What If We Were Wrong About Cholesterol?

For decades, we’ve been told:
👉 “High cholesterol causes heart attacks.”

But the full story is more complex - and emerging science is starting to reflect that.

🧬 What the science actually says:

In 2016, a large meta-analysis looked at data from over 68,000 people aged 60+.

Surprisingly, it found that:

This study, published in BMJ Open, challenged conventional wisdom and raised a key question:

Are we focusing too much on LDL numbers and not enough on metabolic health?

💡 A few important caveats:

That 2016 study received criticism, too. Some experts believe:

• People who are frail or ill often have lower LDL (so the link may reflect reverse causality).

• It focused on all-cause mortality, not just cardiovascular events.

• LDL is still a proven risk factor - but not in isolation.

Bottom line? It sparked a necessary debate.

💉 Let’s talk real numbers (U.S. guidelines):

• ✅ Optimal LDL: under 100 mg/dL

• ⚠️ Borderline high: 130-159 mg/dL

• ⚠️ High: 160-189 mg/dL

• ❗️Very high: 190+ mg/dL

But numbers alone don’t tell the whole story. What matters more is why your LDL is elevated and what else is going on in your body.

🔍 What matters more than LDL alone?

Here are better markers for understanding real cardiovascular risk:

• ApoB - measures the actual number of atherogenic particles

• Triglyceride:HDL ratio - ideally below 2:1

• hsCRP - a marker of inflammation

• Fasting insulin - reveals hidden metabolic dysfunction

• LDL particle size - large = less harmful; small = more dangerous

🧠 Bottom line:

Cholesterol isn’t the villain - but it’s also not irrelevant.
Context is everything.

If you're metabolically healthy, active, and have low inflammation, high LDL might not carry the same risk as it does for someone with metabolic syndrome or chronic inflammation.

Rather than fixate on a single number, a deeper look at your full health profile is the smart path forward.

🔜 Next Week:

We’ll shift focus to your gut microbiome - a powerful, often overlooked part of your longevity blueprint.

Stay curious,
David
Founder, Longevity Enthusiasts