Introduction
I recently reviewed a routine lipid (cholesterol) test report for a middle-aged patient, showing a total cholesterol of 5.3 mmol/L (HDL 1.17 mmol/L, LDL 3.8 mmol/L) and triglycerides of 0.8 mmol/L.
Should he be worried?
Should he go on to cholesterol-lowering drugs?
Here is a screenshot of his blood test results:
By modern standards, these values might be considered "borderline high" because official targets keep drifting downwards. This has left many people wondering: How low is too low, and how high is truly too high?
Historically, a total cholesterol of around 6.0 mmol/L was once regarded as normal. Over the last few decades, however, "acceptable" levels have been repeatedly lowered — to a point where almost no adult male or female can achieve them without resorting to strict dietary extremes or toxic medication — an impossible game of limbo! Forcing cholesterol to ever lower levels may be detrimental to many aspects of health, including brain function and overall vitality.
How low can you go? Let's do the Cholesterol Disco Limbo!
My Personal Journey From Decline to Rejuvenation
I want to share a little of my own story because it shows how our ideas about cholesterol, fats, and overall health can be wrong. They can change a lot over time, often for the better, and sometimes for the worse.
In My 40s As a burned-out athlete, I was increasingly worried about my declining cardiovascular health. So I restricted my intake of animal fats and proteins, thinking that was the right solution — after all, that is what I was taught at university. Ironically, the more restricted my diet was, the worse I got. My energy levels were plummeting. I had atrial fibrillation, and I was consistently tired. My response was to double down even more.
Around 50 By this point, I was so worn out I sold my business and went home to rest. I was seeing a cardiologist for heart issues, and exercising more than a brisk walk was almost impossible. Despite doing everything "by the book" regarding low-fat, low-cholesterol diets, and low salt, my health was at a low ebb.
From about 55 I cautiously began to reintroduce animal products back into my diet — yes, the very foods I had diligently cut down on, or avoided for years. This was entirely contrary to the nutrition guidelines I had been taught and had followed. But it turned out my old training was terribly wrong, at least in my case.
By 60 My energy, stamina, and overall wellbeing had improved dramatically — and they have continued to get better since then. Now, in my early 70s, I am having a great life, enjoying robust health and vitality once more. You can read more about my journey here: https://www.garymoller.com/post/cardiovascular-disease-arteriosclerosis-reversed-here-is-the-evidence And I touch on it here: https://www.garymoller.com/post/a-meat-eater-s-coronary-angiogram-report This article is relevant as well: https://www.garymoller.com/post/sudden-cardiac-death-among-older-athletes
This journey taught me the profound importance of fresh, high-quality fats and adequate protein in the human diet. Chronic under-eating of these macronutrients can undermine cardiovascular health, not strengthen it. Finding the right balance is the key and we are all a little different, so let us not have one-size-fits-all rules for nutrition.
Cholesterol and Brain Health
Cholesterol is a cornerstone of brain function. The brain contains a significant amount of the body's cholesterol, essential for forming protective sheaths around neurons and enabling efficient communication between nerve cells.
Cholesterol, Dementia, and Cognition
Research suggests that people with higher cholesterol later in life often fare better cognitively, showing more resilience to ailments including infectious diseases. On the other side of the spectrum, those with very low cholesterol levels sometimes experience greater frailty and poorer cognitive function. This begs the question: Is forcing cholesterol levels to the floor harming our mental acuity and resilience as we age?
Of course, the answer is "Yes!"
The Role of Polypharmacy in Driving Dementia
Another growing concern is polypharmacy: using multiple prescription medications simultaneously. Many older people (in New Zealand and globally) find themselves on three, five, ten, or even more drugs at once. This can significantly increase the risk of dementia-like symptoms through drug interactions, side effects, or nutrient malabsorption. Some medications also lower cholesterol more than might be healthy for the brain, compounding cognitive decline.
The dementia epidemic is mostly avoidable, starting with good food for the brain and getting people off medication safely, except for what is essential.
Rancid Fats Versus Fresh Fats
In my observation, the real culprit in arterial problems is rancid, oxidised fats — whether from processed foods, overheated oils, or oxidised (damaged) cholesterol in the bloodstream. These can turn into sticky, inflammatory sludge that aggravates and blocks blood vessels. The key to turning things around is to prioritise fresh, high-quality fats along with fat-soluble antioxidants (Vitamins A, D, E, K, plus a host of carotenoids and polyphenols). This helps keep fats from turning rancid in the body.
Balancing Fat, Carbohydrates, and Triglycerides
When people try to force cholesterol too low by slashing fats, they often end up eating too many carbohydrates — hidden or refined. Excess carbs can push up triglyceride levels, a known marker for cardiovascular and metabolic challenges. So ironically, the quest to lower cholesterol to the absolute minimum can create a new problem with elevated triglycerides.
So, How Low is Too Low?
Cholesterol levels that plummet below about 4.0 mmol/L may compromise hormone production, cell repair, and brain health — though actual consequences depend on a host of personal factors. If the aim is to promote long-term wellbeing, forcing a tanking of cholesterol may not be the way to go.
How High is Too High?
However, very high cholesterol, especially if it has been combined with inflammation, insulin resistance, or genetic conditions, can be very unhealthy — of course! But merely whacking a person onto cholesterol-reducing drugs is a poor solution. Many people thrive well into old age with total cholesterol in the range of 5.0–6.0 mmol/L. The bigger picture — metabolic health, inflammation markers, physical fitness — often tells a more accurate story of cardiovascular risk.
Make sure you watch Professor Tim Noakes' lecture here: https://www.garymoller.com/post/a-meat-eater-s-coronary-angiogram-report
Summary
Cholesterol is important to our body's functions: it makes hormones, helps make cell membranes, and is important for brain function.
We need to question the ever-lower cholesterol goals. High-quality fats are not the enemy — rancid, oxidised fats are.
If you eat fresh, healthy fats with a balanced diet full of antioxidants, you may find that you are less likely to get long-term diseases.
You will also feel more energetic, healthy, and live longer.
Yours in Health, Gary Moller
References & Further Reading
Moller G. (n.d.).Articles on cholesterol |Articles on fat and health
Moller G. (n.d.).Gary Moller on Dementia
Moller G. (2023).A Meat-Eater’s Coronary Angiogram Report—Professor Tim Noakes Lecture
Tē Whatu Ora (n.d.).Cardiovascular Disease Risk Assessment and Management for Primary CareNew Zealand Government Clinical Guidelines.
Various sources (e.g., BMJ, The Lancet, Journal of the American College of Cardiology)Studies on cholesterol, cognitive function, and ageing.
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