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Why hasn’t my healthy diet cut my cholesterol?

Tuesday’s Daily Mail has a section called “Good Health” and the resident GP answering questions is Dr Martin Scurr.

On Tuesday 26th June 2012, Susan Bence emailed in to say:

“Twelve months ago, I had a cholesterol test that indicated a higher than acceptable cholesterol level of 5.5.

I took immediate action, lost one-and-a-half stone in weight, began walking 30 to 40 miles a week and completely changed my diet.

I now no longer eat red meat, sausage, bacon, cheese or chocolate, and have increased the amount of fruit, fibre and oily fish I consume.

However, a test last week showed that my cholesterol level remains slightly high at 5.5.

Is there anything else I can do to reduce this?”

You can read Dr Scurr’s reply here:

Dr Scurr’s reply

I would like to make a few comments on Dr Scurr’s reply and then give Susan an alternative reply to consider…

Dr Scurr says: “Your cholesterol level, at 5.5 mmol per litre, is only just above the recommended top end of the normal range.”

Your cholesterol level is, in fact, completely normal. Here’s an extract (in blue) from my book The Obesity Epidemic: What caused it? How can we stop it?

“The average cholesterol levels for England were reported by the National Health Service (NHS) as 5.5 mmol/L for men and 5.6 mmol/L for women. (Ref 1) The NHS further noted that “two out of three adults have a total cholesterol level of 5mmol/L or above”. I found the BBC statement of the position statistically implausible: “The average total cholesterol level in the UK is 5.5mmol/l for men and 5.6mmol/l for women, which is above a normal level.” (Ref 2) What is the average, if not the norm? Even if we get into the detail of the mean, median and mode, surely the average for a data group defines normal for that data group. The notion that an actual norm is somehow abnormal – because it has been decreed to be as such, makes no sense. The normal distribution curve sets a norm by definition. For us to declare the actual cholesterol norm to be abnormal, is not normal in itself. This would be like suddenly declaring normal blood pressure to be 100/60 and not the normal distribution norm of 120/80, because we picked the number and declared it to be so.

In the Western Journal of Medicine, (May 2002) Thomas Samaras and Harold Elrick posed the question “Height, body size and longevity – is smaller better for the human body?” (Ref 3) The study took 100,000 males from six different ethnic populations – in the same city (California) to try to normalise other factors. The table had the following height orders (tallest first): African Americans; White Americans; Hispanics; Asian Indians; Chinese and Japanese (the first two groups were recorded as of equal average height – 70 inches). The age standardised death rates for all causes and coronary heart disease were included in the table. A clear pattern was immediately obvious. I calculated the correlation coefficients as 0.85 for height and CHD and 0.9 for height and all causes of death. What if we concluded that height were a cause of CHD (and all causes of death) and that we should therefore redefine the average height to declare the actual average of 69.7 inches (for all American men) to be abnormal. What if we picked an arbitrary new target 10% lower than the actual average (5.0mmol/L is approximately 10% below the actual cholesterol norm of 5.5mmol/L) and decreed that normal height should be approximately 63 inches. We could then stop the body from performing a normal bodily function (growth) by administering drugs to stop growth hormones from doing their job. I trust that this analogy disturbs you. The Chinese practice of foot binding – an artificial intervention in the normal development of the human body, to achieve an artificial ‘norm’ – was thankfully outlawed in the early twentieth century, but trying to reduce the normal cholesterol level continues.”

Dr Scurr says: “However, some individuals, no matter how rigorous they are with their diet, are unable to get their level down into the normal range.”

a) Susan is in the normal range b) diet has nothing to do with blood cholesterol levels (Ancel Keys: “There’s no connection whatsoever between cholesterol in food and cholesterol in blood and we’ve known that all along. Cholesterol in the diet doesn’t matter at all unless you happen to be a chicken or a rabbit.”)

Dr Scurr says: “This, as you know, is a frustrating situation, and is due to the liver naturally producing too much cholesterol.”

The body is designed to produce cholesterol. Not only the liver produces cholesterol – every cell of the body produces cholesterol. This is because cholesterol is so utterly vital for human life, we die instantly without it, that the body must have fool proof mechanisms for making cholesterol.

Dr Scurr says: “Although we do get cholesterol from food, most is made by the liver, and it is our intake of foods high in saturated fat that is thought to increase levels of ‘bad’ LDL cholesterol (the material that causes havoc with our blood vessels), though we are still unclear exactly how it does this.”

OMG! How many things can a doctor get wrong in one sentence:
a) There’s no connection whatsoever between cholesterol in food and cholesterol in blood and we’ve known that all along.

b) LDL stands for Low Density Lipoprotein. LDL is not cholesterol, let alone bad. LDL carries cholesterol and protein and triglycerides and phospholipids. How a carrier of four substances ends up being called one of them, I know not.

c) LDL is the residue of IDL (Intermediate Density Lipoprotein); IDL is the residue of VLDL (Very Low Density Lipoprotein). LDL, IDL and VLDL are all lipoproteins (think of lipoproteins as ‘taxis’ that transport cholesterol, protein, triglycerides and phospholipids around the body to do their vital, life saving work). Another lipoprotein (the largest) is called a chylomicron and this transports dietary fat from the digestive system around the body to do its vital work. How any dietary fat, saturated or otherwise, leaps out of chylomicrons and finds its way into VLDL and then IDL and then LDL “to cause havoc in blood cells” is not only unexplained, it is ludicrous!

d) The most interesting bit in the sentence is “we are still unclear exactly how it does this.” Quite so! Not only is there no evidence that dietary fat does impact LDL, there is no understanding of how exactly it can!

Dr Scurr says: “Treatment with a statin to lower your cholesterol level might be advisable…”

Dr Malcolm Kendrick says (p160 The Great Cholesterol Con) “Statins do not save lives in women. Statins do not save lives in women. Statins do not save lives in women. Is it possible to highlight how important this fact actually is? Statins do not save lives in women.”

Susan needs to know what statins actually do in the human body. The body is designed to produce cholesterol. Human life depends on the body doing this. Statins impair the body from producing the cholesterol it was designed to make. Thankfully statins don’t work fully, or they would have a 100% death rate.

Statins block something called the mevalonate pathway. This is catastrophic. Blocking the mevalonate pathway means that no cell can replicate or repair itself. Blocking the mevalonate pathway means that every cell in the body dies. The only thing that varies is how long each cell takes to die – some take more time than others.

My letter to Susan would therefore be as follows:

Dear Susan

Your cholesterol level is completely normal. You do not want to lower your cholesterol level in any circumstances. You may like to look at the graphs on this blog – I have done some original research with all the World Health Organisation data available for 192 countries. It shows that (read this carefully) the lower the cholesterol levels the higher the death rates from heart disease and all causes of mortality for both men and women; the higher the cholesterol levels the lower the death rates from heart disease and all causes of mortality for both men and women.

Cholesterol is utterly life vital. We die instantly without it. We need it for every single cell of the body, the muscles, the brain, hormones, bile production, fat digestion, reproduction – it simply cannot be emphasised enough how vital cholesterol is.

