What causes heart disease part XXVI

[Hold the front page]

Last night I watched a you tube presentation which completely astonished me. It was given by Professor Salim Yusuf, who is as mainstream as mainstream can possibly be. Here, from Wikipedia:

‘Salim Yusuf (born November 26, 1952) is an Indian-born Canadian physician, the Marion W. Burke Chair in Cardiovascular Disease at McMaster University Medical School and currently the President of the World Heart Federation, a world-renowned cardiologist and epidemiologist. In 2001, he published a landmark study that proved the benefits of clopidogrel in acute coronary syndrome without ST elevation.

Here, from Forbes magazine in 2012:

‘McMaster University’s Salim Yusuf has tied for second place in the annual ranking of the “hottest” scientific researchers, according to Thomson Reuter’s Science Watch. Yusuf was a co-author of 13 of the most cited papers in 2011. Only one other researcher, genomic pioneer Eric Lander of the Broad Institute of MIT, had more highly-cited papers than Yusuf.’1

On February the 12th he gave a presentation at a cardiology conference in Davos, Switzerland which can be seen on YouTube. In this presentation, he makes the following points:

  1. Saturated fat does raise LDL, a bit, but has no effect on CVD – maybe slightly beneficial. Monounsaturated fats are slightly beneficial. Polyunsaturated fats are neutral.
  2. Carbohydrate intake is most closely associated with CVD
  3. Fruit and vegetable intake has little or no impact on CVD – nor does fish intake [He wonders where the five portions of fruit and vegetable intake recommendations actually came from]. Vegetables in particular have no benefit.
  4. Legumes – beans and suchlike – are beneficial.
  5. The recommendations on salt intake are completely wrong, and set far too low. For those who do not have high blood pressure, low salt intake increase mortality. On the other hand, high salt intake does no harm.
  6. He recommends higher potassium intake.
  7. He criticizes Ancel Keys and lauds Nina Teicholz [Author of big fat surprise].

Well, good for him. It seems to have taken him a long time to get there, but he did in the end. Of course, mainstream medicine will remain in shocked silence, so you will likely hear nothing of this in the mainstream media. But, hey, you get to see it here. Perhaps someone would like to send this presentation to the BHF and the AHA and ask them for a comment?

The YouTube presentation is here:


1: http://www.forbes.com/sites/larryhusten/2012/04/25/when-youre-hot-youre-hot-salim-yusuf-second-most-influential-scientist-in-2011/#6ac825575abe

276 thoughts on “What causes heart disease part XXVI

    1. sam

      he said fruits were good up to 2 per day and said should eat 2 a day and legumes. Legumes hated by low carb zealots. Carbs an issue only when more than 45% of energy intake.

  1. AH Notepad

    Oh dear! He is not a nutrition scientist, but with any luck he will not be censured by the Australian anti-health authority. I will pop this along to the BHF and wait with interest for their comments. Then I will watch it 🙂

    1. AH Notepad

      No surprise here, according to the reply from the BHF, saturated fats are bad for you:

      “Thanks for your email regarding your enquiry on fats and carbohydrates and CVD with reference to the video presentation.

      The video highlights the key messages around what we should be eating – too much or too little of everything is not good for you that is why it is important to look at the whole diet rather than focusing on individual nutrients.

      In the UK we are still eating too much saturated fat . As the presenter mentions, cutting saturated fat doesn’t mean lowering all fat. We all need some fats in our diet and, over time, the very low fat diets recommended in the past have been put to one side as our understanding of the effect of this nutrient has developed. But what you have instead of saturated fat can make a difference to your health. Replacing saturated fat with healthy unsaturated fats ( mono and polyunsaturated fats) and wholegrain foods seems to have a positive impact on our heart health, however replacing saturated fat with refined carbohydrates such as sugary drinks sweets and cakes does not. So, current guidance tells us to switch from saturated to unsaturated fats rather than cutting the fat completely.

      Regarding carbohydrates, like fats the type of carbohydrate we choose to eat also has an impact on our health. We are also eating too much sugar ( part of the carbohydrate family) and just last year new nutrition guidelines were published recommending we cut free sugar intakes by half (https://www.bhf.org.uk/heart-health/preventing-heart-disease/healthy-eating/sugar) and that our current intake of starchy carbohydrates, should remain at 50% of our daily calorie intake and should include high fibre foods, wholegrains and legumes known to be beneficial to health. Of note the 75% calories from carbohydrate the presenter quoted is an old World Health Organisation (WHO) recommendation – current recommendations are 55 percent of total energy coming from carbohydrate.

      There are many factors which cause cardiovascular disease and no single food or nutrient is solely responsible for this. Similar to the presenters conclusions it’s more helpful to focus on the foods that we want to include more of in our diets. Eating a diet rich in fruit and vegetables, pulses, beans ( legumes) , wholegrains, unsaturated oils and fish means there is less room for the foods high in saturated fat and salt like fatty or processed meats and sweet treats. Eating a Mediterranean-style diet has long been associated with a reduced risk of heart and circulatory disease and centres around all on all those foods we should be eating more of. Our UK dietary recommendations are largely consistent with a Mediterranean style diet, so guidelines we should be aiming to achieve.”

      Many factors cause CVD, and no single food or nutrient is solely responsible. Mmmm…, OK, except perhaps saturated fat? Rather mixed messages and what you eat seems to have an effect. That’s alright then as long as it “seems” and we don’t have to mess around with silly things like evidence…………..

      1. Christine Whitehead

        A H Notebook
        Interesting, but predictable, that BHF have skated over the findings that saturated fat is likely protective, along with monounsaturated fat, whereas pufa is neutral. So why did BHF reply find it necessary to tell us we are eating too much saturated fat? surely, if anything, we should be cutting down on pufa which didn’t appear protective.

        They also seem to have also ignored the protective aspects of full fat dairy.

        Given the overall message that fats are protective and excess carbs dangerous, why would we want to replace saturates fat with whole grains?

        Seems like they are going to cling to same old, same old. If fact as I read through their reply I wondered if they had watched the right video.

      2. Sue Madden

        I get so tired hearing officialdom in the UK talking about the “Mediterranean diet”. They don`t know what they`re talking about!!!!!!
        Aside from the olive oil factor and all the unproven things about fruit etc, the assumption is that Mediterranean peoples have diets low in saturated fat!! Having lived for several decades in Italy with Italians, no English of English diet in sight and I can assure readers here that Italians eat lots of saturated fat. They eat fat rich cheeses in quantity, they eat lots of pork including the fat. They have pure meat sausages which are probably about 50% fat (my frying pan as witness). They sometimes eat them raw, on bread, and they are delicious. They eat slabs of the bacon portion of the pig that are almost pure fat, I could go on ad infinitum. The Med diet is NOT low in saturated fats by ANY measure. It may be true that some of younger generation are cutting down on these because of the intense propaganda emanating from the US and the food industry, however, at least in the rural areas I haven`t seen much evidence of this. Very young children sit at table with adults and eat the same food – no messing about, no tantrums and where I am no industrially produced made-up food (ersatz food), I`ve seen a child of 2 eat pieces of octopus and of sausage (as described) and ask for more……..

        enough said!!! Except to say I`m thrilled for you dr K that almost every week now something comes up to vindicate your so obviously valid reasoning. Did you or blog readers see the New Scientist recently??? A cover story throwing doubt (though the article didn`t go nearly far enough) on the statin “theory”….

      3. Mr Chris

        Sue Madden
        What you say about Italian diet, fits with my own observations. I would characterise it as long on saturated fat, and carbs, in the form of pasta, and, I have the impression low on vegetables. Is the melditerranean diet like the loch Ness monster?. If you discuss the point with uber-enthusiasts, they cite Crete as its centre, and when questionned, they claim only in the mountains! Yet De Lorgeril had spectacular results with his mediterranean style diet.
        Incidentally the Italians have a very honourable place in all the mortality tables I have seen for CVD.

      4. Sasha

        The Italians I know never believed in low fat theory, I think. Or low carb theory, for that matter. It’s amazing to take a flight from Milan to London and see the difference in people’s girths… The Anglo-Saxon world is quite confused about nutrition, IMHO.

      5. AH Notepad

        😆 not very bright are they? Maybe they don’t know there are some fairly clued-up people (and me :)) talking to each other. Perhaps they are suffering from oxidative stress, they should take more care as it might promote CVD, or they could take large quantities of vitamin C 😉

    1. mikecawdery

      I am afraid that I have concluded that sometime ago. The Medical research establishment has sold out to Big Pharma and their “perception of profit and status” these days.

    2. Traci

      Waaay too late. In truth all hope was thrown out with the bath water. My only hope is that I will be capable of executing my own Self Directed Death before the bastards figure out how to bankrupt my survivors with snake oils and Charlatans.

    3. Ian Partington

      I think the “establishment” has invested so much in the out-dated ( and plain wrong) everything in moderation mantra ( apart from ‘evil’ saturated fats, of course!) that many simply cannot recognise the plain truth staring them full in the face. But they should remember that “resistance is futile” and that the truth will out…. eventually!

  2. Agg

    So there is hope!! The tide is turning ….
    Or the mainstream establishment will decide he has lost all his marbles, and we will never hear about him again ….
    Or they say “yes but we still need more research into those issues, and in the meantime we shall not change our recommendations”.

    1. Millie Thornton

      Or maybe also stick their fingers in their ears and sing loudly about some other aspect they feel is really to blame…

      Possibly all of the above!

  3. Martin Edmundson

    Very interesting that finally the rest are ‘catching up ‘. To answer the question re 5 a Day, from memory it was an advertising slogan by the California Fruit Growers Association in the depression years to ‘drum up’ sales! Martin

    Sent from my iPad

      1. Martin Back

        Botanically, wheat, rice, and corn are also fruits. What distinguishes them is that the fruit wall has fused with the single seed.

        I eat plenty of fruit, but avoid fructose ;o)

      2. AH Notepad

        When you eat wheat, rice or corn you are eating the seed, as all the outside, arguably fruity bits, have been removed.

  4. Solomon

    Let’s hope in the next few years they will say: “We’ve always said saturated fats do not cause cvd. Carbohydrates seem to be the substance of concern. This much has always been known in mainstream Medicine for several decades.”

  5. AH Notepad

    1st drop off is the ApoB/ApoA at 6:42 where the graph shows between 0.7 and 0.8 but he mentions a spread of 0.72 to 0.85. This unfortunately is the typo equivalent which the vested interests would latch onto.

    1. Herb

      That’s like Watson and Crick hen they were asked about a bond angle and , I think, Cricksaid, “I don’t know what that bond angle is but this IS D N A!”

    1. TS

      I’m delighted because the more people like him who speak out, the more people like you, Dr K, are supported and protected when you speak out.

    2. Jillm

      I bought a glucose meter. I tested after steak and green vegetables fried in butter. Blood glucose one hour later was 4.9. A few days later I had baked beans on toast plus two pieces of fruit. Blood glucose was 11.2. Retested 11.1. I have been a low carber since that day.

      1. Jim Chinnis

        Similar for me. Fifteen years ago I decided to try losing weight by using a glucometer to guide my food choices. I went from about 180 lb to 150 lb and have kept it off for 15 years now. If I cheat too much I gain, and it is harder to take it off again now that I am 72, but it still works.

