More evidence links higher cholesterol with improved immunity

While we are frequently warned about the perils of cholesterol, there exists quite a bit of evidence which links higher cholesterol levels with improved health outcomes and/or longevity in the elderly. These studies do not prove that cholesterol is conferringbenefit here (only that higher cholesterol is associated with improved outcomes). Nevertheless, it’s perhaps worth at least considering any truly protective role cholesterol may have.

One potentially fruitful avenue concerns the role of cholesterol in immunity. Toxins made by bacteria have been shown to bind to cholesterol, which effectively inactivates them. In one study, mice with genetically high LDL-cholesterol were found to be significantly less prone to death after injection with bacteria compared to mice with lower cholesterol levels [1].

A study out this week adds some support for the idea that cholesterol plays a positive role in immunity. In this study, the relationship between cholesterol levels and outcomes in individuals critically ill with an infection was assessed [2]. Overall, those who died had significantly lower levels of cholesterol compared to those who survived. Again, this sort of evidence does not provide the cholesterol confers benefit. However, it does at least support the idea that cholesterol might have some genuinely protective role.

Another recent study found similar results in individuals undergoing cardiac surgery [3]. Basically, what this research showed was that the higher someone’s cholesterol was, the lower their risk of succumbing to an infection after surgery. For those with the lowest cholesterol levels, rate of infection approached 20 per cent. For those with the highest cholesterol levels, rate of infection was zero.

Another interesting study assessed the potential role of cholesterol in immunity in humans [4]. This study took 21 individuals who had confirmed infection with tuberculosis (TB). All of the individuals were treated with standard TB medication (four antibiotics taken in combination) over a period of 8 weeks.

Of the 21 participants, 10 were given a cholesterol-rich diet (800 mg of cholesterol a day – about the amount of cholesterol found in 5 medium-sized eggs). The rest of the study participants were to eat a diet containing just 250 mg of cholesterol each day.

After two weeks of treatment, 80 per cent of those eating a high-cholesterol diet were free of TB infection, compared to only 9 per cent of the others. This difference was statistically significant. It should be borne in mind that the benefits from the diet may not have come from additional dietary cholesterol per se. The cholesterol came via enrichment of the diet with foods such as butter, beef liver and egg yolk. It’s possible, therefore, that the benefits came from other nutritional elements found in these foods, say. The authors of this study acknowledge this possibility.

Overall, though, the evidence does seem to point to cholesterol conferring benefits for immunity. This may go some way to helping explain the link between higher cholesterol levels and improved longevity in later life.


1. Netera MG, et al. Low-density lipoprotein receptor-deficient mice are protected against lethal endotoxemia and severe Gram-negative infections. J Clin Invest 1996;97:1366–72.

2. Biller K, et al. Cholesterol Rather Than PCT or CRP Predicts Mortality in Patients With Infection. POST ACCEPTANCE, 10 April 2014

3. Lagrost L, et al. Low preoperative cholesterol level is a risk factor of sepsis and poor clinical outcome in patients undergoing cardiac surgery with cardiopulmonary bypass.
Crit Care Med. 2014;42(5):1065-73.

4. Perez-Guzman C, et al. A Cholesterol-Rich Diet Accelerates Bacteriologic Sterilization in Pulmonary Tuberculosis. Chest 2005;127(2):643-51

20 Responses to More evidence links higher cholesterol with improved immunity

  1. JeanESH 18 April 2014 at 4:11 pm #

    Before the days of antibiotics, TB was treated with fresh air, bed rest, and as rich a diet as could be provided. Antibiotics can produce a cure, but it is no bad thing to be doing everything else that can help. Like feeding the patient well.

    • Galina L. 19 April 2014 at 3:07 am #

      I commented before on a different post how my mother’s uncle got cured from a tuberculosis at 1944 by selling all his material possessions in order to buy on a black market butter, eggs and salted pork fat. It worked. He didn’t have an access to antibiotics then. That fact of my family history got fresh recollection when I suddenly became immune to viruses and infections after starting a LC diet at 2007. My mom noticed the same phenomenon when she followed my diet steps at 2011.

  2. bill 18 April 2014 at 4:46 pm #

    In many articles re: cholesterol, the authors are really
    talking about lipoproteins such as HDL and LDL.

    Is this article talking about cholesterol, or the lipoproteins
    that carry it?

    Do the toxins bind to the actual cholesterol molecule, or
    do they bind to the lipoprotein carrying the cholesterol

  3. Mike Sheldrick 18 April 2014 at 4:52 pm #

    This is a small study to be sure, but the results were dramatic. Why has this not been followed up with larger studies that are designed to sort out the different dietary components.

    Another, general, question: How are blood cholesterol measurements related –if at all — to the state of one’s arteries. I realize this is a complex question (HDL, triglycerides, particle size, etc.) but couldn’t lesions and calcium deposits be measured in autopsies, biopsies, CT scans, etc. and related to the histories of the patients?

  4. Liz 18 April 2014 at 5:56 pm #

    The more I read about cholesterol the more convinced I am about the benefits of not in the least worrying about cholesterol as it’s vital to every cell in the body, for healing processes such as anti- inflammation and activating vitamin D – Even in your other article this week about low blood sugar causing agression, I was going to say it has been found that low cholesterol levels are linked to depression and agression. It could have been that which initiated the judge’s violent reaction. I’m going to actively encourage it – feed it and care for it – I love my cholesterol!!

    • Tim Grant 19 April 2014 at 11:00 pm #

      I love my cholesterol, and I’m a healthy 66 year old. Not on any medication as I have refused all from the doctor.