It is so vital that the body makes it – the body cannot afford to leave it to chance that we would need to get cholesterol from our diet. This makes cholesterol even more vital to the body than essential fats and protein – as we need to eat these.

Your body makes the cholesterol that it needs. If you were to get pregnant, your body would make extra cholesterol because you need lots of cholesterol to make a healthy baby. If you had an operation or an injury, your body would make extra cholesterol to repair you – because that’s what cholesterol does – repair you.

One statin alone, Lipitor, has been worth $125 billion to Pfizer since 1997. (Ref 4) This statin is the most lucrative drug in the world. It is not the only statin. There is huge financial benefit to statin manufacturers to try to artificially lower your cholesterol level. There is likely no benefit to you and substantial harm.

Statins stop the body from making the cholesterol that it was designed to make (not entirely, or they would have a 100% death rate).

Statins block something called “the mevalonate pathway”. This is catastrophic. Blocking the mevalonate pathway means that no cell can replicate or repair itself. Blocking the mevalonate pathway means that every cell in the body dies. The only thing that varies is how long each cell takes to die – some take more time than others.

Assuming that you had weight to lose, losing one and a half stone will have been beneficial for your health. Walking is also an excellent activity to have chosen – natural and enjoyable and this should have given you further health benefits.

Red meat from grass living animals is the healthiest food that humans can consume. It’s what we evolved to eat. Giving this up will have worsened your health and you may have lost vital complete proteins, essential fats, vitamins and minerals as a result. Giving up any processed food (including processed meat, which sausages and bacon tend to be) is always a good idea. Cheese is a vital source of calcium, phosphorus and magnesium (the bone nutrients, so vital for women to avoid osteoporosis), as well as fat soluble vitamins and protein, hence your health may also have suffered as a result of this random decision. Oily fish actually has more fat overall and more saturated fat than red meat (Ref 5). Not that any natural dietary fat is bad for you, but just to point out that you may not have achieved what you set out to achieve for whatever misguided reason. The only bad fat is the one made by man and found in margarines, spreads and many processed foods.

Do not worry about your cholesterol level. You should revere, not fear, cholesterol. The average GP knows frighteningly little about cholesterol, as Dr Scurr has illustrated.

The Hippocratic oath taken by doctors is “First do no harm”. In my opinion, doctors administering powerful drugs to stop your body doing what it was designed to do and to block the mevalonate pathway is not only in breach of the Hippocratic oath, it is medical malpractice.

Very best wishes – Zoë

p.s. if anyone knows Susan Bence, please send her this link. Her life could literally depend on it.

[Ref 1]

[Ref 2]

[Ref 3] Thomas Samaras and Harold Elrick, “Height, body size and longevity – is smaller better for the human body”, Western Journal of Medicine, (May 2002).

[Ref 4]

[Ref 5] 100g of sirloin steak (USDA database) has 71g water; 0g carb; 21g protein and 5.4g fat (of which 2.1g is saturated)

100g of mackerel (USDA database) has 64g water; 0g carb; 19g protein and 12.1g fat (of which 3.3 is saturated).

113 thoughts on “Why hasn’t my healthy diet cut my cholesterol?

  • Hi Zoe, I’ve just been diagnosed with a very high cholesterol of 9. I’m a 61 year old female and have always been healthy and active. So I was shocked to find out it was so high. My problem is being on a low fat diet. I’m 5’6″ tall and weigh just under 9 stone. My doctor has put me onto statins two months ago. I took them for a month but felt achy and groggy on them so I stopped taking them a few days ago. I used to eat lots of butter on everything, I’ve reduced it drastically in my diet. I’ve cut out cake, biscuits and chocolate but I’m now losing weight and I can’t afford to. How can I retain my weight and cut out the fat in my diet.

    • Hi Lyn – this is my definitive post on cholesterol and statins (

      Was the reading of 9 taken at the end of the winter? Would your body be making extra cholesterol for a reason right now? The post explains all.

      The low fat/high carb diet is likely doing more harm than good. One of the components of total cholesterol is something called VLDL – that’s one that may be worth worrying about and it’s raised with carb intake (Elizabeth J. Parks, “Effect of dietary carbohydrate on triglyceride metabolism in humans”, The Journal of Nutrition, (2001).)

      Cutting out cake/biscuits and chocolate is great – they’re junk that no one needs. You (everyone) should eat real food: meat; fish; eggs; dairy products; vegetables; fruit in season; beans & pulses; nuts & seeds; grains. To avoid losing weight, mix fat/protein foods with carb/protein foods e.g. porridge with cream/full-fat milk; oat biscuits with cheese; steak with baked potatoes etc.

      Best wishes – Zoe

  • Just what I had thought, so pleased that I am normal, all my bloods are normal, I eat a healthy diet and took myself off statins, my cholesterol was 7.8 before i started taking statins, which I took for 6 months: I stopped because I didn’t like the side effects, one year on from stopping the statins and eating an even healthier diet plus exercise I’m still 7.8 I think I will stick to no statins and a cholesterol level that is obviously what is natural for me, with no interference from a drug that is clearly not good (for me). We are all individuals thank God, different shapes, different sizes, why the hell does our cholesterol have to be 4 or below?

  • Dear Zoe
    I have a couple of questions please.
    I am 52 yr old female, moderately active, 5’4 and weigh 70kg. I have just bought your books and am about to start your diet. My last lipids test showed my overall cholesterol to be 7.8 of which my LDL was 5.8. I have a family history of raised chol and was wondering how your diet might affect my risks of heart disease?

    Another unrelated question is that I like to use the Veetee cooked rice for convenience since I live alone. They do a brown version but I am not sure how 50g of uncooked rice equates to cooked rice – would you have any idea please?

    Thanks Sue

    • Hi Sue
      I recently did this post for statin/cholesterol queries

      The key thing about The Harcombe Diet is that it recommends real food and not processed food. I can only see that helping every aspect of health – heart, cancer, mind and all sorts! We were not designed to eat junk :-)

      I’ve just looked at the Veetee rice here ( You can use calories as a conversion (about the only thing they’re useful for!) 50g dry weight is c. 185 calories – so look for about that amount of the Veetee stuff.

      Good luck with the diet!
      Best wishes – Zoe

      • Great thanks Zoe! That’s some bedtime reading for me – I used to be a nurse doing so called ‘health checks’ on patients for many years. I dished out the standard advice as I was trained and as per protocols, so I read with much interest and am starting to rethink much of what I’ve been taught! As I’ve hit the menopause keeping weight under control using all the usual methods that used to work for me, has become impossible, so that’s why I’m changing tack and trying understand what is going wrong. A friend of mine has recently lost a good bit of weight with your diet so thought I’d look into it a bit more. I’ll be spreading the word if it works for me.

        Thanks also for the Veetee advice – that’s helpful – didn’t want to mess up the plan by getting my calcs wrong!

