The Great Cholesterol Con: The Truth About What Really Causes Heart Disease and How to Avoid It

by Malcolm Kendrick

Statins are widely prescribed to lower blood cholesterol levels and claim to offer unparalleled protection against heart disease. Believed to be completely safe and capable of preventing a whole series of other conditions, they are the most profitable drug in the history of medicine. In this groundbreaking book, GP Malcolm Kendrick exposes the truth behind the hype. He will change the way we think about cholesterol forever. Rubbishing the diet-heart hypothesis, in which clinical trials 'prove' that high cholesterol causes heart disease and a high-fat diet leads to heart disease, Kendrick lambastes a powerful pharmaceutical industry and unquestioning medical profession, who, he claims, perpetuate the madcap concepts of 'good' and 'bad' cholesterol and cholesterol levels to convince millions of people to unnecessarily spend billions of pounds on statins. Clearly and comprehensively debunking assumptions on what constitute a healthy lifestyle and diet, "The Great Cholesterol Con" is the accessible, indispensable and absorbing case against statins and for a more common-sense approach to heart disease and general wellbeing. No more over-hyped miracle drugs; no more garlic, red wine, anti-oxidants, fruit or vegetables; even a vegetarian diet is rejected in this controversial yet authoritative critique of how we have been mislead over how food and drugs affect our coronary health. Here, for the first time, is the invaluable guide for anyone who though there was a miracle cure for heart disease, "The Great Cholesterol Con" is a fascinating breakthrough that will set dynamite under the whole area.

Genres: Health, Nonfiction, Nutrition, Medicine, Science, Diets, Biology

384 pages, Paperback

First published January 1, 2007

Reviews

[Jodi · Rating 4 out of 5]

This book explains that the cholesterol hypothesis is well and truly dead! It has been disproven, comprehensively. The current obsession with cholesterol levels and avoiding saturated fat and cholesterol in the diet is utterly misguided.

This book was very convincing on this point but if you'd like a far more in depth explanation and history I'd highly recommend 'Good Calories, Bad Calories' by Gary Taubes. This book is also impeccably referenced and argued.

This book explains that:

- High cholesterol levels don't cause heart disease
- A high fat diet, saturated or otherwise, does not affect blood cholesterol levels
- Saturated fats are not in any way damaging or dangerous
- Statins offer very little protection against heart disease and are not worth taking for most people, especially women
- Concepts of good and bad cholesterol are ridiculous and 'madcap'
- Statin drugs are the most profitable drug ever and make pharmaceutical companies billions and billions of dollars a year and this is why the cholesterol hypothesis continues to be so relentlessly promoted
- Matthias Rath (as supported by Linus Pauling) has part of the heart disease puzzle right when he talks about the role of low vitamin C levels in causing heart disease
- Statin drugs have many dangerous side-effects such as muscle pain, depression and progressive memory loss, death and hideous deformed babies when given during pregnancy
- Low cholesterol levels are bad for your health
- The war against cholesterol, using statins, comes close to a crime against humanity

I loved the comment that eggs are full of cholesterol 'because it takes a lot of cholesterol to make a healthy chicken' and that our brains need a good amount of cholesterol to function at all well. The idea of throwing away egg yolks and all their nutrition and eating just the whites, for supposed health reasons, is foolish in the extreme.

Overall I'd give this book and 8 or 9 out of 10. I had real problems with the quality of the last chapter however, and that chapter I would give a far lower rating, so I've compromised and given the book 3 out of 5.

I recommend skipping the last chapter entirely or taking it with a huge grain of salt and then reading excellent books on how to treat or avoid heart problems such as 'Detoxify or Die' or 'The Cholesterol Hoax' by Dr Sherry Rogers.

To say that heart disease is caused by emotional stress and to ignore homocysteine levels, omega 3 vs omaga 6 imbalances, low vitamin C levels (as per Linus Pauling and Matthias Rath's research), the huge toxic load of people today (heavy metals, plastics and pesticides etc.), trans fats, the moving away from traditional and nutrients-dense foods and mass nutrient deficiencies (including deficiencies of the major fat soluble vitamins such as A, D, E and K plus magnesium) is not good scientific writing. Stress is but one factor of more than a dozen significant factors and certainly is nowhere near the top of that list. The idea that stress is only a problem now, in recent times, is also hard to take seriously.

