Sign up now to receive our regular news briefs.

The Risk of High Cholesterol Among Young Ashkenazi Jews

July 26, 2012 2:40 pm 9 comments

A doctor uses a stethoscope to examine a young girl's heart and lungs. Photo: wiki commons.

Familial hypercholesterolemia is a common genetic condition that can cause dangerously high levels of cholesterol to accumulate in the blood, increasing the risk of heart disease, stroke and heart attack at an early age. Among Ashkenazi Jews around the world, the incidence of FH is 2-5 times higher than in the general population. But despite this finding, FH remains widely unknown and is often undiagnosed among Ashkenazi Jews until a serious event such as a heart attack or stroke occurs.

The community of Ashkenazi Jews was founded when a group of settlers in 14th Century Europe moved east to escape challenges ranging from the Crusades to the bubonic plague.  To survive, Ashkenazi Jews in areas of Poland and Lithuania created tight-knit communities of mutual support and cooperation.

When a new community is established by a small group of families who live in close proximity for several generations, there is the chance that certain genetic traits can remain prevalent as they pass from one generation to the next.   Known as the “Founder Effect,” this occurrence can increase the likelihood that members of a community will share certain physical characteristics or a risk of developing certain diseases. For Ashkenazi Jews, the Founder Effect was responsible for the increased incidence of Tay-Sachs and Gaucher disease, both of which are fairly well known. It was also responsible for the increased risk of FH among Ashkenazi Jews, which remains widely undiagnosed and relatively unknown.

Understanding FH

FH is agenetic disorder that can be passed on to children by either one or both parents. Itis one of the most common inherited metabolic diseases in the world, found in about 1 in every 500 people.   FH is caused by genetic mutations that lead to abnormalities on the surface of liver cells responsible for clearing LDL(bad cholesterol) particles from the blood. As a result, cholesterol accumulates in the bloodstream beginning at an early age. All first-degree relatives of someone with FH have a 50 percent chance of inheriting the disorder.   As a result, FH families can have striking patterns of very high cholesterol levels and heart disease, heart attack or stroke early in adulthood. Early heart disease is defined as heart disease that occurs before age 65 in women and age 55 in men. In many cases, untreated people with FH who are in their 40s have arteries that are more like someone in their 80s. In addition to Ashkenazi Jews, FH is more prevalent among certain populations of people of French Canadian, Christian Lebanese andSouth African Afrikaner descent.

Only about 20 percent of people with FH have had a proper genetic diagnosis. One challenge in identifying FH is the fact that people can appear healthy and show no symptoms until they develop vascular disease that leads to a heart attack or stroke. In addition, high cholesterol is often considered to be a problem that affects people who are older or who have risk factors such as high blood pressure, diabetes or obesity. Children and young adults are rarely screened for high cholesterol.

If FH is diagnosed early, the associated vascular problems can often be properly treated and monitored, helping to delay or prevent serious events including heart attack and stroke. Many FH patients can manage their condition with cardiac medications and changes in diet and exercise. However, children who inherit the trait from both parents, and even some who inherit it from only one parent, can develop a severe form of FH that leads to cholesterol levels 2-4 times above the target level even with lifestyle changes and treatment with the maximum doses of cholesterol lowering medicines.

All families, and especially those at high risk of carrying the trait for FH, should develop a family tree to identify family members who had high cholesterol, heart attack or stroke at an early age. When one person in a family is diagnosed with FH, doctors will often suggest that parents, siblings, and children also be screened. The latest guidelines from the National Heart, Lung, and Blood Institute (NHLBI) and The American Academy of Pediatrics (AAP) recommend that children in families with a pattern of early heart attacks or heart disease have their cholesterol screened between the ages of 2 and 8.

FH in Ashkenazi Jews

In the late 1980s researchers at Hadassah University Hospital in Jerusalem led an effort to identify the trait that is associated with FH in Ashkenazi Jews, and found a genetic mutation called G197del LDLR that may have been prevalent in the Jewish settler communities of the 14th Century.

The research showed that G197del LDLR is now prevalent among populations of Ashkenazi Jews in many locations around the world, including families in the United States, South Africa, the United Kingdom, Germany and Russia. A decade of exhaustive historical and medical research unveiled a prevalence of G197del LDLR well-beyond the initial discovery, showing that it was particularly common in South Africa and Israel. Researchers were able to piece together clues through a process called linkage disequilibrium analysis, and worked backwards to develop a timeline mapping the migration of the gene mutation.

Results suggest G197del LDLR originated in the late Middle Ages when new opportunities for a Founder Effect were offered by a small group of European Jewish settlers moving eastward. The settlers eventually established a community in Lithuania around 1338. Favorable conditions led the community to grow to a population of 10-12 thousand Ashkenazi Jews living in Lithuania and Poland by 1500.

Russia conquered Lithuania in the 17th century, and Ashkenazi Jews continued their migration east, settling in St. Petersburg. There they remained in relative isolation until the turn of the 19th Century, when significant pogroms sparked a massive emigration by Jewish families. Many traveled to Great Britain, South Africa, Australia, Palestine, and America, carrying with them the G197del LDLR mutation.

