's all right. I won't get angry because I know that you are only repeating what you were told over and over again like a broken record. After all, if we're being told that a rock is an apple often enough, there is a point where we might start believing it. I must also consider another thing. You haven't had the opportunity to look into this issue in any depth. I am about to change that!
The findings of Dr Harlan Krumholz of the Department of Cadiovascular Medicine at Yale University are changing people's erroneous beliefs about high vs low cholesterol levels. Interestingly, he observed that old people with low cholesterol died twice as often from a heart attack as did old people with high cholesterol.
Of course those that support the view that high cholesterol is bad ignore his observations or just attribute the results to a rare exception produced by chance among a huge number of studies which found the opposite to be true.
This is no longer true. There are now a large number of findings, mostly of old people that show that high cholesterol is not a risk factor for coronary heart disease. Research in the Medline database found that eleven studies supported the new hypothesis while seven more found that high cholesterol was not a predictor of a person dying any sooner.
The numbers really boil down to say that high cholesterol is only a risk factor for less than 5% of those who die from heart attack. There is even more comfort for those who have high cholesterol; six of the studies found that total mortality was inversely associated with either total or LDL-cholesterol, or both. This means that it is actually much better to have higher than lower cholesterol if you want to live to be very old.
Read that last statement again: "it is actually much better to have high than to have low cholesterol if you want to live to be very old."
High Cholesterol Has Its Uses:
1. Protection Against Infection
In 19 large studies of more than 68,000 deaths, reviewed by Professor David R. Jacobs and his co-workers from the Division of Epidemiology at the University of Minnesota, low cholesterol predicted an increased risk of dying from gastrointestinal and respiratory diseases.
Most gastrointestinal and respiratory diseases have an infectious origin. Then one should ask whether it is the infection that lowers cholesterol or the low cholesterol that makes one susceptible to infection?
To answer this question, Professor Jacobs and his group, together with Dr. Carlos Iribarren, followed more than 100,000 healthy individuals in the San Francisco area for fifteen years. Not so surprising, the study revealed that those who had low cholesterol at the start of the study had more often been admitted to the hospital because of an infectious disease.
This finding cannot be explained away with the argument that the infection had caused cholesterol to go down, because how could low cholesterol, recorded when these people were without any evidence of infection, be caused by a disease they had not yet encountered? Isn't it more likely that low cholesterol in some way made them more vulnerable to infection, or that high cholesterol protected those who did not become infected? Much evidence exists to support that interpretation.
2. Protection Against HIV/AIDS
We know that young, unmarried men with a previous sexually transmitted disease or liver disease run a much greater risk of becoming infected with HIV virus than other people. Doctor Ami Claxton followed such individuals for 7-8 years after which time it was concluded that those who became HIV-positive during the first four years, of those who tested positive for HIV and had low cholesterol at the beginning of the study, were twice as likely to test positive for HIV at the end compared with those with the highest cholesterol.
Similar results from more than 300,000 young and middle-aged men, which found that 16 years after the first cholesterol analysis the number of men whose cholesterol was lower than 160 and who had died from AIDS was four times higher than the number of men who had died from AIDS with a cholesterol above 240.
3. Protection Against Chronic Heart Failure
Heart disease can weaken the heart muscle. A weak heart means that less blood and therefore less oxygen is delivered to the arteries. To rectify this problem, the heart beat goes up, but in severe heart failure this is not sufficient. For patients with severe heart failure there is shortness of breath because too little oxygen is delivered to the tissues which increase the pressure in their veins because the heart can't deliver the blood away from the heart with sufficient power. So fluid accumulates in the legs and in serious cases also in the lungs and other parts of the body. This condition is called congestive or chronic heart failure.
A lot of evidence now points to bacteria or other microorganisms playing an important role in chronic heart failure. In such sufferers, a higher number of a specific hormone needed to fight a specific bacteria toxin, is found and thus indicates that inflammatory processes are going on somewhere in the body. It is the presence of this hormone in high numbers in the blood that is the real predictor of death for patients.
