Swedish Centenarian Study: Highest Cholesterol Lived to Over 100

In 2023, the internet world of Medfluencers got very excited over a study that was published supposedly demonstrating that centenarians had higher cholesterol than non-centenarians. The internet went crazy!

All the keto and carnivore doctors celebrated thinking they finally had the evidence they needed to prove that high cholesterol offered longevity benefits, and did not shorten your lifespan.

One huge problem.....

The authors ended up retracting their findings. Why?

Scientist love to verify and critique each others work. Many people, including myself, pointed out that the supplemental tables, did not support their conclusion.

They likely sent letters to the editors and messaged the authors. The authors agreed, and retracted that finding.

Here is their retraction:

Swedish AMORIS Authors Retracted Findings

Retraction:
https://link.springer.com/article/10.1007/s11357-023-00996-y

But what if they never retracted their findings? The study just doesn't support the conclusion that those who lived to over 100 had higher cholesterol.

Let's take a deep dive.

Survivorship Bias

This study is the ultimate in survivorship bias. They did not collect blood markers until people were between age 64 and 99. This already eliminates a very large portion of society that died young due to elevated cholesterol. Those who survived to 65 had their blood markers tested.

In the 1950s, 60s, 70s, and 80s, most people who were having a heart attack were given a hospital bed, some oxygen and morphine and laid in bed all night. Over 80% would be dead by the morning. It wasn’t until bile acid sequestrants and statins in 1987, that we finally saw a reduction in mortality. Couple that with angioplasty, heart catheterization, and improving stent technology, and that’s when you saw the biggest reductions in mortality.

The Swedish AMORIS cohort study started out with 44,636 individuals, of which, only 1224 made it past 100. Of those 1224, 86% of them were women.

Let’s look at the population make up.

On the far right are non-centenarians. On the left are centenarians. A cursory look will tell you everything you need to know. Those who died before their 100^th birthday had 5 times more heart attacks, 4 times more congestive heart failure, 4 times more peripheral artery disease, 8 times more COPD, 6 times more diabetes and the list goes on. This is population bias. The population that did not make it to 100 had more chronic disease. This is also a case of reverse causality.

The ones that made it to 100 years of age, had far less incidence of these horrific diseases.

In the data that was provided in the study and supplemental tables, you will find a different story being told.

Total Cholesterol (TC) was no different between the centenarians and non-centenarians.

If you look at the supplemental data that was provided, you’ll notice that the difference in total cholesterol between the two groups was only 0.1 mmol/L, which is 3.86 mg/dL in American.

That means one person could have a cholesterol of 197 mg/dL and the other 200 mg/dL. That’s an insignificant difference, especially given the inaccuracy of labs tests and the margin of error. If you run the same blood sample twice through the same machine, you could easily end up with a difference of 3.8 mg/dL and no one would bat an eye.

Look at the top left corner. That’s Total Cholesterol (TC). The difference between the centenarians and non-centenarians was minimal. Compare that to uric acid, creatine, or GGT. There are very obvious differences.

If you look at the supplemental data that was provided, you’ll notice that the difference in total cholesterol between the two groups was only 0.1 mmol/L, which is 3.86 mg/dL in American. That means one person could have a cholesterol of 197 mg/dL and the other 200 mg/dL. That’s an insignificant difference, especially given the inaccuracy of labs tests and the margin of error. If you run the same blood sample twice through the same machine, you could easily end up with a difference of 3.8 mg/dL and no one would bat an eye.

The authors themselves, in the conclusion, admitted that chance probably plays a role and that genetics probably plays a role as well. Further, the sample size is quite small at only 1200.

It’s a stretch to conclude from this data that a 0.1 mmol/L increase in total cholesterol explains the entire story of why some people live to 100.

So, while the headlines sounded interesting, the study falls flat. We have mountains of evidence demonstrating that elevated cholesterol shortens your lifespan. But the anti-cholesterol crowd will probably try to run with it.

Read the study:
https://link.springer.com/article/10.1007/s11357-023-00936-w