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Can Your Cholesterol Be Too Low?

Unlike a lot of men, the writer never worried about cholesterol -- until some surprising studies linked low cholesterol to violent behavior.
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They may also be more likely to hurt someone else. When Mitropoulou and her colleagues at Mount Sinai recently studied 42 patients with personality disorders, they found a strong link between lower-than-average cholesterol and impulsive, aggressive behavior.

What's behind the violent behavior and suicidal tendencies? One answer could be depression. In findings published in the September 1999 British Journal of Psychiatry, researchers from Finland's National Public Health Institute showed that in a group of more than 29,000 Finns studied, low total cholesterol put men at greater risk of being hospitalized for major depression. A link between low cholesterol and depression has turned up in at least half a dozen other studies.

The Serotonin Connection

No one knows for sure whether low cholesterol levels are the cause of these psychological problems -- or just an innocent bystander. It's always possible, for instance, that people who are depressed or violent eat less than psychologically healthy people, which could lower their total cholesterol level.

But one leading researcher, Beatrice Golomb, MD, PhD, an internist who specializes epidemiology, is convinced there is a direct link. I reached her at the University of California, San Diego, where she had reviewed all the existing studies on low cholesterol and violence for an article in the March 15, 1998 issue of the Annals of Internal Medicine.

The link, Golomb told me, may be the brain chemical serotonin. "We know that monkeys placed on low-fat or low-cholesterol diets show significantly lower serotonin activity in their brains. What's more, studies show that animals with low serotonin activity are more likely to be aggressive."

No one has looked to see whether low-fat or low-cholesterol diets decrease serotonin in humans. Golomb says there are good data from human studies linking low serotonin to both aggressive and violent behavior, including suicide. The connections between low serotonin, depression, and these behaviors are not yet understood. Antidepressant drugs like Prozac and other selective serotonin reuptake inhibitors, or SSRIs, are believed to work by increasing the effective concentration of serotonin in the brain.

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