On the plus side, this book had one of the best styles of writing I have ever found in a health book. The first few chapters in particular were very enjoyable to read and even made me laugh out loud a few times!

I just wish the very poorly written and argued conclusion chapter had been omitted form this book, it really lets down what is otherwise an excellent book.

This book is essential reading if you're an egg yolk, cholesterol or saturated fat dodger and especially if you're taking a statin drug. Don't fall for the statin drug hype and be very wary of any doctor that does!

Jodi Bassett, The Hummingbirds' Foundation for M.E.

[Jacques Bezuidenhout · Rating 4 out of 5]

Kendrick presents a very theoretical subject in a light hearted way, using a whole lot of dad-/corny-jokes. This might get too much for some, but I found it quite entertaining.

The content seems very well researched. With little cause to doubt the validity.

Where it does become a bit of an internal struggle, is the fact that it goes against everything that has been drilled into us our whole lives. And everything the medical industry is forcing on us.
- Cholesterol must be below 5
- Saturated fat is bad
- Statins are good
- There are Good cholesterol and BAD cholesterol

But it then presents the statistics around mortality if you were to try and adhere to the above, and that in most cases, it is either not making a difference, or you might be worse off.
It highlights some problems like:
- The medical industry profiting billions from statins
- Side effects of statins
- Side effects of low cholesterol
- Arguments that separate Cholesterol and heart disease into different issues

The final chapter probably needs to be taken with a grain of salt. But it did sit very well with what I believe, and have observed.
- Avoid / reduce / eliminate unnecessary stress
- Exercise ... all the time
- Use alcohol, don't abuse it
- Relax and socialise with friends
- Have fun

Not sure if this is a topic for everyone, but easily recommended book if you are interested in the topic.

[Daniel · Rating 4 out of 5]

I'm giving this book a 4 only because Kendrick can be annoying at times with his Dad humor.

Otherwise, it's a well-researched compelling book that debunks a lot of the conventional wisdom we associate with high cholesterol being bad. Cholesterol doesn't end at a figure below or above 200. Even LDL itself has different particles than are dense and more susceptible to oxidation (Pattern B) vs. Large, buyoant LDL particles which do not easily penetrate endothelial walls (Pattern A).

He points to the higher incidence of stroke in countries such as Japan despite the fact that they have low cholesterol levels. Additionally high cholesterol levels do not point to an increase in overall mortality. From memory, a restriction on fat, saturated fat and cholesterol also had a statistically significant impact on incidence of dementia.

Despite what doctors and Big-Pharma will have us believe, cholesterol is a vital component of our bodies. It regulates numerous biological processes, comprises a large part of the brain and is vital for sex hormones.

A thought-provoking (and necessary) read if you believe your health lies in 1 number to determine your susceptibility to heart disease and future health.

[Kim · Rating 1 out of 5]

DNF at 40%. Out-dated use of studies, some more than 30 years old. Omitted studies which do not support his hypothesis or simply writing them off as “BS” without clear explanation as to why they would not be a sound arguments against his hypothesis. There are some interesting points but at some point I just couldn’t continue - it’s not good science writing and I subsequently felt I couldn’t trust what I was reading.

[Nana · Rating 3 out of 5]

Interesting new views are presented in this book. However the credibility is almost nonexistent since citations were neglected and you are supposed to find the resources used to support important arguments, by yourself. If you manage that is.
Which does not really speak for the quality of this book.
I would therefore not necessarily recommend this book.

[Amber · Rating 5 out of 5]

I've never been more entertained reading a medical text. He argues that high fat diet has nothing to do with cholesterol and that cholesterol has nothing to do with heart disease. It's a tough theory to get behind as it is so opposite to everything I've learned and everything I teach my patients. However, his supporting evidence is quite compelling. Certainly thought provoking.

[Dr. Hannah Mathew · Rating 4 out of 5]

4, not 5: due to lame sense of humour and lack of references. Thankfully I have my own references from my own research so what he says make sense.

