CHOLESTEROL MEETS DARWIN - PUBLIC-HEALTH AND EVOLUTIONARY IMPLICATIONS OF THE CHOLESTEROL-SEROTONIN HYPOTHESIS

A restricted intake of saturated fat and cholesterol, health advocacy groups suggest, is an effective and safe way to lower plasma cholester ol concentrations and thus reduce the risk of coronary heart disease a nd other atherosclerotic disorders. Indeed, recent treatment trials in dicate that the newest cholesterol-lowering agents, collectively calle d ''statins'' provide substantial protection against coronary heart di sease. However, epidemiologic data also show a troubling and unanticip ated association between low serum cholesterol, whether naturally occu rring or due to treatment, and increased mortality from suicide, accid ents, and other causes that are unrelated to illness. Other studies in dicate that low or reduced serum cholesterol adversely affects behavio r and mood, possibly mediating the epidemiologic association between l ow cholesterol and violent death. These results are controversial beca use they are at variance with current public health policy in favor of cholesterol lowering, and because the findings have not always been r eplicated.