Hats off to the Japanese

(Raised cholesterol is good for you)

For many years I have told anyone who will listen that, if you have a high cholesterol level, you will live longer. Equally, if you have a low cholesterol level, you will die younger. This, ladies and gentlemen, is a fact. The older you become the more beneficial it is to have a high cholesterol level.

This fact has become more difficult to demonstrate recently as so many people have been put on statins that the association between cholesterol levels and mortality has been twisted, bent and pumelled into the weirdest shapes imaginable. However, Japan, provides some very interesting data. Japan has always had a very low rate of heart disease, an enviable life expectancy, and… generally low cholesterol levels. Aha!, surely this means that low cholesterol levels are good for you? Well….

Well, here is the introduction to a one hundred and sixteen page review of the cholesterol hypothesis published in the Annals of Nutrition and Metabolism. It was published on April 30th 2015. I have just finished reading it for the first time. I thought I would share the Introduction, in full:

High cholesterol levels are recognized as a major cause of atherosclerosis. However, for more than half a century some have challenged this notion. But which side is correct, and why can’t we come to a definitive conclusion after all this time and with more and more scientific data available? We believe the answer is very simple: for the side defending this so-called cholesterol theory, the amount of money at stake is too much to lose the fight.

The issue of cholesterol is one of the biggest issues in medicine where the law of economy governs. Moreover, advocates of the theory take the notion to be a simple, irrefutable ‘fact’ and self-explanatory. They may well think that those who argue against the cholesterol theory—actually, the cholesterol ‘hypothesis’— are mere eccentrics.

We, as those on the side opposing the hypothesis, understand their argument very well. Indeed, the first author of this supplementary issue (TH) had been a very strong believer and advocate of the cholesterol hypothesis up until a couple of years after the Scandinavian Simvastatin Survival Study (4S) reported the benefits of statin therapy in The Lancet in 1994. To be honest with the readers, he used to persuade people with high cholesterol levels to take statins. He even gave a talk or two to general physicians promoting the benefits of statins. Terrible, unforgivable mistakes given what we came to know and clearly know now.

In this supplementary issue, we explore the background to the cholesterol hypothesis utilizing data obtained mainly from Japan—the country where anti-cholesterol theory campaigns can be conducted more easily than in any other countries. But why is this? Is it because the Japanese researchers defending the hypothesis receive less support from pharmaceutical companies than researchers overseas do? Not at all. Because Japanese researchers are indolent and weak? No, of course not. Because the Japanese public is skeptical about the benefits of medical therapy? No, they generally accept everything physicians say; unfortunately, this is also complicated by the fact that physicians don’t have enough time to study the cholesterol issue by themselves, leaving them simply to accept the information provided by the pharmaceutical industry.

Reading through this supplementary issue, it will become clear why Japan can be the starting point for the anti-cholesterol theory campaign. The relationship between all-cause mortality and serum cholesterol levels in Japan is a very interesting one: mortality actually goes down with higher total or low density lipoprotein (LDL) cholesterol levels, as reported by most Japanese epidemiological studies of the general population. This relationship cannot be observed as easily in other countries, except in elderly populations where the same relationship exists worldwide.

The mortality from coronary heart disease in Japan has accounted for around just 7% of all cause mortality for decades; a much lower rate than seen in Western countries. The theory that the lower the cholesterol levels are, the better is completely wrong in the case of Japan—in fact, the exact opposite is true. Because Japan is unique in terms of cholesterol-related phenomena, it is easy to find flaws in the cholesterol hypothesis.

Based on data from Japan, we propose a new direction in the use of cholesterol medications for global health promotion; namely, recognizing that cholesterol is a negative risk factor for all-cause mortality and re-examining our use of cholesterol medications accordingly. This, we believe, marks the starting point of a paradigm shift in not only how we understand the role cholesterol plays in health, but also how we provide cholesterol treatment.

The guidelines for cholesterol are thus another area of great importance. Indeed, the major portion of this supplementary issue (from Chapter 4 onward) is given over to our detailed examination and critique of guidelines published by the Japan Atherosclerosis Society. We dedicate a large portion of this work to these guidelines because they are generally held in high regard in Japan, and the country’s public health administration mechanism complies with them without question. Physicians, too, tend to simply obey the guidelines; their workloads often don’t allow them to explore the issue rigorously enough to learn the background truth and they are afraid of litigation if they don’t follow the guidelines in daily practice.

These chapters clearly describe some of the flaws in the guidelines—flaws which are so serious that it becomes clear that times must change and the guidelines must be updated. Our purpose in writing this supplementary issue is to help everyone understand the issue of cholesterol better than before, and we hope that we lay out the case for why a paradigm shift in cholesterol treatment is needed, and sooner rather than later. We would like to stress in closing that we have received no funding in support of writing or publishing this supplementary issue and our conflicts of interest statements are given in full at the end.