Just after I’ve finished reading all of the trials on statins, PCSK9 inhibitors, their criticisms, their (pharma funded) praises, Lp(a) research, and over a thousand pubmed articles on cholesterol and heart disease, I have now realised that I know very little about heart disease. And if I know nothing about cholesterol and heart disease after reading this much, cardiologists don’t even know what cholesterol is. (they probably actually have no clue!)

But Kendrick? He’s one smart cookie, and although his sense of humour is questionable and a little lame, the man really knows how to read scientific research. He has the most thorough research and explaination of heart disease I have ever read. I mean, the man is talking about Lp(a) back in 2008 when cardiologists probably didn’t have a clue!

Now they do, and we have Big Pharma to the rescue, with Lp(a) destroying gene silencing drugs coming our way. I am very excited and waiting for Merck to publish their initial trials, with a side of pop corn, a drink and my thousand research papers and articles at the side. That is, IF they allow independent researchers such as myself to actually get hold of the data. They’re not very good with transparency. I’m still waiting for the CTT research team from Oxford to release their research on statins. They refuse to release their data for independent analysis. Why, oh why? Hmmm.

Some interesting facts I have learnt from my research:
- every cell in the body is made of cholesterol and phospholipids that are in turn made of a mix of saturated and unsaturated fatty acids.

- LDL HDL VLDL etc are not cholesterols they are proteins that carry cholesterol in the form of esters

- it is impossible for cholesterol esters from LDL to turn into cholesterol crystals in the plaque because there will have to be an enzymatic process to allow this de-esterification to occur. Therefore THE LDL-C HYPOTHESIS IS BIOLOGICALLY IMPLAUSIBLE.

- it is also biologically impossible for LDL particles to “slip underneath” the endothelial cell lining. The endothelial cells are not that leaky, even when dysfunctional. If so, you’d be leaking and bleeding to death (like in dengue or Ebola - haemorrhagic fevers where this does happen)

- eating carbohydrates makes your liver produce saturated fatty acids, turns them into triglycerides and then puts them out as VLDL, which then turns into LDL. The triglycerides then exchange with HDL, thereby causing “Dyslipidaemia” or low HDL-c.

- eating carbohydrates stimulates liver cholesterol production because it stimulates the growth hormone insulin, (which means more cell growth, and what do cells need? Cholesterol)which uptakes more cholesterol from LDL, therefore reducing LDL-C.

- fasting, or eating a low carbohydrate diet suppresses cell growth and reduces liver cholesterol production, therefore liver will pick up less cholesterol from LDL, increasing LDL-C. If you are a lean person with good muscle mass, or you have an apoE4 gene, you are likely to be excellent at using fat as energy, so your LDL-c will be high. ANY TIME THAT YOU GO FROM SUGAR BURNING TO FAT BURNING MODE, LDL-C goes up. And there is a diabetic drug (SGLT2i) which is the best drug studied so far, which reduces plaque size in the heart, heart attacks, dementia, etc which INCREASES your LDL-c.

- eating saturated animal fats suppresses liver fat production & insulin production, thereby reducing risk of metabolic disease; it also reduces Lp(a).

- eating cholesterol from egg yolk and animal fat means that our liver REDUCES cholesterol production in the liver because it needs to produce less cholesterol. Your cardiologist probably has no clue.

- the reason vegetable oils reduce LDL-C is by damaging normal cholesterol esters into cholesterol oxides. This isn’t tested on a blood test. Also, phytosterols are plant sterols that confuses our liver. Our body excretes these sterols because (well, we are not plants therefore our cells are made of CHOLE not PHYTO sterol). When we eat too much of this, our liver thinks it’s not getting enough cholesterol from the diet therefore absorbs more cholesterol from LDL.

