Book Review: The Great Cholesterol Con
The Truth About What Really Causes Heart Disease and How to Avoid It by Dr Malcolm Kendrick, John Blake publishing 2007
I don’t know about you, but practically everyone in my world over the age of 45 years is taking statins and fussing over their cholesterol levels. I often suggest that these people might want to read this entertaining and informative book, but sadly, I don’t think anyone to date ever has. So I recommend it here to anyone that is taking statins or to anyone who knows and cares about someone who is taking statins.
I set out to read this book because I was interested in finding out more about the issue of cholesterol as a causative factor in heart disease, however, I was not expecting it to be one of the funniest books I have read in a number of years – on any topic. This book literally made me laugh out loud on practically every page as the author vents his frustration with the currently accepted cholesterol theory of heart disease and the twists and turns used to keep it in place in spite of having little to no evidence to support it.
The aims of the book
In this book, the author, a physician, starts by explaining the science of cholesterol in a very accessible way and then the somewhat opaque terms used in relation to this matter – which, frankly, even most doctors and researchers are probably confused by.
He then sets out to convince the reader that:
A diet high in fat - saturated or otherwise has no impact on cholesterol levels.
That this is unimportant because high cholesterol levels don’t cause heart disease anyway.
Statins do not protect against heart disease by lowering cholesterol levels - they work in another way.
The protection against heart disease provided by statins is so small as to be not worth bothering about for most people (and all women) and that the benefits have been hyped beyond belief.
Statins have many more unpleasant side effects than has been admitted – up to and including death and the creation of horribly deformed babies.
Experts in the cholesterol/heart disease causation arena should not be listened to because they are all paid ridiculous sums of money by statin manufacturers to sing loudly from the prepared hymn sheet.
As you might expect, however, it is all a bit more complicated than that ...
The cholesterol/heart disease hypothesis
Dr Kendrick starts by debunking the current hypothesis du jour which is the ‘cholesterol hypothesis’ and, as he points out, has the advantage of being so simple that doctors, the general public and even small children can easily understand it. It states that if you eat a diet high in cholesterol it will deposit in, and clog up your arteries leading to heart disease. The only problem with this theory being that there is very little evidence to suggest that this is true, and biological systems tend to be a little more complex than that theory permits.
To quote the author: “Everywhere you look, everybody is in agreement about the need to lower your cholesterol. How can almost everybody be wrong? In fact, almost everybody being wrong has been quite a normal phenomenon throughout human existence.”
He researches back into the advent of the cholesterol hypotheses and finds that it was based in large part upon an experiment involving feeding normally vegetarian rabbits on a high fat diet which, as you may appreciate, is not a very good model for human physiology. He unpicks the studies into the relationship between cholesterol and heart disease, one by one, upon which this hypothesis is based. This is complicated by the fact that the first description in the literature of a heart attack only appeared in 1926 and International classification standards for heart disease were only agreed upon 40 years ago!
Dr Kendrick explains why you cannot have a blood ‘cholesterol level’, the controversy over ‘good’ and ‘bad’ cholesterol and triglyceride levels. He also states that our LDL ‘bad’ cholesterol levels are remarkably stable over time, and impacted very little by diet. Lower cholesterol levels appear to be associated with an increased risk of death from cancer and, as he points out, there is always a time-lag in realising the connection between cause and effect.
The diet/heart disease hypothesis
The author then sets out to debunk the connection between dietary fat – any kind of dietary fat – and heart disease. Amongst much other evidence he quotes from a Duke University study which monitored obese people following the high fat, low carbohydrate Atkins-type diet. They found that not only did the subjects lose weight, but their ‘good’ cholesterol levels increased and their blood triglyceride levels dropped by nearly 50%! Results that are, unfortunately, hard to explain away with the currently accepted fat/heart disease theory.
He also states that one of the biggest trials of dietary modification involving fifty million people being placed on an enforced low saturated fat diet for 14 years was called rationing and occurred during the Second World War. During this time the incidence of heart disease increased by 150% - although as he points out – the incidence of bombs falling on your head also increased during these years.