  6. Mike Hannan

    Wow, mainstream medicine finally catching up with the facts! Whatever next….evidence based medicine ….how could they?
    Malcolm, I have been meaning to ask you about the salt issue, but up till now I didn’t want to distract from your main message, (that of it being non-dietary issues which have the greatest effect, such as lack of sunlight, stress, polution, or having the misfortune of being born male etc). However seeing as you have introduced the subject……..
    As we all know, salt intake increases blood pressure due to thickening of the blood, and generally increased blood pressure indicates an increased risk of CVD. Can it be that it is the cause of blood pressure which matters, not the blood pressure itself? That is to say, it is the increased blood pressure due to damaged endothelial repair mechanism which is the danger rather than a thicker blood in healthy arteries that is the issue?
    Additionally (being gready here) I don’t recall reading your full discussion yet of why artherogenesis occurs in arteries and not veins? I thought it was that arteries run at higher pressure, and higher pressure equals more damage. But if pressure is not the culprit, it must be something else. Might it have anything to do with arteries being more rigid, or is it that arteries carry oxygenated blood which does the damage?
    Whatever the answer, it’s a riveting thriller of a “whodunit” you are producing. I am hooked. Might we expect another book in the making?

    1. anglosvizzera

      Do we know for sure that salt has that effect on blood? Or is it another urban myth put about by so-called experts? I no longer know what is fact and what is fiction (vested interest) any more!!

      1. BobM

        No, we don’t understand the relationship between blood pressure and salt. In many studies, when salt intake goes down blood pressure goes up. Of course, there are studies showing the opposite too. For more, search for “gary taubes salt” and you’ll find two discussions of salt. You can also read two articles on salt here (search for salt): https://eathropology.com/

    2. JDPatten

      Arteries and not veins . . .
      This was discussed.
      It would be great, Dr Kendrick, if, somehow, you could provide a term search function that covered all of these Roman Numerals

    3. David Bailey

      I think the point is that the rise in blood pressure associated with salt intake is negligible. Here is a Scientific American paper on this subject – unfortunately now behind a pay-wall:


      As I understand it, the original idea was that with more salt in the blood, more fluid would be drawn into the bloodstream by osmosis – thus raising the pressure (I don’t know about thickening the blood – I haven’t seen that mentioned before). However, that takes no account of the various feedback loops that control BP, sodium in the blood etc.

      I don’t bother limiting my salt intake any more!

    4. mikecawdery

      Lots of references on Pubmed. Some examples
      J Gen Intern Med. 2008 September; 23(9): 1297–1302.
      Randomized clinical trials confirm that lower sodium intake lowers mean systolic/diastolic BP values in the range of 1/0.6 to 5/3 mmHg An impressive(??) reduction in healthy people.
      Hazard ratios and 95% CIs for the associations of sodium as a continuous variable (per 1,000 mg of sodium) for both CVD and all-cause mortality outcomes with the three different calorie adjustments revealed inverse associations that approached statistical significance for CVD mortality with sodium and residuals adjusted sodium
      After full adjustment (Table 3), comparisons of sodium intake in quartile 1 to quartile 4 consistently showed a trend towards an inverse association, but this was not consistently the case for quartiles 2 and 3. However, no statistically significant direct association of higher sodium with higher mortality was observed in any comparison

      NHANES II data revealed a stronger, statistically significant inverse association of CVD mortality with sodium, sodium/calorie ratio and residual adjusted sodium as well as sodium <2,300 mg/day (<100 mmol/day)-the threshold for current US dietary guidelines and close to the median intake in that study population

      Hypertension. 1995 Jun;25(6):1144-52.
      Low urinary sodium is associated with greater risk of myocardial infarction among treated hypertensive men.
      Alderman MH, Madhavan S, Cohen H, Sealey JE, Laragh JH.
      The frequency of heart attacks was LOWEST in the group with the highest salt intake
      Alderman et al
      Lancet. 1998 Mar 14;351(9105):781-5.They found that those with the lowest salt intakes showed the HIGHEST death rates from cardiovascular disease.
      And so and on………………… But who is using the little grey cells?. But this way it adds to the problem making the healthy unhealthy and better candidates to become lifetime users of drugs.

  7. Christine Whitehead

    One has to wonder how long “they” can go on ignoring these studies. However embarrassing it might be they surely have to change the guidelines soon. I suspect it will be done a tiny bit at a time over about 20 years to avoid having to say sorry.
    Excellent lecture. I hope it gets lots of publicity in the health care world.

    1. gillpurple


      I think you’re right, I doubt here’s going to be any big public apology. Too much serious harm has been done, especially to those with type 2 diabetes, and the cost of successful litigation would be sky high.

  8. Marine Health Foods

    Do you have the you tube link to his talk?

    My daughter just got marked down in Science in school because she put carbohydrates in the wrong place on the food pyramid…my fault ……what chance have kids with this education system……….


      1. Trish

        It appears that the video is now removed from view! So glad I took the time to watch it twice one week ago. Thanks for posting the best points

    1. AH Notepad

      The pyramid is wrong. An appeal should be made about the marking as it is at fault. That is a certainty, and I haven’t even seen the marking system.

  9. Lor

    Re: “Perhaps someone would like to send this presentation to the BHF and the AHA and ask them for a comment?”

    What if…
    all fans of Dr Malcolm Kendrick use their accounts on Social Media to send the presentation to the BHF and the AHA for comment. Perhaps we could start another Twitter Revolution? The Nutrition and CVD Spring???

    1. AH Notepad

      I think that may be counter productive. This series of blogs have recieved comments from fairly knowledgeable people for the most part and has, in my opinion a significant amount of credibility as a result.

      Twitter storms by comparison are the realm of often hysterical and ill considered verbiage.

  10. paola

    Wonderful! But I have to say that I have never seen any benefit so far in my practice from reducing salt in people with high blood pressure. What do you think about this?

      1. David Bailey

        I thing ‘they’ are desperate not to see headlines that say it all,

        “Doctors were wrong about which type of fat to consume, wrong about cholesterol, wrong about the safety and usefulness of statins, and wrong about the dangers of salt!”

        Heads might really roll then!

        However, their acute embarrassment is entirely of their own making!

      2. mikecawdery

        David Bailey
        Please excuse me for mildly disagreeing with you on the use of the word “doctors”. In one sense you are right but in truth the real problem lies with the medical research establishment, the writers of the DIRECTIVES and their intention of contributing to the Gospel, Chapter SALT or whatever. I have on several occasions supported my GP, practice medical staff and junior doctors and nurses in hospitals – they are the ones that on a daily basis keep me alive on those occasions that I require treatment. Sorry that is my belief.

      3. Mr Chris

        Interesting what you say that the policy stuff in medical care comes from high up. I came across a heart age calculator today on the NHS website. I stuck my figures in and it gave my heart age as ten years older than I am. Looked though the figures and saw I had inadvertently inverted the systolic and diastolic figures. When I corrected that, the result was worse, and my blood pressure too low. The thing that was against me, total cholesterol levels. Yet if you use the figures for TC you see that I am in the sweet spot for long life (we shall see)., taking the chart that occasionally is referenced on this blog.
        Summary: keep away from the NHS website, and be diligent in reading here.

      4. David Bailey


        I hoped it was clear that I was quoting an imaginary newspaper headline from the near future! I think that is exactly the way a newspaper would put it!

        Maybe the majority of doctors deserve it for not standing up against the bullying – collectively they could achieve a lot.

    1. BobM

      Try asking them to go on a low carbohydrate diet, or better yet, to perform intermittent fasting (even several days) with a low carb diet. It might be that insulin resistance (cellular, but mainly fatty liver and fatty pancreas) is one of the true causes, and LC and IF in particular reduce fatty liver and fatty pancreas, thereby causing blood pressure to go down. (Probably need exercise and staying away from vegetable oils to reduce cellular IR.)

      1. Ari

        No. It’s the insulin itself, that tells the kidneys not to let salt out of the system. If you cure your hyperinsulinemia with low-carb or fasting, insulin goes down and kidneys are again free to let salt out. Salt gets all the blame, but the real villain is insulin.

  11. Gay Corran

    Great news! I wonder how long it will take to trickle down? Our grandchildren are still being told at school that butter, fat on meat, and indeed meat, and cream are bad for you and must be avoided, which makes it difficult to feed them properly at home. School meals offer massive amounts of carbs and “heart healthy” low fat options. Another generation is growing up misinformed and denied proper nourishment.

    1. Chancery Stone

      Couldn’t agree more, Gay. It’s struck me many times, in all the bickering between nutritionists (and there’s a LOT), that the bad advice just sits there, doing its damage to people (like kids and hospital patients) who desperately need someone to step up and be unequivocal. What we need is a league of dinner ladies to take a stance to ‘Bring Back Fat!’ (I’ve invented their campaign title.)

      1. Gay Corran

        Yes indeed, Chancery Stone. Hospital meals are very difficult for coeliacs and those of us who control our statin/lwofathighcarb diet-induced diabetes entirely with a LCHF diet. They, like school meals, need a complete overhaul. And the low fat propaganda needs to stop!

    2. Michael J. Jones

      yes here in the USA the FAT IS BAD myth still prevails and CHOLESTEROL WILL KILL YOU, with moves to put statins in the drinking water, and /or give them to children with their vitamins along with the already poisonous sodium fluoride. Safe numbers are always reducing to make healthy people into patients. When you tell your dentist that you dont want flouride toothpaste it is like you are the antichrist and no doctor I do not want statins, I enjoy my three eggs a day or to take an aspirin a day to thin my blood!

      1. Gay Corran

        Yes, Gary, lucky French children! It seems that there is little if any ADHD in French children, and little obesity.

      1. JanB

        Hey, we could start a cookery column as an offshoot. I cook mine chopped up with sliced leeks, then raw chopped garlic and a big dollop of mayo at the end. I agree though that sprouts and bacon are a marriage made in heaven.
        Apologies, Dr. K. for going just a tad off topic, but when you gotta share you gotta share.

  12. Sylvia

    May I just give my plug for vegetables and to a lesser extent fruit. Professor Yusef does say of course that a neutral effect is good, and that there is likely to perhaps be a slight benefit from eating them. Just from seeing my husband recover from bowel cancer, 10 years now, I feel it has something to do with fresh veg every day, plenty actually, children always complained.
    Not scientific in the least I confess. What an excellent video, have sent it on, they will be saying, not again! Can’t she just act like a nice old lady. No I won’t. Thank you.

      1. Frederica Huxley

        A neutral effect on CVD, but I am convinced that vegetables are highly beneficial in other respects!

      2. Ken Strain

        I’ve been reflecting on the talk all day. The more I think about this video, the more disappointed I am in what passes for science these days in the medical field. In amongst the few sentences of “good news” in the video, there was a lot of poor quality evidence (particularly for the money).

        Even though some of the message was what we like to hear – and I think genuinely presented, based on the expressed need to get out of the surrogate measure trap, most of the evidence presented was the usual epidemiological drivel, with barely any significance (only a few results out of at least 100 data points had decent clearance between the OR=1 axis and the error bars). There was no where near enough information to allow biases or confounders to be considered, and there was still plenty of bias in the presentation.

