Cholesterol After 65: Why Pushing It Too Low Could Be a Serious Mistake

# CHOLESTEROL AFTER 65: WHAT IF TRYING TO LOWER IT IS A SERIOUS MISTAKE?

**by Laurent Glatz – for Athletic Carnivore**

For decades, we've been told that high cholesterol is dangerous and that lowering it is essential to protect our health. But what happens as we age? What if this logic, applied rigidly after 65, sometimes backfires?

Several large-scale scientific studies involving tens of thousands, even millions of people, reveal a surprising phenomenon: **among older adults, those with relatively higher cholesterol sometimes live longer than those with very low cholesterol.**

This observation deserves close attention. Because behind a simple number on a blood test lies a far more important question: are we truly aiming to extend life, or merely to reduce a biological marker?

Cholesterol: An Enemy Your Body Produces Itself?

Here lies the first paradox.

If cholesterol were inherently harmful, why would our bodies invest so much energy producing it?

Our liver produces cholesterol daily, as do several other tissues, because it is an indispensable molecule for bodily functions.

Cholesterol contributes to the structure of cell membranes, participates in the synthesis of steroid hormones—such as testosterone, estrogens, and cortisol—and serves as a precursor for vitamin D and bile acids essential for fat digestion.

It also plays a structural role in the nervous system, particularly in the myelin sheath surrounding nerve fibers.

**Without cholesterol, no human cell could function properly.**

However, it is crucial to understand a key distinction: the cholesterol necessary for cellular function is not directly proportional to its concentration in the blood. A higher blood cholesterol level does not automatically mean better cellular function.

This nuance becomes especially interesting when examining longevity data.

12.8 Million People: Results That Raise Questions

In 2019, researchers published in *Scientific Reports* a study involving over 12.8 million South Korean adults.

During follow-up, 694,423 deaths were recorded.

They found that the relationship between total cholesterol and mortality was not linear but rather U-shaped.

In other words, both very low and very high cholesterol levels were associated with increased mortality.

Among participants aged 65 to 74 and 75 to 99, the lowest overall mortality was observed with total cholesterol approximately between **2.10 and 2.49 g/L**.

Even more surprising: in the 65–74 age group with cholesterol below 2 g/L, each 0.39 g/L increase was linked to about a 20% reduction in overall mortality. For those aged 75–99, this reduction was about 13%.

These figures do not prove that artificially raising cholesterol would extend life. However, they demonstrate one thing clearly: **very low cholesterol is not systematically synonymous with longer life expectancy.**

This significantly changes how we should interpret this marker in older adults.

After 60, Higher LDL… and Sometimes Lower Mortality!

In 2016, a systematic review published in *BMJ Open* analyzed 19 studies including 68,094 individuals aged 60 and over.

In 16 cohorts, researchers observed an inverse association between LDL cholesterol and overall mortality.

In practical terms, people with higher LDL had lower mortality in these cohorts.

This finding challenges the idea that LDL should always be pushed as low as possible regardless of age.

However, observational studies cannot establish causality. This review also had limitations regarding participant selection and accounting for confounding factors.

Other research confirms the complexity of this relationship.

A Danish study published in the *British Medical Journal* in 2020, involving 108,243 people, found minimal overall mortality around 1.40 g/L LDL in the general population.

Conversely, the same study linked increased LDL to a higher risk of myocardial infarction.

**Here lies the difficulty: the cholesterol level associated with the best overall survival is not necessarily the one linked to the lowest cardiovascular risk.**

Why Might Low Cholesterol Accompany Higher Mortality?

This is likely one of the biological keys to understanding the phenomenon.

With aging, chronic diseases, inflammatory states, malnutrition, or frailty can cause blood cholesterol to drop.

This means abnormally low cholesterol can sometimes be a consequence of deteriorating health rather than its cause.

Researchers call this *reverse causality.*

Consider two 75-year-olds with different cholesterol levels.

The first maintains good autonomy, satisfactory muscle mass, adequate nutrition, and relatively high cholesterol.

The second experiences unintentional weight loss, decreased appetite, persistent fatigue, and very low cholesterol.

Would it be reasonable to conclude that the second is healthier simply because their cholesterol is lower?

Obviously not.

But beware: this example does not prove that high cholesterol protects the first individual.

It mainly shows why **an isolated biological result can give a misleading picture of the true physiological state.**

At 70, Should You Pursue the Same Goals as at 40?

This is the central question.

At 40, cardiovascular risk assessment must consider decades of exposure to risk factors.

At 70 or 80, other dimensions become crucial: frailty, existing diseases, muscle mass, nutritional status, autonomy, and medications.

It is not to say that high LDL suddenly becomes protective after 65. No such biological threshold has been demonstrated.

It would also be incorrect to conclude that lowering LDL is always a mistake in older adults. Randomized trials show that LDL reduction can decrease cardiovascular events, especially in those with prior heart attacks or atherosclerotic strokes.

In primary prevention after 75, data are less complete, and the benefit of intervention depends more on individual context.

The real mistake might be elsewhere: **applying a uniform strategy without assessing the person’s actual situation.**

What If We Finally Looked at the Whole Metabolism?

At Athletic Carnivore, we advocate an approach that does not reduce health to a single biological value.

Cholesterol must be considered within a broader context: nutritional status, body composition, blood sugar, triglycerides, HDL, ApoB, inflammation, physical activity, and cardiovascular history.

A carnivore or low-carb diet can improve certain metabolic markers in some people, notably triglycerides and glycemic control. It can also significantly raise LDL in others.

Such an increase does not prove improved longevity. It deserves interpretation based on the individual profile rather than being systematically downplayed or alarmed.

Because two people can follow similar diets, have very different blood results, and not share the same risks.

So, it’s not simply a matter of eating more animal fats or trying to raise cholesterol.

It’s a matter of understanding the biological terrain.

After 65, the Lowest Cholesterol Isn’t Necessarily the One That Will Help You Live Longer!

This is the essential message from these studies.

Large observational studies show that very low cholesterol can be associated with higher overall mortality in older adults.

They do not demonstrate that one should deliberately raise LDL to extend life.

This distinction is fundamental but does not diminish the question raised: why do we sometimes continue to interpret a biological marker without sufficiently considering age, history, and physiological state?

The true goal is not to win a battle against a number.

**It is to preserve health, physical abilities, autonomy, and quality of life for as long as possible.**

And that sometimes means questioning generic advice.

At Athletic Carnivore, this is precisely the value of personalized analysis: understanding what the numbers truly reveal about your body, rather than interpreting them in isolation.

**And you, after 60 or 65, do you know why your cholesterol is at its current level, or are you just trying to lower it because you were taught that lower is always better?**

**Discover the Athletic Carnivore Premium Report — Understand Your Metabolic Terrain**

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Scientific References

**Yi S.-W. et al. (2019).** *Total cholesterol and all-cause mortality by sex and age: a prospective cohort study among 12.8 million adults.* Scientific Reports, 9, 1596.
https://doi.org/10.1038/s41598-018-38461-y

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

**Johannesen C. D. L. et al. (2020).** *Association between low density lipoprotein and all cause and cause specific mortality in Denmark: prospective cohort study.* BMJ, 371, m4266.
https://doi.org/10.1136/bmj.m4266

**Cholesterol Treatment Trialists' Collaboration (2019).** *Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials.* The Lancet, 393, 407–415.
https://doi.org/10.1016/S0140-6736(18)31942-1

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