Youngsters advised to cut bad cholesterol for long-term benefits

By Stephen Daniells

- Last updated on GMT

Related tags: Atherosclerosis, Cardiovascular disease, Low-density lipoprotein

Young people should be encouraged to lower their 'bad' cholesterol
intake to reduce their long-term risk of heart disease, says a
major new study.

"These data indicate that a moderate, long-life reduction in LDL [bad] cholesterol is associated with substantial reduction in the incidence of coronary events, even in populations with a high prevalence of other cardiovascular risk factors,"​ said researcher Helen Hobbs from the University of Texas.

The link between high levels of low-density lipoprotein (LDL) cholesterol and increased risk of coronary heart disease (CHD) has been supported by a variety of experimental, genetic and epidemiological studies.

CHD and cardiovascular diseas (CVD) causes almost 50 per cent of deaths in Europe, and is reported to cost the EU economy an estimated €169 bn ($202 bn) per year.

The new study, published in the New England Journal of Medicine​ (Vol. 354, pp. 1264-1272), followed more than 12000 multiethnic volunteers for more than 15 years.

The researcher found that people with a mutant form of a gene, called PCSK9, had significantly lower blood levels of LDL cholesterol.

It was also apparent that black volunteers were more susceptible to the mutant gene, and were associated with a 28 per cent reduction in LDL cholesterol.

During 15 years of follow-up only one of the 85 black subjects with the mutant gene developed CHD, compared to nine per cent of black subjects with the 'normal' gene. This 28 per cent reduction in LDL cholesterol equated to a 90 per cent reduction in the rate of CHD.

White participants with the mutant gene had a 47 per cent reduction in the risk of CHD.

By using this result that lower levels of LDL cholesterol over long periods of time led to a reduction of the risk of CHD, the scientists suggested that: "relatively moderate reductions in LDL cholesterol level (20 to 40 milligrams per decilitre) would markedly reduce the incidence of CHD in the population if sustained over a lifetime."

In an accompanying editorial, Alan Tall from Columbia University Medical Center welcomed the study, and said the discovery has "public health implications."

"The new findings suggest the need to redouble our effort to reduce LDL cholesterol levels in younger persons by promoting healthy diets and reducing obesity.

Even small successes will probably be leveraged for later gains in lowering the risk of cardiovascular disease,"​ said Tall.

The news is good news for the heart health foods market, already experiencing impressive growth. Cardiology experts said recently that more effort should be focussed on increasing so-called 'good' cholesterol (HDL) and less on reducing LDL.

According to a recent report from Leatherhead Food International, the heart health market was valued at €3.0 bn ($3.6 bn) market in 2004, and expects that sales will grow by nearly 60 per cent over the 2004-2009, to reach nearly €4.7 bn ($5.7 bn) by 2009.

Cereals make up the largest slice of the market because they are naturally high in fibre, but foods designed to lower cholesterol reduction continue to dominate in terms of new launches.

There are five ingredients that are added to products aimed at lowering cholesterol: phytosterols, soya, oatbran, psyllium (a husk used almost exclusively in Japan and Australia) and wholegrains.

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