Here is the introduction to the chapter on cholesterol and mortality:

All-cause mortality is the most appropriate outcome to use when investigating risk factors for life threatening disease. Section 1 discusses all-cause mortality according to cholesterol levels, as determined by large epidemiological studies in Japan. Overall, an inverse trend is found between all-cause mortality and total (or low density lipoprotein [LDL]) cholesterol levels: mortality is highest in the lowest cholesterol group without exception. If limited to elderly people, this trend is universal. As discussed in Section 2, elderly people with the highest cholesterol levels have the highest survival rates irrespective of where they live in the world.

I don’t think that I really need to say anything else, other than to repeat this fact. If you have a high cholesterol (LDL) level, you will live longer. This is especially true of the elderly.

Ann Nutr Metab 2015;66(suppl 4):1–116 DOI: 10.1159/000381654

123 thoughts on “Hats off to the Japanese

        1. Dr. Malcolm Kendrick Post author

          There is a hypothesis on almost every vitamin, foodstuff and mineral….and CHD. I could find five hundred on a good morning. I feel I must add, if you have read anything of what I write, cholesterol has no influence on CHD.

      1. Tytti

        Yes there are many. And I have read your book and and am not opposing it. I thank you for your writings.

  1. Jennifer

    Dr Kendrick, I think it is especially kind of you to write such essays as this, and for free on your blog.
    I am retired, but now spend much time working at home, hopefully, being a good housewife, as I ever did working for a living. I just could never find the time to research and read the stuff you so generously give us. I am sure I speak for many.

  2. Stuart Firth

    Thanks Dr. Kendrick, some of your posts should come with a health warning, especially for me. It’s great to see all the stats showing higher cholesterol associated with a lower mortality risk but spare a thought for people like me who have naturally very low cholesterol, off the lower end of the scale in my case. There is no shortage of advice on how to reduce your cholesterol by natural means but how does one raise it without giving up red wine, that is. Please turn your attention to us poor souls in future posts!

    1. Dr. Malcolm Kendrick Post author

      Stuart, the increased risk is, in reality, very small. I am mainly trying to make the point that LDL/cholesterol has very little do with health (except at the very extreme ends). It is just a thing, like being six feet two, rather than five foot six. I would no more advice to you chop your legs off, of stretch yourself, than worry too much about cholesterol. But the other side have got everyone so panicked that I feel I have a duty to redress the balance.

      1. BobM

        Thanks for that, as I also have low cholesterol (everything is low, total, LDL, HDL, etc.). (Although my former primary physician wanted me put on a statin; I say “former” because there’s no way I’m going on a statin and therefore no way I’ll see that physician again.) I’ll be interested to see what happens when I get a blood test done this year. Though I’m not sure any of these values matter, I have been on a low carb diet for over a year now. I assume something has happened to my values. I’m more interested in my blood glucose and insulin values than lipoprotein values.

      2. Bernadette Griffin

        After reading your book a couple of years ago, I took myself off statins (Simvastatin) and felt hugely better for doing so. 2 months ago I had a stroke – cholesterol 8.3 – and so I was pushed into taking statins again (Atorvastatin 80mg now reduced to 40mg as I got my level down to 3.2 in 6 weeks – I’m still on the statin). I am in my early 50s and had led a very sedentary life – long hours sitting in front of a computer. At the time of my stroke my BP was very high, but more importantly in my view, my stress levels were pretty elevated. I have read lots of articles about the cholesterol myth and am persuaded that statins are generally unhelpful but I’m confused about my own situation as the consultants firmly blame my raised cholesterol for the stroke. I really wish GPs (and insurance companies) could be persuaded on this issue.

        Bernadette Griffin

        1. Zachary


          5 years later: You didn’t have stroke because you stopped taking a statin. You had a stroke because of metabolic syndrome. You need to be on a LCHF (low carb, high fat) / ketogenic diet to avoid stroke and heart disease. Go to https://www.dietdoctor.com. Watch Fat Head The Movie by Tom Naughton. Look up talks by Dr. Eric Westman from Duke University and Low Carb Down Under on YouTube. Read books like “Good Calories, Bad Calories” by Gary Taubes. Those are just the tip of the ice berg. Dive in and educate yourself.

          1. Bernadette Griffin

            Zachary – thank you for your comments. I will check out the references. Quick update on my position – so, I ditched the statins some years back after more research and being satisfied that there was no problem with having a high cholesterol (quite the reverse it would seem) and yes metabolic syndrome does seem to be the right conclusion. I have been well in the past 5 years. Even my doctor has stopped trying to push statins on to me so I’m hoping the education process is spreading more widely. many thanks

    2. maryl@2015

      Stuart, I am just reading this new blog of Dr. Kendrick’s. Dr. Mercola who is basically an expert in nutrition among other things has an inherently low level of cholesterol. You may want to access some of his blogs or go to YouTube to see if you can find out more information. He appears to be in the best of health and actually states he has to eat a certain way to help raise his cholesterol levels. I think he would be a great reference for you if you are concerned. I would not worry if you are healthy in general, but it can’t hurt to find out from an expert on health and nutrition. Good Luck!