        Best wishes

  • Hi Zoe, so glad I came across your blog today re Cholesterol. Recently both my husband and I have been told we have high cholesterol and we are certainly taking measures to modify our lifestyle (we sort of knew we had slipped into some bad habits and it was a wake up call we were happy to embrace)After 8 weeks my husbands cholesterol showed to be higher and so I was seeking an answer and fell across your site. I will be reading avidly over the next week or so everything you point to and link to and just wanted to say thanks – almost everything you say we have been echoing for years but without any substance other than gut feeling and common sense….. once again thanks…

  • Hi Zoe,

    Ten years ago when I was 32 my doctor wanted to start me on statins as my cholesterol test came back at 7.2. I refused and said I wanted to try and bring it down naturally by changing my lifestyle. Since then I’ve given up smoking and drinking, I don’t eat salt or sugar, I eat only pasture fed meat, I eat fish 2 to 3 times a week and I eat between 7 and 10 fruit and veg a day. I don’t eat processed foods or any artificial additives. I also exercise daily and run regular 10k’s and half marathons. I’m 5’8”, 150 lbs, and have 14% body fat. I was feeling happy, fit and healthy when my doctor asked me to go for my NHS health check a couple of weeks ago. To my disbelief my cholesterol results came back even higher at 7.8. My doctor then immediately booked me in to the lipids clinic for further testing. However he also said my overall risk of heart disease or heart attack over the next 10 years is only 2.3% but because of his reaction to my cholesterol results I’m now worried. Any reassurance would be great!

    • Hi Alex
      I don’t know if you’re a female Alex or male. If female there’s no evidence that statins would give you any ‘benefit’ whatsoever and you’re of child bearing age so I won’t write what I think of statin recommendations for those who may want children. If male – do statins impact sperm? They must do – not really thought about it before. Not sure I’d want anyone on statins near my eggs anyway! Just one thing to think about.

      Here are some more:
      1) Your cholesterol is entirely normal – as defined by the normal distribution. The medical profession/drug industry is trying to redefine normal. This may help

      2) If you’re a male, in your 50s (you’re not) and you’re already had a heart attack (I’m guessing you haven’t) – these are the cold facts for the highest risk group possible
      98.2 will get no benefit and all are at risk of the side effects.

      3) Assuming you live in the northern hemisphere – your cholesterol will naturally be higher now than at any other time of the year. As soon as you see the sun shine – expose limbs and you will turn cholesterol into vit D – the Vit D will give you health. The lower cholesterol is just an unavoidable consequence of making vit D.

      Hope these help – check out these blogs for more reassurance

      Best tip of all – don’t go near doctors unless you’re ill!

      Best wishes – Zoe

      • Thank you ever so much for your reply there is a lot of good information and a lot of reading there for me. I already feel more assured.

        I’m not sure if this has any relevance but I am a British male my mother was English and she died in 2001 at the young age of 62 my dad was half Chinese half Russian, he also died at 62 in 1988. Both of them lead very unhealthy lifestyles, they both smoked, and eat all the wrong things and too much of them. They also didn’t ever do any exercise. My dad died of emphysema and my mum died of a heart attack, she had been diagnosed with angina. What worries me is that i’ve been told high cholesterol can be hereditary so even though my mum was unhealthy could i also be more prone to heart disease?

        Also as i train quite hard could weight lifting and pushing my body to its limits for example running half marathons cause higher cholesterol as my body will need more repair than the norm?



        • Hi again
          High cholesterol can be hereditary. Heart disease can be hereditary. The two are not necessarily related! I would worry far more about heart disease in parents than whatever their cholesterol levels were. I would expect smoking/lack of activity and poor diet (and possible relocation for dad?) to be of far greater importance than some arbitrary body measurement. Looks like you’re already avoiding poor lifestyle choices so you should be much reassured by that.

          Yes – the body makes more cholesterol when it needs to do more repair/building. That’s why pregnant women make more cholesterol/people who’ve had surgery/an injury/an infection/an illness etc make more cholesterol – if you “push your body to its limits” it will need to continually repair and it will make more cholesterol to do this. Why push your body to the limit? Do good activity like walking/swimming/gardening – don’t do the excessive stuff maybe?!

          Best wishes – Zoe

          • Hi Zoe,

            I visited my doctor yesterday who informed me my last blood test (last Oct 15) showed I had slightly high cholesterol – 6.1. At the time I was told it was normal.
            I’m male, 35, 5ft 6″ and 11 stone. I also normally watch what I eat and pretty active. (I run Marathons, go on long distance cycles etc)

            Recently, I’ve stayed off any alcohol for five weeks, cut out tea, coffee and fizzy drinks and generally try to eat my 5 a day.

            I’m a little concerned that the high cholesterol could be hereditary as my father passed away from a heart attack when he was 45. Would you recommend I went for any further tests to do a thorough check up? (reading your post above makes me slightly distrusting of my GP)

            Many thanks,


  • I am 5 foot 2 and weigh about 125 pounds. I am a very active person, and I am 49. I have a family history of heart disease, my mom had super high cholesterol, and my dad hand low cholesterol. They both had heart disease and were on Statins for years. My brother was put on statins and it damaged his liver. I was put on Statins. My last cholesterol test was 280 and LDL 200, Hdl 65 and trig 65. I have been struggling with rising blood sugars (ever since beginning the statin) I dumped the statin. Oddly the doctor said I need the statin because my blood sugars fasting are about 105. I don’t understand how a drug that causes high blood sugars be good for my heart. I also ditched the low fat diet. The worst thing I eat is a little bit of sausage or salami. on top of a salad. I too wish the doctors would stop measuring cholesterol. IT doesn’t seem to matter what I do, it’s always high, unless I take statins.

  • Hi I was hoping for your opinion, struggled with cholesterol since I was 5. I am now 35, I have been on and off statins since I wAs 18. I was just put back on Lipitor last week, cholesterol 243, ldl 171, hdl 43, trig, 133. I weigh 133 lbs, what I don’t understand , was I started working out. ( 3 to 4 hours a week ) and eating better and the results got worse. What I am afraid of is what will my arteries look like in 20 years if I don’t take this med?????? Or should I be concerned now ??? And what should I eat??? I have tried to eat more chicken, fruits, and vegetables. My breakfast consist of an apple and fiber one bar every morning, I do like to eat out. Any suggestions???

  • I’m a 62 year old female. I eat healthy, exercise vigorously for at least 30 minutes a day. I’ve always had cholesterol in the 250 range and was told yesterday that it’s now almost 300. I’ve refused statins for years at the utter distain of my doctors. Now my doctor has prescribed Welchol – apparently this new drug lowers cholesterol without interacting with the liver. Although I’ve read everything posted here, I’m still concerned – I suppose it’s from years and years of being told that not treating high cholesterol is like playing russian roulette. Why are doctors still so adamant about prescribing these drugs? Can you comment on Welchol, because I would like to have educated comments for my Dr. when she reads me the riot act at my next appointment.

    • Hi Lorraine – I don’t know much about Welchol other than that it also has a role in lowering blood glucose levels, which is messing with your body’s normal operation of insulin/glucagon and natural glucose regulation. That can’t be a good idea. I would never mess with my body’s natural production of cholesterol in any circumstances. Maybe take these diagrrams into the doc:

      For women especially – higher cholesterol is associated with lower heart deaths and lower deaths from all causes. I would put money on your doc dismissing this because they are so entrenched. I don’t go to docs unless I have to!