- when we inhibit cholesterol production in the liver cells with a statin, our body desperately cries in the need of cholesterol, therefore absorbs more cholesterol from LDL. This reduces LDL-C. The benefit of statins lies in their anti-clotting and anti-inflammatory properties. Both of which are conferred by Aspirin - in my opinion a much safer drug without side effects of diabetes, dementia, cancer and heart failure (yes these are actual side effects of statins - especially lipophilic)

- LDL, a protein supplies cholesterol to a cell when its membrane is damaged, and is rich in antioxidants such as vitamin E, carotenoids and coq10. There is evidence that it localizes to damaged cell membranes. But if there is too much inflammation, LDL can get oxidized turning into oxLDL, which is picked up by a macrophages and turns into a “foam” cell that can form plaques. Those with high LDL-C live longer, are smarter, and have much lower risk of dying from cancer and infection. And there is no correlation between high LDL-C levels and heart attacks except in men under age of 50. Everything else is a so-called cholesterol “paradox”

- Paradoxes of note: French paradox (high saturated fat, low CVD), Israeli Paradox (high PUFA, high CVD), Sri Lankan Paradox(low fat consumption, low cholesterol, high CVD), European paradox (41 countries - inverse relationship between saturated fat and cardiovascular deaths), paradox in South Asians (low cholesterol, low BMI, mostly vegetarian diets, really high rates of CVD), Paradox in ALL Women (high cholesterol, low CVD), cholesterol paradox in heart failure and MI (those with higher cholesterol die less), stroke paradox(low cholesterol = higher risk of bleeding), paradox in centenarians (high cholesterol = live longer), paradox that cholesterol is much lower now than before but CVD is rising (DuBroff has a few papers on this)
🫠 there’s so many paradoxes I have found that I’ve abandoned the hypothesis itself🫠🫠🫠

- Lp(a) is a protein that helps stabilize blood clots, and neutralize oxidized LDL. The reason it’s increased in those with heart disease is because those with cardiovascular disease have high levels of inflammation and oxidative stress.

[Aneliya Petrunova · Rating 4 out of 5]

(на български по-долу)
I have been a fan of Dr. Kendrick's for years. I like his analytical mind, his passion to question everything and not stop at anything before he has uncovered the truth, and I also like his sense of humor. I have come upon his blog and find the posts there to be extremely useful, even though I have not had the patience to read his series on what causes heart disease. So instead of the series I thought I would read his book and see how he dismantles the diet-heart hypothesis (you know, all that nonsense that saturated fat raises cholesterol, which then ends up in plaques, thus blocking the arteries more and more and this is what causes heart disease). The book is not too long and it is quite well written, with that same sense of humor I so much love about Dr. Kendrick. The first half is dedicated to disproving the diet-heart hypothesis. Dr. Kendrick does that quite convincingly. And no, you don't have to worry about your saturated fat intake or your cholesterol level.

The second half of the book is dedicated to what Dr. Kendrick has concluded does cause heart disease - and it is stress, both physical and psychosocial. First the arteries get damaged by stuff like high blood pressure, high blood sugar or high insulin levels. Stressors cause HPA axis disregulation and this - stress causing HPA axis dysregulation - is what ultimately causes heart disease. In case you're wondering what it is that normally provides women certain protection, it is not their estrogen, but another aspect of female physiology - women produce less cortisol when under stress and in general react in a more positive way to stress than men, which is why women tend to get fewer heart attacks and/or get them at a more advanced age than men.

I have given the book 4 stars - the only reason is that I would have liked Dr. Kendrick to elaborate more on nutrition, the metabolic syndrome etc. (he does mention hypertension, hyperinsulinemia and high glucose levels as causes of arterial damage). But I guess I have to read his (terribly long) series of blog posts on what causes heart disease. After all, the book was published in 2007, i.e. 12 years ago. Surely Dr. Kendrick has more to say on the topic now. But thank you for dismantling the cholesterol hypothesis, Dr. Kendrick. I enjoyed reading your book.
***
Почитателка съм на д-р Кендрик от години. Харесвам неговия аналитичен ум, страстта му да подлага всичко на съмнение и да не се спира пред нищо, докато не открие истината, а харесвам и чувството му за хумор. Натъквала съм се на блога му и намирам статиите за изключително полезни, въпреки че не съм имала търпението да изчета серията за причините за сърдечно-съдовите заболявания. Затова вместо тази серия, реших да прочета книгата му и да разбера как разнищва хипотезата за връзката между храненето и сърдечните болести (сещате се, цялата тази глупост, че наситените мазнини повишават холестерола, който се озовава в плаките и така запушва артериите и именно това причинява сърдечно-съдовите заболявания). Книгата не е много дълга и е доста добре написана, със същото чувство за хумор, което толкова харесвам у д-р Кендрик. Първата половина е посведена на опровергаване на хипотезата за връзката между ССЗ и храненето. Д-р Кендрик се справя много убедително с тази задача. И не, не трябва да се тревожите за приема си на наситени мазнини и нивото си на холестерол.

