"The longest-lived people had high cholesterol levels."
That line opens a clip shared by Metabolic Must Haves (@metabolic_must_haves), and it has started a lot of conversations. In the interview, the doctor calls it "one of the most consistent themes of longevity research". He then asks why we live in a world that "hates cholesterol".
It's a bold claim, so we looked at the research behind it. In this guide, we cover what a major Swedish study found about people who reached 100, why cholesterol matters more as you age, and where the science is still debated.
Video credit: Metabolic Must Haves (@metabolic_must_haves). Shared with credit. The views in the video are those of the speakers.
What the Swedish centenarian study found
The "Sweden study" mentioned in the video is most likely the AMORIS cohort study, published in GeroScience in 2023 (Murata et al.).
Researchers at Karolinska Institutet tracked about 44,000 Swedes who had blood tests between the ages of 64 and 99. They followed them for up to 35 years. In that time, 1,224 people (2.7%) reached their 100th birthday, and about 85% of them were women (ScienceAlert).
This is how the people who reached 100 differed, from their sixties onwards:
|
Blood marker |
What it reflects |
People who reached 100 |
|---|---|---|
|
Glucose |
Blood sugar control |
Lower levels |
|
Total cholesterol |
Blood fats |
Low levels were linked to a lower chance of reaching 100 |
|
Iron |
Iron status, nutrition |
Low levels were linked to a lower chance of reaching 100 |
|
Creatinine |
Kidney function |
Lower levels |
|
Uric acid |
Inflammation and metabolism |
Lower levels |
This matches what the doctor says in the clip: the longest-lived people "had good glucose control and high cholesterol".
The fine print: Most of the differences were small. People who reached 100 also "seldom displayed extremely high or low values" on any marker. The authors say the study can't tell us which lifestyle habits or genes caused these results. It shows a link, not a cause.
Why cholesterol matters more as you age
The doctor in the clip makes three points about why cholesterol is more than a number on a blood test.
Your sex hormones are built from it
"All sex hormones are built on cholesterol," he says. Oestrogen, progesterone and testosterone all start life as cholesterol molecules. These hormones already fall naturally with age, especially around menopause and andropause. His view is that lowering cholesterol hard can lower them further.
Your cells and mitochondria use it
Cholesterol is part of every cell membrane, including the membranes around your mitochondria, the parts of your cells that make energy. Energy production naturally becomes less efficient as we age, which is why mitochondria are a big focus of longevity research.
LDL has a role in immunity
LDL is usually called "bad cholesterol", but the doctor argues that label is "not entirely fair or accurate". He calls LDL "an unsung hero of immunity" because it helps the body fight infections. This is an area of ongoing research rather than settled science.
Want the full picture of what cholesterol does, from vitamin D to brain health? Read our guide: Why Your Body Needs Cholesterol.
The balanced view: is high cholesterol good or bad?
The honest answer is that it depends on the person, and the evidence points both ways.
Why low cholesterol in older age can be a warning sign: Illness, frailty and poor nutrition can all lower cholesterol. So when older people with low cholesterol die sooner, the illness may be lowering the cholesterol, not the other way round. Researchers call this "reverse causality".
Why LDL still matters for your heart: A study of 12,334 healthy adults with an average age of 75 found higher LDL was still linked to a higher risk of dying from heart disease. Each 1 mmol/L rise came with about 19% higher risk. Yet the same study found the lowest overall death rate at an LDL of about 3.3 mmol/L, which is above many targets (ASPREE analysis, AHA 2022).
Look beyond one number: In the clip, the doctor asks why we are "so obsessed with cholesterol" and not triglycerides, another blood fat he believes is more predictive of heart attacks. Whatever your view, a full picture is more useful than a single result. Ask your GP about:
- Total cholesterol, LDL and HDL
- Triglycerides
- HbA1c (long-term blood sugar)
- Blood pressure
- Your overall heart risk score (QRISK3 in the UK)
The bottom line: Don't stop or change any cholesterol medication on your own. If you have questions about your results or your treatment, talk them through with your GP.
What the longest-lived people have in common, and how to start
The centenarians in the Swedish study weren't defined by one marker. They tended to stay in the middle on everything, with steady blood sugar, healthy kidneys and few extremes. That points to everyday habits more than any single fix.
Daily habits that support healthy ageing
- Keep blood sugar steady. Build meals around protein, fibre and healthy fats, and cut back on sugary snacks and drinks.
- Eat real food. Oily fish, eggs, olive oil, nuts, beans and plenty of vegetables.
- Keep moving. Daily walking plus strength training two or three times a week.
- Sleep well. Aim for 7 to 9 hours a night.
- Get tested regularly. Track your full blood panel over time, not one result in isolation.
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Frequently asked questions
Do people who live to 100 have high cholesterol?
In the Swedish AMORIS study, people with low total cholesterol were less likely to reach 100. But people who reached 100 also rarely had extreme values. Overall, they stood out more for steady blood sugar and healthy kidney markers than for very high cholesterol.
Is high cholesterol bad for older adults?
It's debated. Low cholesterol in older age can be a sign of illness or frailty. But higher LDL is still linked to a higher risk of heart disease, even in people over 70. Your GP can weigh up your personal risk.
Is LDL really "bad cholesterol"?
LDL carries cholesterol to your cells, where it's used for hormones and cell membranes. Some researchers believe it also plays a role in immunity. High LDL is still a recognised risk factor for heart disease, so it's worth discussing your results with your GP.
What blood tests should I ask for?
A full lipid panel (total cholesterol, LDL, HDL and triglycerides), HbA1c for blood sugar, kidney function and blood pressure. In the UK, your GP may also calculate your QRISK3 score.
Can supplements replace cholesterol medication?
No. Supplements are not a substitute for prescribed medication. Never stop or change your medication without speaking to your doctor.
Sources
- Metabolic Must Haves, @metabolic_must_haves (video clip)
- Murata S et al. (2023). Blood biomarker profiles and exceptional longevity: comparison of centenarians and non-centenarians in a 35-year follow-up of the Swedish AMORIS cohort. GeroScience.
- ScienceAlert. The blood of exceptionally long-lived people reveals key differences
- Medicom conference report. Higher LDL cholesterol levels linked to higher CVD mortality risk in the elderly (ASPREE analysis, AHA Scientific Sessions 2022)