    1. maryl@2015

      Roy, that was my first question two years ago when someone referred me to Spacedoc.net. I had been on statins for years and was in so much pain, I felt hopeless. But, I could not accept some doctor telling me that I had a back injury and that was why my legs ached 24/7. I was placed on cholesterol lowering drugs, B/P meds, and Plavix (for a short time). I read three of Dr. Graveline’s books. Dr. Kendrick had written the intro to one of the books and I bought his first book, The Great Cholesterol Con. After that, I was told to get a copy of Statin Nation. These were difficult concepts for me. I did not understand heart and vascular disease from anyone else except the doctors who had treated my late husband. Those doctors were just fixing plumbing problems. They did not explain a damn thing to me except to say that heart disease was caused by cholesterol blocking our arteries. I just accepted their word as gospel and did what I was told to do like the good Catholic girl I was. I also had been diagnosed with an abdominal aortic blockage, which had been stented. I had no heaviness in my legs any longer, but the pain was still awful. I was a woman on a mission for years to find out why I still ached so much, had spasms, began to have one leg just give out (not enough to fall but enough to make me concerned). I read those books with gusto. I highlighted and read again and again those parts I found troublesome. I reviewed Statin Nation over and over again, making notes for myself and particularly listening to the extended interview sections. Whenever I would not understand one of my notes, I researched certain medical terminology and began to get a very clear picture of what atherosclerosis really was and how for years on end we had been led to believe it was fat (saturated) and foods containing cholesterol that were killing us and causing heart disease. I had friends who had not touched an egg yolk in years. That is how duped we were into believing cholesterol, even in the diet, was the number one cause of heart disease. It was the old dusty diet heart hypothesis. I had actually tried a diet that consisted of moderate fat intake, low glycemic foods and vegetables and that had worked for me for years.

      I would strongly suggest that you purchase Statin Nation, review Spacedoc.net, and later Statin Nation II. Don’t get too bogged down. It is a very complicated subject. But you will learn. It will not be overnight, but you will one day have that Ah Ha moment that will change your life. I ditched those statins by the way and really don’t care what my cholesterol levels are. They were good numbers when I was diagnosed with a blockage.

      Start there and whatever you don’t understand…look it up. Even if you have to read it 10 times to understand…do it. I find that Dr. Natasha Campbell McBride explains the whole process as though she were teaching a 6th grade class. That was very helpful. The rest will fall into place. Kendrick, Graveline and Uffe Ravnskov stand out in my mind (and I speak only for myself) as the Founding Fathers of the dismantling of the Diet Heart hypothesis. They took years of their precious time to research this issue not for love of money but because they loved medicine and helping others. They, among others, have faced so much backlash from the establishment, but bravely did what they knew was the right thing. You cannot expect yourself to learn it in one blog. Go for it. You will not be sorry!!!

      Good Luck!

    2. bart goodell

      Refined foods and the animals we eat that eat refined foods. Add in the man made chemicals we allow to be sprayed on our foods. ALL these things have side effects for the plant or animal who eats them (This is basic quantum mechanics). And this includes us.

  3. mec76

    Another superb thump to the statins brigade – roll on the hour when the wretched stuff is *withdrawn from the market place – then health services can better spend the savings on a better spend in other health directions. And someone do dethrone that fella who was intent on pushing statins on each and every person over the age of 50…
    Bless you Kendrick – a breath of fresh air and sanity in a very strange pharma led world ! Good job man.

  4. Nigella Pressland

    I feel sure the tide must be slowly turning on statins. However, the cynical part of me, can’t help wonder how long it will be before research (with a vested interest) shows that the Japanese have some genetic disposition to high cholesterol, or find some other way of discrediting the research.

  5. Sylvia Brooke.

    This latest posting has cheered me so much Dr. Kendrick. I stopped taking statins some months ago after following one of your earlier postings, but admit to wondering if I was “jumping the gun”. This latest information has reassured me that I did the right thing, after taking on board the advice that so many people were willing to give. Their experiences were a revelation to me at that time as so many of them mirrored my own. Thank you so much for continuing to care, and for passing on your findings as and when they happen.

  6. Helen

    Dr Kendrick, I read your book, the Great Cholesterol Con, on the recommendation of Dr Barry Peatfield a few years ago. Immediately afterwards I gave a copy to an elderly relative, who is a retired academic with an analytical background. When his GP menaced him with a statin prescription, he was prepared and he refused it successfully.

    For my own part, I felt very angry that for more than 30 years I had followed the recommended high-carb, low fat, near-vegetarian diet, only to end up overweight and insulin-resistant. What a waste, and what a bloody boring diet. Your book and your blog have been very liberating. And, as you say, hats off to the Japanese! The tide may be turning at last.

        1. Justin Roy Olson

          Is there anything that the Weston A Price Foundation does that you would advise against?

      1. Stephen Town

        Justin, I changed to a low card diet three months ago and the article doesn’t worry me at all. The author clearly accepts the ‘standard’ thinking that high cholesterol is harmful. Dr Kendrick’s comments and the Japanese article refute that position completely. Low carb has been good for me and there’s no reason for you to doubt it.

        Earlier today I came across this excellent Ted-x talk by a diabetic professor of biochemistry called Wendy Pogozelski. Based on her knowledge of biochemistry she went on a low carb diet and successfully dealt with her diabetes. She was then referred to a dietician who was predictably appalled. I think people interested in diet or diabetes will find the professor’s experience and short talk enlightening.