      Best wishes – Zoe

  • Hi Zoe
    I am a South African of Indian origin. I am on a low carb high protein diet. I am on Simvastatin 20mg and my cholesterol level was around 4.0. I stopped taking Simvastatin for a few weeks and continued on my diet. I went into my pharmacy on Saturday and did a quick pin prick test on my finger for cholesterol and guess what! My cholesterol reading was 15.6mg. I was devastated! Should I be worried? I am back on Simvastatin and do not like it one bit! Please, please advise!!!

    • Hi Michael
      I can only guess that the 15.6 reading was wrong. There is a known c. 20% error on such tests ( If you’re on statins, you’ll have a doctor so you need to see him/her. I see cholesterol readings as the body telling you something ( a marker – not a maker) – what could your body be trying to tell you if it has gone up? Your body has made more cholesterol for a reason – are you ill? fighting infection? have you had an injury? operation? are you stressed? 15.6 is high on any scale so you do need to get to the bottom of this – don’t just silence what your body is trying to tell you with statins!
      Good luck with the doc
      Best wishes – Zoe

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  • Hi im on atorvastatin for high cholesterol.. since taken this medicine I have suffered very hot feet
    and tingly as well. Could this be the statins…

  • My TC = 280 , LDL is high 100 and HDL is low = 45
    I have quit alcohol 2 years back but my Lipid shows high GGT (58) and SGOT (118) i am now having low diet and low fat food. If i control this by reducing weight, diet and exercise and then after can i start having normal food, normal life style or i have to take care entire life?
    Is 280 is very high?
    Age = 35 , Male

    • Hi Raj
      I would prescribe you a lot of reading! The Great Cholesterol Con by Dr Malcolm Kendrick. Uffe Ravnskov Fat & Cholesterol are good for you and Ignore the Awkward. Natasha Campbell McBride Eat your heart out. Jonny Bowden, Jimmy Moore, Duane Graveline and anything along these lines.

      This blog may reassure you that the biggest worry is low cholesterol:
      And even if high cholesterol were a cause of anything, which it isn’t, yours isn’t high!

      Stress is a genuine risk factor in heart disease so I wouldn’t worry about your perfectly normal cholesterol – worry might harm you!
      Best wishes – Zoe

  • I have been told my cholesterol is 7.1 and doctor recommends a low fat diet.

  • Hello Zoe, so helpful readig yours and other comments on cholesterol. I am a very fit 74 lady with type 2 Diabetes — because my total Cholesterol is 5.22 and my Glucose level is 7.22. I have never taken pills for anything and dont want to start now! However my nurse is angry with me and i get the impression i will be dead in a month if i dont start on her meds — Atorvastin and oral Glucophage. Please, are my levels too high?? I am truly worried. Nurse says not to go back to see her if i dont do as she says!!Many Thanks Jo

  • My cholesterol: 7.5
    Tryglycerides: 5.6
    I’m also on bp meds micardis for mod bp 140/90 I was a healthy 65kgs a year ago but after the bp meds I’ve gained 15 ks and I feel dreadful.i suffer with PTSD and I feel soo bad because my Dr’s said if you want to die early then don’t take the lipidil and crestor!! He also said I’m printing your results out for you to take home and keep so you can’t sue me when you die..omg I was so shocked I cried when I got in the car and drove home..Please help me.
    Thank you.

    • Hi Kerry – In my view you are a victim of medical intervention.

      Your starting BP was normal ( not high. But normal has been redefined as high for BP (just as it has for cholesterol). You are then put on BP meds, that your normal reading says that you don’t need. We know that BP meds can cause weight gain (different meds work in different ways and can be more or less obesogenic). 15kgs is one of the worst gains I’ve heard of and it is unlikely that the meds are directly responsible for that amount but indirectly responsible is quite possible. You may gain some kilos with the meds and the general ‘dulling down’ action of BP meds can make you feel less inclined to do things – including eating well. You can then gain more as you feel understandably upset with the initial weight gain and a vicious circle ensues.

      The meds you didn’t need in the first place have started a chain of events. Your cholesterol is not high at 7.5 and the test is not accurate anyway etc and you are at the end of the winter and so cholesterol hasn’t been turned to vit D etc. If your cholesterol has gone up for you personally – weight could be the cause of this. You can take this extract from my current research to your doc:

      “Denke et al reviewed the association between BMI and serum cholesterol levels using the second National Health and Nutrition Examination Survey (NHANES II) for American white males. They found that changes in BMI from 21-23 kg/m2 to 27-30kg/m2 were associated with a total cholesterol 23 mg/dL higher. (Denke, Sempos and Grundy, 1993) Their overall conclusion was that “Excess body weight is associated with deleterious changes in the lipoprotein profile. Higher BMI was associated at all ages with higher total cholesterol levels.”

      These are American numbers but they equate to approximately a 10% increase in cholesterol as weight increases from 21-23 BMI to 27-30 BMI. This may well describe your situation. This on top of the test being c. 20% inaccurate and this is why I never have a cholesterol test.

      So BP meds -> weight gain -> cholesterol rise -> statins and the weight gain is going to make BP worse anyway! Doc should go back to the beginning and stop all meds, advise you to eat real food/managed carb to drop the weight and then he won’t need to see you again. What does he do instead? Medicate a side effect caused by the first medication. The only thing I can say in your doctor’s defence is that he is following standard UK guidelines and he clearly cares more about his being sued than your health.

      I can’t advise you – I only tell people on these blog comments what I would do. 1) I would have avoided ‘getting into the system’ in the first place. 2) I would not take BP meds for normal BP. 3) I would have stopped any meds at the first sign of weight gain – especially where weight gain will make the alleged condition worse. 4) I would never medicate a side effect caused by a med I didn’t need to take and 5) I will never let a statin pass my lips. You need to decide what’s right for you but don’t let anyone bully you – least of all a doctor who should care more about you than a flipping lawsuit (I wanted to put a different F word there – he deserves it!)
      Very best wishes – Zoe

  • Hello please help me I just got my blood results back from the Dr and he was really angry at me for not taking lipidil and crestor he said if you want to die then don’t take your meds!! I suffer with PTSD

  • Hi, my mum is type 2 diabetes controlled by insulin and medication, she has been a diabetic for 12 years now, I have only found out due to her cholestoral being in double figures now, that 9 years ago she was put on statins, recently these statins have been changed vigourously due to her cholestoral rising and rising. After reading your articles I am angered by our family gp and diabetic nurse who had been putting her on these. Aswell as taking statins she eats healthy and walks each day but cholestoral still high also she has never been told to fast before having her cholestoral reading.
    Do you have any advice you could give us as I will be attending the diabetic nurse and gp with her due to this, I have took notes but do know that I am likely to be looked and talked to like I don’t know best when after reading these articles I know I now know more than the nurse as we have known her for years.

    • Hi Danielle – this gets me so angry! The body makes cholesterol. It is a marker – it is the body trying to tell us something.