He quotes big studies where swingeing cuts in dietary cholesterol and saturated fat had no effect upon heart disease. In fact, one study found that you were twice as likely to die of heart disease within a year of following a low cholesterol diet! He also points to other inconvenient data such as the ‘French paradox’ whereby the French eat more saturated fat, smoke more, drink more, have higher blood cholesterol levels, and a greater incidence of hypertension and yet have a fraction of the incidence of heart disease found in comparable countries. At the other end of the scale, Australian Aboriginal people have extremely low cholesterol levels and very high rates of coronary heart disease. Asians too, who also tend not to drink, smoke or eat meat also have a very high incidence of heart disease which cannot be explained using the cholesterol hypothesis.
The ‘protective’ effect of oestrogen on heart disease
Dr Kendrick then goes on to puncture the notion that women are protected from heart disease by oestrogen, which is the ancillary theory used to explain why women have a much lower incidence of heart disease than men in spite of tending to have higher cholesterol levels. He reminds us that millions of women were prescribed HRT in attempt to reduce heart disease and that this intervention actually increased the rate of heart disease.
How medicine works
The author also examines the fact that most doctors will not have researched this subject in any great depth, but will for the most part rely upon the information that they get from pharmaceutical representatives and medical ‘experts’ who are highly paid by the pharmaceutical companies to endorse their products. This system plays into the fact that most doctors are well intentioned and keen to embrace any product that will help them face the tsunami of chronic illness that they are confronted by every day of their working lives.
He then looks at how pharmaceutical companies present and ‘spin’ their results and how they move the goal posts over time so that, according to some current recommendations, the majority of the population are now defined as being ‘at risk’ of heart disease from early adulthood requiring, of course, that they be prophylactically medicated using statins for life. Which, as Dr Kendrick states “Is about as far from the concept of health as you can get.”
I am sure if your doctor did take the time or trouble to read this book, they would almost certainly change their working practices. Having said which, even an informed physician will come under pressure from their patients and their patient's families and from other colleagues to toe the line and might even be judged negligent if they do not go along with the prevailing nonsense.
Statins – the latest wonder drug?
Statins turn out not to have been the end result of intense and expensive high level research conducted by the pharmaceutical companies, but as is often the case, were discovered by accident. In this particular case, the US army had been investigating a poisonous Chinese plant called red yeast rice for its utility as a biological weapon when they discovered that it blocked a pathway in the liver. Evidently, it wasn’t much good as a poison, but the pharmaceutical companies picked up on it.
The fact that statins may do no good would not be so tragic, if it weren’t for the fact that they may do so much harm. Dr Kendrick states in no uncertain terms that: “I am deadly serious in my belief that the misguided war against cholesterol using statins represents something very close to a crime against Humanity.” And he continues: “With most drugs, putting them into the body is a bit like handing a five-year-old an Uzi 9 mm machine gun in a hostage situation, then hoping that when the ammo runs out the net result will be that more bad guys got killed than good guys.”
The side-effects of statins
Whilst reluctantly conceding that statins may have a role in prolonging the life of men with pre-existing heart disease, he points out that this effect is extremely marginal. Using the pharmaceutical companies own data he presents their results in a rather different light stating that if 10 million people at high risk of heart disease were treated with statins for 30 years then the average increase in life expectancy would be the equivalent of 2 months per person.
Statins are thought to increase the chances of contracting cancer, acute pancreatitis and severe dizziness. They are also known to block the synthesis of Coenzyme Q10 which is vitally important to energy production and shares a synthesis pathway with cholesterol.
What does cause heart disease?
As he states, the cholesterol hypothesis is like the many-headed hydra and no matter how often you cut off its head it just refuses to die. Dr Kendrick has a pretty good go at slaying the beast once and for all in this book.
Finally, he analyses the data and tells us what he believes DOES cause heart disease – and what you can do about it. And reader you already know what he says is true until you are bamboozled with science and people in white coats insisting that they are right. But for that, I recommend that you buy this informative and humorous book.
To buy a copy of The Great Cholesterol Con click the appropriate link to go to Amazon UK or US.