‘Badder’ cholesterol decreases in western countries

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Cholesterol levels – a marker of cardiovascular risk – are declining sharply in western countries, including Spain, but are increasing in low- and middle-income countries, particularly in Asia, according to the largest study of global cholesterol levels by hundreds of researchers from around the world, led by Imperial College London.

The research, published in the journal Nature, used data from 102.6 million people and examined cholesterol levels in 200 countries, including Spain, over a period of 39 years, from 1980 to 2018.

This study, assures ABC Salud Ana B Crujeiras, from the Santiago Institute of Health Research and the Santiago University Hospital Complex (CHUS), evidences that in the last almost 40 years there has been «a change in the levels of the cholesterol fraction that favors the development of cardiovascular diseases “.

The data, adds the CIBEROBN researcher, show that western developed countries show a “decrease in non-optimal cholesterol levels” while these figures have “increased in developing countries”.

The work reveals that high cholesterol is responsible for approximately 3.9 million deaths worldwide. Half of these deaths occur in East, South, and Southeast Asia.

The results reveal that total and non-HDL cholesterol levels have fallen sharply in high-income nations, particularly in north-western Europe, North America and Australia, while increasing in low- and middle-income nations, particularly in the East. and Southeast Asia. China, which had some of the lowest levels of non-HDL cholesterol in 1980, had one of the highest rates of non-HDL increase during the study period of 39 years. [No-HDL colesterol, explica Crujeiras, es una medida que incluye todas las lipoproteínas diferentes de las HDL colesterol, es la diferencia entre el colesterol total y el HDL-colesterol].

China, which had some of the lowest levels of non-HDL cholesterol in 1980, had one of the highest rates of non-HDL increase during the study period of 39 years

According to the work, countries with the highest levels of non-HDL cholesterol, which is a marker of cardiovascular risk, changed from those of Western Europe, such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, the Philippines, and Thailand. In Spain there has been a reduction of between 0.30 and 0.20 mmol / liter in the levels of non-HDL cholesterol, “which can mean a significant reduction in the risk of cardiovascular disease,” says Crujeiras.

The causes? The report ensures that this change appears to be primarily due to changes in nutritional patterns. The main factors involved in this reduction, indicates the Spanish researcher, “are associated with an improvement in the nutritional pattern, with a greater consumption of foods of plant origin, reducing the consumption of saturated and trans fats.”

In addition, he continues, an important factor also in the improvement of cholesterol levels is physical activity and the reduction of sedentary lifestyle. «This has been achieved thanks to a significant involvement by scientific societies such as the Spanish Society for the Study of Obesity (SEEDO), among others, in raising awareness both in society and in political and clinical authorities to promote habits healthy life. All of them together with an increase in the consumption of statins that is accessible to all patients thanks to the healthcare system in Spain. ”

For Professor Majid Ezzati, lead author of the research, he notes that, “For the first time, the highest levels of non-HDL cholesterol are outside the Western world. This suggests that we now need to establish price and regulatory policies around the world that change diets from saturated to unsaturated fats, and prepare health systems to treat those in need with effective medications. This will help save millions of deaths from high non-HDL cholesterol in these regions. ”

Diet and lifestyle have the greatest impact because they already help with prevention

Crujeiras remembers that hypercholesterolemia is an important risk factor for cardiovascular diseases such as atherosclerosis. Also, experimental and clinical studies have shown that hypercholesterolemia and high fat diets favor the development of cancer. Therefore, the control of cholesterol levels by promoting a diet and healthy lifestyle habits that reduce cholesterol levels are crucial in the prevention of cardiovascular diseases and cancer and thereby induce a significant reduction in the mortality rate in the general population.

Hypercholesterolemia or high total cholesterol is an important risk factor for cardiovascular diseases, such as atherosclerosis. Furthermore, says Crujeiras, “some experimental and clinical studies have shown that hypercholesterolemia and high-fat diets favor the development of cancer.” Therefore, he stresses, «the control of cholesterol levels by promoting a diet and healthy lifestyle habits that reduce cholesterol levels are crucial in the prevention of cardiovascular diseases and cancer and thereby induce a significant reduction in the rate of mortality in the general population ».

And for them there are three important factors, although it is the diet and lifestyle that have the greatest impact because they already help with prevention. .

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