        Possibly it was reassuring to see the “salt” data, though I don’t think there is anything very new there as the case was already clear enough. Otherwise, the data presented are good for nothing more than generating hypotheses and absolutely not useful for setting policy – whether personally choosing to eat sprouts or nor, or national nutrition policies.

        I’m going to eat sprouts which I like (had some today) and not legumes (which I don’t like), but there is in my view no evidence that either choice will affect the health of *my* heart. This is in stark contrast to such things as lead and organophospates which certainly could harm my heart, and for which there is real evidence.

        Still, some of the conclusions are welcome.

    1. TS

      Fruit probably had the edge over vegetables because it tends to be eaten raw and the vitamins not cooked or leached away!

      1. TS

        For anyone feeling depressed/stressed, etc.

        I have a friend who really benefited from one of the courses – completely cured of chronic fatigue and remains so several years after it.

    1. Gary Ogden

      BobM: Fish is good for the brain. So what if it does nothing for the old ticker. It does matter where it comes from. I stick pretty much with wild Alaskan salmon and sablefish, and mollusks and crustaceans, and avoid freshwater fish like the plague because of mercury..

    1. mikecawdery

      As I have pointed out before the probability of NO BENEFIT seems to approach 1.00 or near certainty that the likelihood of being lucky and actually benefiting is pretty remote. This issue of the real lack of efficacy is never raised in reports – would not promote sales.

    2. Jim Chinnis

      The statin industry has got us. We take statins until we develop diabetes, and then we actually might need the statins.

      1. AH Notepad

        The statin industry hasn’t got me, and it never will! Nor will the vaccine industry, nor almost all of the drugs industry. 🙂

      2. Gay Corran

        Me too, AH Notepad! I will never take another statin after rhabdomyolisis and what they did to my kidneys, legs, and diabetes development. And BP drugs first ruined my singing with a non-stop cough, and the next made me feel dizzy most of the time. Better without medication. No vaccinations either. The Pharma companies have got the doctors, but not all of the rest of us! And, thankfully, not all of the doctors either! There will slowly be more thinking like Dr K. And our grandchildren will look back in wonder at what we allowed the drug companies to do to so many of their grandparents and parents, for so long…

      3. Sasha

        I think people like Dr Kendrick will always be the outliers. It’s much easier and financially more lucrative not to rock the boat and many MDs by definition are not independent thinkers nor are they comfortable with being outside the establishment. I know plenty of MDs who agree with Dr Kendrick in private but they will not say that publicly, let alone try to educate the people they have never met.

      4. Gay Corran

        Yes, Sasha, so thank God for Dr Kendrick and other outliers, who have given thousands of us the courage of our own and their convictions.

  13. Bill Chambers

    However on another youtube video he does seem to support statins….aspirin…..


  14. Errett

    We don’t have much time—–http://www.heart.org/idc/groups/heart-public/@wcm/@adv/documents/downloadable/ucm_491543.pdf

    1. AH Notepad

      “By 2035, nearly half of the US population will have some form of cardiovascular disease.”

      But don’t worry we will have an expensive drug for you to take for the rest of your life, and of course all your blood relatives will need it too, just in case.

    2. Ken Strain

      Look closer. In the report there is a plot incorrectly titled “Population Projected Prevalence of Stated Disease (2015-2035)” – it should say “Population Projected Prevalence of Stated Condition (2015-2035)” – Hypertension is not a disease (and not independent of the actual diseases included). Notice that even a small error in the projection for hypertension would swamp everything else.
      The appearance is of some kind of advertising material (perhaps along the lines suggested by AH Notepad), very far from science.

    3. mikecawdery


      Once again thank you. I have always suspected that prevalence was rising along with incidence.. However with better effective treatments (stents, CABG and medical-excluding statins) survival has improved but that means more patients with CVD (prevalence up). But with all forecasts based on past data what actually happens in the future is often very different from the forecast. An old statistical warning “Don’t extrapolate beyond the data range” is so often proved right.

  15. Brigid McManus


    The y tube presentation attached to this post is very interesting.

    Brigid On Wed 15 Feb 2017 at 09:42, Dr. Malcolm Kendrick wrote:

    > Dr. Malcolm Kendrick posted: “[Hold the front page] Last night I watched a > you tube presentation which completely astonished me. It was given by > Professor Salim Yusuf, who is as mainstream as mainstream can possibly be. > Here, from Wikipedia: ‘Salim Yusuf (born November 26, 1952)” >

  16. Anna

    This might cheer you up – the next New Scientist is called – Cholesterol Wars: The truth about fats, statins and heart disease.

      1. David Bailey

        Actually that article isn’t so bad – it was written by a reporter who suffered badly from muscle problems caused by guess what. He describes exactly what happened to him. The aricle also shows some NNT values for statin treatments.

        At the end, he says that when he feels fully recovered he will let the doctor try another statin on him. I wrote to him telling him my story, and pointing out that some people don’t recover fully from the side effects of statins. He replied that in reality he probably won’t take statins again.

        From the way he described it, I assume he has FH because he said in the article that his cholesterol values (and those of his mother) are very high.

      2. mikecawdery

        Mr Chris

        That is a very astute observation; It is often the case that it is the last stand against a failed hypothesis.

    1. JanB

      I shelled out some serious money for it last week and was very disappointed. The writer was seriously sitting on the fence and ended his piece by saying “But while people with diagnosed heart conditions should keep on popping the pills, it’s far from obvious that the rest of us should. I probably shall; when I’m fit again (after all the hideous side effects – my quote) I’m going to try a diiferent statin…”
      By the way, in the same edition of the mag there is an article about gene editing to “Lower your cholesterol – for good.”

      1. David Bailey

        Yes, I can see some really bad consequences coming from permanently and drastically reducing someone’s cholesterol. Maybe not muscle problems, but what about the brain! Conceivably moderate brain damage would not even show up clearly in animal tests, and a fair few people might be treated this way before the consequences became apparent.

        I suppose those affected might have to take LDL injections for the rest of their lives!

    2. Eliot

      When I went to search on “Cholesterol Wars” in order to read the article I ran across a 9 year old review by Chris Masterjohn of a book called “The Cholesterol Wars: The Skeptics vs. the Preponderance of the Evidence” by Daniel Steinberg, MD, PhD. (Steinberg was one of the original architects of the lipid hypothesis.)


      Masterjohn claims that statins actually disprove the lipid theory and promotes the theory that statins also limit the production of an enzyme called Rho which inhibits nitric oxide production.

  17. Old fogey

    So happy to see that word is finally getting out. I just wish he had the courtesy to send a thanks to you as well, Dr. Kendrick.

  18. gillpurple

    Excellent. Thank you for posting this. Can now combine my question to BHF about difference in death rates on graph from Monday’s blog, and ask for their comment on the video together in one letter.

  19. Michael J. Jones

    Hello Malcolm, great article as always.
    Our kids 9.5 and 10.5 yrs old have every morning as do we, the Dave Asprey style bulletproof coffee (blended with organic grass fed butter, MCT coconut oil and some honey. And a couple of pieces of grilled bacon, occasionally eggs if hungry. This keeps them going most of the day. They have never drunk nor desire soda’s of any sort and Cow Dairy is almost non existent. The school tries to insist they take a snack for mid morning, they are not interested nor hungry. The food at the school is disgusting. They also have a spoon of MCT coconut oil which he calls his gut protector, and a quality multi-vit and a B complex supplement. We also have a lot of Tumeric. They are very fit lean, healthy and full of energy all the time ( a bit like a dog) , on the swim team etc. Their Pediatrician says at the annual checkup that they have the thinnest file of any at the of her patients at her clinic and it is unusual for kids in the USA. On the occasions they have been sick they never take painkillers and fever is allowed to run its 2 or 3 day course and do what it is supposed to do, kill off whatever causes it with the final high 103 temp for a night at the end as usual. The next morning they wake up and are full of energy. Cuts, sore throats etc.bruises are treated with apple cider vinegar and coconut oil,
    The body cures itself!

    We in Florida have the misfortune to have regular chemtrail spraying which cause some respiratory epidemics every few weeks for the medical profession to profit from. The advantage of Trump living in FL is when he is here the Sky is blue and clear……not a trail in site. What does that tell you??

    Our carb intake especially sugar is kept to a minimum which is difficult in the USA, the girl snacks on frozen veggies. Yes they like chocolate etc, but it is kept to a bare minimum and the boy at 9 yrs old reads labels on everything understanding all the made up names for sugar and that SUGAR is the cause of ALL illnesses in the Western world. He also understands the world is run by liars thieves and cheats who poison us for profit.
    Kids (or Adults) do not need to look like beachballs, I believe in most cases sickness and heart disease are a lifestyle choice and to my mind many people are full of excuses and rationalisations for not being healthy or having healthy kids. Yes, it takes effort and responsibility to reject the mainstream especially in the USA where the Media promotes poison as healthy and Pharmaceutical medicine is taught as opposed to the Hippocratea nutritional medicine. My Wife being brought up on the American diet has a harder time not eating carbs but makes the effort but it is all COMMON SENSE. Humans are not designed to eat processed food, eat something that was alive recently and you will be ok. If it has a label and a list of ingredients, or is ‘fortified with something don’t eat it!

    On the Blood pressure issue, I have had high BP every since I stupidly replaced many years ago dairy with Soy, it f***** me up basically. Never had an issue before. Obviously my diet is very different now but I struggle with this. I would like to know what exactly causes it as I am Pilot and have had full heart tests twice with no significant faults found, could easily do 15 mins on the Bruce Protocol and regularly run 5k and gym. There are limits on BP for my medical so it is a pain in the ass really. BP meds just slow me down as clearly my body is needs the higher BP. I take high dose D3 and K2, and CoQ10 plus a few others.

    anyway, I could write for hours so I will force myself to stop, thanks again Malcolm for being a champion of the Human Race, it takes Courage.

    1. Old fogey

      Loved your comment about the chemtrails! We live quite close to the Rockefeller family Westchester County estate in NY and we never have chemtrails in our neighborhood. I doubted that they were a problem until we visited the Seattle and Vancouver areas a few years ago where the sky was covered with a careful grid every single day and I could see why people were freaked out over the issue..

  20. Michael J. Jones

    Further to my long post, I believe that it is insulin production that causes obesity, lack of energy, diabetes and other related illnesses. If you dont take in foods that spike insulin you will be healthy. The blood can only hold so much sugar and It seems to me that the body cannot do two things at once .1) Deal with excess sugar via insulin OR 2) repair, generally function and build new cells. If there is any insulin in your blood, then the fat burning, processing mechanism stops until the excess sugar is dealt with. People with a high sugar (ok, carbohydrate) diet get an over-production of insulin and it leads to diabetes and weight gain. It is all down to sugar (carbs) and insulin, the two partners in crime.

    1. mikecawdery

      John Collis

      Many thanks for the link. I find the following extract to emphasize the ignorance of facts
      It’s generally agreed that eating too much fat is bad for you
      This is the sort of idiotic logic that is so common these days like “everyone knows” or “there is a concensus that…..” when there clearly isn’t. or as in the WHO-EU-Monica report “carbohydrates are good” followed by a complete absence of any data to support the view and this supposedly from reputable researchers.