  7. Sue Richardson

    Another encouraging post Dr K. I wonder if Big Pharma & the Statinators are huddled round the table biting their nails and wondering how to get out of this one? As Nigella suggested, they’re bound to find a ‘reason’ for such damaging (to their hypothesis) information. Their whole world is at stake – and their bank balance of course.

      1. Carolyn

        They are probably all huddled in a bunker with the endocrinologists ignoring the thyroid research. They probably all get on very well! :-/

  8. Tim Ozenne

    I am not a doctor, but it seems likely that you are right: high cholesterol is associated with lower all-cause mortality. But before we get excited about this, we might want to ask how strong the association appears to be. We might also want to know if steps to increase cholesterol–other than discontinuing statins–would be expected to increase longevity.
    Personally, I’ve been amused that my doctors seem to focus on lowering risk of heart disease (especially with statins) while ignoring the fact that even those with a higher risk of heart disease are likely to die of something else (we, thankfully, don’t know what).

    1. David Bailey

      From reading Dr Kendrick’s books, and other materials, I think the staggering truth is:

      1) There isn’t much/any correlation between saturated fat intake and cholesterol in the blood. Saturated fat is actually good for you!
      2) There isn’t much/any correlation between cholesterol in the blood (or LDL in the blood, or LDL/HDL) and heart disease.
      3) There is evidence that lots of carbohydrates mean lots of glucose in the blood – because that is what they break down into – so encouraging diabetics to eat more carbs is criminal!
      4) Statins cause extra diabetes as well as what are euphemistically called ‘muscle pains’ (some people end up in wheel chairs) and memory loss for some.

      Taken all together, this is an unbelievable scandal.

      I don’t take statins any more, and I don’t even have my blood cholesterol levels measured.

  9. mec76

    I am in the middle of reading the absorbing book by Prof Peter C Gotzsche – “Deadly Medicines and Organised Crime – how big pharma has corrupted healthcare”. What an eye opener. Afraid that they could `ignore` the findings, or, find a crutch in the shape of different genetics, even diet perhaps, to continue to hang their lies from. But the whole fabricated tissue cannot go on forever, the rug is slowly but inevitably being pulled from under their disgraceful machinations.
    More power to Dr K and to the Prof. Sigh of relief that we have such bold excellence to call on.

    1. Professor Göran Sjöberg

      As “Doctoring Data” Prof Peter C Gotzsche – “Deadly Medicines and Organised Crime – how big pharma has corrupted healthcare” is really great reading. You are not the same person anymore in relation to the healthcare when you have read these books.

      1. mec76

        I received the following last night…
        Get paid to help find new therapies for Heart Disease
        “CureClick invites you to become a Clinical Trial Ambassador where you get paid each and every time someone clicks on your unique link and explores information about a new trial for people suffering from high cholesterol and at risk for heart disease.”
        `Seems` that I can earn money (!) by entering in to their `plan` and recommendations and passing on their message – if only they knew !! Had a good chuckle at this one
        Must find a way of sending the info to Prof Gotzsche – think he would be amused at their further shannanigans.
        Then, this was another item dropped in my in-box today – https://reachmd.com/activity/7358/
        Cardiovascular Controversies: Exploring the ACC and AHA Guidelines on the Treatment of Blood Cholesterol
        Hosted by Dr. Brian McDonough with Dr. Seth Martin
        Play Program (you will have to log in – free)
        A careful listen and will note the *new wriggling… They are beginning to wriggle now…”Too high intensity statins” “Too much emphasis on LDL / HDL numbers” “Lipids – overestimate risk” I love it. Ohhhh – they are admitting they must “change their guidelines – potential risks – `shared` decision making” !! What a turnaround… “Get patients more involved in their own conditions and treatments…” HaHa Pharma sure is seeing the statins rug being pulled from under their feet !
        Well, let us just `hope` that NICE will change their guidelines and *STOP stuffing statins at us and *stop badgering GPs to hand out the Rx for em.

  10. Jacques Brun

    Thank you for the interesting info Dr. Such a relief to get this positive info. Just wish other Dr. would make time to educate themselves or at least keep pace with changing times. My Dr. wanted to put me on Statins a month ago, but I insisted on a LDL particle test. Thanks to you and other Physicians on the subject matter I was able to educate myself on Cholesterol. Otherwise I would be another sucker to contribute to the Pharma coffers at the expense of my health.

  11. Kate

    Hi, I was diagnosed with familial hypercholesterolemia a couple of years ago. I do take stations, as I’m afraid not to! What are your thoughts on this issue please? Thank you.

  12. Leigh Gold

    In addition to ‘Big Pharma’ and the ‘healthy’ ‘better-than-butter’ spreads/foodstuff manufacturers, may I add the holiday insurance industry, which exploits the prevailing consensus that hypercholesterolaemia is a disease and an additional source of income to swell their obscene profits, and a godsend to their bottom-line. That I should continue being prescribed for hypercholesterolaemia and alleged raised BP and then, Heaven forfend, dumping the dreaded pills in the waste bin, just so as I can continue to get insured for my Spanish holiday. Who me? Whatever gave you that idea!

