Not all cholesterol is bad. Cholesterol is a type of fat that plays an important function in every cell wall. It is used by the body to make other substances, such as hormones, which are essential to our health and well-being.
While cholesterol is found in some foods, the body also produces needed cholesterol in the liver. Low-density-lipoprotein (LDL) cholesterol carries cholesterol from the liver to cells. Alternatively, high-density-lipoprotein (HDL) returns “extra” cholesterol in circulation to the liver.
Diet and lifestyle choices, as well as health conditions, can cause the cholesterol balance to become skewed. Heart disease risks rise when LDL levels become too high and/or HDL levels drop too low. This is the point where many patients are prescribed statin medications to lower LDL cholesterol levels back to a healthy range.
No connection between LDL cholesterol and mortality?
The BMJ, a medical reseach journal, published a research article claiming there is no association between LDL cholesterol and mortality. This was a review of 19 studies with over 68,000 participants finding no evidence between LDL cholesterol and mortality. I was interested to see this because it seems like we are going too far in our efforts to lower LDL cholesterol. Cholesterol does have a relevant role in health.
Statins are still warranted in many cases to lower LDL cholesterol
Unfortunately, the study methodology was weak and the research doesn’t hold up under closer scrutiny. There is stronger research supporting the connection between using statin drugs to lower LDL cholesterol for reduced heart disease risks.
How low is too low for LDL cholesterol
Current recommendations for people at cardiovascular risk seem to be the lower the LDL cholesterol, the better. An LDL cholesterol level below 70 mg/dL is the standard goal if you are at high risk for heart disease. During the past 10 years new research leans towards dropping guidelines even lower -- to less than 60 mg/dL. These studies are seeing the risk for heart attack and other cardiovascular events reduced further with this additional decrease in LDL cholesterol levels.
Statins are frequently prescribed to lower LDL-cholesterol levels, but lowering levels through diet and lifestyle changes is a valid option for many individuals. It typically takes 4-6 weeks to see results. If you are not at high risk for heart disease, aim for an LDL cholesterol of 100 mg/dL or less. If you are at risk for heart disease, discuss goal levels with your doctor.