Disorders of lipid metabolism

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Intervention studies have shown that cholesterol reduction using diet, drugs, or surgery reduces the risk of developing or worsening coronary disease. In general, a 1 per cent reduction in low-density lipoprotein-cholesterol has been associated with roughly a 2 per cent reduction in disease end-points. (59 General agreement exists that eating less saturated fat and cholesterol, and adopting a diet and exercise habits to reduce obesity will benefit the health of most people. Exercise has a much greater effect in reducing triglyceride levels than in reducing low-density lipoprotein-cholesterol concentrations. Triglyceride levels are reduced after even a single exercise session. The efficacy of regular aerobic exercise in mild-to-moderate hypertriglyceridaemia has been repeatedly demonstrated. Diet and exercise programmes for patients with disorders of lipid metabolism are more successful than for patients with obesity, because positive reinforcement is immediate (namely, lower triglyceride levels).

The relationship between lipid levels and psychopathology is complex and controversial. Several studies suggest that low cholesterol levels are associated with violence. Freedman et al.,(57) in a study of 3490 male veterans, found that men diagnosed with generalized anxiety disorder had higher cholesterol levels whereas men with antisocial personality disorder had significantly lower cholesterol levels than normal. These associations were independent of other factors that could influence lipid levels, but precise cause-and-effect relationships are unclear.

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