There are now many online and other resources available to help people learn about FH and how to protect themselves and their families, including www.FHJourneys.com and www.learnyourlipids.com.  For most patients, the tools to identify and manage high cholesterol associated with FH are available. Among Ashkenazi Jews, we must continually reinforce the risk of FH and the need to research family history, get tested, and talk to a doctor early, before problems become severe and life threatening.

9 Comments

  • Thank you for for this post; it’s good to learn a bit more on this topic, being healthy and being aware of this issue is paramount.

  • Cat Davis Ahmed

    Excellent article. The Familial Hypercholesterolemia (FH) Foundation (www.thefhfoundation.org) is also a good resource for people with FH.
    Cat Davis Ahmed
    Director of Outreach
    The FH Foundation

  • This isn’t a big deal; contrary to established wisdom, high cholesterol isn’t necessarily bad for us. Indeed, our bodies NEED cholesterol to function; without it, we are at risk for heart disease. Sound crazy? It’s not; I found all this out from reading “The Great Cholesterol Lie,” a comprehensive book exposing the lies about nutrition we’re force-fed on a daily basis. Ever since reconfiguring my diet according to its advice, I’m healthier, more energetic, and less stressed out. My review of “The Great Cholesterol Lie” is at my website.

  • Yes, I’m sure that researchers are crunching the numbers to identify other factors of the Bio-Chemistry. My Father’s Mother was Ashkenazi with high incidence of Heart disease AND his Spanish-American father and his family had H-D history. My father died of heart failure at 66 and I had a 6 way bypass at 45, 4 months later. I wish my father had alerted me after he had his heart attack with what his Cardiologist briefed him on, but he didn’t!!! Well, at least I know now and am right on it with my Son, who “looks Jewish” by the way. He’s going to get all the tests so he’s not taken by surprise, that’s for sure.

  • I am 48, have heterozygous FH, and also have a 0 calcium score and a c-reactive protein result of 0.11 that shows very little inflammation. I have tried all the statins, zetia and niacin and could not tolerate any of them, so I have used my diet and nutritional experiments to stave off the potential for heart disease that afflicted my paternal ancestors. I have shared my results on the website I listed.

    My latest research is into liver (bile acid production.) Studies in 1987 showed that FH patients who died from heart attacks had no higher cholesterol than the ones who had survived, however they smoked more often and had far less bile acid in their feces. It seems that cholesterol level may be less important that the ability of the liver to remove cholesterol. How to increase bile acids in the feces? Run or exercise daily, especially before breakfast and take milk thistle and Taurine to help the liver out. I continue to test foods and supplements, so please let me know any ideas to try.

    • Hi Robert,

      I discover one of the foods and supplements called CHOLEDUZ OMEGA SUPREME. It is made of a combination of molecularly distilled High Potency fish oil (Omega 3 Fatty acids) and Vitamin E, which not only guarantees to reduce your bad cholesterol but lowers the risk of a coronary heart disease and its complication.

    • Thanks for sharing your observations about hypercholesteremia. I’m very new to this, having discovered 6 months ago through Ancestry DNA I was 50% European Jew and last month hypercholesteremia. I’m now on a low fat/ low cholesterol, exercise regimen. Not so bad, on a learning curve.

  • Robert Bramel

    Not all people with FH develop vascular disease even after a lifetime of extremely high serum cholesterol, so it is far from clear what really causes plaque to form. My readings suggest that approximately twenty percent of those of us with heterozygous FH never develop any significant plaque. Specifically, I am a 66 year old male with a serum total cholesterol of 599, an LDL of 540, absolutely zero coronary calcification by EBCT and “the heart of a 41 year old” by stress ultrasound. It isn’t just that I haven’t had a heart attack yet, I don’t have the beginnings of the disease process. This is similar to finding elderly 3 pack smokers with pink, healthy lungs. There has to be something else going on besides high serum cholesterol in order to start coronary disease, yet no one in the medical community seems interested in really understanding what that something is. (By the way, I eat a very high animal-fat diet, eschew carbohydrates, don’t exercise, and put salt on everything.)

    • Hi Robert,

      I discover one of the foods and supplements called CHOLEDUZ OMEGA SUPREME. It is made of a combination of molecularly distilled High Potency fish oil (Omega 3 Fatty acids) and Vitamin E, which not only guarantees to reduce your bad cholesterol but lowers the risk of a coronary heart disease and its complication. You can check it out if you want :)

Leave a Reply

Please note: comments may be published in the Algemeiner print edition. Comments written in all caps will be deleted.


Current day month ye@r *

More...