    1. Stephen Town

      Leigh, I declined blood pressure medication. How does that affect my holiday insurance? Any advice?

      1. Leigh Gold

        Don’t decline your medication. I’d imagine that your refusal would show on your records and, in the event of an insurance claim, it could compromise your position. Declining medication is one thing. Receiving medication and not taking it is another. It has been said that simplicity is the ultimate sophistication, so contact your travel insurance company and ask them. But don’t expect a favourable reply.

    2. Lucy

      I was born with natural high cholesterol. I was on statins for a while but they screwed up my blood sugars. They went from 85 fasting to 100 and they have not yet come down. Every time I walk into the doctor’s office there’s a red label on my chart that says HYPERCHOLESTEROLEMIA and now they have added PREDIABETIC.

      1. Anne

        What does it vary on ? I’m 62. I don’t feel ‘elderly’ but would my cholesterol level consider me ‘elderly’, if you see what I mean, because saying a higher cholesterol level is protective in the elderly surely depends on what it means to be elderly. Btw, I’m not worried about my cholesterol levels ! I’m just trying to be a bit scientific here about the phrase protective in the ‘elderly’.

        1. Dr. Malcolm Kendrick Post author

          There is no scientific definition of ‘elderly’ that I have seen. It varies in study after study. In the case of cholesterol it means over 55. In other studies it means something else. Sorry. I don’t make the rules

    1. mikecawdery

      Interesting question: At 81+ the old muscles are wobbly which statins probably contributed but I DO NOT FEEL OLD. The brain is a bit slow (statins again???) but still packed with a lot info and my computer storage helps as well. I think one is as old as one feels – don’t bother about numbers in this case.

    2. Lucy

      I read that before the age of 50 there is a weak association between high cholesterol and heart attack, but after 50 it disappears.

  13. Lorna

    Good to see the contradictions in the cholesterol hypothesis challenged in ‘real’ population data. One question: what’s the difference between hypercholesterolemia and ‘naturally’ high cholesterol? Could it be some people are told they could hypercholesterolemic but are actually meant to have higher than average cholesterol? I understand that some unfortunate people do have damaging genetic cholesterol problems but have heard of experiences when this ‘diagnosis’ is used to frighten one into statins even before any tests for the condition has taken place.

    1. Jennifer

      Yes, Lorna. Then ‘average’ becomes ‘normal’…..and that is what starts the ball rolling for the pharmaceutical industry……who interpret this to mean we are deficient or in excess of something or other, so must take a pill to ‘normalise’ us.
      In the world of arithmatic, only a precious few of us can possibly be normal, that’s the way ‘average’ works( or so I learned at junior school)…..thus that lucrative majority on either side will fall into the catergory of needing a pill or potion ….CHING CHING.

  14. jim burns

    Hi Dr k !!
    The world that we live in at the moment is all about control !! too many sheep in the world !!

    Just thought you may like the above link.
    Cheers jim

    Oh! I am glad your scottish and not a sheep lol too much of the Macallan lol

    1. mikecawdery

      How very true. It seems that US “democracy” is government by corporations such as the “security-industrial complex, defence industrial complex, health industrial (pharmaceutical) complex and others. Frightening. Same in UK I suspect!

      1. Jim burns

        Mmmmm! Statins £££££ as as Scottish Irish what I would say a man of
        Not the cloth but of travel Not bio and detailed research lol I like u Dr k . Might be A bit over he edge just now but Like what about a pub in glasg

  15. Sylvia Gibson

    My husband’s cholesterol were all “within normal limits”, yet he died at the age of 50, from coronary occlusion, all were 90-95% occluded.

    A few years ago, my cholesterol levels were “high” and the doc wanted to immediately start statins. I said no. My Vitamin D level was 18. I started taking Vit D3 5000-10000iu/day and B complex, and a multivitamin and 5 months later my cholesterol was “normal”. Who was it that said let you food be your medicine and your medicine be your food?

    Sylvia, RN-retired

  16. Kathy

    My total cholesterol (both LDL and HDL) have increased on a low carb diet with intermittent fasting. And as the good doctor says, it is ok. We are looking at the wrong thing where heart disease is concerned. There is good evidence that high insulin is a possible culprit.

  17. Mark Janson

    And yet even though we have all the warnings of giving statin meds to the elderly, a UK tabloid (Daily Express) carries a front page story today extolling the 30% reduction in stroke benefits to that very same age category of patients’ (>75s).

    The Daily Express has considerable form when it comes to such front page stories (I guess it helps to sell papers) but it’s still very sad that no attempt is made to balance such a story in any meaningful way. It’s also a shame that no attempt is hardly ever made to explain the NNtT / harm or indeed how the meaningless relative reduction percentages are calculated. Contrast this to the vicious attacks on a programme such as that of the Australian Catalyst variety for its “lack of balance”.

  18. Lynda Cooper

    Great news. I stopped takin statins after trying 3 different brands that made me ill and in physical pain. Since I’ve stopped feel so much better. I also believe that the exceptionally bad treatment recieved by Thyroid patients contributes to them being given statins that they do not need (together with lots of other unneccesary medication). This is also driven by pharmaceutical companies and the medical professions unwillingness to listen to their patients and treat accordingly.