Втората половина е посветена на същинската причина за ССЗ според д-р Кендрик – а тя е стресът, както физическият, така и психосоциалният. Най-напред артериите се увреждат например от високо кръвно налягане, високи нива на кръвната захар или инсулина. Стресовите фактори водят до дисрегулация на оста хипоталамус – хипофиза – надбъбречни жлези и именно това – тази дисрегулация причинява ССЗ. Ако се чудите какво по-точно защитава донякъде жените, не е естрогенът им, а друг аспект на женската физиология – жените произвеждат по-малко кортизол в състояние на стрес и като цяло реагират по-положително на стреса от мъжете, поради което обикновено жените получават по-рядко инфарти и/или ги получават в по-напреднала възраст от мъжете.

Дадох 4 звезди на книгата – единствената причина е, че ми се искаше д-р Кендрик да разгледа по-подробно храненето, метаболитния синдром и т.н. (все пак споменава хипертонията, хиперинсулинемията и високата захар като причини за увреждане на артериите). Но явно ще трябва да прочета неговата (ужасно дълга) серия от статии за причините на ССЗ. В края на краищата, книгата е публикувана през 2007 г., т.е. преди 12 години. Със сигурност д-р Кендрик вече има какво още да каже по темата. Но благодаря, че направихте холестероловата хипотеза на пух и прах, д-р Кендрик. Книгата ви ми хареса.

[Tara · Rating 1 out of 5]

I've tried and failed to finish this book twice - I'll try reading it again at a later point. His style of writing was extremely irritating, it was too chatty without giving me facts. The studies he used (at least up to the point I read to) were mostly ~10 years old, making them about 20 years old now - bit out of date for medicine. He has different views than the majority of people working in healthcare, but it's great that we have doctors that are truly invested in research and are willing to question pharmaceutical companies. However, I wish I hadn't bought this book.

[Debra Faust-Clancy · Rating 4 out of 5]

Best book on why NOT to take statins and an a good expose on publish or perish for the medical field.

[Joe · Rating 5 out of 5]

Recently a Cholesterol test showed that I had a reading of 7.59 of which only 1.49 was "good" HDL and the remainder "bad" LDL.

The nurse suggested I speak to my GP about statins. I started to read this book due to my concerns about my imminent death and the alternative fate worse than death - being a healthy slim 33 year old talking statins for the remainder of my life (albeit a very short due to the high cholesterol).

This is what I learned:

In men, across the entire age range… and in women from the age of 50 onward only, low cholesterol was significantly associated with all-cause mortality, showing significant associations with death through cancer, liver diseases, and mental diseases.

So I may be more likely to die of heart disease but I am less prone to a number of other conditions. The impact on my actual life expectancy of this test is minimal.

Low serum cholesterol concentrations (4.8mmol/l), present in 5% of the men, were associated with the highest mortality from all causes, largely due to a significant increased in cancer deaths. ...

So I am actually less likely to die than someone with a "healthy" cholesterol. Not sure why the NHS are spending £1 billion a year on Statins when there is so much evidence to the contrary. I'm sure it cannot be corrupt and driven by the drug companies because money never clouds people's morals or decision making. Ever.

During the first ten years of follow-up… men with high cholesterol levels had lower all-cause mortality… because of their low cancer mortality and residual mortality.

So again, I'm more likely to be alive in 10 years than someone with low Cholesterol.

The lowest mortality rate was at an average cholesterol level of 7.0mmol/l, and the highest mortality rate was at an average cholesterol level of 4.0mmol/l. At this level, the mortality rate was 5.2 times higher than at 7.0mmol/l.

Brilliant, so I'm actully very close to the optimum range and 5.2 times less likely to die than a "healthy" person.

Under the age of 50, your cholesterol level doesn’t really make much difference to your risk of dying. However, if your cholesterol level starts falling, watch out. You are at a terrible risk – a 429 per cent increased risk of death per 1mmol/l cholesterol drop, according to the Framingham Study.