      1. Maureen H

        along the same lines….”such and such may be helpful”. What the heck does that mean? Is it helpful or not? And what exactly does “help” mean? Help what?

    2. Eric

      Well, at least they qualified that in the first paragraph to omeg-6-fats should be avoided.

      The test diet, other than the soda drinks, actually looked like something hardcore LCers might approve of…

  21. Soul

    With my quirky sense of humor, the first thing that popped into my mind was, oh my, my childhood friend that was fond of the rhyme could have been right! – “beans beans good for the heart, the more you eat the more you fart.”

    Hopefully some will find the low carb, and further CVD information beneficial. I’m personally not much of a low carb follower any longer. My health issues were not helped all that much by following low carb, but it certainly is an idea to try in hopes of being beneficial.

  22. mikecawdery

    From my analysis of the WHO-EY-Monica study 2005 http://www.ehnheart.org/files/statistics 2005 I found that:

    1) Saturated fat does raise LDL, a bit, but has no effect on CVD – maybe slightly beneficial. Monounsaturated fats are slightly beneficial. Polyunsaturated fats are neutral.
    Both total fat and saturated fat were negatively and significantly associated with CHD mortality

    2) Carbohydrate intake is most closely associated with CVD
    Carbohydrate was positively and significantly associated with CHD mortality
    Carbohydrate was estimated by subtraction.

    3) Fruit and vegetable intake has little or no impact on CVD
    Fruit and Veg were negatively and significantly associated with CHD mortality

    Furthermore by multiple regression involving the three factors confirmed these associations

    Fish was not a factor in the Monica study

    – nor does fish intake [He wonders where the five portions of fruit and vegetable intake recommendations actually came from]. Vegetables in particular have no benefit.

    In subsequent reports saturated fat was left out for unknown reasons (?? contradicting the official gospel perhaps) while the word “carbohydrate” appeared only once because it “was known to be good

    1. mikecawdery

      Harvard was recently associated with the sugar industry paying two of its researchers to show sugar was not involved.

      Classic example of industry agnotology in shifting blame
      Under the circumstances anything from Harvard supported by industry (eg Willett and statins) must be taken with a cellar full of salt for personal good health.

  23. Paul v Nguyen

    but still very main stream here in his HOPE-3 study with Crestor

    Cholesterol Lowering in Intermediate-Risk Persons without Cardiovascular Disease
    Salim Yusuf, M.B., B.S., D.Phil., Jackie Bosch, Ph.D., Gilles Dagenais, M.D., Jun Zhu, M.D., Denis Xavier, M.D., Lisheng Liu, M.D., Prem Pais, M.D., Patricio López-Jaramillo, M.D., Ph.D., Lawrence A. Leiter, M.D…………….., and Eva Lonn, M.D., for the HOPE-3 Investigators†
    N Engl J Med 2016; 374:2021-2031May 26, 2016DOI: 10.1056/NEJMoa1600176

    1. mikecawdery

      Paul v Nguyen
      Thanks for the link – available in full. The number of Lives saved per 1000 patients per annum by rosuvastatin is a magnificent 1.1, a NNT of 900. In other words the probability of an individual patient not benefiting from treatment is 899/900 = 0.998889 or to 3 decimal places 1.000 near certainty. In my book about as unimpressive as one can get. with a “significant” result

    2. mikecawdery

      Yusuf et al n engl j med 374;21 nejm.org May 26, 2016
      Death from cardiovascular causes Rosuvastatin in medium risk patients
      Odds ratio 0.8957 0.1134 = relative rate

      95% confidence interval from 0.7184 to 1.1167 Not Significant

      Outcome 1 Outcome 2 Total
      Group 1 154 6207 6361
      Group 2 171 6173 6344
      Total 325 12380 12705
      Chi-square with Yates correction
      Chi squared equals 0.853 with 1 degrees of freedom.
      The two-tailed P value equals 0.3557

      Not a wonderful result for saving lives. A lot of comparisons with surrogate end points which are subject to bias

  24. Gordon Ferris

    So growing up in the West of Scotland on a diet of slice sausage [don’t ask] eggs and chips fried in a chip pan full of beef dripping, then salted, turns out to be right after all? Thanks Mum …and Dr Kendrick.

      1. BobM

        Although that meal is so filling, you probably don’t eat many chips. I went to France and had duck confit with a side of what was basically some sliced potatoes floating in cream, butter, and cheese. Even though I ate a relatively small amount of potatoes (and thus some carbs), the rest of the meal was so filling I didn’t want anything else to eat. Now, if I was to start out eating just chips (say potato chips), I could eat a bag before I stopped. (Though, when on my low fat diet, I didn’t eat chips, as they had fat…which probably helped me for a while, as most chips are fried in vegetable oil, which appears from my research to be horrible for you.) In American, the restaurants know this, so the first thing they usually bring you is something carby and cheap to make (usually bread, but could be chips).

  25. Kay

    On the matter of salt/sodium, from a non-scientist:

    Is it possible that adequate sodium intake would make it possible for a person’s cardiovascular system to heal any damages, before the lesion – – – – – lesion plastered-over-with-cholesterol cascade developed?

    Is it possible that besides bedrest, another unhelpful 1950s/1960sl treatment for heart attacks was the salt-free diet? When Grandpa had his heart attack in the early 1950s, Grandma was even baking salt-free bread to comply with his suggested salt-free diet. He died in 1954.

  26. Dr. Göran Sjöberg

    Every second person in my age (70 +) who I meet seems to have a story to tell about the “side effects” of statins. Today, e.g., when cleaning up in our garden a couple of neighbors stopped by for a chat and one of them then told her story about her unsustainable abdomen pains which only gave away when she refused further statins and this against her doctor’s will.

    And this is just one in the row of horrifying “anecdotes” I am now being acquainted with.

  27. roisin costello

    Malcolm I m solid delighted . it will be a tsunami of change shortly . on the ground people are already accepting advice.to eat butter and meat and cut the processed and low fat shit . You have been a pioneer . fair play .Your re a brave and clever man

  28. AH Notepad

    I looked at the forbes link, and below the article about Salem Yusuf was an article giving the mainstream view of vaccines = good. IMO a view pandering to the vested interests.

  29. Gary Ogden

    Finally had time to watch it. He’s good, and he’s right. Shouldn’t take more than a few decades for the food guidelines to be tossed in the trash, where they belong.

      1. Spittin'Chips

        No doubt. I didn’t intend my comment to come across as critical of your post – I was, perhaps not very effectively, raising the question of whether he would have been ‘allowed’ to do such a talk if he was still head of the WHF.

        Thanks for the video.

  30. Alan Bent

    Hi Malcolm,
    You did a really good post showing there is no obvious way that incoming dietary fats can affect LDL levels as they are transported in Chylomicrons, any idea why they still seeing this link?

  31. John Collis

    Q: What causes CHD?
    A: no one knows for certain.
    Probably nothyperlipidaemia too many anomalies for the simple reason that if there is a single deviation from a hypothesis then the hypothesis needs modifiying, When a hypothesis matches all of the observations then it is promoted to a theory. If there is a single observation that doesn’t match the theory then the theory is inadequate and needs extending/modifying (cf Newtonian theories with Einsteins theories with Hawkings theories, Newton wasn’t wrong within his frame of reference in the 17th century). Our Victorian working class forebears ate predominantly bread and potatoes, approximately 6000 calories per day, which they needed due to the physical nature of their work, they probably didn’t live long enough to develop chronic diseases that may be associated with this kind of diet. Modern day infantry soldiers consume nearly as much but mainly in the form of protein, again due to the nature of their jobs.
    Could CHD in some circumstances have an infective cause leading to inflammation? Why should coronary arteries be affected in some people without affecting the carotids and vice versa? What about other arteries, do you get arethrosclerosis in the pulmonary artery, the abdominal section of the Aorta or the Femoral arteries for example, or is it because the coronary/carotid arteries are small bore vessels but take blood from close to the heart where the pressure is higher than elsewhere in the circulatory system, thus are subject to a high pressure?

    1. Ken Strain

      It depends exactly what you mean by your question – what is CVD. In a sense there is a huge amount of knowledge and understanding of CVD, at its metabolic core. For example, and with respect to one tiny corner of the problem, I did a Web of Science search on TITLE: (endotheli* AND homocysteine) and restricted results to the last 3 years. The broad sweep and also detail of the ~dozen papers I’ve looked at so far are closely in line with Dr Kendrick’s theme, certainly as regards the details of endothelium, NO etc.

      As a tiny example, it is known how homocysteine (Hcy) promotes mitochondrial failure, leading to apoptosis. Further, it is known how -by which process, in detail and according to which genetic background applies – certain agents can be protective (Se, folate, BH4, others, in no particular order) and others harmful (mercury, lead, many others) – though a lot of these experiments are in vitro and so the results are hard to translate to “cures”.

      To take just one result at random (by chance it relates to “infective cause”), the last paper I looked at is by Xi et al “Caspase-1 Inflammasome Activation Mediates Homocysteine-Induced Pyrop-Apoptosis in Endothelial Cells” DOI: 10.1161/CIRCRESAHA.116.308501. This notes the similarity in response of these cells to Hcy or lipopolysaccarides (usually from bacterial cell walls). In both cases there is a violent inflammatory cell death “pyroptosis” – a new word for me.

      My point – of course it is complex, indeed horrendously so. However, many sufficiently precise questions do have clear answers. The biggest problem is that the real, hard science resides in a world very remote from the epidemiological drivel that we hear about so much. The hard stuff does have practical applications (someone with high Hcy would probably not want to be selenium deficient, for example).

      1. John Collis

        Sorry I’ve taken so long to respond. I’ve had another thought regarding the difference between coronary arteries and other arteries, which may also have an impact on flow. Most arteries are long and straight or have long lengths that are straight, the exception for the main arteries is the Aorta as it loops over the top of the heart; the other exceptions are the coronary arteries which have relatively tight loops around the heart, does this not introduce turbulent flow which could damage the epithelium? Do other mammals develop CVD, particularly thos that are long lived, or is it peculiar to humans?

      2. JDPatten

        And, it gets more peculiar.
        The heart feeds itself that bright oxygenated blood, but it shuts itself off from that flow with each contraction. Those loops of coronary artery on the surface bring the blood supply to smaller vessels that delve into the heart muscle where they must be to satisfy each and every muscle cell. Those smaller vessels are squashed flat and shut off with every systole. It’s the elasticity of the whole system that allows for myocardial perfusion during diastole – between “beats”.
        Those little vessels take quite a beating. The outer “loops” must endure systolic pressure that goes nowhere momentarily.
        Amazing that it all works as well as it does!
        See Coronary Circulation in Wikipedia.