  19. Sarah C

    My total cholesterol is 3.9. Does this mean I’m at risk of falling off my perch ahead of time? How low is too low? Not medicated, but has come down steadily since following Harcombe diet. On meds for BP. Should I be concerned?

  20. Maggie

    Having read your book and several of your online articles, and being quite opposed to taking statins, I’d like you view on my husband’s situation. He’s in his early 50’s, extremely fit, regular exercise, good diet, cholesterol of 4 at the moment (historically he;s been around the 4.5-5.5 mark). During a company medical he experience a significant S-T depression during the 5th stage of the Bruce protocol – he had no symptoms whatsoever and was happy to keep going. He has never had chest pains, breathlessness etc. A CT angiography suggests coronary artery disease with a calcium score in the 50 to 75th percentile for his age. The recommendation is 40mg statins. We would very much like to know what your thoughts are on this, and your reasoning.

    1. Dr. Malcolm Kendrick Post author

      I am going to say what I say to anyone asking for patient specific advice on this blog. I cannot do this. Even if I wanted to, I would lose my license to practice medicine very rapidly.

      1. Maggie

        Thank you for your reply. I appreciate your situation and should have thought of that before I asked the question.

      2. robert lipp

        Hi Dr K.
        To me there is an elephant in the heart health room. It is one thing to change to a LCHF or Paleo or similar diet to improve one’s heart health risk, this research just adds to that need for such change, and so improve one’s metabolic syndrome risk. The question that must asked. Will this repair change the damage (plaque etc.) and over what period? What about 20 years of statins, will the damage be repaired by changing to LCHF and stopping statins? In my view, for many this is the real issue, and I perceive what may be in Maggie’s mind.

      3. Sarah C

        Sorry – wasn’t asking for patient specific, just a general reply. At what level would you be concerned that cholesterol was too low? in the general population, rather than on an individual basis

      4. Maggie

        Good question, Robert Lipp, and one which is definitely in our minds. We’ve been told repeatedly that once arteries are ‘furred up’, that’s it without some form of medical intervention.

    2. David Bailey


      As Dr Kendrick says, he can’t risk his license to answer internet questions, but if you read his books you will realise that he doesn’t believe there is any value in taking a statin if you haven’t had a heart attack or stroke, and only minimal value if you have.

      I was on 40 mg of Simvastatin (the dose varies depending on the type of statin), and all went well for 3 years before I got extreme cramps in one leg (which made it look like another problem), and I really only escaped because I remembered the list of side effects from 3 years earlier (how nerdy is that!) and stopped. I recovered completely, but *not everyone does recover*.

      I have talked to others of my age who have had similar problems, and one whose muscle cramps were combined with severe memory problems. Fortunately he has also recovered completely after giving statins up.

      I think the best advice would be to read “The Great Cholesterol Con” and make your own minds up.

      1. Maggie

        I’m glad that you have recovered and are feeling well. We have read Dr Kendrick’s book and my husband was quite firm in his view that he shouldn’t take statins, but when a medical professional makes a strong case for taking them, it becomes difficult. The argument goes along the lines that due to my husband’s age, fitness levels and so forth, there must be an underlying reason why he has developed coronary artery disease and, therefore, statins are the only way to slow down the development of plaque and to prevent fissures which can cause blood clots and possible death.

      2. David Bailey


        Interviews like that can be difficult, I know. My usual doctor knows what happened when Simvastatin, and hasn’t tried to persuade me to try another statin. However, one time I went, I saw a different doctor in the practice, and when I had finished explaining my experience with Simvastatin, and the concept that saturated fat was good for me (so I wasn’t trying to keep my fat intake down) she seemed a bit bemused!

        I suggest that you should maybe get the paperback version of “The Great Cholesterol Con” so you can highlight various passages – particularly those parts that deal with actual trials – and you can lend (or even give) the doctor the book – which may make it easier to say “No”. Also discuss the concept of Number Needed to Treat with him (http://www.thennt.com/nnt/statins-for-heart-disease-prevention-without-prior-heart-disease/ ). These are numbers calculated from the actual trials performed.

        You should also look at this site which contains reports of problems with Simvastatin:


        I think you can find similar sections on that site for the other major statin drugs.

        Ultimately, I think you have to do as I did, and breath deeply and say that nobody lives forever, and if you take something that messes up whatever time you do have, that is a rotten deal.

      3. Maggie

        Thank you for your post and the links. I’ll take a look at them, and also forward them on to my husband. Your suggestion about taking Dr K’s book to a future appointment is sensible, but likely to be given short shrift if my experience is anything to go by. A few years ago I took a book regarding thyroid treatments along with a number of questions to an appointment. The doctor was incredibly dismissive and refused to discuss it, branding the authors quacks (they were all practicing doctors). She also warned me of the ‘perils’ of looking at the internet, although I was referring to published BMJ articles amongst others!

  21. Dawn

    Reblogged this on KungFuAngel103 and commented:
    This is important, and goes against accepted health advice, which, it seems to me, increasingly about profit, not health.