On this basis I will actually keep my Cholesterol nice and high. I don't want it to drop and increase the risk of death by 429%.

After the age of 50, a low cholesterol level is associated with a significantly greater overall mortality. The older you get, the more dangerous it is to have a low cholesterol level.

Lets hope I keep my dangerously high cholesterol levels well in to my 50's.

Here is the latest "mis"guidance from my private health insurer.
In recent years, the established link between fat, obesity and cardiovascular disease has been challenged. High-fat diets (such as the Atkins diet) have helped some people lose weight. And recent reports have questioned whether saturated fat really raises the risk of cardiovascular disease – some experts believe high cholesterol may be less important as a marker of heart risk than was once thought. Other research has suggested that full-fat dairy may actually be cardioprotective – instead, some scientists suggest, it’s high-carbohydrate foods that are behind the rise in obesity, type 2 diabetes and heart disease, with our sugar intake a particular culprit.

While excess sugar is certainly harmful, the weight of evidence clearly suggests we should also limit our intake of processed and saturated fat, which most studies have shown push up cholesterol and the risk of cardiovascular disease. Ultimately, it’s not a question of fat versus sugar – too much of either can have a negative effect on your health.

Do I need to eat fewer eggs?

Dietary cholesterol, found in foods including eggs and shellfish, actually has little affect on blood cholesterol levels, so there’s no need to avoid it, unless your doctor has advised you to. If your cholesterol is already raised, you may be prescribed a medicine called a statin to lower cholesterol.

So they say that eating fat may be healthy and eating cholesterol has little effect on blood cholesterol, but at the same time you should cut down on fat and sugar (and eat what, recycled paper??).

[Brenden · Rating 5 out of 5]

Wow, I absolutely loved reading this book. Absolutely dripping with entertaining yet informative sarcasm. I really liked that it not just poo-pooed the cholesterol hypothesis, with plenty of counter-evidence, but then put forth a new hypothesis regarding stress and supported it with more evidence.

[Omikun · Rating 3 out of 5]

I really did not like the tone of the writing. It was too casual and filled with fluff. I didn't want to trust it because it tried too hard to sound like a close friend or something. But I do appreciate how deep it goes to explain the mechanisms underlying heart disease and how statin does not change overall mortality for the young or men who have not had heart disease before. Very useful overall and I recommend it. But I'll be doing more research before I take any actions because... I find it very hard to trust the author.

[Julie Hotchkiss · Rating 5 out of 5]

Robust dismissal of the heart / diet relationship

I have been working in Public Health for the last 30 years. I now find out that what I held to be proven in relation to cholesterol levels and cardiovascular disease is nothing of the case. It will be hard to break out of the mindset that a fatty diet leads to atherosclerosis. I now need to read up on the details of how statins lower (or not) mortality.

[Miranda · Rating 5 out of 5]

Another great read from the cheeky and brilliant Dr Kendrick! I would highly recommend this book for anyone that wants an easily digestible synopsis on the diet-heart hypothesis, why it’s wrong, and what we really should be focused on.

[Glyn · Rating 3 out of 5]

I'm afraid I had to abandon this one. I couldn't get on with the writing style. Whilst it seems approachable and not too science-y, some points are skipped over with insufficient exploration, whilst others are laboured well beyond what's necessary.

[Lynette · Rating 5 out of 5]

Absolutely brilliant, even though is doesn’t work on any level as an audiobook.
Paperback ordered so I can highlight away.
This will alter my clinical practice immensely.

[Judy Osowiecki · Rating 2 out of 5]

Disappointed

The book started off ok but then just dumped "stress" as the cause of heart disease. I expected more science and possible solutions.

[Mskychick · Rating 1 out of 5]

This book is nearly worthless. There’s a little bit of data and a metric ton (see what I did there?!) of hyperbole. Don’t waste your time.

[Michael Haseloff · Rating 5 out of 5]

My doctor is not going to be happy with me.😱😁

[C.L. Spillard · Rating 5 out of 5]

"The Japanese eat less fatty food than the English, and have fewer heart attacks.
The French eat more fatty food than the English, and have fewer heart attacks.
The Chinese drink less beer than the Americans, and have fewer heart attacks.
The Germans drink more beer than the Americans, and have fewer heart attacks.
Conclusion: eat and drink what you like: it's speaking English that kills you!"