      If your mum’s cholesterol is in double figures – why? Has it always been? This could indicate Familial Hypercholesterolemia (FH) – but an estimated 1 in 500 have this, so it is very rare. FH is a genetic defect such that cells of the body cannot receive LDL lipoproteins as they should and so LDL levels in the bloodstream are particularly high. To me – the problem with FH is that the cell is not getting the LDL that it needs (LDL carries protein, cholesterol, phospholipids and triglycerides for the cell to be healthy). The LDL in the bloodstream is the marker – not the problem per se.

      Why is your mum’s cholesterol “rising and rising” on statins? (Why is any woman on statins?!) Is her body especially good at ‘fighting back’ and cholesterol production is going into overdrive to resist the statin impairment? Has she got an illness? injury? insufficient sun exposure? This is what the docs should be trying to work out – not ending the conversation with the body with statins!

      As we know that glucose in the blood stream is seriously harmful to the body (that’s why diabetes is such a serious condition) it could be that the high level of glucose in the blood stream has caused damage to which the body responds by producing more cholesterol. The best intervention may then be a real food/low carb diet (meat, fish, eggs, veg, dairy and limited fruit/brown rice etc) and control the blood glucose levels as the main issue.

      This post may be of interest too!

      Good luck
      Best wishes – Zoe
      p.s. sorry – advice – ask questions. Why did you put my mum on statins? (They’ll say because she had high cholesterol). Why did she have high cholesterol? (that should stump them!) Has she always had high cholesterol? Is it hereditary or circumstantial? Don’t you think you should understand why before medicating? Why is it still rising? What evidence do you have that any woman should be on statins? Do you know that statins block the mevalonate pathway (the link above)? Do you know the consequences of this? I’d have a field day!

      One of the most powerful ways in which to disarm the patronising approach that we know people do get is to wait until they say good or bad cholesterol and then laugh and say “There is no such thing. Cholesterol is cholesterol. It’s not good or bad. LDL is a lipoprotin and HDL is a lipoprotein. They are not even cholesterol. Feedback on that one is very positive! However we should not have to prepare to go into battle with the medical profession – they should realise that we are the customer and treat us with respect and care, not contempt and condescension :-(

  • My cholesterol has been measured as high for over a year.

    The first test I had however didn’t measure my LDL and HDL, if it did I wouldn’t have been given misleading information to lower my cholesterol levels.

    The private test I had next did measure these and I’m at no risk at all.

    While I have a family history of heart disease it would help if doctors did the correct tests before making wild assumptions. This is the third time I’ve found doctors making assumptions in two years.

    Previously I did a lot of sport and had to relay all the sports science information done on healthy people to medical doctors.

  • I’ve been extremely interested in diet and heart disease since every man in my family has experienced a heart attack or stroke by the age of 50, except for me. I considered myself to be at a higher risk since I weighed 60 lbs at the age of two. When I turned 50, my older brother experienced his second major heart attack, so I went to a cardiologist to be evaluated. My tests were inconclusive except for the EBCT. That test showed mild calcification in two coronary arteries. The cardiologist immediately added a statin to my niacin regimen and at one point my total cholesterol dropped to 97 (2.5).

    I then made the biggest mistake of my life by reading Gary Taubes, GCBC. I periodically had to stop reading because I became too agitated. As I read, I realized that everything I was taught growing up, including pharmacy school, was built on a house of cards.

    After taking niacin and simvastatin for 6 months, I developed elevated liver enzymes. I had to discontinue both drugs for a month. At the end of that month, I had another blood test to see if my liver enzymes had normalized. I had also started to transition to a low-card, high-fat diet. My pre-niacin HDL levels were around 30 (0.78 mmol) and had risen to 42 (1.1) on niacin. I expected my HDL to drop down to previous levels and was shocked when the test showed it was now 52 (1.34).

    My family doctor asked me if I wanted to restart niacin or simvastatin, and I chose niacin. At a follow-up appointment with my cardiologist, he was adamant about me restating simvastatin. I pointed out that my HDL was now 66 (1.70) but he stated my LDL was still too high…it was 80 (2.1). I then pointed out that there has never been a study showing that lowering LDL had any effect of heart disease. He reluctantly agreed and mumbled something about pleitropic (e.g. anti-inflammatory) effects. Even after that he was still adamant about the statin.

    I fired him.

    Two years later I went to a different cardiologist so I could get a second EBCT. The second test revealed that the calcium score in one artery was now zero, and the score for the other had decreased. He said he had never seen that happen before.

    I then described my high-fat, low-fat carb way of eating and his response was priceless. His eyes got really wide and he said that “that’s not what we were taught in medical school!”

    Oddly enough, in pharmacy school in 1980, the rule-of-thumb for a healthy serum cholesterol level was “200+age” and statins were not in anybody’s formulary. Although I only stayed in pharmacy for another 8 years, I remember that I rarely dispensed any medication for diabetes. An occasional Rx for metformin and a couple of patients were on insulin.

    It’s very interesting how medical information has been corrupted over the years.

    • Hi Ed – wow! What a story. I completely agree with you – how corrupt this has become over far too many years.
      May your curiosity and good health continue :-)
      Very best wishes – Zoe

  • Hi I’m 28 healthy female u.s size 6,I went to the doctor last week for a checkup and got told I have high cholesterol 5.9 .I am now free king out should I be worried? I have shaped all full cream for skim and started taking kill oil vitamins. This is a surprise to be as I thought I was a healthy young woman.

    • Hi Katie – I actually said “OMG” out loud as I was reading your message. Someone should seriously be struck off for this. It’s free king outrageous to use your lovely words. 5.9 is not high – norms used to be around 7 until we started statinating everyone. We have artificially lowered the true average. I use an analogy in my obesity book…

      What if we concluded that height were a cause of heart disease (and all causes of death) and that we should therefore redefine the average height to declare the actual average of 69.7 inches (for all American men) to be abnormal. What if we picked an arbitrary new target 10% lower than the actual average and decreed that normal height should be approximately 63 inches. We could then stop the body from performing a normal bodily function (growth) by administering drugs to stop growth hormones from doing their job. I trust that this analogy disturbs you. The Chinese practice of foot binding – an artificial intervention in the normal development of the human body, to achieve an artificial ‘norm’ – was thankfully outlawed in the early twentieth century, but trying to reduce the normal cholesterol level continues.”

      We’re at the end of the winter – depending on where you live you may not have seen the sun for 6 months, which means cholesterol has not been turned into vitamin D and is at its highest point of the year. Your body makes the cholesterol that it needs so let it do so. You’re also a perfect child bearing age. Why do eggs have so much cholesterol? Because it takes a lot of cholesterol to make a healthy chicken. It takes a lot of cholesterol to make a healthy baby too – I would expect your cholesterol to rise if you became pregnant, as your body would make more as needed.

