Proof that
Lifelong Chol
Reduction Prevents Heart
We know LDL, the so-called bad cholesterol, plays “a central role” in the initiation, development and progression of heart disease. In fact, more than 100 prospective studies involving more than a million people have demonstrated that those with higher LDL levels are at higher risk. In a long-term study, young men 18 through 39 years of age were followed for up to 34 years and their cholesterol levels, even when they were young, predicted long-term risk of heart disease and death. Men in their 20s and 30s who have a total cholesterol just under 200 have a “substantially longer estimated life expectancy”- around 4 to 9 years longer than those with levels over 240. Evidence from observational studies, however, is vulnerable to confounding” factors. Eating a diet that is plantbased enough to lower cholesterol below average, for example, may add years to our lives regardless of what our cholesterol actually is. Ideally, we would have a long-term, randomized,
14
controlled trial. Luckily, nature may have actually set one up for us. Each of us, at conception, gets a random assortment of genes from our mother and our father and some of those genes may affect our cholesterol levels. Just like there are rare genetic mutations that result in unusually high cholesterol levels, there are rare genetic mutations that lead to unusually low cholesterol levels, “providing an ideal system in which to assess the consequences of low LDL cholesterol levels independently of other factors that may modify disease progression,” such as confounding diet and lifestyle factors. About 1 in 40 African Americans have a mutation that drops their LDL cholesterol from around 130 down toward more optimal levels. This group didn’t eat healthy to achieve that drop. It’s just in their genes. More than half had high blood pressure and there were a lot of smokers and diabetics in the group, yet those with genetically low LDL levels still had a significant 88 percent reduction in the incidence of coronary heart disease, even in the
presence of all those other risk factors. The same 20 to 40 point decrease in LDL from drugs only reduces risk around 30 percent. Makes sense, though, because the people with the mutation had low levels their entire lives. They didn’t simply start taking a pill when they were 60. “Therefore, a primary prevention strategy that promotes keeping LDL [cholesterol] levels as low as possible, beginning as early in life as possible, and sustaining those low levels of LDL [cholesterol] throughout the whole of one’s lifetime has the potential to dramatically reduce the risk of CHD,” coronary heart disease. If you don’t know your cholesterol level, you should get it checked maybe even starting in childhood.