  32. mikecawdery

    Once again today’s new is promoting Vitamin D supplementation. But the NHS is not providing an easily accessible testing facility.
    Serum Vitamin D and Change in Lipid Levels over 5 years
    Deficient 25(OH)D was prospectively associated with lower TC and HDL-C and greater TC/HDL-C ratio after considering factors such as diabetes and adiposity. Further work including randomized controlled trials is needed to better assess how 25(OH)D may impact lipids and cardiovascular risk.
    Key words:
    Vitamin D, lipids, total cholesterol, HDL-cholesterol, Total cholesterol/HDL-C ratio

    1. Edward Hutchinson

      But there is an NHS PATHLAB that supplies postal 25(OH)D tests for a modest fee £28.
      I hope many of you will choose the bulk buy option to get a discount on your purchases and SHARE the tests with your family, relatives, friends and workmates at the discounted price.
      It’s a simple finger prick test and you only need to supply 3 drops onto a card which you post back to the lab with your phone number and email addy on.
      They email the result in a couple of days, (they will phone you to discuss your level if it’s over 200nmol/l)
      Each of the test kits come in separate bags to sharing them is easy.

      Those concerned about heart disease may well appreciate the knowledge that keeping 25(OH)D at/above the natural level found in indigenous peoples living traditional lives (around 50ng/ml 125nmol/l) also allows freely bioavailable cholecalciferol.to remain in circulation. This is important because that form of the vitamin is not inert as was previously thought, but active in maintaining endothelial function.
      Dietary Vitamin D and Its Metabolites Non-Genomically Stabilize the Endothelium
      but obviously, because the half-life of cholecalciferol is just 19-25 hours daily dosing only will demonstrate this action.
      Vitamin d only optimally resolves inflammation when 25(OH)D is at/above 50ng/ml 125nmol/l

      1. mikecawdery

        Dr Hutchinson

        Many thanks for that. Most useful at a very reasonable price. Medichecks does the 25(OH)D for £39 and the 1-25(dihydroxy) for £99
        Thanks too for the paper – down loaded in full.

        The use of a card is interesting; 50+years ago a colleague and ! validated a test for CBPP ( a bovine respiratory disease) based on blood on filter paper in the Vet. Record. I always wondered if the concept would go anywhere.

      2. Mr Chris

        Edward Hutchinson
        Very interesting. Do you have a link for your figures on the half-life. This certainly explains why taking massive does twice a month has so little effect on vit D levels. When last tested in July I was at 46 ng/ml, which my GP thinks is wonderfully high, and he tells me that a lot of his patients are in the 8-10 range.

  33. Errett

    Vitamin C may inhibit progression of AD symptoms—through pharmacological intake (in rats) of 100mg/kg daily—–effectiveness related to prevention of membrane lipid peroxidation—-among others—-the same membrane lipid peroxidation involve in CVD

    Format: Abstract
    Environ Toxicol Pharmacol. 2017 Feb 6;50:200-211. doi: 10.1016/j.etap.2017.02.010. [Epub
    ahead of print]

    Ascorbic acid ameliorates behavioural deficits and neuropathological alterations in rat model of Alzheimer’s disease.

    Olajide OJ1, Yawson EO2, Gbadamosi IT2, Arogundade TT2, Lambe E2, Obasi K2, Lawal IT2, Ibrahim A2, Ogunrinola KY2.
    Author information


    Exploring the links between neural pathobiology and behavioural deficits in Alzheimer’s disease (AD), and investigating substances with known therapeutic advantages over subcellular mechanisms underlying these dysfunctions could advance the development of potent therapeutic molecules for AD treatment. Here we investigated the efficacy of ascorbic acid (AA) in reversing aluminium chloride (AlCl3)-induced behavioural deficits and neurotoxic cascades within prefrontal cortex (PFC) and hippocampus of rats. A group of rats administered oral AlCl3 (100mg/kg) daily for 15days showed degenerative changes characterised by significant weight loss, reduced exploratory/working memory, frontal-dependent motor deficits, cognitive decline, memory dysfunction and anxiety during behavioural assessments compared to control. Subsequent analysis showed that oxidative impairment-indicated by depleted superoxide dismutase and lipid peroxidation (related to glutathione-S-transferase activity), cholinergic deficits seen by increased neural acetylcholinesterase (AChE) expression and elevated lactate dehydrogenase underlie behavioural alterations. Furthermore, evidences of proteolysis were seen by reduced Nissl profiles in neuronal axons and dendrites which correspond to apoptotic changes observed in H&E staining of PFC and hippocampal sections. Interestingly, AA (100mg/kg daily for 15days) significantly attenuated behavioural deficits in rats through inhibition of molecular and cellular stressor proteins activated by AlCl3. Our results showed that the primary mechanisms underlying AA therapeutic advantages relates closely with its abilities to scavenge free radicals, prevent membrane lipid peroxidation, modulate neuronal bioenergetics, act as AChE inhibitor and through its anti-proteolytic properties. These findings suggest that supplementing endogenous AA capacity through its pharmacological intake may inhibit progression of AD-related neurodegenerative processes and behavioural alterations.

    Copyright © 2017 Elsevier B.V. All rights reserved.
    Cholinergic transmission; Neurodegeneration; Neuronal bioenergetics; Oxidative redox; Proteolysis
    PMID: 28192749 DOI: 10.1016/j.etap.2017.02.010

    1. mikecawdery


      Once again many thanks for the reference. You really are a mine of information.

      Our results showed that the primary mechanisms underlying AA therapeutic advantages relates closely with its abilities to scavenge free radicals, prevent membrane lipid peroxidation…….

      Brings me back to my point that good health is associated with a high total anti-oxidant level in blood.

  34. Chris

    Dear Dr. Kendrick, please tell me what to think about the recently published paper “Intake of individual saturated fatty acids and risk of coronary heart disease in US men and women: two prospective longitudinal cohort studies” (BMJ 2016;355:i5796) which concludes: “Higher dietary intakes of major SFAs are associated with an increased risk of coronary heart disease. Owing to similar associations and high correlations among individual SFAs, dietary recommendations for the prevention of coronary heart disease should continue to focus on replacing total saturated fat with more healthy sources of energy.” I am not a scientist, I cannot understand why an exact disciplin as medicin can come to so different conclusions as “SAF are good / bad for you”. Thanks in advance.

    1. Dr. Malcolm Kendrick Post author

      You are not a scientist, not are most of those involved in medical research. Medicine is far from an exact discipline, and medical research is, in many cases, a horrible distorted biased mess. Sorry if you don’t like that answer, but I believe it to be absolutely true.

      1. mikecawdery

        Dr Kendrick

        I wholeheartedly concur about docs and research. I would say that docs are in most cases very competent in what they were trained for but they are not trained for research and the obligatory use of statistics. Unfortunately they call in statisticians who know very little about medical problems etc. One wonders how many of the docs on some of these multi-centre studies with multi-authors actually know what they have actually supported

        A statistical student (later a Prof of Statistics at a major UK University and in much demand by the pharmacology industry) did his thesis on an area of work in which I was working; a very successful partnership – he learnt a lot as did I.

        A rare mathematician who could make himself understood by lesser mortals.

      2. Dr. Göran Sjöberg


        This is exactly what I arrived at when getting interested in medicine some years ago now after having spent most of my life in the “hard core” metallurgical research. At the outset I though thought medicine was just a branch of science like my own discipline.

        Irrespective of it’s complexity I am convinced medicine “in theory” could be and should be a part of science.

    2. David Bailey

      It might be fun if Malcolm pulled that study apart. It seems odd that they would look at individual fatty acids in order to conclude that SFA’s in general are bad for you. Since nobody (that I know of at least!) consumes pure fatty acids, my guess is that these would need to be estimated, which might offer endless opportunity for fudging!

      I remember joking some time ago that researchers would start to muddy the water by testing individual fatty acids, rather than saturated fat as a whole.

      1. Edward Hutchinson

        I think Dr Kendrick has more important things to do.
        Quite a few people did respond to the Zong paper when it was published
        Dr Zoe Harcombe made a short and to the point response.
        “Why are observational studies still being done?
        The latest paper by Harvard TH Chan School of Public Health/Unilever observed 10 non-significant associations and 6 very small statistically significant associations between coronary heart disease and energy substitution for individual saturated fatty acids and alternative nutrients.

        This followed searches for patterns in two prospective cohort studies (the Nurses’ Health Study and the Health Professionals Follow-up Study), from which more than 30 papers for 2016 alone have been generated with Walter C Willet and Frank B Hu as co-authors.

        Surely an institution as esteemed as Harvard, would know that epidemiological studies can merely suggest associations, which should then be tested for causation with randomised controlled trials (RCTs). On the subject of dietary fat, epidemiology and dietary interventions have been running in parallel since the 1950s. If the observations being repeatedly made by Harvard had any value, they would have been supported by RCTs and they have not. So when will Harvard admit this and stop this endless stream of non-sense?”

      2. David Bailey

        Edward Hutchinson,

        I am sure what you say is correct, however surely the value of Malcolm dissecting the odd paper on this forum, is sometimes not because the paper is a beacon of quality research, but because it is an attempt to mislead the increasing number of people who are switching back to foods rich in SFA’s. His book, “Doctoring Data”, focusses heavily on shoddy research, but so it should because it is this shoddy research that is reflected in the health advise we receive!

        The original condemnation of saturated fat did not distinguish between the individual fatty acids, and it was clearly based on fraudulent cherry picked data. The honest response now would be to admit the fraud/error and tell people to stop avoiding foods rich in saturated fat.

        People need help! A few years ago, if I had seen a reference to a paper like that, I would have taken it as an indication that the jury was still out on SFA’s, and continued to avoid them – exactly the response, I think, of Chris, who linked to this paper.

      3. mikecawdery

        Dr Hutchinson

        One problem in the academic world is that “Status” and money for research is often based on the number of published papers, not quality or value. When you look at the numbers of papers that some leading “researchers” have it is just not possible that they were seriously involved in any way with most. Their names are added (and paid for>) to give the impression of importance. I have already posted my view on Harvard Nutrition and its credibility

  35. TS

    Answer – don’t follow the packet instructions.

    The peas are blanched before they are frozen. (To quote Wikipedia: “Blanching is a cooking process wherein the food substance, usually a vegetable or fruit, is scalded in boiling water, removed after a brief, timed interval, and finally plunged into iced water or placed under cold running water (shocking or refreshing) to halt the cooking process.”)
    So there is no need for further cooking. Good quality peas are wonderful just thawed and very gently warmed through. I’ve done this for years with no ill effects. Boiling them is dreadful – ruins the flavour and no doubt the nutrients.

    If you allow yourself the odd piece of dark chocolate trying eating it with a piece of coconut – break up a real coconut. (With the use of a corkscrew, drain the milk into a cup. Put the empty coconut into a couple of plastic bags and get to work on it with a hammer.) Then you have your own version of a Bounty Bar – but much less sweet and quite wholesome (in my humble opinion).

    1. Mr Chris

      Seems to me that you have not reagd the BHF website on the evils of chocolate cocoa etc. More dangerous than Flora margerine!

    2. mikecawdery

      Thanks for the Tips. Personally I use coconut oil with youghurt (home made – strained) for breakfast every day plus desiccated coconut (or coconut flour). Coconut milk (ex-nut) or fresh from the green nut with a drop of gin makes a great cocktail.

  36. Randall

    Thx Dr. Kenkrick. Another correlation to my best theory – cause of arteries plugging up – endothelial cells have no GLUT4 (glucose transporter). Which is the very, very beginning of damage to endothelial cells. After eating a carb meal, the damage starts little by little because they cannot defend themselves. Sugar can increase reactive oxygen species (ROS), which can damage and kill endothelial cells.

