Low cholesterol increases total mortality in the elderly

Part 2 - Confirmation from Japanese studies

Studies in Japan added yet more weight to this argument.

Japan is reported to have low levels of death from coronary heart disease but Okinawa has the lowest of all. Yet Okinawa's cholesterol levels are similar to those in Scotland — much higher than the average in Japan.

In 1992 a paper examined the relationship of nutritional status to further life expectancy and health in the Japanese elderly based on three population studies.[1] It found that Japanese who lived to the age of one hundred were those who got their protein from meat rather than from rice and pulses. The centenarians also had higher intakes of animal foods such as eggs, milk, meat and fish; significantly, their carbohydrate intake was lower than that of their fellow countrymen who died younger.

These comparisons are important, as Japan might not have the low levels of heart disease deaths that are attributed to it. Although heart disease deaths are reportedly low, deaths from stroke and cerebral haemorrhage are very high. Keys attributed the lowest levels of heart deaths to Japan in his studies.

These findings have been used to support recommendations that we should adopt Japanese eating patterns based on fish and rice. But vital statistics from death certificates are too unreliable for scientific use.

One of the recognized facts about Japanese statistics is that the cause of many deaths was not certified by a qualified doctor. Another is that coronary heart disease was an undesirable cause of death; stroke was a more desirable one as it was thought to be indicative of intelligence in the family. More recent autopsies have revealed that stroke is not as common as once believed and that heart disease is much more common than original figures suggested.[2]

This is a good example of why vital statistics used by Keys and others may be unreliable.

However, if we lump deaths from all causes together, we get a figure that cannot be fudged. Comparing average age at death from all causes and food intake, we find that the Japanese who live longest are the ones who eat the most animal products and the least carbs.


1. Shibata H, et al. Nutrition for the Japanese elderly. Nutr Health 1992; 8: 165-75

2. Stehbens WE. The Lipid Hypothesis of Atherogenesis. RG Landes Co, Austin, Texas 1993.

Part 1. Overall Death -1 | Part 2. Overall Death -2 | Part 3. Overall Death -3
Part 4: Young deaths
Part 5: Middle aged deaths
Part 6: Elderly Death — 1 | Part 7: Elderly Death — 2 | Part 8: Elderly Death — 3

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Last updated: December 9, 2011