Cholesterol Countdown for WHAT??!!
Late last year I had my annual medical exam for work after a month of eating carnivore, and the doctor was absolutely appalled at my cholesterol results. They were the highest figures he had ever seen, and I’m not exaggerating when I tell you that he was absolutely terrified for me, urging me on the phone to please start taking statins immediately so that I wouldn’t drop dead on the spot. I objected. I am extremely reluctant to willingly go down the slippery slope of a lifetime course of medication unless there is absolutely no other option. And I knew that in this case, I could lower my cholesterol with diet. So I asked him for the chance to do that, and I was given two months to prove that I could.
So why was my doctor so distraught for me? He’s a super lovely guy, who’s been practicing medicine for more than 40 years and is very good at his job. He’s a very caring doctor. But, he’s old school and he’s operating on old information. Doctors are incredible. They study for many years to learn about the extraordinarily complex ways in which the body works, and I have a great deal of respect for them. But, as I’ve grown older, I’ve come to realise that it’s not a GPs job to keep up with all the latest medical research. In my experience, doctors are generally useful for one of two things: issuing sick leave certificates and prescribing medication. Actual treatment for an ailment is what referrals to specialists are for. In Dubai particularly, you can’t see a doctor without walking away with a prescription for at least one medication. Even if it’s just Panadol, docs be peddlin’.
I’m glad that I resisted taking the statins. After our appointment, I took a much deeper dive into the world of cholesterol research, and the role that statins play. What I found, particularly pertaining to women, was eye-opening. Author Nina Teicholz says, “In 1992, a National Heart, Lung, and Blood Institute expert panel reviewed all the heart disease data on women and found that total mortality was actually higher for women with low cholesterol than it was for women with high cholesterol, regardless of age.” Hmm! And that was nearly 30 years ago. Not coincidentally, it also turns out that there is absolutely no benefit to women of any age taking statins, and this report, published by Dr. Malcolm Kendrick, supports that.
Dr. Kendrick is a well known author of several books about nutrition, one of which is called The Great Cholesterol Con. The dude knows cholesterol. And this is what he says about it for people of my age, “As you get older, the higher your cholesterol is, the longer you will live. This is a fact. People with lower cholesterol are more likely to develop Alzheimer’s disease, Parkinson’s, multiple sclerosis and other neuro-degenerative diseases.”
If that’s the case, then how is it that we just “know” that cholesterol is bad? How do we “know” that LDL cholesterol is even worse (it’s even called “bad cholesterol”). No really, how do we “know” this stuff? Spoiler alert: we don’t. We are conditioned to believe it. We are indoctrinated. How on earth can something that our own body produces, be bad for us? Around 30% of all our cell membranes are composed of the stuff. And approximately 25% of the dry weight of the brain is cholesterol. It’s so vital to its functioning that the brain actually makes its own. We need it, or we will die. Lierre Keith, author of the amazing book, The Vegetarian Myth, points out, “One of the main functions of the liver is to make cholesterol because life isn’t possible without cholesterol.” So why would anyone want to reduce it?
Probably because we are still being told that we have to. Doctors use an algorithm to predict a person’s risk of developing heart disease based on factors like age, sex, ethnicity, blood pressure, LDL and history of illness. If you get a score of 10, doctors prescribe you statins. But, check this out. According to the algorithm, once you hit 60, that’s an automatic score of 10, and doctors will prescribe you statins anyway. Even if you are in perfect health, even if you have perfect blood pressure and optimal LDL. WTAF! It’s a huge double dip for the pharmaceutical companies. You get the statins if your cholesterol is high. And if you’re “old”, you get the statins anyway. Which is absurd considering that there’s a proven, inverse association between LDL cholesterol and mortality in people over the age of 60.
That cholesterol is even considered a risk factor for heart disease is sheer dogma. The Lipid (or Cholesterol) Hypothesis, developed by Ancel Keys over 65 years ago (more on this mofo later), posits that high cholesterol causes vascular damage and/or dysfunction which leads to a build up of plaque on your artery walls, restricting blood flow, triggering a clot and ultimately leading to a heart attack. It has been taught in medical school for over half a century, and most doctors (including mine) act on that information for the rest of their careers because they simply don’t know any better. They never seek out clarification, and they never look for evidence to support the hypothesis. If they did, they would discover that there is none. In fact, there has never been a clinical study that has proven that cholesterol causes heart disease. Ever.