      You’re young, slim and by all accounts healthy – best advice would be to stay away from doctors!
      Very best wishes – Zoe

  • I am totally confused. I had a T.I.A. in January. My doctor said my cholesterol was a bit high and he wanted to put me on lipitor. I refused it and have eliminated meat, poultry and dairy from my diet the past month. I do miss eating chicken, beef not so much. I also miss eating eggs and sour cream and yogurt. I am trying to eat more of a plant based diet, and adding beans and rice. Am I on the right track or am I eliminating these foods unnecessarily?
    I want to do my best to prevent a major stroke and the research I am doing is very confusing, some say eliminate meat and dairy, others say it is not necessarily, to just make sure you eat organic. I would appreciate your opinion.

    • Hi Patrice – where to start?! You’ve got some reading to do because you’ve just started down the path of (rightly) questioning everything you’ve been told about cholesterol to date.

      Here’s some for starters:
      Most of the things I’ve written about cholesterol in one place:
      How higher cholesterol is associated with lower deaths – yes- that was the right way round:
      What statins actually do:

      Also check out Dr Malcolm Kendrick, Dr Uffe Ravnskov, Duane Graveline, Natasha Campbell McBride, Jonny Bowden, Stephen Sinatra and many more.

      In a nutshell
      – I bet your cholesterol is not high (the actual norm was around 7 until statins started being dished out like smarties. The normal distribution of people would have ranged from 4-10.)
      – If it is ‘high’ – your body makes cholesterol for repair – is there a reason it’s gone up? Surgery? Injury? Illness? Stress? Everyone in the N hempisphere has higher cholesterol at this time of year because we’ve not been in the sun (and we make vitamin D by synthesising cholesterol)
      – Even if it is high – this is great for longevity!
      – Meat and dairy is going to have no impact on cholesterol whatsoever.

      Well done for refusing Lipitor – hopefully the how statins work article will convince you that was a good decision.

      Enjoy the journey!
      Very best wishes – Zoe

  • Hi Zoe, I just came across this research project that seems to prove that statins reduce mortality rates in people at risk of heart disease:

    Would love to hear your views. My cholesterol is 6.9 (also have high bp) and my doctor whose husband is a cardiologist is keen for me to take them which is why I’ve been doing some research.

    • Hi Eileen
      1) your cholesterol is not high – it’s slightly below where the true population average was before medics started statinating everyone. I bet you don’t have high BP either – normal BP is 140/86-90 – it’s just been redefined as high. (see figs 1 and 2 on this

      2) you may find this interesting

      3) I haven’t read the article on the link attached. I always start with the conflicts of interest. Scroll down and you can see them: Competing interests: AMG is a consultant for Genentech, Kowa, Martek, Merck, and Merck/Schering-Plough, and serves on the board of directors for Aegerion and Arisaph. He is a member of DuPont’s health advisory board and serves on the data safety monitoring board for Novartis. JS carried out consultancy work and receives support for research from Bristol-Myers Squibb. RGJW receives support for research from Bristol-Myers Squibb. HN has received travel grants and speaking honorariums from Sankyo. RHK has received research fees and speaking honorariums from Pfizer. PR has received research grant support from the National Heart Lung and Blood Institute, the National Cancer Institute, the Donald W Reynolds Foundation, the Leducq Foundation, Astra-Zeneca, Novartis, Merck, Abbott, Roche, and Sanofi-Aventis; consulting fees and lecture fees from Astra-Zeneca, Novartis, Merck-Schering Plough, Sanofi-Aventis, ISIS, and Vascular Biogenics; and is listed as a co-inventor on patents held by the Brigham and Women’s Hospital that relate to the use of inflammatory biomarkers in cardiovascular disease. These patents have been licensed to Siemens and Astra-Zeneca.

      Would you believe an article funded by Coca-cola telling you that Coca-cola is good for you?!

      4) You and hubby need to read this before taking or prescribing statins ( You may also like to read The Great Cholesterol Con (Kendrick); Statin Crisis Damage (Graveline); anything by Uffe Ravnskov and come back for more reading if you like.

      Keep researching would be my advice – and don’t blindly believe any white coat – even when you’re married to it!
      Good luck
      Very best wishes – Zoe

  • Polytetrafluroethylene (PTFE) is a synthetic polymer used in many applications including non-stick coatings applied on kitchenware. This was developed and patented in 1941.

    PFOA is a super villain even for those resigned to the Lex Luthor that is PTFE. Besides persisting indefinitely in the environment, and being both toxic and carcinogenic to animals, it has been universally found in extremely low trace amounts in the blood of atleast 98% of the US population and in 100% of the US newborn population.

    Exposure to PFOA has been associated with increased cholesterol and uric acid levels and there has been a correlation between elevated PFOA levels in the blood and increased risk of chronic kidney disease.

    Because of its widespread applications, PFOA has been used in many applications which need water or oil repellent properties – for example in wax coated paper that is used to wrap French fries , pizza boxes, sweets , sandwiches or coated paper used in microwave popcorn bags. Besides this it is used in dental floss, apparel or fabric that are sold on a “stain guard” claim, floor wax and wax removers, sealants used for stone, tile or wood, and non stick cookware.

    There are currently no labelling requirements that manufacturers need to follow to declare the presence of PFOA in their packaging.

    PFOA is part of a broad stream of chemicals called PFCs or Perflourocarbons – When PFCs are heated, they break down into compounds which are assimilated into the bloodstream through the food we eat.

    In your home, PFOA can be found as an enabler to create non stick cookware. Apart from this, it could also be found in the following products:

    1. Microwave popcorn bags
    2. Frozen pizza boxes
    3. Gore-tex clothing
    4. Packaging for French fries in popular fast food chains
    5. Any other food packaging with a coating that repeals oil and water

    PFOS is now widely seen across wildlife, being resistant to environmental breakdown, and is found right from polar bears in the arctic to dolphins in Florida, and seals and otters in Canada. Traditional scans did not detect PFOS earlier, because unlike other POPs (persistent organic pollutants); PFOS binds to protein in the body and not to fat.

    PFOS is a persistent, bio accumulative global pollutant that is toxic to mammalian species. In addition to its industrial production, PFOS can also accumulate from the degradation of its chemical precursors in the environment.

    There are species related differences in how long PFOS persists in animal and human bodies – its half life in rats is 100 days, whereas its estimated half life in human beings is 4 years. Repeated exposure results in hepatoxicity and mortality across animals especially in infants and children within the womb.

    PFOS is persistent in the environment and has been known to bio-accumulate in fish. It is acutely toxic to honey bees.

    PFOS levels in pregnant women have been associated with preeclampsia. It has also been associated with altered thyroid hormone values, an increased risk of high cholesterol and an increased risk of ADHs among early teens.

  • hi zoe and team. i have been following the harcombe principals for some time now albit phase 2 during the week and phase 3 at the weekends. i know i should be more strict as i have two stone to loose and an aiming phase 1 during the week and phase 2 at the weekend. i really do feel so much better not eating processed foods and not mixing carbs and protein. my problem is that my cholesterol 6 months ago was 6.6 and according to the nurse the bad out weighed the good. i have read with great interest your articles on statins and although i dont always understand the info and medical side do not want to take statins. i am 56 years old but even though i dont want to take statins i have noticed little white spots at the side of my eyes(one of the things the doc mentioned in connection with high cholesterol) just wondered what your view is on these spots. i have seen people develop them over time and look very unsightly.i am just worried how they relate to my cholesterol. many thanks for your time

  • hi.i went few months ago for a cholesterol doc said it was high at 6.3 and recommended me taking simvastatin 40mg.i took them on and off(whenever i remembered to take them) for about a month during which time i started to get increasing bouts of heartburn.i put it down to the statins and just stopped them immediately.since stoppig them i have had no heartburn and feel much better.i am going for a cholesterol check in the morning(have to fast for 14 hrs) so will be interested to get the results in a weeks time.dont eat butter or fatty flora spread good for me?thanks.your blog was very helpful and extremely helpful.