It's a joke, right?

I mean everybody knows that eating more fatty food gives you high cholesterol, and makes it more likely you'll be felled by a heart attack. Or indeed by a host of other ills. It's 'a truth universally acknowledged'...

Well, it's bunk.

And our lad from Scotland, home of the Deep-Fried Mars Bar no less, has the figures to prove it.

After taking the reader through a detailed but user-friendly tour of heart attacks, cholesterol types (and how they're measured), how Statins - today's drug of choice for addressing the 'problem' - come in, and how the theory behind them ("Fatty foods increase cholesterol level, which in turn increases the chance of heart attacks") came into being, Kendrick poses an alternative theory for the cause of changes in heart attack rates in populations all over the world.

Why, for example, did the healthy and clean-living Finns suddenly succumb to heart attacks in large numbers in the '60s? Why did Glasgow's heart attack numbers surge a decade later, when their diet had hardly changed? And what about the high casualty rate among Australian Aborigines - not exactly notorious for tucking into bacon butties and chips?

Spoiler - it isn't speaking English.

What I really love about this book is that Kendrick doesn't mince his words. One minute he'll be analysing the best and most thorough medical statistics (with references from peer-reviewed studies), the next he'll cheerfully round off the expert debunking of a well-loved bit of 'truth universally acknowledged' with phrases like "Hello? Cause and effect?" Or when he teases out one of the many contradictions in the present theories it'll be: "Freedom is slavery - George Orwell to the rescue."

I might add that the scientific skullduggery on page 67 is something to behold. It's the sort of thing that turns up in Ben Goldacre's 'Bad Science' (which I also recommend, by the way).

Let me close with the reason why I, personally, reckon we should all think twice about Statins, cholesterol, and hearts - and why this book is so important:

I am your canary in the coal mine: an 'Extreme' heart patient. By that I mean I had life-saving heart surgery back in the days when the chances of its giving a child even just a few extra years of life were less than 50-50, and the lucky patient had to be chilled down so far that the external blood circulation was done using an adapted ice-cream machine (I kid you not: it was made in Croydon, and it's now in the Science Museum).

Every year since then, I've attended check-ups where careful measurements are taken to make sure that nothing's putting my heart in danger. Teams from all over the country have done this as I've moved about following my career. Dozens of top cardiologists and surgeons.

And of all these people none - not one - has even so much as mentioned cholesterol, or statins.

[Иван Гърков · Rating 5 out of 5]

Хипотезата за това, че високият холестерол предизвиква атеросклеротични плаки и респективно сърдечно-съдови заболявания отдавна е отхвърлена. Масово всеки гледа да поддържа нисък холестерлът, консумират се все по-малко мазнини и масово се предписват статини за свалянето на холестерола. В същото време над 25% от общото количество холестерол в тялото и над 2% от общото тегло на мозъка е холестерол. Ако искаме мозъкът ни да функционира както трябва, това изисква холестерол. Холестеролът също така е важен и за правилното функциониране на синапсите, които осъществяват връзките между невроните и по този начин се предават сигналите от неврон на неврон. Мисля че ще ви е интересно да разберете, че ниският холестерол е свързан със значително увеличаване на риска от получаване на исхемичен или хеморагичен инсулт. Този и много други интересни факти може да научите в тази мини енциклопедия по ''защо хипотезата за холестерола е пълна простотия''. Авторът се спира на всички основни аргументи и хипотези, поддържани най-вече от фармацевтични компании продаващи лекарства за намаляване на холестерола и буквално ги унищожава с посочване на множество научни данни и проучвания, и позовавайки се на човешката физиология. Препоръчвам!

