Lowering bad cholesterol may cut risk of dementia by 26%, study suggests
Lowering your levels of bad cholesterol could reduce the risk of dementia by 26%, a study suggests.
People with low levels of low-density lipoprotein cholesterol (LDL-C) in their blood have a lower overall risk of dementia, and a reduced risk of Alzheimer's disease specifically, according to research published in the Journal of Neurology Neurosurgery & Psychiatry.
Taking statins also provided an 'additional protective effect' against the condition for those people with low levels of bad cholesterol, researchers found.
The number of people living with dementia worldwide is forecast to nearly triple to 153 million by 2050, but evidence suggests almost half of cases could be prevented or delayed.
LDL-C is often referred to as bad cholesterol and can cause plaque to build in arteries, leading to cardiovascular disease, which can increase the risk of strokes, heart attacks and death. However, until recently, the relationship between LDL-C levels and dementia has been less clear.
Last year, a Lancet report found 7% of cases of dementia were linked to high levels of bad cholesterol in midlife. Now a new study suggests having low levels of LDL-C could reduce the risk of dementia by a quarter.
Researchers collected data on 571,000 people in South Korea who had not been diagnosed with dementia – 192,213 people with LDL-C levels less than 1.8 mmol/L and 379,006 patients with LDL-C levels higher than 3.4 mmol/L (>130mg/dL).
Analysis of subsequent diagnoses of dementia showed that LDL-C levels below 1.8 mmol/L were associated with a 26% reduction in the risk of dementia and a 28% cut in the risk of Alzheimer's disease specifically, compared with LDL-C levels above 3.4 mmol/L.
Statins appeared to offer additional protection against dementia in the presence of low LDL-C levels. Among people with LDL-C levels below 1.8 mmol/L, statin use was linked with a 13% reduction in dementia risk and a 12% cut in risk of Alzheimer's disease, compared with non-users.
This was an observational study, and no firm conclusions can be drawn about cause and effect. The authors also acknowledged several limitations, including the focus on baseline LDL-C levels when lipid profiles could change over time.
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Nevertheless, they concluded: 'Low LDL-C levels … are significantly associated with a reduced risk of dementia, including Alzheimer's disease-related dementia, with statin therapy providing additional protective effects.'
Dr Francesco Tamagnini, a neurophysiologist at the University of Reading, who was not involved with the study, said: 'There is clearly more to the story of Alzheimer's than we first thought.
'This paper looks at the correlation and potential causal relationship between high levels of bad cholesterol and dementia risk. The results give a convincing argument for researchers to consider LDL cholesterol in addition to the classic approaches.'
Dr Julia Dudley, head of research at Alzheimer's Research UK, said: 'The use of statins seemed to offer a protective effect – even in those who already had cholesterol levels within a lower range.
'However, dementia risk is complex and influenced by many factors. Without a detailed picture of what's going on in the brain, we do not know if there is a direct link between lower cholesterol and reduced dementia risk.
'Clinical trials will be key to understand what effects statins might be having on disease processes in the brain.'
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2 days ago
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Why milk, cheese (and even a smidgen of butter) is good for your health
Queue for a coffee in your local café and you'll hear a dizzying array of orders – oat flat whites, almond macchiatos, soya lattes. Increasingly rarely will anyone order a drink made with dairy, which has fallen so far out of fashion that in some circles it's become a dirty word. Since the 1970s, our consumption of cow's milk has halved – from an average of 140 litres per person per year to 70. Today, just under 35 per cent of British households buy plant-based alternatives, according to data firm Kantar, with annual sales of oat milk alone topping £275 million – up from £155 million five years ago. But while vegan alternatives are generally considered better for the environment than cow's milk, is giving up dairy good for our health? The latest research suggests not. A new study from the University of Reading has found that including dairy in your diet may help control blood sugar levels more effectively than a plant-only diet – and could help prevent diabetes. Participants were either vegetarians who included dairy in their diets, or vegans. Blood tests showed the dairy group had higher levels of acetyl carnitine – a compound that helps cells use fat for energy and reduces oxidative stress, the damage that can occur when blood sugar is too high. And this is far from the only benefit. 'Eating dairy is one of the easiest ways to get enough calcium,' says Dr Emily Leeming, a microbiome scientist at King's College London, dietitian and author of Genius Gut. Calcium is vital for bone health, muscle, nerve and heart function – and it's also strongly linked to protection against bowel cancer. The largest study to date on diet and bowel cancer found that people who ate more dairy tended to have a lower risk of developing the disease. 'An extra 300mg of calcium – found in a typical glass of milk – is associated with a 17 per cent lower risk of bowel cancer,' says Dr Leeming. Alongside calcium, 'dairy contains a high level of protein and other important nutrients including vitamin B12, iodine, phosphorus, potassium and riboflavin,' says Laura Southern, founder of London Food Therapy. So what type of dairy should we be going for – and how much? Skip to: Milk Cheese Yogurt Butter Milk can lower your risk of heart disease Many adults today claim to be lactose intolerant – a condition in which the body doesn't produce enough of the enzyme lactase to break down the sugar in cow's milk. It's believed to affect around 15–20 per cent of the population. Cow's milk protein allergy is common in babies – affecting around seven per cent of those under one – but most outgrow it, and in adults it's very rare. For most people, then, choosing a plant-based alternative is a lifestyle decision – but one that could have unintended health consequences. Our declining intake of cow's milk has led to a drop in iodine consumption – a trace mineral that's crucial for thyroid function. A 200ml glass of milk provides around 70mcg of iodine, half the adult recommended daily intake of 140mcg. 