By Joseph E. Scherger, MD, MPH
Core Faculty, Eisenhower Health Family Medicine Residency Program, Eisenhower Health Center, La Quinta, CA; Clinical Professor, Keck School of Medicine, University of Southern California, Los Angeles
SYNOPSIS: Among 1,224 participants who lived to their 100th birthday, there were higher levels of total cholesterol and iron, and lower levels of glucose, creatinine, uric acid, liver enzymes, and alkaline phosphatase compared with non-centenarians. These differences were seen as early as age 65 years.
SOURCE: Murata S, Ebeling M, Meyer AC, et al. Blood biomarker profiles and exceptional longevity: Comparison of centenarians and non-centenarians in a 35-year follow-up of the Swedish AMORIS cohort. Geroscience 2023; Sep 19. doi: 10.1007/s11357-023-00936-w. [Online ahead of print].
Swedish researchers studied a database that contained information about 44,636 participants who underwent biomarker blood tests from ages 64 to 99 years. There were 1,224 centenarians, 84.6% of whom were women. The purpose of this study was threefold. First, to describe and compare biomarker profiles at similar ages between those individuals living to 100 years against the same data for their shorter-lived peers. Second, to investigate the association between specific biomarker values and the chance of reaching age 100 years. Third, to examine to what extent those living to age 100 years have similar biomarker profiles earlier in life.
Murata et al reported they found higher levels of total cholesterol and iron, and lower levels of glucose, creatinine, uric acid, and liver enzymes among those who lived to age 100 years. The centenarian group exhibited healthier biomarker profiles at age 65 years onward.
COMMENTARY
The news headlines this study caused concerned the finding of higher levels of cholesterol in those living to age 100 years. The other findings are predictable signs of good health, such as normal levels of glucose and iron, along with proper kidney and liver function.
Cholesterol is a critical molecule in the human body. Its main function is to maintain the integrity and fluidity of cell membranes and to serve as a precursor for the synthesis of substances that are vital for humans, including steroid hormones, bile acids, and vitamin D.1,2 A disservice was done to Western populations when cholesterol became something to avoid in our diet and the goal became to drive cholesterol as low as possible.
Cholesterol as a risk factor for heart disease become important in the 1980s, when scientists issued the first clinical guidelines.3 The lipid panel became common with the concept of “good” cholesterol (HDL) and “bad” cholesterol (LDL). Even these are too simplistic for an analysis of cardiac risk.4
There is more recent evidence suggesting inflammatory markers, such as high-sensitivity C-reactive protein, are as important (if not more important) than the lipid panel when it comes to assessing risk of heart disease.5
The takeaway message from this study by Murata et al is that cholesterol is not a bad molecule. In fact, higher levels of total cholesterol may be a sign of better health. We know eating saturated fat from healthy, natural sources is to be encouraged, not avoided.6,7 Patients still ask me how many eggs a week they can eat. My answer is that if they are healthy eggs from pasture-raised chickens (preferably organic), eat however many you want. They are a great source of protein and other nutrients.
REFERENCES
1. Zampelas A, Magriplis E. New insights into cholesterol functions: A friend or enemy? Nutrients 2019;11:1645.
2. Cleveland Clinic. What is cholesterol? Page last reviewed Aug. 3, 2022.
3. Talwalkar PG, Sreenivas CG, Gulati A, Baxi H. Journey in guidelines for lipid management: From adult treatment panel (ATP-I to ATP III) and what to expect in ATP-IV. Indian J Endocrinol Metab 2013;17:628-635.
4. Scherger JE. LDL: Not always bad and HDL: Not always good. Desert Health. November/December 2022.
5. Polyakova EA, Mikhaylov E. The prognostic role of high-sensitivity C-reactive protein in patients with acute myocardial infarction. J Geriatr Cardiol 2020;17:379-383.
6. Bazzano LA, Hu T, Reynolds K, et al. Effects of low-carbohydrate and low fat diets: A randomized trial. Ann Intern Med 2014;161:309-318.
7. Scherger JE. Welcome back, saturated fat. Internal Medicine Alert. June 15, 2016.
Among 1,224 participants who lived to their 100th birthday, there were higher levels of total cholesterol and iron, and lower levels of glucose, creatinine, uric acid, liver enzymes, and alkaline phosphatase compared with non-centenarians. These differences were seen as early as age 65 years.
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