[Jim Gilmour · Rating 4 out of 5]

Firstly I listened to this on audible so technically didn’t ‘read’ it. This was intentional because I knew I would get bogged down trying to follow the sciency bits so it was easier just to listen. Having said that I’d much preferred if Dr Kendrick had read the book in his highly intelligible Scots lilt if only to pronounce Cumbernauld properly. I imagine it’d have been better with his own voice.
Regards the content I was able to digest and appreciate his arguments and be convinced of them by the end of the book. Parts of the book were easier to follow than others and I’d say you’d need to really want to understand these issues to want to read the book. There’s something here for both the medically trained and for the average non medically trained such as me, who can get the gist of the argument without needing to fully understand the mechanisms of the science.

[Laurena Mary · Rating 4 out of 5]

Having been prescribed statins because my cholesterol level was a little high, and having had quite upsetting side effects from the drug, I began to wonder if there was another side to the statin story - were they as safe and as useful as we had been told? Was there anything I could do instead to take control over my own health?
This book was recommended on Amazon because of its style, and from that point alone I would recommend it myself. There is a jokey, quite sarcastic style to it (which makes the diagrams, technicalities and acronyms more palatable - I don't think I would have finished it otherwise.) Dr Kendrick is a GP so this book is written from a medical point of view, and his research is backed up with links so that you can look up his evidence yourself.

[Sam Burrell · Rating 4 out of 5]

Overall excellent book. Well written, easy to read, well cited. Debunks and lifts the lid on the scam of cholesterol and statins very well. High cholesterol is healthy! It always was and always will be. It’s a terrible predictor for heart disease and a low cholesterol leaves you with a much higher risk of developing cancer. Just it must be noted, the last chapter is well meaning but poor. The role of stress in heart disease is greatly over stated. It’s diet, oxidised LDL in your adipose tissue. Consuming omega 6 polyunsaturated fat in excess via seed oils is a huge contributor to heart disease. Overall though a good book, gets much closer to the truth than a lot have done and it’s pretty funny too

[Ange · Rating 5 out of 5]

This book confirmed what I instinctively knew. Chronic stress causes heart disease and not cholesterol. I was diagnosed with heart disease last year and have had doctors insisting that I need to take statins for slightly elevated cholesterol levels. As Dr Kendrick states “statins do not save lives in women”. I took statins (I wasn’t given a choice whilst in hospital) for a few months but felt like they were killing me so, I stopped taking them. Best thing I did. Cardiologist and other doctors I have dealt with are so fixated on prescribing statins that I have to dig my heels in all the time. I will NOT take statins ever again.

[Becky L Long · Rating 5 out of 5]

audiobook. add this one to the "everyone should read this" shelf. if you like your facts with a healthy helping of sarcasm and humor this is the book for you. if you just want the facts this book won't disappoint. note if you can only read one of Malcom Kendrick's books I do think The Clot Thickens was more entertaining and was read by the author so his true feelings really came through in his voice. but you'll love it so much you just won't be able to help yourself and jump right into this book ..... well ..... it may take a year like it did for me but hey there’s a lot of distractions out there.

[Nora Chouko · Rating 5 out of 5]

For anyone who has been put on a statin drug or told their cholesterol levels are too high, this is a MUST READ! Who decides what the safe levels are? You will be shocked, appalled, and disgusted. It's a con all right. Who conducts the studies? Researchers paid by drug companies selling the statins. How do they get those studies to come out in their favor? Discard the studies that show how unsafe the drugs are. Doctors don't have a clue.
Truly a remarkable book, well written, researched, and told with a dry wit that made me chuckle even as I vowed to make sure I never go on a statin.

[Alison D · Rating 5 out of 5]

Excellent apart from reading medical terminology, it has put forward some interesting facts which can be sourced on any search engine. It shows how money can influence prominent medical scientists into following a certain path(same with climate change) however I digress. Wonderful sense of humour throughout (sarcastic at best) it helped me & husband to decide not to take statins but to reduce stress, eat more wisely & exercise.
Plenty of evidence and some facts I'd never encountered, well worth the read.

[Adam McKenna · Rating 4 out of 5]

Some interesting points and compelling arguments. The man also comes across like a bit of a nut. A funny nut, but a nut all the same.

He gives a compelling argument that saturated fat and cholesterol most likely aren't the cause of heart disease (he alludes to the fact that it may in fact be healthy, which feels less compelling).

The counter-argument is that stress, and not nutritional at all, the main cause of heart disease.

I'm not sure how I feel about it, but it's good food for thought.