  • Hi Zoe – my doctor has just put me on 5mg of Amlodipine as she felt my blood pressure was too high. I so resist taking medication of any sort and would welcome your comments on these meds and perhaps some advice on how I can lower my blood pressure by diet or a more natural way. I do have quite a lot of weight to lose ans am really trying to do so via your diet. Doc has not made any suggestions, just put me on the pills. Thanks Zoe – Vicky

    • Hi Vicky
      A few thoughts:
      1) Check out this post – especially point (5). Do you have BP significantly higher than the norm of 140/90? What docs call high is actually the average – this has led to far more people being medicated than should be. Very lucrative for the drug companies.

      2) BP is not a problem in itself – it’s your body trying to tell you something. In your case it could be your body saying it is carrying more weight than is ideal. You don’t need meds to know that!

      3) The Harcombe Diet naturally lowers BP – we have even had people with normal BP ‘suffer’ low BP within a week of Phase 1. BP is worsened by water retention and the diet does a lot to overcome water retention. Try the diet and see how much this helps.

      4) One of the common side effects with BP meds is water retention and weight gain – probably why you’re on meds in the first place?! What on earth is a doc doing putting an overweight/water logged person on meds that could make this worse?!

      I know where I would stick the meds and how determined I would be in sticking to the diet :-)
      Very best wishes – Zoe

  • Hi Zoe

    I just got my cholestorol checked. I’m 37 next month. The reading was 6.3. Nothing to worry about.
    My only concern is my dad had a heart attack in his mid 50’s. He came very close to death. Arteries blocked. He is a heavy smoker and drinker. Plus there is heart disease history in the family.

    I don’t want to continue that same history. What can I do to stay healthy? I deal with a lot of stress at work. I don’t smoke, and I don’t drink that much. Social drinker. I walk 5.5 Km’s a day.
    Thank you for the wise words.

    • Hi Brian – the three main factors in heart disease are gender, age and genetics.

      Gender: You’re male, so far less likely to get breast cancer but more likely to get heart disease. Women in England are likely to outlive men by 4 years; women in Scotland are likely to outlive men by 4.5 years and it’s 4.2 years in Wales. Nothing you can do about any of that.

      Age: Heart disease is massively correlated with age. Using American 2006 stats (just because I’ve analysed them for my obesity book) – if you have 500 friends, you should expect to lose 1 from heart disease in any one year. You would need to have 166,667 friends aged 5-14 to lose 1 from heart disease and yet you would only need to have 5 friends aged 85+ to lose 1 from heart disease. You’re very young for heart disease at the moment – so you’ve got no worries on this factor for some time.

      Genetics is the final one of the three biggies that you can’t do anything about. Dad being a heavy smoker and drinker has not helped him. You say there is heart disease in the family. If it’s also in smokers/drinkers/overweight/sedentary/bad diet family members, then you may not have much to worry about. It’s heart disease in non smoking, naturally active, normal weight, red wine drinkers with a pretty good diet that you want to watch out for. If your dad/uncles/grandfather (esp on dad’s side) have been otherwise healthy and had heart disease in their 50’s/60’s – then there is likely something genetic. Alas – you can’t do much about your genes. Angelina Jolie can have breasts removed – you just have to do the best you can for the factors that you can control.

      The ones you can control are the ones you are doing (with the stress exception). Your non smoking/drinking little and walking are perfect. Stress will be the one to work on – can you learn to meditate? Try Pilates? Yoga? Don’t laugh – our neighbour is absolutely loving his new found interest in Yoga and Pilates. He started to manage his work stress (very senior sales job) and wouldn’t give it up for the world.

      This will help to explain the process by which arteries get blocked (because dietary fat and cholesterol are NOT the culprits!)
      These may also be of interest:

      and anything on this site:

      Hope this helps
      Very best wishes – Zoe

  • I don’t smoke don’t drink my weight is back to normal after being on beta blockers and a Mirenea coil my weight ballooned to 10 stone (only 5 foot 2) which i could not handle as i have never been fat all of my life. I swim 2 miles a week and do 3 hours a week on an exercise bike. I try to eat a health diet don’ eat MacDonald no sugar in tea. told i have chloestral of 6.8 been put on Simvastain whihc i would rather not be on i don’t want to balloned to 10 stone again. Is my Cholesterol to high? i also have damge to the back of my head whihc may or not be MSand was told to build up the muscles in my body whihc i have done the last thing i want is something that will waste muscle. Im taking evening primrose oil and Sea kelp. Any advicwld be appreciated.

    • Hi Fiona – your cholesterol is not high. Even if it were, this would not be bad (see this post)

      Here’s a lot of info on cholesterol. If I were you I’d read it thoroughly and this book and then sue your doctor for putting you on statins. Some GPs should be tried for crimes against humanity – seriously

      Good luck
      Best wishes – Zoe

  • Hi Zoe
    I came across this blog by accident after doing some research into colesterol, I was thinking the same as Helen’s comments.
    I had never had problems before hitting the menopause, I had bad problems with hot flushes since I have developed slightly raised blood pressure which I circumbed to medication which caused digestive problems which neede another medication.Now after recent blood test a raised colesterol level 6.7 I am resisting medication as I have had enough. One wonders if we really need all this scare mongering, when I was told about my blood pressure I did nothing but worry about my numbers which is good for your readings ? Now they are trying to scare me into worrying about my colesterol numbers I just want to be able to enjoy my life healthily not spend it worrying. I have never smoked or drank alcohol I’m not over weight I have always had a good diet I love fruit and vegetables and eat fish often. I have side effects from the drugs I take already and I do not want to add any more. I would like to thank you for enlightening me with this blog ,there have been some very educational comments by lots of people.

  • HI Zoe
    I am 56 and just had a cholesterol test done after fasting it came in at 6.6 and LDL of 33. I was told I am borderline (what?) I had to push for the test because I just wanted to know. I seem to be following exactly the same pattern of health as my deceased Mum, she had Severe menopausal hot flushes and lack of sleep like I am now, she ended up having quadruple bypass heart operation due to heart disease, but was not overweight, didn’t smoke, hardly drank, was active all her life till 75. I am worried that nobody ever talks about a possible link to post menopausal women and risk of heart disease going up due to falling oestrogen levels, and whether this affects higher cholesterol levels too. I don’t have high blood pressure, I am not overweight, I probably don’t exercise enough, I just do a lot of walking, but I don’t smoke. My diet is normal, I try to eat reasonable amounts of fruit and vegetables, olive oil, I drink about 10 units of wine a week. Its the lack of doctors knowledge about hormone balance/links to heart disease that worries me. I have had breast cancer, also something that makes me worry about womens’ hormone levels and general health.

