Updated June 3, 2013
Cause: The American diet is the real culprit. A cholesterol level of 210 mg is the average for people living in industrialized countries; this level predicts a 50% chance of premature death from strokes or heart attacks due to atherosclerosis. A rise in cholesterol level from 200mg/dl to 260 mg/dl increases the risk of death by 500%. People with levels below 180 mg/dl during their lifetime rarely have heart disease; and finally, in the famous Frammingham, Massachusetts study on the relationship between heart disease and cholesterol levels, no one has died of heart disease whose cholesterol level was kept below 150 mg/dl. Each 1% decrease in cholesterol is represented by a 2% to 3% decrease in the risk of dying from heart disease. Based on all I know, I would set a goal for you of less than 150 mg/dl.
Some studies show that caffeine will increase the cholesterol level by an average of 10%. More sensitive individuals will show even greater rises in response to caffeine.
I treat my patients in steps–adding one kind of therapy after another, providing each is well tolerated. My goal is to get levels down below 150 mg/dl safely, and as soon as possible.
For a complete discussion of cholesterol and heart disease see The McDougall Program for a Healthy Heart (Dutton 1996).