  • Arts and Culture Middle East Larry King Asks Saudi Arabian Fan If Taking Pictures With Jews Is Permitted

    Larry King Asks Saudi Arabian Fan If Taking Pictures With Jews Is Permitted

    Jewish former CNN host Larry King asked a Saudi Arabian fan if taking pictures with Jews is allowed in his country, before agreeing to pose for a photo with the man, The New York Times reported on Wednesday. The world-famous interviewer was leaving the Ritz Carlton hotel in Washington, D.C. with a New York Times reporter when a “dark-skinned man” approached and asked to take a picture with him, according to the publication. Whereupon, King asked the fan where he was from. When the man said Saudi […]

    Read more →
  • Europe Sports Britain’s Lord Sugar Says Synagogues Will Be Empty With Yom Kippur Matchup of Jewish-Supported Soccer Teams

    Britain’s Lord Sugar Says Synagogues Will Be Empty With Yom Kippur Matchup of Jewish-Supported Soccer Teams

    British-Jewish business tycoon Lord Alan Sugar joked on Wednesday that London synagogues will likely be empty during Yom Kippur with congregants fleeing to watch the match-up of two leading English soccer teams known for having hordes of Jewish fans. “Spurs V Arsenal cup game drawn on most important Jewish festival,” Lord Sugar pointed out on Twitter. “Both teams have loads of Jewish fans. Conclusion Synagogues will be empty.” North London rivals Tottenham Hotspur and Arsenal FC will go head-to-head in the Capital One Cup third-round […]

    Read more →
  • Arts and Culture US & Canada Jewish Men Pass Jimmy Kimmel Social Experiment, Rescuing ‘Spongebob’ in Distress (VIDEO)

    Jewish Men Pass Jimmy Kimmel Social Experiment, Rescuing ‘Spongebob’ in Distress (VIDEO)

    Two Jewish men were the only unwitting participants in a social experiment conducted by Jimmy Kimmel, for his popular TV show. As part of a candid-camera-like sketch featured Monday night on Jimmy Kimmel Live, the host devised different street scenes to observe human behavior — in particular, to see how long it would take people walking down California’s bustling Hollywood Boulevard to notice and interact with others in distress. One scene involved a man in a Spongebob Squarepants costume who had “fallen down” on the sidewalk and needed help […]

    Read more →
  • Education US & Canada International Jewish Organization Blasts Israeli-Born Star Natalie Portman for Comments on Holocaust Education

    International Jewish Organization Blasts Israeli-Born Star Natalie Portman for Comments on Holocaust Education

    A major Jewish organization rebuked actress Natalie Portman on Monday for saying in a recent interview that Jews put too much emphasis on teaching about the Holocaust relative to other genocides. The Israeli-born movie star told the U.K.’s Independent that the Jewish community needs to examine how much focus it puts on Holocaust education over other issues. She said she was shocked when she learned that a genocide was taking place in Rwanda while she was in school learning only about the horrors of the […]

    Read more →
  • Arts and Culture Israel Book Draws Parallels Between Holocaust and Palestinian Nakba, Sparks Outrage

    Book Draws Parallels Between Holocaust and Palestinian Nakba, Sparks Outrage

    JNS.org – A new book that draws parallels between the Holocaust and the Palestinian Nakba (the Arabic term for the displacement of Palestinian refugees during Israel’s War of Independence) has sparked outrage ahead of an official book launch, to be hosted by the Van Leer Jerusalem Institute on Sept. 7. The Zionist organization Im Tirtzu wrote a letter to the institute demanding that it cancel an event it planned in honor of the book’s authors, under the title The Holocaust and […]

    Read more →
  • Education US & Canada Natalie Portman Says Holocaust Education Shouldn’t be Used for ‘Fearmongering’

    Natalie Portman Says Holocaust Education Shouldn’t be Used for ‘Fearmongering’

    Famed actress Natalie Portman warned on Friday against the use of Holocaust education to evoke fear and paranoia. In an interview with the U.K. Independent she added that the trauma should make Jews more empathetic to others who have also experienced hatred. “Sometimes it can be subverted to fearmongering and like ‘Another Holocaust is going to happen,’” the Israeli-American star said. “We need to, of course, be aware that hatred exists, antisemitism exists against all sorts of people, not in the same way. I […]

    Read more →
  • Book Reviews Commentary A Righteous Gentile Navigates the Sharkpool of Washington’s Middle East Correspondents (REVIEW)

    A Righteous Gentile Navigates the Sharkpool of Washington’s Middle East Correspondents (REVIEW)

    The Tribalist, by Louis Marano, is ostensibly a work of fiction but at its core a kind of love song by a gentile journalist for the State of Israel, and especially its secular Zionist core. (Because of the relentless attacks by left-wing polemicists on Israel’s allegedly “messianic” fringe, it’s often forgotten that most of Israel’s founders and all its leaders have been secular Zionists.) The author, the product of an Italian-American family in Buffalo, served two tours of duty in […]

    Read more →
  • Food Jewish Identity Rugelach Roundtable: Does Beloved Pastry Need Dairy to Taste Good?

    Rugelach Roundtable: Does Beloved Pastry Need Dairy to Taste Good?

    JNS.org – Rugelach (singular: rugala) are a beloved traditional Jewish pastry, with a quirky history to boot, but they often present a kosher conundrum. Though parve rugelach are often a preferred dessert after a meat meal for those observing kosher laws (which stipulate a waiting period between eating meat and dairy), some of today’s most popular rugelach are known for their dairy fillings. Pastry chef Paula Shoyer—author of the books “The Kosher Baker: Over 160 Dairy-free Recipes from Traditional to Trendy” and […]

    Read more →