So let’s look at an alternative theory of correlation between cholesterol in the body and atherosclerosis. It’s called the Response to Injury Hypothesis and it views the high level of cholesterol found in an atherosclerotic artery as the body’s way of responding to an artery that’s already been damaged. Let’s say the artery was damaged by a high level of glucose in the blood, caused by insulin resistance. The LDL rushes to the site as a protective “response to injury”, but unfortunately it is damaged when it becomes oxidised due to the presence of that high blood sugar. This is when LDL actually does turn into bad cholesterol. Oxidation takes a protective molecule (LDL) and turns it into something that contributes to harm. LDL doesn’t cause heart disease, unless it becomes oxidised. And, as long as you’re not a smoker, your cholesterol will never oxidise on a high fat, low carb diet. It’s impossible.
If you want to know how the medical profession became so trapped in an abusive marriage to the unfounded notion that saturated fat and high cholesterol are risk factors for heart disease, follow me down this rabbit hole. The villain of the story is Ancel Keys, an American scientist whose dubious beliefs about saturated fat determined the dietary guidelines of an entire country which, more than sixty years later, is full of overweight diabetics dying of heart disease. In 1956, Keys undertook the world’s first multi-country epidemiological trial (known as the Seven Countries Study), in order to prove his Lipid (or Cholesterol) Hypothesis. By the time the massive study was published in 1970, he had become a master at cherry-picking through the copious amounts of data and fudging them to suit his hypothesis, leaving out all the data that didn’t support his theory. For instance, data was actually collected from more than a dozen countries, but it was only the seven that proved his beliefs that were included in the final published paper.
The study was flawed from the very beginning because Keys’ theory was one that he wanted to prove, desperately. And that’s not how science works (or at least, not how it should work). The study was never peer reviewed, and it was never replicated. It was a shoddy paper that, despite never actually demonstrating causality at all, was framed as though it had. Years after it was published, Alessandro Menotti, the lead Italian researcher in the trial, reviewed the data and discovered that, lo and behold, sugar was more strongly correlated to heart disease fatalities than saturated fat or cholesterol.
But, due to a number of influencing factors at the time, Keys’ study was accepted as gospel, and subsequently adopted by the US government. This happened despite prominent scientists protesting the study’s legitimacy at a congressional hearing. And despite several other studies proving the exact opposite to be true. Ancel Keys was an asshole and a bully, and he had powerful friends in the US government. He had become so influential in the political and scientific worlds that he was able to quash any dissenting voices, ruining the careers of many promising scientists along the way.
And so, from Keys’ study, the egregious USDA food pyramid was created and shoved down consumer’s throats. The food manufacturers got on board the low-fat bandwagon and started producing items that were low in fat but, in order for them to be palatable, had to be high in sugar. Funnily enough, the agricultural industry also suddenly became very keen to promote, and protect, the grain-heavy food pyramid, which shockingly still looks like this. And here we are today with supermarket shelves packed full of products that our bodies don’t even recognise as food. And people keep on getting fatter and sicker, and more dead.
It actually really boggles my brain that one man could have yielded so much power, and with such a profoundly fucked up result. The idea that science should be pure and objective is a beautiful one. When I studied Science at Monash University, we would conduct experiments with no bias, no agenda and with the truth as our ultimate goal. Unfortunately, science in the real world is driven less by the urge to impress your professor, and more by inflated egos, frenzied publishing, heated competition and of course the influence of billions of dollars. Of course there are many studies that are scientifically and objectively conducted. But a large chunk of trials are funded by industry. One such example is Coca Cola funding a study “proving” that Diet Coke is healthier than water. Pharmaceutical companies funding studies “proving” that statins reduce the risk of heart disease, with little or no side effects, is another.
There were several other studies from Keys’ time that clearly showed an inverse relationship between cholesterol and the risk of heart disease, but for some reason most of them were unpublished. Buried, literally gathering dust in garages for decades, and only recently coming to light (did anyone say Minnesota Coronary Experiment?). Now why would this be the case?
I believe it’s because there’s too much money to be made from statins. In the course of my research, I was shocked to learn that statins are the most prescribed medicine in the world, with over 200,000,000 people taking them every single day. And the kicker is, once you start taking these meds you are stuck with them for the rest of your goddamn life. So, statin prescriptions are increasing exponentially, cholesterol levels are plummeting. And we’re all eating from the food pyramid, right? But somehow heart disease is still the leading cause of death everywhere on the planet. According to WHO, “The world’s biggest killer is ischaemic heart disease, responsible for 16% of the world’s total deaths. Since 2000, the largest increase in deaths has been for this disease.”
