The Association Between Cholesterol and Longevity
Heart disease is the “silent killer” behind which many see a diet high in saturated fat and high cholesterol levels. Yet, it’s not that simple.
According to systematic reviews, evidence is lacking to claim that saturated fat increases the risk of heart disease (Ramsden et al., 2016, Ramsden et al., 2013, Praagman et al., 2016).
When it comes to cholesterol, lower is not always better. There seems to be a “golden plateau” of cholesterol levels linked with better health outcomes (210–249 mg/dL). It follows a U curve, according to a Korean study on 12.8 million adults (Yi et al., 2019).
NOTE: This figure was taken from Yi et al., 2019
Other studies highlight associations between excessively low total cholesterol and higher mortality in patients with coronary heart disease, the elderly, and healthy middle-aged adults (Behar et al., 1997; Tuikkala et al., 2010; Nago et al., 2011).
On the other hand, hypercholesterolemia is a major risk factor for heart disease—the number one cause of death globally.
High LDL cholesterol is thought to directly cause atherosclerotic cardiovascular disease, increasing the chance of potentially fatal complications. High LDL and low HDL have been linked with an increased risk of dying from cardiovascular disease in the long term (Gidding & Allen, 2019; Abdullah et al., 2018).
In healthy older people who are not taking statins, however, high LDL levels might even be beneficial (Ravnskov et al., 2016; Bathum et al., 2013).
As studies continue to question what we know about cholesterol levels, it’s time to look at longevity in a new light too. Based on the existing evidence, optimizing total and LDL cholesterol levels may turn out to be a better health goal than aggressive lowering treatment.
The Role of Heart-Healthy Probiotics
Studies suggest that probiotics might “reset” the gut microbiome, helping to reduce the excessive absorption of cholesterol from food. This may contribute to normal cholesterol levels and reduce the risk of atherosclerosis (Wu et al., 2017).
Clinical reviews found that Lactobacillus reuteri NCIMB 30242 is the probiotic strain with the highest level of evidence for supporting normal cholesterol levels and heart health (DiRienzo, 2014).
In a clinical trial of 127 people, L. reuteri NCIMB 30242 capsules reduced LDL cholesterol by 11.6%, total cholesterol by 9.1%, and the LDL-C/HDL-C ratio by 13.4% over 9 weeks compared with placebo (Jones & Prakash, 2012).
In the same study, L. reuteri NCIMB 30242 also lowered CRP, fibrinogen, and ApoB-100—markers of heart disease and inflammation. Overall, it reduced heart disease risk categories in 27% of people whose CRP values were normal or high (Jones & Prakash, 2012).
In another study of 114 adults with high cholesterol, L. reuteri NCIMB 30242 yogurt reduced LDL by about 9% and total cholesterol by 5% over 6 weeks compared with placebo (Jones et al., 2012).
Vitamin D and Cholesterol: the Missing Link?
Low serum 25(OH)D levels have been linked to all-cause, cardiovascular, cancer, and infectious-related mortality (Pérez-López et al., 2011).
Preclinical studies even hypothesize that vitamin D3 may play a role in lifespan extension, but this hasn’t been proven in humans (Mark et al., 2016).
According to a Danish study, vitamin D may also improve cholesterol status. The authors believe that vitamin D may be the missing link to optimal lipid status. They discovered that higher vitamin D is associated with fewer deaths from digestive, endocrine, metabolic, nutritional, and respiratory diseases (Skaaby, 2015).
Lactobacillus reuteri NCIMB 30242 is the only probiotic strain so far that increased blood levels of vitamin D3 in placebo-controlled clinical studies. This opens the possibility of supporting vitamin D status by targeting the gut microbiome (Jones et al., 2013).
Defining the Anti-Aging Microbiome
Animal studies indicate that age-related gut dysbiosis may contribute to unhealthy aging and reduced longevity (Hopkins et al., 2001; Yatsunenko et al., 2012; Odamaki et al., 2016; Kim & Jazwinski, 2018).
The main age-related chronic health problems revolve around cardiovascular and neurodegenerative diseases. Gut dysbiosis contributes to chronic low-grade inflammation (inflammaging), the underlying cause of unhealthy aging and many age-related diseases. It also alters the immune response (immunosenescence) and disrupts nutrient signaling (Kim & Benayoun, 2020; Kim & Jazwinski, 2018; Vaiserman et al., 2017; Buford, 2017).
A balanced gut microbiome, on the other hand, may improve markers of health and longevity.
Can the gut microbiome predict a person’s age? And can probiotics have anti-aging effects by mimicking a youthful-like gut microbiome?
Recent research claims this might be possible. By modeling a “human microbiome clock,” scientists were able to predict the participants’ age based on their microbiome composition (Galkin et al., 2018).
Another study uncovered that the microbiome of the elderly lacks beneficial probiotic genera and has more genera related to inflammation and cancer. The authors say that this is a step toward designing probiotics that may help maintain a youthful and health-promoting gut microbiome in older people (Xu et al., 2019).
Microbiome-targeted dietary and probiotic interventions may support health and longevity by enhancing antioxidant activity and immunity, suppressing chronic inflammation, balancing fat deposition and metabolism, and preventing insulin resistance (Vaiserman et al., 2017)
Many questions still remain unanswered. For example, how does the microbiome of people who “successfully” age adapt so well? What’s so special about the microbiome of long-living people from around the world? How do nationality and ethnicity play in? What does the next generation of probiotic supplements look like? (Biagi et al., 2017)
As science moves closer to finding the answers, the vision of an anti-aging microbiome becomes a more likely reality.
What Is the Bottom Line?
High cholesterol is a risk factor for atherosclerosis and heart disease. Additionally, gut microbiome dysbiosis contributes to chronic inflammation, unhealthy aging, and reduced longevity.
Probiotics may help maintain a youthful-like microbiome and normal lipid and vitamin D status. Research has yet to define the characteristics of an anti-aging microbiome, opening the door to targeted probiotic supplementation.
Lactobacillus reuteri NCIMB 30242 is a probiotic with clinical evidence for supporting cardiovascular health and already normal cholesterol and vitamin D levels. It is currently sold under Microbiome Plus+ (ex Cardioviva).