  5. Soul 19 April 2014 at 7:38 pm #

    I read on the newspaper web sight where I reside in Illinois that health officials there are concerned about a TB patient. The patient developed active TB but is not willing to take medications. Electronic ways to quarantine and track the fellow were being worked on the article went on to mention.

    As a result of the local TB patient scare I began to re-read Rene and Jean Dubos’s book on Tuberculosis called “Tuberculosis, Man and Society”. Written in 1952 some feel today that the book remains a top writing on the topic of TB.

    The Dubos’s had an interesting mention much as you write Dr Briffa. Beginning on page 140 the two note that fatality from TB dropped significantly in western societies once diets improved, in particular once dairy and meat products could be afforded by the poor. As the two mention the reason why TB cases dropped due to eating animal foods (or possibly some other reason) remained unknown. With this study possibly after all these years an answer has been found.

    Along these lines, Dr Susan Humphries and Roman Bystrianyk wrote a book called “Dissolving Illusions”. The book is about how the two researched public health records and found that most deadly diseases that used to plague UK and American citizens disappeared once diets improved and sanitation methods were developed. Their books’s web sight has several nice charts highlighting the drop in different disease incidence once diet and sanitation improved.

  6. Jennie McGinlay 19 April 2014 at 7:58 pm #

    The more I read about cholesterol, the more I wish I had a bit more of it! My new GP sent me for a test and my level was 3.5. Since I eat a low carb diet, with plenty of animal fat, this does at least show that all the warnings about saturated fat causing high levels are a bit misleading. I do get a bit concerned about my low levels, but I wonder if, as long as my diet is good, those levels are just right for me.

  7. Lynne 19 April 2014 at 10:35 pm #

    My Mum’s Dad died of TB in 1946 at the end of the war, when high cholesterol produce was still in short supply and had been obviously for many years. Are you therefore saying his death may have been prevented had he had access to cholesterol enriched food? In your great day At the Office book you state that most of the cholesterol in the bloodsrtream is not derived from food, but from the liver. May it therefore be a liver problem?
    I am due a medical check at my Drs, I am concerned that my cholesterol will be high and they will make me do something about it….do you think it is better to go to find out, but then argue the case for high cholesterol?

    • Janet B 20 April 2014 at 7:17 am #

      Lynne – your doctors can’t MAKE you take a statin or adapt your eating habits to low fat. Just so “no, thank you.” You will be tutted at and it takes a certain courage to defy medical convention/intervention. Since I ditched the 40mg per day statin I no longer suffer the nasty side effects and feel so much better. My total cholesterol has risen from 4.3 to 7.3, but the HDL is good, triglycerides are low, low, low and because I anyway an essential part of our immune system. This week the family came to visit bringing with them the inevitable colds. For a couple of hours my body felt a bit like a battle ground but me and my cholesterol (pardon the grammar) won the day. In fact, I haven’t had as much as a sniffle for a year now.
      Thank yiu, Dr Briffa, for all your wonderful and informative posts.

    • Janet B 20 April 2014 at 7:19 am #

      P.s. Don’t bother to even try to argue the case. You won’t be listened to.

      • Paul 21 April 2014 at 3:28 pm #

        Although your doctor cannot MAKE you take a statin, or adjust your habits, if one has private health insurance, life insurance etc, the insurance company can ask you to provide a letter from your GP about your health.

        It worries me that if one refuses to take recommended medication (ie, statins), then this is something that would be reported back to the insurance company (ie, they have a belligerent patient who refuses to take the recommended ‘preventative’ medication and who puts his/her health at risk by doing so).

        • Liz 22 April 2014 at 7:56 am #

          Take the meds home and flush and/or dispose of them sensibly!! No-one can make you put them in your mouth!! Tell ’em you’re taking them, if it’s that important. And feign surprise when they “appear” not to be working!!

          For anyone interested I have just started a Facebook page called “I love my Cholesterol”. Please support – “like” my page and please post any info/links you think is relevant about cholesterol and statins. –

  8. Gregory Barton 21 April 2014 at 3:30 am #

    Good post, John on a topic that is not sufficiently covered.

    Cholesterol and the innate immune system discussed here:

    “In the mele of an acute infection the LDL particle becomes oxidised and so gets eaten, along with its AIP 1 burden, by a macrophage. Thus endeth the virulence factor of the MRSA, unless you have particularly low LDL or VLDL lipoprotein levels. In which case you are in big trouble.”

    And Robb Wolf relates an interesting anecdote in support of the hypothesis, here:

    Bottom line: far from being a toxin, cholesterol or lipoproteins, are essential in quantity for survival.

  9. Elaine Precious 23 April 2014 at 10:47 am #

    There is an interesting article on the possibility that statin use both increases the risk of contracting Norovirus disease and increases mortality from Norovirus (see: There is also some evidence to suggest that statin use increases levels of Norovirus (see: Statins increase levels of Norovirus proteins and RNA (Chang KO. The Role of Cholesterol Pathways in Norovirus Replication. J Virol 2009)). Small scale but interesting stuff.

  10. Lynne 24 April 2014 at 1:08 am #

    Thanks Janet Paul and Liz for your responses. I will go and have the health check as it has been offered and I am interested to see what my cholesterol level is. There is no way if it is high I will be taking anything for it, but I would have to argue the case in my defence. Thanks for the sound advice though Janet! I do actually think it won’t get me anywhere even if I try ….but it’s just something I have to do!

  11. JeanESH 25 April 2014 at 3:17 pm #

    Interesting about the Norovirus – – That would help to explain the nightmare cruise ship outbreaks – pehaps the silver cruisers should be compelled to leave their statins in the embarkation lounge!


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