Guest article by Sam Hadadi,
For years, doctors and the media have bombarded us with advice warning that cholesterol is bad for the heart. All too often, patients at risk of heart problems have been told to steer clear from LDL, the so-called “bad cholesterol”.
Yet now, the advice may be about to change, with a brand-new study suggesting that LDL isn’t quite the baddie it was made out to be.
In fact, far from it - the study has flipped things on its head so much that many have accused health officials of scaremongering. LDL may not be the health villain we once thought.
So, what’s the deal? Well, in an almighty review of 19 studies (involving close to 70,000 people), researchers discovered that there’s no link between the supposed "bad" cholesterol and heart disease in the over-60s. That’s right – no link at all.
In fact, the once-villainous LDL may actually help people to live longer. Throwing all current guidelines into uproar, researchers writing in the BMJ Open Journal discovered that a massive 92% of those with high cholesterol levels actually lived longer.
For starters, we may have been following the wrong advice for too long. Researchers on the review even went as far as to suggest that cholesterol could be vital to our health, especially in the elderly and could help to prevent infection, strokes, cancer, cataracts, muscle pain and fatigue.
In the words of Malcolm Kendrick, a GP and co-author of the study: “The truth has always been out there: that the cholesterol hypothesis is wrong.
“What we found in our detailed systematic review was that older people with high LDL levels — the so-called ‘bad’ cholesterol — lived longer and had less heart disease. Many of us suspected this may be true but the consistency of the results was astonishing. The diet/heart cholesterol hypothesis [has been called] the greatest scam in the history of medicine. It seems that is right.”
The review also called for “more research about the cause of atherosclerosis (a hardening and narrowing of the arteries) and cardiovascular disease (CVD) and also for a re-evaluation of the guidelines for cardiovascular prevention, in particular because the benefits from statin treatment have been exaggerated."
As a result of the review, heart experts have called for our NHS guidelines to be overhauled completely, with many questioning the amount of people being prescribed cholesterol-lowering drugs. This is pretty worrying when you consider that more than seven million people in Britain are prescribed statins to try to slash their risk of heart disease.
Then there’s also the matter of refocusing our health – what do we need to do to stay in tip-top condition if everything we once believed is actually pretty flawed? As a result of this study, Aseem Malhotra, a cardiologist, told The Times newspaper: “The scientific evidence clearly reveals that we must stop fear-mongering when it comes to cholesterol and heart disease and focus instead on insulin resistance, the most important risk factor as a precursor to many chronic diseases.”
Insulin resistance, as you may or may not know, is where our body produces insulin but fails to use it effectively. This causes glucose to build up in the blood and can lead to type 2 Diabetes.
It’s thought that the biggest causes of insulin resistance are a poor diet and excess weight – and, more and more, scientists believe that this could be the trigger of all kinds of diseases, including heart disease1.
Given all this fuss, you’d be forgiven for wondering what the heck cholesterol is. And why is research into it so important?
Put simply, cholesterol is a fatty substance known as a lipid and helps our body to keep functioning properly. It’s carried about in our blood by proteins.
There are two types of cholesterol (or lipoproteins): LDL cholesterol — low-density lipoprotein – and HDL, the high density lipoprotein.
As you now know, LDL cholesterol is usually made out to be the bad guy and is often called "bad cholesterol”. Why? Well, while it carries cholesterol to the cells in the body which need it, too much is thought to lead to a build-up in artery walls, triggering disease.
Meanwhile, HDL is usually referred to as "good cholesterol" because it is protective and carries cholesterol away from the cells and back to the liver, where it's broken down or secreted from the body as waste.
The NHS guidelines2 say that our total cholesterol levels should be 5mmol/L or less for healthy adults, or 4mmol/L or less for those at high risk.
The study is just one more to add to a growing pile of evidence which seems to contradict official guidance. Remember how we’ve always been warned to steer clear from fats3?
In fact, following so many new studies in favour of fats, there are some government bods who believe that an overhaul of guidelines will come in the next year.
After this review, it will be interesting to see how the future of cholesterol and our health pans out. Of course, as convincing as this study seems, there are those who are warning that this review could prove to be dangerous – and that there’s no solid evidence to suggest that LDL is anything but bad for us.
Prof Colin Baigent, professor of epidemiology at Oxford University, told press that the study had "serious weaknesses and, as a consequence, has reached completely the wrong conclusion4."
He went on to argue that random trials of statin therapy show "very clearly that people benefit just as much from reducing their cholesterol when they are in their 70s as when they are younger.”
Perhaps we need to wait for a little more research to be done before we start pouring the cream…
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Sam Hadadi is an ex-BBC journalist and now a freelance writer specialising in fitness and food.