  22. eagaffan

    Dr Kendrick, please can you tell me the names of the first and second authors, and/or the title, of the article that you’re citing in Ann Nutr Metabol. I want to read it, but the search engines available to me (Pubmed and Google Scholar) haven’t found it from the journal name only. I have also checked the contents list of the latest issue online but not spotted it. Thank you.

      1. Justin Roy Olson

        Can you possibly answer my question about the Weston A Price Foundation when you have the time? Thanks again doctor!

          1. Dr. Malcolm Kendrick Post author

            People ask questions for reasons. That is context. Frankly, I am not here to answer any question people decide to lob at me. I just write a blog, I am not, actually, a paid state employee.

          2. Justin Roy Olson

            I understand! You don’t have to answer questions which you don’t want to or have time to? Is this what you mean? I am a State Employe. I get to working so hard but it’s worth it!

            More or less I just meant if you disagreed on their certain guidelines, absolute use with fermented cod liver oil and high vitamin butter oil, use of organ meats or fatty cuts of meat with muscle meat. Questions like that!

          3. Jennifer

            Justin Roy Olson.
            Where is your thread leading us?
            I think you should use a different blog to research your queries, if, in fact you genuinely have some.
            Or is your aim to cause embarrassment?
            In the main, subscribers tend to use this blog as an informative, positive and non-combatative resource.

      2. eagaffan

        Thanks Stephen, your link works, I was being dumb, had not spotted that Dr K provided the DOI. I have the article niow.

      3. Anne

        Thanks for the link Stephen ! I’m now reading it….most interesting.

        So a new question arises: it is not clear whether the LDL levels were direct measurements of LDL, which hardly anyone in the UK is able to have, or whether they were calculated by the Friedewald formula. I think the suggestion is that it is the Friedewald LDL. This makes a huge difference for those of us who have low triglycerides and high HDL as the Friedewald formula gives an inaccurate LDL measurement in that case ! So……..


    1. mikecawdery

      Got to pubmed and enter “Ann Nutr Metab 2015;66(suppl 4):1–116 DOI: 10.1159/000381654. I have just downloaded the entire paper!

  23. Brian Wadsworth

    I seem to recall Uffe (the Ravnskov) reporting on the longevity value of high cholesterol in at least one of his publications. Did he not do a meta-review of studies to arrive at his conclusion?

  24. Bruno

    Hello dr kendrick. Where can I find the entire study you’ve quoted? I’d like to translate it in Italian. I guess nobody translated. Thank you very much

  25. mikecawdery

    Dr Kendrick wonderful blog!

    But beware the following extract is a very truthful assessment: We believe the answer is very simple: for the side defending this so-called cholesterol theory, the amount of money at stake is too much to lose the fight. When money is at stake the losers are very dangerous!

    I have downloaded the document in full from Pubmed using “Ann Nutr Metab 2015;66(suppl 4):1–116 DOI: 10.1159/000381654″

    At 81+ the extract “ elderly people with the highest cholesterol levels have the highest survival rates irrespective of where they live in the world is encouraging

  26. Pingback: Cholesterol and Heart Disease | Mark's Daily Apple Health and Fitness Forum page

  27. robert lipp

    Hi Dr Kendrick
    It is one thing to change to a LCHF or Paleo or similar diet to improve one’s heart health risk, this research just adds to that need for such change, and so improve one’s metabolic syndrome risk. The question that must asked. Will this change repair the damage (plaque in the arteries, arterial elasticity, etc.) and over what period? In addition, what about the damage caused by 20 years of statins, is this repaired by changing to LCHF and stopping statins?
    In my view, for many this is or will become the real issue.

  28. Pingback: Big Pharma Myth Buster: High Cholesterol Makes You Live Longer* | Hwaairfan's Blog

  29. Pingback: Japanese Research Exposes Statin Scam: People with High Cholesterol Live Longer | From the Trenches World Report

  30. Ken McMurtrie

    Reblogged this on The GOLDEN RULE and commented:
    A touchy subject. Time for some new information.
    “The mortality from coronary heart disease in Japan has accounted for around just 7% of all cause mortality for decades; a much lower rate than seen in Western countries. The theory that the lower the cholesterol levels are, the better is completely wrong in the case of Japan—in fact, the exact opposite is true. Because Japan is unique in terms of cholesterol-related phenomena, it is easy to find flaws in the cholesterol hypothesis.”

  31. John Cowburn

    Well thanks Malcolm! For years I thought the only health statistic I possessed which seemed beneficial was my naturally low cholesterol level ( cholesterol 3.1 mmol/L and triglycerides 1.08 mmol/l) but it now it would appear that I’ve been dealt a dud card on that as well! I have essential high blood pressure (reasonably controlled with drugs) and I have multiple sclerosis. So it would now seem that if I don’t die early from the HBP or the MS, I’ll probably die from my low cholesterol levels! What a swizz! Incidently, what will be the cause of death from my low cholesterol?