In more tests of the same nature, researchers were surprised to find that mortality was higher in the patients with the lowest lipid values, including total cholesterol, LDL-cholesterol and HDL-cholesterol as well as triglycerides.
Dr. Rauchhaus, this time in co-operation with researchers at several German and British university hospitals, confirmed these findings. Now other researchers have made similar observations. The largest study has been performed by Professor Gregg C. Fonorow and his team at the UCLA Department of Medicine and Cardiomyopathy Center in Los Angeles. The study included more than a thousand patients with severe heart failure. After five years 62 percent of the patients with cholesterol below 129 mg/l had died, but only half as many of the patients with cholesterol above 223 mg/l. And the mortality rate was independent of whether the patients were malnourished or not.
There is also much evidence that supports the theory that those born with high cholesterol are protected against infection. If born with low cholesterol and the diet is supplemented with pure cholesterol or extra eggs, the cholesterol goes up and bouts of infection become less serious and less frequent.
High cholesterol levels can be a factor of possible heart trouble when young men in the prime of their careers are stressed at which time the body needs cholesterol because it is the building material of many stress hormones. Therefore, any possible protective effect high cholesterol may have during that time would be counteracted by the negative influence of a stressful life on the vascular system.
Research also now supports the theory that bacterial toxins and hormones found in white blood cells during infections and seen more often in the blood of patients with recent heart disease and stroke, are a much better indicator for coronary heart disease than cholesterol.
So the big question here is does high cholesterol really protect against cardiovascular disease?
Let's answer that question with these:
If high cholesterol really did cause hardening of the arteries then people with high cholesterol should have more hardened arteries than those with low cholesterol. Why is this not the case?
Again, if high cholesterol, touted as the most important cause of hardening of the arteries, is lowered, then that should also influence the hardening process in the same proportion to the amount of its lowering. Why is this also not the case?
And last but not least, if high cholesterol is so bad then all populations are at risk, no matter what age or sex. Why is this then not the case either?
There are many myths out there concerning the cholesterol issue.
To summarize, consider this:
“ Cholesterol is vital to our cells and not a deadly poison. Mental stress, being active and fluctuating body weight may influence the levels but by itself, having high levels is not dangerous other than being a reflection of an unhealthy lifestyle, or it could be totally just there.
" Hardening of the arteries and coronary heart disease are blamed on high cholesterol. Many studies have shown that people whose blood cholesterol is low have hardened arteries too
" Left alone, the body produces 3 to 4 times more than what we eat. Eating a little food high in cholesterol will make it increase a little bit but why does it decrease when you eat a lot? Then dieting really cannot do more than lover cholesterol just a little bit.
" If diet and animal fat is such an important aspect of controlling cholesterol levels, then why is it that more than 20 studies have shown that people who suffered a heart attack did not eat more fat of any kind than other people?
" Drugs are deemed to be the only effective way to lower cholesterol. No more lives have been saved and studies have proven that these drugs are dangerous to your health and may shorten your life. A recent column by the New York Times, Jan/08 has reported that " Zetia, a cholesterol-lowering drug prescribed to about 1 million people each week, has no medical benefits, according to a trial by Merck and Schering-Plough…. trials have not shown that Zetia reduces heart attacks or strokes, or that it reduces plaques in arteries that can lead to heart problems."
In conclusion, it is a sad state of affairs when many of these facts have been presented not only in scientific journals and books for many years but have not swayed the die-hards of the old beliefs that high cholesterol is bad. Is this stubbornness, ignorance, confusion or all three?
But the parting shot should be this: if high cholesterol has been recorded in persons that live the longest and that it occurs most often in people with the lowest mortality rate then how is it possible that it is harmful to the artery walls and causes fatal coronary heart disease, the commonest cause of death, if those whose cholesterol is the highest, live longer than those whose cholesterol is low?