    1. mikecawdery


      Thanks, makes sense to me. Have you a reference for Sugar can increase reactive oxygen species (ROS), which can damage and kill endothelial cells.?

  37. Raphael

    Today’s New Scientist. I never thought this day would come!

    Keep up your great work! Regards Fr Dr Raphael Hawkes

    ___________________________________ Fr Raphael Hawkes. (Retired Doctor) 11 Penlee Villas Playing Place Truro TR3 6EY Cornwall

    Tel: 01872 864586 Mobile: +44 7500008653 Email: Raphael.Hawkes@gmail.com


  38. James Hammond

    I note that on one of the other YouTube presentations from Professor Yusuf (link: https://www.youtube.com/watch?v=RHiiOa18S_g) about halving premature heart diseases and strokes, he recommends for those with disease ‘…widespread use of generic statins’ which he claims, along with smoking cessation, can reduce morbidity by 50 to 70%. Any comments?

    1. David Bailey

      James Hammond,

      If you have ever encountered the side effects of statins, you would understand one reason for not taking them. If I hadn’t stopped taking them, I would presumably have been suffering the leg cramps and general pain for over four years by now – even if those problems didn’t continue to worsen.

      There is only so much of that someone take – I mean even if someone receives chemotherapy it is in the hope that it will fix their cancer, they don’t want to be treated continuously for the rest of their lives!

      Quite apart from the dodgy statistics (e.g. quote the gain for people who also give up smoking, and don’t estimate how much extra life they enjoyed), people should really ask themselves if it makes sense to mess up the latter end of their lives in this way.

      1. robert lipp

        i support you
        i suffered leg cramps brain fog and who knows what else without realising that i had slowly deteriorated over time. could not even walk, (more like stumbled) for 20 minutes on successive days. i could not continue. stopped statins, changed to LCHF (Prof Noakes). as they say the rest is history.

  39. Herb

    Because my doctors– GP and cardiologist(s)–truly seem to believe pancakes only have one side I have made this other side available to them by becoming more a more sane and healthy patient. Even suffering a relapse of my CHF, taking a ride in an ambulance (!) I am on the mend and I know why. Deep, profound thanks to you Malcolm.

  40. kjellgranelli

    Dear Dr. Kendrick,

    Many thanks for your interesting articles, and now for sharing Salim Yusuf’s presentation. Very powerful indeed.

    I thought it might interest you that I passed your article along to DietDoctor.com and LCHF Deutschland, who have both published this:



    I am a perfectly normal individual who after five decades of normal life started to study first evolutionary biology then evolutionary medicin, so since about 5 years I am fascinated with the evolutionary perspective of health and disease, and since a few years I do volunteer work for DietDoctor.com and LCHF Deutschland. Our recommendations for a healthy diet seem very similar to your ideas.

    All the best


    _____________________________________ Kjell Granelli Nattviolvägen 20 Hofterup SE-24651 Löddeköpinge Sweden Tel: +46 (0)72 86 34 440 kjell_granelli@hotmail.com

    ________________________________ Från: Dr. Malcolm Kendrick Skickat: den 15 februari 2017 10:41 Till: kjell_granelli@hotmail.com Ämne: [New post] What causes heart disease part XXVI

    Dr. Malcolm Kendrick posted: “[Hold the front page] Last night I watched a you tube presentation which completely astonished me. It was given by Professor Salim Yusuf, who is as mainstream as mainstream can possibly be. Here, from Wikipedia: ‘Salim Yusuf (born November 26, 1952)”

  41. Dr. Göran Sjöberg

    I am since a couple of years a subscriber to the daily newsletters from Dr. Mercola and most of the time they are well informed although sometimes, to my sadness, they are passing the “quack” line in my mind.

    However, yesterday morning an interesting one arrived where the content suites well this blog and adds to the message by stressing the insulin resistance issue of the CHD etiology.

    Most interestingly it features the Ivor Cumming’s interview with Dr. Kraft who spent his clinical carrier by measuring the actual insulin resistance among thousands of diabetic patients. This interview has been one of my favorites for long and together with the book Dr. Kraft wrote about his measurements and conclusions.

  42. carol cox

    I am a 70 years young female, I have T2 which is diet controlled with an Hba1C of 41 on LCHF eating regime and have lost over 4 stone, now weigh 8st 10lbs. I have an under-active thyroid treated by Levothyroixine 100mcg, have high blood pressure 134/70. I have stopped taking Bendroflumethiazide as the leaflet says ‘decreases carbohydrate tolerance’ and am just on Losartan 25mg. I believe that not having the correct treatment for my thyroid i.e. supplementing T3 which is low, is contributing to my high BP and raise cholesterol. Any help gratefully received.
    Thank you

    1. AH Notepad

      I have no medical qualifications, but Bendroflumethiazide appears from the name to contain flouride. In my mind that does not sit well with underactive thyroid. Having said that, I read that tea can contain 20ppm (or more) of fluoride per cup.

      1. Jean Humphreys

        Bendroflumethiazide contains something magical, for sure. It gave me type2 diabetes, which went away when I realised what was happening..

    2. Gary Ogden

      carol cox: The following contains good information about the risks associated with blood pressure by age and gender:
      “Systolic Blood Pressure and Mortality,” pp. 175-80. Look at figure 4 on page 177. The dotted line for women 65-74 shows no increased mortality risk below about 165 (systolic). Your diastolic number is excellent. Do you take drugs for BP?

      1. Mr Chris

        when I tried to follow your link, I got this
        “An error has occurred
        The page or action you requested has resulted in an error. Please go back to the previous page by using your browser’s Back button, or visit the Home Page.3

      2. Gary Ogden

        Mr Chris: If you are in the US you can access the paper thusly: Go to thelancet.com. In the search box click “Article title, Abstract, Keywords.” Type in “Systolic blood pressure and mortality.” On the left side (date) click 2000-2009, then click search. At the bottom of the first page of results, click page 2. At the bottom of this page will appear the article by Sidney Port (vol 355, No. 9199, pp. 175-80.

    3. carol cox

      Thanks Gary but the link isn’t recognized. Could you post it again please. Doctor says my blood pressure should be lower. I have searched and found that if the thyroid isn’t treated properly it can raise BP and cholesterol. I love confounding the diabetic nurse, she said last week that my cholesterol was too high, i replied that my breakdown is very good but she said that LDL was too high, it wasn’t a fasting test and there was no breakdown of the LDL, ie VDLP or HDLP, she changed the subject because she didn’t know what I was talking about.

      1. JanB

        Yes, Carol, I play that little game with my DN. Fun, isn’t it. I love the slightly glazed over expression. And, hey, a month or so ago, I asked the (locum) GP about my apparently disappearing low renal threshold which has been there since I was 15 (I am now 74) and he didn’t know what I was talking about. “What’s a low renal threshold?” he asked me. Ditto expression.
        By the way, your BP sounds great too me.

      2. Gary Ogden

        carol cox: Sorry about that. I realized it was not a clickable link after I posted my comment. The Lancet is something of a headache to search. This is how you can find the article: Go to thelancet.com. In the search box at the top click “Article title, Abstract, Keywords.” In the box on the left side (date) click 2000-2009. Type into the search box “Systolic blood pressure and mortality.” Click search. Go to the bottom of the page and click page 2. At the bottom of page 2 you will find it: Systolic blood pressure and mortality, Sidney Port, The Lancet, vol 355, No. 9199, p. 175-180. If you have a printer open the PDF and print it out. It is well worth having around. I showed it to my GP. Sounds like you know more than the nurse. Stick around here a while and you’ll know more than most of them!

      3. Gary Ogden

        Frederica Huxley: It’s not behind a paywall here in the U.S. Are you in the UK? I would be happy to send it as an attachment by email to anyone who wants it.

      4. Frederica Huxley

        Yes, and it is large sum to view – over £32, if I recall. What I would really appreciate are the graphs you mentioned re BP/mortality. Would it be possible to copy the graphs and post here? Thanx

      5. Sasha

        Also, look into “Malignant Medical Myths”. It has a great chapter on BP and a chart with age adjusted safe numbers.

      6. Gary Ogden

        Frederica Huxley: It would be a daunting task to learn how to create a chart on Pages. One blind alley after another. What I can do is describe Figure 4. The x-axis is Systolic BP from 100 to 200, and the y-axis is Deaths per 1,000. What is crucial in the data is at what level of SBP does the mortality rate begin to rise. I’ll summarize what it says:
        For women 44-54, mortality is about 4/1000 from 100-142 SBP, gradually rising to 15 at 200
        For women 56-64 mortality is about 7/1000 from 100-160, gradually rising to 16 at 200
        For women 65-74, mortality is about 16/100 from 100-168, gradually rising to 30 at 200
        For men 45-54, mortality is about 8/1000 from 100-142, gradually rising to 25 at 200
        For men 55-64, mortality is about 15/1000 from 100-150, rising more steeply to 45 at 200
        For men 65-74, mortality is about 32/1000 from 100-160, rising fast to 70 at 200
        What the data essentially says is that the guidelines are wrong regarding risk; it varies by age and sex, and normal BP rises with age. For example, for a woman 65-74 there is no additional mortality risk if her SBP is below about 168. The conclusions in the paper state that anti-hypertensive treatment can be beneficial, but treatment based solely on SBP “exceeding 140 mm Hg is not justified.”

      7. Frederica Huxley

        Thank you, I did not mean for you to go to such trouble! I found the description of the chart very illuminating.

      8. AH Notepad

        Blood pressure should be lower eh? I read recently (please don’t ask where) that higher blood pressure in older people results in lower incidence of dementure. I suspect it also reduces the possibility of fainting and consequently falling over. Just in case that happens, large (by conventional standards) of vitamin C protects against osteoporosis.

      9. chris c

        You met her too? (grin)

        I had the opposite problem – hyperthyroid – which sent my BP through the roof and curiously dropped my LDL by exactly the same amount as the statin I no longer take. When overtreated, ie. hypothyroid, the LDL shot up.

        Since the PCT and the last Practice Manager went away my GP seems to be allowed to be a lot more clueful than she previously appeared. She’s no longer so concerned about my BP which is generally below 140/90 on minimal meds, and agrees that there’s no point even checking my lipids while my thyroid is misbehaving, and anyway since my HDL and trigs are so good the LDL is a bit of an irrelevance, and she almost agreed that having LDL a bit high as I age was probably not such a bad thing after all.

        There was a time that the nurses also appeared to be quite clueful but this was then beaten out of them. I haven’t bothered to see one again since being told that I had not had an A1c which I KNEW I had done, and that she was unwilling to give me my actual results since she also informed me that “we don’t test your “cholesterol” again once you are on your statin!”

        You might think that “healthcare professionals” would actually care about health, but seemingly not when they have boxes to tick and pennies to save. Meanwhile I’ve actually saved them pounds by not needing the “two or three diabetes medications” I was “expected” to be on by now, or all the other drugs I no longer require. You’d think they’d be grateful, NOT. You might even think they’d want to know how I did it, NOT.

    4. Mark Johnson


      How on earth can any “health care professional” claim you have high blood pressure with a reading of 134/70, particularly at the age of 72? Ludicrous.

  43. dearieme

    Buggering bastards! I looked at this youtube yesterday, but when I tried it again this morn, it had gone. Gone I tells ye!