So, if millions of people are taking statins, and heart disease is still the biggest killer on the planet, who is actually benefiting from all those little pills? Is it the patient? Sure doesn’t look like it. Is it the doctor? Well, they might be getting a little kickback. Nope, the big winner here is Big Pharma. And they have absolutely no incentive to disavow us (or doctors) of the idea that we all need statins to survive. And, of course, they encourage us to keep eating from that crappy food pyramid. And they’ll just keep handing out pills like candy (which, incidentally come with their own smörgåsbord of significant, negative side effects). Shockingly, in 2010 a cardiologist published a paper suggesting that statins be handed out with Original Recipe Chicken Buckets and Big Macs. Let. That. Sink. In. It’s absolutely diabolical.
Pharmaceutical companies are famous for obfuscating the data from their in-house clinical trials. Transparency is not in any of their mission statements. And so, most of us are simply uninformed, or worse, misinformed. And most of us don’t ever question the authority of our doctors. Which is why people are so happy to commit to a lifetime of taking statins when a doctor prescribes them. They are under the impression that the pill will save them from heart disease, and extend their life. Isn’t that what we all want? To live a long and healthy life? A study, however, has shown that for those with a history of heart disease, taking statins extended their lives (on average) by only five days!! And for those with no history of heart disease, their life expectancy was increased by an average of three days. THREE FUCKING DAYS!!!!! That’s the reward you get at the end of a lifetime sentence of daily pill popping (never mind the cost, never mind the side effects). No thanks, you can count me out.
And look, it’s not as if the medical profession hasn’t got it wrong before. As Lierre Keith elegantly argues in her book, lobotomies, leeching, hormone replacement therapy, thalidomide, electric shock therapy etc. were all once considered fine medical treatments. We know better now, and I have a feeling that one day we’ll know better about statins too.
So, while I am vehemently opposed to reducing my cholesterol, unfortunately we had to do it to keep our jobs. So, the cholesterol had to come down. And it had to come down a shit-tonne. So, how did we do it? Every day, before lunch we’d start with a tablespoon of chia seeds that had been soaked in a cup of water for an hour. This is fibre, and it scrapes out your gut. We did intermittent fasting, meaning we skipped breakfast. Every day for five weeks lunch was oats, pumpkin seeds, sunflower seeds, chia seeds, cinnamon, blueberries, almonds and walnuts, all known to reduce cholesterol. We used almond milk instead of cow’s milk. It’s absolutely horrendous for the environment, but hey, it’s fat free. When we were peckish (which was often) we would snack on nuts and kiwi fruit. And for dinner we mostly alternated between salmon, pan-fried in little bit of olive oil, which is an unsaturated fat, and soup with lentils, lemon and spinach. Lentils, again, are rich in fibre, so we were shitting five times a day (and I’ve gotta admit, that part was pretty satisfying). This sounds like a relatively “healthy” diet right? But, knowing what I know, I literally felt like I was poisoning my body. My joints started aching again, my stomach was constantly cramping and bloated, I was gassy as hell and I gained back the inches that I’d lost from around my waist, despite losing a couple of kilos.
We needed to throw everything at this problem, so that we could pass our cholesterol tests and go back to eating food that’s actually healthy for us, and the environment: pasture-raised meat, eggs, yoghurt, cheese and butter. So, we levelled up with supplements. Every day we took milk thistle, plant sterols and stanols, and red yeast rice extract (and, because red yeast rice blocks the body’s own production of CoQ10, which is essential for heart and muscle health, we also had to take CoQ10 supplements). Like I said, we were in this to win. Neither one of us wanted to have to go back for another check-up in two months. So we gave it 100%.
And it worked. Here are the results after five weeks of eating a diet which I am passionately, and diametrically, opposed to. My total cholesterol reduced by an astonishing 60%. And my “bad” cholesterol, LDL, went down by a pretty fucking crazy 73%. Was I healthier? No. But my doctor thought I was. Was I less at risk of dying of heart disease than I’d been eight weeks before? Absolutely not, but my doctor was delighted. He signed our medicals, gave us both a figurative pat on the head and sent us on our way. We went out and had steak for lunch.
