Changes in diet and lifestyle have led to a sharp increase in deaths linked to high levels of cholesterol in Asia, according to a study published on Wednesday.
Cholesterol-linked deaths from heart disease and stroke have been seen as a problem for high-income Western countries but the balance has shifted to Asia over the past four decades, according to an article in the journal Nature.
The study showed a small reduction of average cholesterol in the Middle East and North Africa, where levels are already lower than the global average.
The study examined data from more than 100 million people worldwide from 1980 to 2018, which suggested that changes in diet, behaviour and medication were behind the changes.
In 2017, so-called ‘bad cholesterol’ was linked to 3.9 million deaths worldwide with half of those in East, South-East and South Asia, it said. In 1990, Asian deaths were only responsible for one quarter of deaths.
The research found that China had some of the lowest levels of cholesterol in 1980 but was among the highest in 2018, while Belgium and Iceland saw some of largest declines.
Major cuts in European countries attributed to dietary changes and the increased use of cholesterol-controlling statins.
Cholesterol can be affected by a number of different factors so it was difficult to say specifically why levels had not changed in the Middle East, said one of the authors, Professor Majid Ezzati of Imperial College London.
He said it was likely that cholesterol levels in the Middle East had not shifted because the balance between animal and plant-based food had not much changed compared with Europe and Asia. He said improvements in healthcare may also have been significant.
China’s rising prosperity and changes in eating habits have been blamed for rising obesity and lifestyle-related conditions, such as diabetes. The authors of the report recommended changes to the Asian diet that replaced saturated fats with unsaturated ones and improvements in treatment.