A new study from Sardinia’s Blue Zone area has shed light on longevity and cholesterol levels, suggesting that moderate LDL cholesterol may be a key factor for living longer than expected—challenging traditional medical advice.
Published in the journal Nutrients, this research examined nonagenarians from central Sardinia to explore whether high cholesterol could contribute to extended lifespan. Researchers observed that individuals with LDL-C levels above 130 mg/dL had a longer median survival compared to those below this threshold, indicating a potential benefit of moderate hypercholesterolemia in older populations.
However, the study also found that very high cholesterol levels were detrimental for women’s longevity. This complex relationship between cholesterol and lifespan suggests that current medical guidelines on cholesterol management may need reevaluation, particularly for individuals over 90 years old.
The “cholesterol paradox” refers to studies showing higher LDL-C levels could be associated with lower mortality in the elderly. Some experts attribute this to reverse causality—where declining health leads to lowered cholesterol rather than vice versa—but others believe that cholesterol may offer protection during aging by supporting immune function and cellular repair.
Physical activity played a crucial role in Sardinia’s long-lived population, with 85.2% of men and 69.0% of women exercising at least three times weekly. The study involved selecting nonagenarians from the Blue Zone region, which is known for its high proportion of elderly residents living past 90.
Cholesterol levels were measured through standard blood tests after an overnight fast, analyzing total cholesterol, LDL-C, HDL-C, and triglycerides. Participants were divided into groups based on their LDL-C levels at a baseline measurement taken in 2018, with follow-up health data collected until December 2024.
The study’s findings suggest that moderate hypercholesterolemia might be an indicator of genetic resilience or adaptive traits acquired through historical factors like malaria exposure. However, the research has limitations due to its small sample size and single-point cholesterol measurement, which may not reflect long-term trends.
Despite these challenges, this study adds to growing evidence that current cholesterol management guidelines for older adults might need reconsideration. Future research should explore whether reducing cholesterol through medications is beneficial or potentially harmful for individuals in their 90s.
In conclusion, while the findings do not recommend abandoning cholesterol management entirely, they emphasize the importance of developing more personalized and age-specific approaches to cardiovascular health based on individual genetic and environmental factors.
