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  • Dietary determinants of serum total cholesterol among middle-aged and older adults: a population-based cross-sectional study in Dar es Salaam, Tanzania

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Nutrition and metabolism
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Dietary determinants of serum total cholesterol among middle-aged and older adults: a population-based cross-sectional study in Dar es Salaam, Tanzania
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  • Published on: 12 June 2017
    Response to Uffe Ravnskov
    • Goodarz Danaei, Assistant Professor of Global Health Harvard TH Chan School of Public Health

    As the two comments posted on PubMed for the cited article by Dr Ravnskov et al clearly state, there are several major shortcomings in the design and analysis of their meta-analysis. In addition, benefits of statins in reducing risk of myocardial infarction in older age patients without cardiovascular disease have been shown in several randomized trials.
    Our analysis adds to the literature by providing an insight on how use of palm oil for cooking (as opposed to sunflower oil) may worsen lipid profiles in a population from a low-income country with implications for cardiovascular disease. As we have discussed, a large case-control study has already shown an association between palm oil use and non-fatal myocardial infarction.

    Conflict of Interest:
    None declared.
  • Published on: 8 June 2017
    High cholesterol is an advantage for the elderly

    There is no reason to lower the intake of palm oil or other types of foods rich in saturated fat because elderly people with high levels of LDL-cholesterol (the "bad" one) live the longest. This is what we have documented in a meta-analysis of 19 cohort studies including more than 68,000 individuals.(1). Those with high LDL-cholesterol lived even longer than those on statin treatment.
    Our study has been heavily criticized by several groups of supporters of the cholesterol hypothesis, but hitherto nobody has been able to find a study showing the opposite.

    Reference:
    (1) Ravnskov U, Diamond DM, Hama R et al. Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review. BMJ Open 2016;6:e010401. doi: 10.1136/bmjopen-2015-010401

    Conflict of Interest:
    None declared.