    1. David Bailey

      This sort of thing makes my blood boil, because it demonstrates so transparently that medical science deliberately wants to cover up the facts about CVD and its causes – and it doesn’t matter if people suffer and die in the process. I hope that perhaps Dr Yusef is in a sufficiently powerful position to resist.

      If our weak media had some guts that could blow this whole issue open with one TV program – but nowadays they prefer to censor the truth.

      1. AH Notepad

        Boiling blood is probably not good for CVD. 😉 That people die because of information does not worry me, they have to go sometime. What I don’t accept is the mis-information pedalled by what are either liars or incompetents. Fortunately we have such honest people as Dr. Kendrick, Dr. Humphries to name but two. I apologise to others who feel left out bu not being named, but there is nothing significant in this. Conversely we have people such as Prof Collins and IsabellaB. Now we know it’s lucre that drives at least one of them, but the other appears to be not a person at all but a nom-de-plume of someone paid by vaccine manufacturers, who in turn is driven by filthy lucre. What is frightening is ignorant interferers like Bill Gates and his missus. They are pouring piles of money into vaccines with the misguided opinion that they can save millions every year dying from commonplace diseases, when providing good nutrition would be cheaper and more effective. Not only that, nature has developed complex systems for maintaining internal control, but sometimes this fails. Along comes someone pretending to care for people, but messing things up, and causing huge long term problems.

        My goodness, what a bigot, I’ll stop now, sorry for the rant.

      2. Sasha

        People are dying or getting sick all the time because of deliberate misinformation motivated by commercial interests: pharma drugs, medical procedures, industrial pollutants… In some ways, progress made our lives better and more comfortable, in others it created new ways to kill us off. That’s why I personally believe that as a species we are getting genetically weaker.

      3. David Bailey

        “Boiling blood is probably not good for CVD. 😉”

        I did wonder about that metaphor as I wrote it!

        However, I do worry that people die or become ill because of misinformation – particularly when it is deliberate. Anyone who works in science can make a mistake, but if anyone deliberately misinforms others about serious health matters from a position of seeming auhority, then perhaps it is time we called that what it is – either GBH or murder.

  44. John Burton

    The Youtube link now says the video is private. This has happened on some other heart- skeptical websites. Conspiracy theorists step forward?
    However at the time of posting it is still here:

    1. Antony Sanderson

      In a previous posting John Hammond mentioned a TEDx Talk video https://www.youtube.com/watch?v=RHiiOa18S_g in which Dr Yusef suggested taking statins as part of the route to cutting CVD deaths. Having had a look at the video I now see why the “Dietary Guidelines are a Lie” video was pulled.

      In the TEDx video he talks about the importance of lowering cholesterol (He proposes statins). Yet in the “Dietary Guidelines (~5:00. . .” video he shows that although saturated fat increases LDL-C . . . saturated fat in their study is associated with reduced CVD in a reverse hockey stick curve fashion. This to my mind says that the results indicate at the most a weak association of LDL-C with CVD. His main point is that . . . relying on surrogate end points (presumably like LDL-C) is an unreliable way to inform dietary opinion . . . A point I have come across many times.

  45. camraman

    Here’s another strange comment for people to wonder over. I’ve been looking into ApoB and found this editorial from a couple of years ago in the European Journal of Preventive Cardiology: http://cpr.sagepub.com/content/22/10/1317.full.pdf+html
    As far as i can make out they go on and on about how great measuring ApoB is compared to the usual lipid tests, and then seemingly from nowhere they make this amazing statement: “Since apoB is powerful in predicting future CHD, one has to ask whether it could, or even should, supersede the inferior lipid-based metrics in the evaluation of CHD risk in certain well-specified patient groups. The answer is obviously ‘no’: in the foreseeable future, apoB, either alone or in combination with apoA-I, cannot be regarded as an adequate substitute for the traditional well-known lipid metrics …”
    What?? Surely if it’s that good they should be using it?

    1. Antony Sanderson

      “Since apoB is powerful in predicting future CHD, one has to ask whether it could, or even should, supersede the inferior lipid-based metrics in the evaluation of CHD risk in certain well-specified patient groups. The answer is obviously ‘no’: in the foreseeable future, apoB, either alone or in combination with apoA-I, cannot be regarded as an adequate substitute for the traditional well-known lipid metrics …”

      Read the editorial . . . I am incredulous at the conclusion . . . The argument seemed to go something like this: . . . I admit that using LDL-C is not a very good predictor of heart disease “it is inferior”. . . the APOB metric is a better predictor . . . But we have being using LDL-C for a long time – we know where we stand with it – we have lots of calculations and procedures set up – It would be a shame to lose all the previous efforts.

      What hope is there when faced with such logic? I’m off to the asylum . . . There must be more chance of sanity there.

      1. mikecawdery

        The scientific logic of some “researchers” and workers in the disease fields just displays a basic ignorance. I asked a certain disease society about a particular therapy. Their answer was they knew nothing about it at all but in the that total lack of knowledge, they condemned it as a “SCAM” . It may well be but without any evidence to call it a scam is just ludicrous and plain ignorat. Science as practiced and we are expected to believe their recommendations

      1. Kathy Sollien

        Hi Dr. Sjoberg. I read earlier that you subscribe to Dr. Mercola’s publications. I have been reading a publication called Health Radar that I have found to be very interesting. You might also – the website is HealthRadar@newsmax.com
        Haven’t been able to read all the comments on Dr. K’s latest report – just too overwhelming!!

  46. Richard Amerling

    Getting a “video unavailable ” message.

    On Wed, Feb 15, 2017 at 05:42 Dr. Malcolm Kendrick wrote:

    > Dr. Malcolm Kendrick posted: “[Hold the front page] Last night I watched a > you tube presentation which completely astonished me. It was given by > Professor Salim Yusuf, who is as mainstream as mainstream can possibly be. > Here, from Wikipedia: ‘Salim Yusuf (born November 26, 1952)” >

    1. Edward Hutchinson

      Some kind person anticipated this may happen and put a copy on another link.

      No doubt the same thing will happen again so perhaps it would be wise to download a copy to repost when that eventuality occurs.

      1. AH Notepad

        I hope someone has downloaded a copy. I didn’t (holds head in shame) All the available links have been removed, so I can’t find a working link anywhere. This is a shining example that conspiracy theorists are not always wrong, as this must have been removed under pressure. I’m glad Dr. K alerted us to it while it was still available. Truth is obviously unacceptable to the authoritarian bigots that have control.

  47. mikecawdery

    Many thanks for the link. I missed this one. The BMJ is doing a lot to encourage “knowledgeable” patients to get involved via rapid responses and as patient reviewers. It is surprisinnhg the amount of support given to non-medics. I believe that this is a way to increase doctors’ awareness of patients views.

    1. mikecawdery

      Thanks for the link. It is indeed interesting that the evidence often says “no point” in protecting the healthy but the DIRECTIVES(in medical terms – guidelines) say “must do this”.
      The classic example is Collin’s claim Treat 3 million, save 10,000 lives a year
      1 life saved for 300 treated, which means that 299 are not saved (they are just a nuisance to all but Big Pharma – a great financial resource).

      Re stenting – I did find a paper which compared medical therapy with stenting over decades – survival curves were “essentially” similar. The problem of course is always a choice for the cardiologist; if patient dies on medical therapy then the issue of liability raises its head. Stenting means that all that could be done was done and would probably be backed by the courts and expert witnesses. It is one of the problems medicine has inherited from the US and their class action system and the rise of defensive medicine which invariably ends in a second best compromise for the patient

      The BMJ paper cited above “Should people at low risk of cardiovascular disease
      take a statin?”. The patient reviewer seems to be very close to what I would have written.

    2. Stephen T

      Brian, that’s an excellent article. Thank you for the link. It’s a long article but one every patient and most doctors would benefit from reading.

    3. chris c

      Long but excellent!

      Yes my cynicism is directed not so much at doctors but at the people who feed them their “evidence”. It’s a GP’s job to know a bit about a lot of things. A specialist needs to know more about fewer things, but a lot of specialities now contain far more information than a single person can remember IMO. They are fed a subset of information by Official Sources, and are left to find out the rest for themselves IF they have the time or the inclination, but in order to do that they have to know where to look and what to look for.

      Enter the Informed Patient and Social Media. Someone with only one disease to worry about can equal or even exceed the knowledge of a specialist, especially with feedback from their own results added to knowledge from clueful doctors like Malcolm and clueful researchers with blogs and Twitter accounts followed by digging on PubMed into what they are pointed to.

      Increasing numbers of Informed Patients are routinely achieving the impossible, such as controlling diabetes or defeating obesity. Small but increasing numbers of doctors and nurses, and yes, even a few dieticians, are now understanding this, plus now probably hundreds of researchers. When the likes of Salim Yusuf, David Ludwig of Harvard, Ron Krauss, past president of the AHA, start to speak out contrary to what they are expected to believe they have more credibility simply because they are in a position to have a nice comfortable life from following dogma yet choose not to do so.

      1. Martin Back

        Well said about the role of the Informed Patient. A minor example from my own experience: I got a dangerous inflammation in the left eye. The eye specialist said it was due to my ankylosing spondylitis. When I told my GP the diagnosis, he pooh-poohed it, saying in that case the inflammation should be in both eyes. Subsequently I discovered, through research and reading the stories of other people with AS, that inflammation in a single eye is typical; inflammation in both eyes at the same time is unusual. Next time I see him I shall inform him.

        Of course, one has to be pretty sure of one’s facts and be able to back them up with reputable references. I know how annoying it is when someone acts like he knows better on subjects that I happen to be knowledgeable about.

    4. Dr. Göran Sjöberg


      Thank you for this great reference!

      What I read just confirms my present conviction, as a “victim” of serious CVD since 17 years now, that it was probably the best decision in my life when I refused the suggested comprehensive bypass surgery and all medication. That was also the departing point when I started my so far “successful” search for alternatives.

  48. Joyce

    Sadly, this will go unchallenged by the patient, in the majority of cases. The reason? The “doctor” knows best, don’t dare question him! After my own comedy of errors after a cardiac arrest two years, I have tried, unsuccessfully to “educate” people regarding the out of date advice after a heart attack/surgery. Without exception they have all looked at me as if I was mad! You have to take your statins…don’t touch the evil saturated fat….low fat yoghurts, sorry no fat yoghurts! No butter, it’s poison.. use healthy low fat spreads. On top of that there seems to be little criticism of their lovely sugary desserts. The inconsistency stinks! Just as I’ve said many times previously, what the heck kind of world do we live in where we are being lied to on such a gigantic scale. This unnecessary destruction of people’s lives will never end if those in the know grumble, then bury their heads in the sand, and let “them” get away with it!

    1. mikecawdery


      Today the news is that the expert advice is is to eat Ten potions of fruite and veg.
      I suppose a meta-analysis is involved. The problem as I see it with meta-analyses is that they are SELECTED (a no-no statistically) on the basis of a set of criteria which in turn are based on what the researchers want to show as a result but as a consequence ignore a whole range of other factors which may well be associated with the chosen factors. Then with the huge numbers of “statistical units” involved (ie humans) trivial real differences can be demonstrated to be “significant” but in reality are totally irrelevant to the average human.

