High cholesterol: Nutritionist reveals top prevention tips

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The link between high cholesterol and heart disease is well established with countless trials showing that lowering cholesterol both through lifestyle changes and pharmacologic means was highly beneficial in reducing serious health outcomes. However, some scientists wondered if there was a hidden price to be had for better heart health.

Several studies have found that low serum lipid levels are associated with persistently low platelet serotonin levels in depressed patients.

Researchers have hypothesised that low cholesterol levels indirectly lead to reduced brain serotonin because of the requirement of adequate cholesterol in nerve cell membranes to maintain the functional integrity of serotonin receptors.

These observations are consistent with a high rate of severe depression in individuals afflicted with a rare genetic syndrome which causes an enzyme deficiency resulting in abnormal low serum cholesterol.

A study published in the journal Biochemistry looked at direct links between abnormal low brain cholesterol levels and impaired serotonin function.

Researchers looked at the correlation between increased rates of suicide and violent behaviour and low cholesterol levels.

Researchers reported a significant reduction in the level of serotonin binding and G-protein coupling to serotonin 1A receptors resulting from chronic cholesterol depletion following treatment with mevastatin, which is one of the more lipophilic statins.

Another study published in the National Library of Health, cholesterol and mental health was further investigated.

The study noted: “A quarter of a century ago, a meta-analysis of six primary prevention randomized controlled trials (RCTs) suggested that lowering serum cholesterol levels was associated with an increased risk of mortality related to accidents, suicide, or violence; a decade later, a meta-analysis of 19 RCTs showed that deaths due to these causes were not increased in patients treated with statins for either primary prevention or secondary prevention.

“In fact, meta-analysis of epidemiological as well as RCT data suggests that there is a lower risk of depression in statin users, and that statin augmentation of selective serotonin reuptake inhibitors has an antidepressant effect.

“Finally, and most important of all, it is important to reduce serum cholesterol in patients with major mental illness if only because such patients are at an increased risk of metabolic syndrome; statin treatment in such patients could, in the long run, significantly reduce medical morbidity and mortality, much as it does in the general population.

“The risk–benefit ratio clearly favours the reduction of serum cholesterol through statin treatment.”

A significant amount of evidence exists that cholesterol, mood and behaviour are related.

Low cholesterol levels, either in the brain or in the blood, may contribute to negative mood and behaviour possibly through the regulation of serotonin.

The finding is not surprising, considering the brain is the most cholesterol-rich organ in our bodies, containing 25 percent of our total body cholesterol despite the fact that it’s only two percent of our total body weight.

Statin psychiatric effects can include irritability/aggression, anxiety or depressed mood, violent ideation, sleep problems including nightmares, and possibly suicide attempt and completion.

It has also long been observed that total cholesterol levels are consistently lower in more severely depressed and more aggressive patients.

However, on the flip side of this it does not mean one should now increase their cholesterol levels or stop taking their cholesterol-lowering medication in the hopes it will improve their overall mood.

One of the best things you can do for both low mood and cholesterol is to get regular exercise, with the NHS recommending at least 150 minutes of physical exertion a week.

For confidential support call the Samaritans in the UK on 116 123 or visit a local Samaritans branch.

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