Another Look at the 'Ideal' Serum Cholesterol Level?

To the Editor.  —The May 11,1979 issue of JAMA reported the deliberations of an international panel of heart specialists and nutrition experts.¹To arrive at their suggested optimal level of total serum cholesterol, the panel compared the serum cholesterol levels of the affluent societies of North America, Central and Northern Europe, New Zealand, and Australia with those of populations found in the Orient, Latin America, and Mediterranean areas who are relatively free from fatty artery diseases.While the North American blood cholesterol averages of 220 to 275 mg/dL represent an upper extreme, a cholesterol level of 150 to 160 mg/dL, found in some Mediterranean areas, is thought to be the "ideal" level for all populations... Such a level, the panel concluded, "may be considered compatible with substantially reduced risk of fatty arteries, good general health, and low rates of premature death from coronary heart disease."On the other hand,