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Tuesday, July 12, 2011

How Low Should Your Cholesterol Levels Be?

Ideally, your total cholesterol should be below 150 mg/dL. According to William Castelli, who was the medical director of the Framingham Heart Study for many years, people with a total cholesterol value of less than 150 mg/dL simply don’t get heart attacks. And once someone’s total cholesterol is that low, the ratio between the “good” and “bad” cholesterol simply doesn’t matter.

The total cholesterol value is the single most important clue to a person’s risk of heart attack. Once the cholesterol levels in the blood rise to, say, the mid-160s, then the ratio of good versus bad cholesterol (HDL versus LDL) really starts to matter.

William Castelli once explained, “Four out of five people on this earth can’t get their cholesterol over 150; they don’t get heart attacks. One out of five people can’t get their cholesterol down to 150. They do get heart attacks. And almost all of them live in affluent countries.” The “four out of five people” Castelli meant live in societies that eat a low-fat, high-fiber, largely plant-based diet. That kind of diet keeps blood cholesterol levels naturally low.
To see how cholesterol values relate to the risk of heart attack, look at the graphs on this page:


  1. The cholesterol hypothesis may not be correct. The article cited below dissects the Framingham studies and contradicts the conclusions. I am not a crank citing pseudoscience, do some checking and look at the article as well as the newer studies. Interestingly, systemic stress may be one of the culprits.
    "Most studies have found that for women, high cholesterol is not a risk factor for heart disease at all - in fact, the death rate for women is five times higher in those with very low cholesterol."

    Full article: High Cholesterol does NOT cause heart disease | Trusted.MD Network

  2. Oh here is another article about cholesterol discussing the state of the evidence.

  3. Hi Junkman Jim: When I looked up Vreni Gurd,I found that she has a bachelor's degree in how to teach gym class and zero publications in MEDLINE. In other words, she's never studied any of the relevant topics in school, and nothing she has written has been published in any peer-reviewed biomedical journal. So why should I take her word over that of some of the world's foremost experts on nutritional epidemiology?

    Dr. Hyman's article fails to address the simple fact that coronary artery disease is practically nonexistent in populations that eat a low-fat, high-fiber, practically plant-based diet. Populations that shifted from a diet rich in fatty animal-based foods to a low-fat, plant-based diets as a result of food rationing or food shortages during the world wars have also exhibited steep declines in coronary artery disease. If a fatty, animal-based diet doesn't cause heart disease, why do the rates of heart attack drop so precipitously in populations that shift to a low-fat, plant-based diet as a result of wartime rationing? Why does atheroma regress in patients who voluntarily shift to a strict, low-fat, plant-based diet?

  4. Oh, one other important point. You have to be very careful about interpreting the death rates in population studies. Healthy diet is not the only cause of low cholesterol levels. The more common cause is liver failure, which is often due to cancer or alcoholism. So it stands to reason that you'd find high death rates among the people with the lowest cholesterol levels. That doesn't mean that high cholesterol levels are good for you.