'Iodine is quite difficult to find in our diets, but it goes into cattle feed – which means it's in milk,' says Southern. 'We need iodine for our thyroid hormones. Thyroid disorders can cause low energy levels, poor metabolism, fertility problems and issues with foetal development during pregnancy.' Contrary to what many believe, milk isn't likely to make you gain weight or raise your cholesterol. Research from the University of Reading found that milk drinkers had lower cholesterol levels – and a 14 per cent lower risk of coronary heart disease. And semi-skimmed or skimmed options may not be the healthier choice. A 2024 study in the US revealed that drinking whole milk was associated with lower weight, BMI and obesity prevalence. Some plant-based drinks are fortified with calcium, vitamin B12 and iodine – others are not. Organic versions, which are the least processed, cannot legally be fortified. And while some fortified drinks contain added calcium, not all forms are equally well absorbed. The calcium in cow's milk is naturally occurring – and more readily used by the body. 'Cow's milk is a really good package of nutrients in an unprocessed bundle,' says Southern. Eat cheese to ward off dementia Cheese has long been vilified for its high levels of saturated fat and salt – but recent research suggests it offers far greater health benefits than previously assumed. In 2023, a review of dozens of studies by scientists in China and at Harvard University found that eating cheese – around 40g per day – was linked to a lower risk of heart disease, stroke and dementia. A possible explanation for its cardiovascular benefits may lie in its fermentation process, says Southern. 'The beneficial microbes break down the lactose – or milk sugar – and the proteins in cheese. Those are the elements that can have an inflammatory effect in the body,' she explains. 'What's left are the health-promoting components.' Bacteria in many cheeses – including Parmesan and cheddar – break down milk proteins into compounds similar to those found in blood pressure drugs known as ACE (angiotensin-converting-enzyme) inhibitors, potentially helping to prevent hypertension. Fermentation also produces vitamin K, which has been shown to slow the build-up of calcium deposits in the arteries and valves of the heart. Camembert and Edam contain the highest levels. A 2023 study of older adults in Japan found that eating cheese was associated with better cognitive function and lower rates of dementia. The cheese-eating group also had slightly lower BMIs and blood pressure – and walked faster. Hard cheeses are particularly rich in calcium. Parmesan contains 19 per cent of the recommended daily amount in just one 30g serving. Official guidance recommends no more than 30g of cheese a day. 'We don't want to eat too much because of its fat content, but I advise clients to measure two fingers' worth of hard cheese, chop it up and sprinkle it into a salad,' says Southern. 'That way you're getting the benefits, plus flavour, protein and satiety.' Vegan alternatives are another matter. 'They're mostly salt and fat and are very highly processed,' says Southern. 'Most varieties aren't health-enhancing – and cheese is notoriously difficult to replicate.' The benefits of the good bacteria in 'live' yoghurt for the gut microbiome are well established – making a daily portion one of the healthiest dairy choices around. 'I often advise clients to start their day with a couple of tablespoons of fermented or Greek yoghurt with seeds,' says Southern. 'It's very satiating, provides a high level of protein and helps keep blood sugar steady throughout the morning.' Several major studies have highlighted further health advantages. The most recent – published in Gut Microbes – showed that long-term consumption of two or more servings of yoghurt per week was linked to lower rates of one type of bowel cancer. Another study, based on data from 5,000 people, found that eating 40g of yoghurt daily lowered the risk of liver cancer by 5.4 per cent. Research from the Medical Research Council's epidemiology unit at the University of Cambridge also found that people who regularly ate natural, unsweetened yoghurt had a 28 per cent lower risk of developing type 2 diabetes than those who never consumed it. Still not convinced? A comprehensive 2023 meta-analysis published in The American Journal of Clinical Nutrition, which examined data from almost 900,000 participants, found that higher yogurt intake was significantly associated with a lower risk of death from all causes – and from cardiovascular disease. Dairy-free alternatives generally contain far less calcium, protein and potassium – although some now include added probiotics to support gut health. Butter – stick to small amounts Who doesn't love a slice of hot toast slathered in melting butter? Delicious as it is, butter is high in saturated fat – so 'moderation is key,' says Southern. One analysis, which included data from more than 600,000 people, found that moderate butter consumption wasn't linked to a higher risk of heart disease – and may even offer slight protection against type 2 diabetes. But compared to other forms of dairy, its benefits are limited. 'New research has shown that it's not just the nutrients themselves that affect health – it's how they're packaged within a food, something called the food matrix,' says Dr Leeming. She points to a study comparing the matched nutrients in cheese and butter, which found that cheese lowered levels of 'bad' LDL cholesterol – while butter did not. 'It suggests the food matrix plays a role in how our bodies respond,' she says. A major study published earlier this year, involving more than 200,000 people followed over 30 years, found that those who consumed more plant-based oils – particularly olive, rapeseed and soya – had a 17 per cent lower risk of death than those who regularly ate butter. 'We don't need to be frightened of butter,' says Southern. 'Although plant-based spreads are now largely free from unhealthy trans fats, I'd still choose butter for toast or baking. But for cooking, a good quality oil is much better for us.'
