View the Show Notes For This Episode Dr. Ben Weitz discusses the Implications of a new paper on Centenarians and Biomarkers and in particular whether having higher levels of cholesterol are better for longevity. [If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.]    Podcast Highlights The paper that is discussed in this podcast episode is  Blood biomarker profiles and exceptional longevity: comparison of centenarians and non-centenarians in a 35-year follow-up of the Swedish AMORIS cohort, published in Geroscience in September, 2023. 1:09  While it is difficult to conduct randomized trials using humans to test strategies to improve longevity, is that humans live a long time, so you would have to do a 100 year study, another way to get ideas about longevity is to study centenarians to see how they made it to 100.  This new study on centenarians and blood biomarkers cited above resulted in some results that were expected, including that centenarians had higher lower levels of glucose, which is not surprising, since higher levels of glucose are associated with diabetes, non-alcoholic fatty liver, poor metabolic health, insulin resistance, and more inflammation. But a few of the results seem to be surprising, including that centenarians had higher levels of cholesterol and of iron.  3:37  A popular health podcaster--Mike Mutzel on his High Intensity Health podcast--recently remarked (published Sept 29, 2023 on YouTube as Low Glucose, High Cholesterol & Living to 100 Years Old) that this paper demonstrates that higher levels of cholesterol are associated with better health and longevity. I disagree that that is the right conclusion to draw from this study.  4:26  This study looked at total cholesterol levels, which is not the best way to assess your risk of cholesterol causing heart disease. It would be better to look at LDL-C and even better to look at LDL particle number or ApoB or oxidized LDL or small, dense LDL. 5:52  Cholesterol. When we look at the charts supplied in the paper about cholesterol levels we see that to begin with, the difference in levels of cholesterol were very slight as compared to differences in glucose and other parameters. Second, we see that for men aged 64-74 they actually had slightly lower levels of cholesterol, while men aged 75-84 had slightly higher levels of total cholesterol. It might be more appropriate to conclude that having lower levels of cholesterol are beneficial in that they will likely result in lower levels of heart disease, but that once you hit your 80s it probably doesn't matter as much, since developing heart disease likely takes decades of build up.  Also as you get older, lower cholesterol levels can be an indicator of poor overall diet and of vitality, and in the 80s and 90s sarcopenia and frailty can be bigger causes of mortality due to falls and weaker immunity making you more vulnerable to not being able to fight off viruses or pneumonia. 9:40  Iron. The other marker that was somewhat surprising was iron, where overall slightly higher levels of iron were associated with longevity.  But this is similar to the cholesterol story. Those men and women in the 85-99 year old group had slightly higher levels of iron, though those in the younger groups had the same of lower levels of iron.  High levels of iron above what is needed to produce hemoglobin to produce red blood cells are generally associated with higher levels of oxidative stress and negative health consequences.  On the other hand, higher levels of iron at the oldest decades may be associated with higher levels of nutritional status and less frailty.  Those 90 year olds with greater vitality and greater muscle mass and bone mass are likely to live longer because they are less likely to fall and break a hip.   Dr. Ben Weitz is