  32. Paul

    Very interesting comments on here. I would like to add my experience.
    I am a 54 year old male in reasonably good condition. A couple of years ago I went for a routine medical check where it was discovered that I had raised blood pressure and ‘high’ cholesterol levels.
    Mass panic ensued and I was immediately, without consultation, handed a prescription for 40mg Atorvastatin and 10mg Amlodopine. I obediently accepted my treatment and sure enough, mild headaches, achy muscles and a general feeling of being ‘detached from reality’ followed.
    A friend of mine put me onto Dr Kendrick’s book The Great Cholesterol Con and after reading the first few chapters I decided to stop taking the statins. I accepted the importance of the hypertension medication so continued with that.
    On a subsequent visit to my GP for a BP check, I was asked if I was still taking the statins. My response of “no, because I have done some research” was met with a shrug of shoulders and “ok”. No argument or attempt to persuade me back on to them.
    I got a very similar response form another GP at the same practice when the subject of statins came up at a more recent visit.
    Is it possible that more practitioners are changing their opinions on the cholesterol/statin subject?
    By the way, a recent blood test has revealed my cholesterol levels are now near to ‘normal’. This was achieved by some adjustments to my diet

  33. S.Lau

    Dear sir
    I would like to know if statin therapy is a must for heart bypass patient.?I have 3x cabg 1 yr ago, because I can’t tolerate statin, I took off the stay in therapy n go on with ezetimbe.
    I was worried as my Dr say that statin is a must for all heart bypass patient.

    Any comments?

  34. Worried of Worcester [Alan]

    Dr Kendrick,
    I have just finished your book and had decided to stop taking my daily 10mg of simvastatin until I got to near the end when I read just one sentence which made me pause again. All the research data you referenced convinced me that I should cease taking a statin UNTIL you said that for “secondary prevention” taking a statin was beneficial. In other words [I hope I understood correctly], if someone already has CHD, the research indicates to continue taking a statin.
    Have I understood correctly? If so, why should this be?
    If the cholesterol hypothesis is not directly causal/relevant to CHD, why should it be beneficial to take a statin in this one particular circumstance?
    Relevant info
    1. age 70
    2. diagnosed with CHD at age 47 and 2 CABG carried out in 1993
    3. 2 stents carried out 2004
    4. no further cardiac symptoms, active life
    5. present LDL 2.9 mmol/L. HDL ratio 2.4.
    6. medication— aspirin, simvastatin, atenolol, ezetrol.

    I was also puzzled by one apparent anomaly in the final chapter. Your conclusion that CHD was stress triggered is convincing in that the damage to the arterial wall is related to cortisol and the subsequent “repair” by the body and consequent “covering” by cholesterol creates the thickening which builds to a fatal level by the continued stress triggered identical process repeating. Why should this blood vessel damage/repair/damage/repair cycle not occur in veins as well as arteries? I noted earlier in the book that this plaque build up ONLY occurs in arteries and not veins yet later you describe arteries and veins being essentially the same composition except that arteries are thicker but that if they are transposed, each gradually changes to become the other. ie. if a vein is used as an artery graft it’s walls will thicken in time and function as an artery and perhaps become susceptible to plaque build up. If stress related cortisol damages the internal wall of an artery, why doesn’t it do the same to a vein if the internal wall structure & composition is the same as an artery?

    I’m not medically trained or trying to throw a spanner—I just couldn’t understand the logic of the situation I’ve just described—-maybe I’m dumb or missed something.

  35. Pingback: Velká cholesterolová lež – MUDr. Dwight Lundell, statiny a omega-3 – Dary od přírody

  36. Peter

    I am very cautious about statins also. But I would also caution about refined sugars and carbs as the sole cause of heart disease by reminding that artheroscleosis has been found in ancient mummies recovered from populations that had no access to either sugar or refined carbs. Eskimo populations that at a very fatty meat and fish based diet for example.

  37. robert lipp

    My understanding is that the ancient Egyptians (before they became mummies) ate a high carb diet and were riddled with what we now know as lifestyle disease. I think the reference is in one of Gary Taubes’ books, if my memory is correct.

  38. Burt Furuta

    People in some provinces in Japan eat a lot of natto, fermented soybeans, which is very high in vitamin K2. Matrix gla protein is a vitamin K2-dependent enzyme which removes calcium from soft tissues like arteries and veins. Calcium makes up about 20% of arterial plaque in a definite structure rather than random buildup. Vitamin K2 is also anti-inflammatory. Excerpts from VitaminK2.org, answers by Katarzyna Maresz, PhD:

    Q: Why do you and your colleagues believe in Vitamin K2?
    A: The evidence is overwhelming. On one hand, you have the health benefits confirmed by many clinical trials. At the same time, we recognize Vitamin K2 is the compound missing in Western society – one in which most Western populations are deficient.

    Q: Who will benefit from taking Vitamin K2?
    A: Anyone interested in supporting healthy bones and their cardiovascular system will benefit from taking Vitamin K2. And, in truth, unless you are eating natto every day, you are woefully deficient in Vitamin K2, so start today.

    Q: As a doctor and scientist, what health areas/studies/issues interest you?
    A: My main scientific interest is inflammation and modulation of inflammatory disorders. Recently we found that vitamin K2 is able to inhibit inflammatory markers, which is important for many diseases.

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