      As an example I would suggest Ancel Keys 7 country study totally ignored the possible effect of Vitamin D on the the outcomes of what he measured.

      1. David Bailey

        Since most people don’t snack on vegetables (I know there are exceptions), the new advice amounts to eating a lot of extra fruit, and I can’t help wondering if that won’t provide more sugar than is desirable.

      2. Joyce

        Mike, I’m so busy trying to please everybody, my diet is going to pot, and the weight is “creeping” back on! What with 10 portions of fruit/veg, a juicy sirloin steak, a lamb steak, and going to the gym 3 times a week, I’ve just about lost the plot. Who knows what tomorrow will bring. Losing the will to live here! P.S. forgot to mention the Vit D3 capsules! Pass me a tube of blue smarties, I need the energy! lol. Not to worry, when I do go, at least I’ll look GREAT!

  49. Antony Sanderson

    I have a lot of time for my GP. When I told him I had stopped taking statins for 1 month to see if the debilitating pains in my shoulder and upper arms would go . . . he asked if there was an improvement. I said “yes”, and he came back with “1 month is not enough, stay off them for another 2”. Needless to say, after a further 2 months the pains had reduced even further. (It took over a year for them to get to negligible level) He did not pressure me to take up statins again. And now to my main point: During odd visits I have given him an indication of the studies/papers I had been following (Cholesterol, diabetes, diet etc). As I was getting up to leave a couple of visits ago, he said “The thing is, we do not have the time to do all that reading”. . . . I left with no comment.

    1. David Bailey

      Of course, he is right in a way – a GP obviously has to keep abreast of so many different aspect of medicine – that is the awful part – they absolutely rely on the ‘experts’.

  50. camraman

    My understanding is that most GPs work in group practices, and a small number of ailments cover a large number of deaths. You would think they could share the load and have each GP keep fairly up-to-date on one main issue, as Malcolm does on CVD.

    1. Sasha

      This isn’t about keeping up with research. It’s more about going against established practices and recommendations by the medical authorities…

      1. chris c

        Yes! My GP is a “diabetes specialist” but frankly I know a LOT of patients that know a LOT more than her. Mainly because she is fed her dogma from NICE, NHS Evidence, DUK etc. and would stand a very good chance of getting into trouble if she didn’t follow it.

        Cynical doctors elsewhere have admitted to their patients that being found in possession of well controlled diabetics could lead to an investigation, not with a view to finding out how they achieved their results and thus benefit other patients, but with a view to disciplinary action for “failing to comply” with NICE Guidelines or PCT Protocols.

        I suspect since PCTs were replaced with CCGs this may have improved. Certainly there seem to be a few more doctors sticking their heads up above the parapet, and the likes of David Unwin and Joanne McCormack are actually winning awards, but at the same time there’s a lot more sniper fire from the likes of dieticians. I’ve read/been told that there are now a small number of hundreds of low-carb friendly doctors in the UK, which may just about be critical mass where an attack on the likes of Aseem Malhotra or Rangan Chatterjee may be defended in the same way as the ongoing battles with Tim Noakes, Gary Fettke et al.

        I’ve even heard of a few more doctors using T3 for hypothyroid and getting away with it. Not so sure about ketogenic diets for cancer – YET.

      2. mikecawdery

        Chris C
        This domination of doctors by the medical establishment w.r.t. GMC investigation is used to terrorize doctors into providing “approved” therapies irrespective they are right or flawed.

        I have just sent in a rapid response to Dr Godlee’s editorial ( http://www.bmj.com/content/356/bmj.j939 ) about this sort of thing. I believe that it is essential that “knowledgeable” patients should join her campaign to bring patients into the system. The tendency of researchers to ignore evidence contrary to their results happens but it skews the truth. It is imperative that the alternate view is brought to general attention.

        I believe that this is why Dr Kendrick’s blog is so important. It is outlining alternate interpretations on a very complex problem. While I personally believe he is nearer the truth than the guidelines is not the most important aspect of his blog. The most important aspect is that it is bringing the whole subject into open debate, which in turn is more likely to result in success than the dictate of conflicted “experts”.

  51. mikecawdery

    When I was in training some 6 decades ago we were told “you have to know what good health is before you can understand ill health”. Over the subsequent decades this has become more and more apparent. Food animal production depends entirely on good health. Disease impairs health and reduces performance.

    I am still surprised that papers published over 40+ years ago in ths area are still being cited. I would also claim that in those days, and indeed before, one had to often do one’s statistics using a Brunsviga or Facit calulator and a lot of hand turning. This was improved later but one still had to write ones own programs. Thus one was fully conversant with the study data and the algorithms and assumptions that were used to analyses the data.

    These days with huge studies, the data is simply dumped on a computer and programs applied that include unknown assumptions, unknown algorithms that are possibly not understood and the answer pops out in seconds. This results in the absence of a full knowledge and understanding of what the data are saying. It results in mathematical associations which may or may not be relevant or even meet Bradford Hill’s criteria for epidemiollgical data and its relevance to disease.

    I am afraid that these days in my dotage, I find medical pharmceutical research ignores the cause of a condition and is solely concerned in the chemical modification of the result of that cause. In short it is concerned only in illhealth, which is the basic business model for Big Pharma.

    For the future of human health this approach must be changed and good health of the individual patient must be promoted. In conclusion may I quote from The BMJ editorial by Dr Godlee (http://www.bmj.com/content/356/bmj.j939 ) “Crucially, the key outcomes were those that are important to patients and But with the ongoing help of our patient panel we are more determined than ever to continue our advocacy for patient partnership in healthcare. ( http://blogs.bmj.com/bmj/2017/02/15/paul-buchanan-on-rosamund-snow)

    1. Gay Corran

      Dr Andrew Saul and Dr Abram Hoffer have written extensively about niacin and its uses, in orthomolecular medicine. It immediately and permanently helped someone I know who was in real trouble with alcohol. The effect was absolutely amazing. Gave him his life back. Much larger doses are needed than you get in multivit supplements. Amazon have all the books by Hoffer and Saul I believe, or check out the website of Andrew Saul. (Sorry, don’t have link).

    2. Gary Ogden

      chris: Niacin is one of the B vitamins, and an essential nutrient. Certainly safe to take; millions do every day. Meat, fish, and peanuts are rich food sources.

    3. Errett

      Hi Chris—-I have used niacin for a few years—-I use Inositol Hecanicotinate—–no flushing issues—–beacuse it breaks down slowly in the body into Inositol and free niacin—I take 500mg once a day—with food.

      Inositol nicotinate is a compound made of niacin (vitamin B3) and inositol. Inositol occurs naturally in the body and can also be made in the laboratory.

      Inositol nicotinate is used for treating blood circulation problems, including pain when walking due to poor circulation in the legs (intermittent claudication); skin changes caused by pooling of the blood in the legs (stasis dermatitis) when veins are ineffective in returning blood to the heart; narrowing of the blood vessels leading to cold fingers and toes (Raynaud’s disease); and blood flow problems in the brain (cerebral vascular disease). Inositol nicotinate has been used in conventional medical practice in Great Britain for improving symptoms of poor circulation for many years, although it is usually not the preferred treatment choice.

      Inositol nicotinate is also used for high cholesterol; high blood pressure; sleep problems (insomnia); migraines related to “hardening of the arteries” (atherosclerosis); skin conditions, including scleroderma, acne, dermatitis, psoriasis, and others; inflammation of the tongue (exfoliative glossitis); restless leg syndrome; and schizophrenia and other mental illnesses.

      How does it work?
      Inositol nicotinate releases a form of niacin when it is processed by the body. The niacin can widen blood vessels, lower blood levels of fats such as cholesterol, and break up a protein needed for the clotting of blood.
      From WebMD

  52. Brian Wadsworth

    With 15 years of critical thinking and research behind me, as a consumer of the system, and with many years of investment involvement in healthcare product companies, I have come to see that the underlying structure of what we call healthcare is deeply flawed.

    With Malcolm’s tolerance for yet another off-topic posting, I would like to explain. Please conduct with me a thought experiment.

    You are the head keeper at a zoo. The zoo has a variety of mammalian species and primates. You are charged with their care and preservation..Generally you seek to replicate their living conditions in the wild as best you can and get them to their full life-span. You follow best practices through the life-cycle of the inmates by studying their environmental and nutritional needs. All the while seeking to maximize longevity.

    In a turn of events, you are asked to accommodate a member of the species Homo Sapiens for the first time.

    True to form, you prepare for the new inmate as you would any other species new to your experience. You gain a deep understanding of the habitat and nutritional needs of the species and you create the closest possible replica to its natural environment realizing that any significant deviation is a risk.

    The emphasis is on risk assessment and reduction, preservation by prevention.

    Our healthcare industry, on the other hand, identifies and reacts to symptoms and diseases as they crop up. We identify syndromes deserving attention. We then assume that the attention takes the form of interventions whether pharmaceutical or device addressing the symptom. To be fair we also dig deeper and explore and research the related mechanisms.

    The result is a dizzying array of diseases and treatments with little apparent order or organization in silos of exploration and learning. We do not have a model of the optimal environment for a human being. We cannot state coherently how to maximize longevity or which environmental elements are most important.

    What we humans need is a an understanding of the threats to our health and longevity embedded in our modern civilization and how to avoid them, in my opinion.

    1. Dr. Malcolm Kendrick Post author

      I know. I think it has been downloaded and can be viewed by links on this post. My understanding is that this was not a conspiracy. More a case of the journal not wanting the main points of Yusuf’s study being posted all over the internet prior to publicationsl

  53. mikecawdery

    This presentation is dealing with oxidative stress and its effect on many conditions with Vitamin C. In particular as the FDA and EMEA are both trying to convert vitamins to prescription drug status. I can understand why Big Pharma and the medical establishment supports this change. As Dr Levy explains the various activities of Vit C. if any Big Pharma drug had these effective characteristics it would be promoted world-wide in 100 point bolded headlines and the price of this nutrient would go through the roof, just as daraprim (an old anti-malarial) has done.

    It confirms my view of the importance of the total antioxidant capacity (TAC) of blood and its association with good health.

    1. mikecawdery

      as a follow up:
      Cardiovasc Drug Rev. 2006 Summer;24(2):77-87.
      Oxidative stress as the leading cause of acute myocardial infarction in diabetics.
      Di Filippo C1, Cuzzocrea S, Rossi F, Marfella R, D’Amico M.
      Similar articles
      Review Role of oxidative stress in development of cardiovascular complications in diabetes mellitus.
      [Curr Vasc Pharmacol. 2006]
      Review Oxidative stress in diabetes: a mechanistic overview of its effects on atherogenesis and myocardial dysfunction.
      [Int J Biochem Cell Biol. 2006]
      Review Oxidative stress and diabetic cardiomyopathy: a brief review.
      [Cardiovasc Toxicol. 2001]
      Review Role of nitrosative stress and poly(ADP-ribose) polymerase activation in diabetic vascular dysfunction.
      [Curr Vasc Pharmacol. 2005]
      Review Diabetes and the impairment of reproductive function: possible role of mitochondria and reactive oxygen species.
      [Curr Diabetes Rev. 2008]

      Why are these papers so ignored by the medical establishment?


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