  • Hi Zoe

    Reading all this makes me wanting your comments on my situation
    I am asian(chinese) race with 170cm height and 6months ago is 78-80Kg weight
    I got checked and doctor found out I have essential hi blood pressure and cause my heart axis to shift a little bit

    My cholesterol at that time Trigliseride 154, LDL 145 HDL 48
    6 months after that I work out and loose my weight to 67Kg and what surprises me is my followup check is the same!! The only thing is trigliseride is 145 now and HDL 43 slightly lower and hDL remains about the same!

    My question is:
    1. What I am losing in my weight does not affect my cholesterol?
    2. Is my cholesterol and LDL cell transportation problem you stated above cause my heart problem?
    3. I dont have to take statin, do I?

    Thanks for your comment in advance

    • Hi Citra – well done for thinking and questioning about this. You may find this blog interesting. You may find this special report helpful.

      Hopefully these will explain many things – why higher cholesterol is better than low – yes really! Why your cholesterol is independent of diet (your body makes it as it needs it – if your cholesterol level doesn’t change, it means you needs haven’t changed.)

      You may also like to read The Great Cholesterol Con by Dr Malcolm Kendrick, Fat & Cholesterol are good for you by Uffe Ravnskov or Ignore the Awkward by Uffe or many other books telling the truth about this substance, which is so vital that your body makes it.

      Best wishes – Zoe

  • Dear Zoe

    Very, very interesting reading here. I have just come back from a work health insurance (I’m in the USA) screening. My BMI was too high at 26.6, my total cholesterol is 285, my LDL is 185 and that ratio was 5.5.

    I was told I am over weight (200 lbs at 6’2″) and in the High zone for my cholesterol. I was told to walk some each day, but I run marathons! I do admit my gut is just a bit flabby but not bad for 50.

    Reading these comments here makes me think there is not much to worry about.

    • Dear Duncan – certainly don’t worry – stress is the most likely thing to kill you!
      Best wishes – Zoe

  • Thank you for the prompt reply Zoe, I will read the book. I know what I believe and feel about statins! To be fair, he is not being forced to take them but ” strongly recommended” is a fair description and after the artery blockage, he feels he should take their advice. He feels that the statins caused it to reduce but I refute that, saying there is no proof of that and no medic ever suggested that would happen. In fact, prior to the second investigation, our GP was asking if he had heard from the local cardiac rehabilitation group – almost taking for granted that he would have to have a stent fitted, or worse! The GP ( from a practice we changed to just recently)referred him to the lipid specialist ” who knows far more about cholesterol than I do”she said, so we then could have as much info. as possible to enable him to make an informed choice about taking them or not.He certainly listened to him/us but I could have put money on the fact that he would recommend statins, even suggesting Lipitor saying ” That’s the one that I take and I wouldn’t recommend something I would not take myself”.He wasn’t in a white coat as he was a higher up the chain than that! I can’t tell my husband what to do and my thoughts are not helped by the fact that he comes home most weeks and tells me he has met yet another person who is on them!That only makes me more determined not to take them as I feel it cannot be right to try to drug a generation.


  • Hello Zoe,
    My husband, aged 66 ,was diagnosed with a partially blocked artery last August.We immediately radically changed our diet,excluding all processed food and increasing fruit and veg intake.He was put on Simvastatin. He took them for 18 days, whilst on the new diet,then was called for a blood test and a further procedure to measure the blocked artery to see if a stent was needed.This showed that the blockage had reduced in size,a stent was unnecessary and his cholesterol was down to 4.1 – all due to the statins we were told.I am totally against statins and after much discussion, he stopped taking them, continued with the diet then went for another,fasting, test one month later(3months into the changed diet).However, I must mention that 1 week prior to the fasting blood test , he had a bad fall and injured his breast muscle,possibly cracking a rib. The bruising was severe and he was in a lot of pain. The subsequent test result showed his cholesterol level to be 7.7.On seeing a lipid specialist a couple of months later, we were told that the injury would not have affected the level of cholesterol (though his LDL was very high), he must have FH and should start taking Lipitor 40mg, which he now does. I am not happy about this but it is his decision. He has been on them for 5 weeks now,has started feeling more tired but he does work full time running his own business in a cold workshop – tiredness due to work/ cold/ age OR statins?He has no family history of CHD, strokes etc. doosn’tt smoke , BP fine.What do you think we should do?
    Also, I (60y.o.female) had a health check recently,nothing wrong except a slightly arthritic thumb,was told my cholesterol was 7.5 (non-fasting) and was advised to “talk to the doctor”. I ignored this advice as I refuse to take statins. I feel, like you , it is a Big Pharma money making racket and will be shown, in due course, to do more harm than good.

    Carol Watson

    • Hi Carol – I can’t believe that a ‘lipid specialist’ would not know that cholesterol heals damage and therefore the body will produce more cholesterol after a fall/bruising/possible fracture to repair the damage.

      Plus a cholesterol level of 7 is not even high (nowhere near FH territory – this is ridiculous scare mongering).

      Plus, as this post shows, higher cholesterol is associated with lower deaths rates for men and women for heart deaths and all cause mortality (

      Plus you and your hubby should have the final say in whether or not the side effects of statins (fatigue, muscle ache, loss of libido, memory loss, forgetfulness, just not feeling your usual self etc) are worth having the marvelous substance that is cholesterol artificially lowered in your body!

      If I were you I would read this book and then ask your doctor to read it and see if s/he is quite so prepared to force you onto statins when they know what they really do to a human.

      I can’t tell you what to do – that’s entirely your call. I know that I personally will never take a statin – ever. That’s my call and I will not be bullied by any medic who knows less about cholesterol than I do. You have to do what’s right for you. But, whatever you do, make it an informed choice and your own choice – don’t assume that someone in a white coat has the right to force you to take something that you don’t feel comfortable with.

      Very best wishes – Zoe

  • Hi Zoe

    Reading through your comments, has both reassured and confused me in equal measure. In Oct 2012, my Doct’s surgery contacted me to advise I was due a health check, I went in after fasting overnight & had my blood test done, as per their instructions I called them a week later for the results, was advised my cholesterol was 7.5, considering all the hype, I thought this was high, so I asked when the Doc needed to see me. Apparently he didn’t. I asked what I needed to do, the receptionist advised the Doctor hadn’t stated that I needed to do anything but maybe I should just monitor things myself but I should be careful because 7.5 is really high for a woman, my age, incidentally, 44. I did research & changed my diet slightly, I added more oily fish, added a daily cholesterol reducing yoghurt drink, changed my margarine to a cholesterol reducing low fat spread. Since I don’t smoke or drink,I eat fresh food, the only food I fry is the occasional fried egg, I thought I had done enough. I lost nearly a stone in weight & feel fantastic. Blood test was redone last week, called today for results, cholesterol now 8.1, Doctor now needs to see me as a matter of urgency.
    I am unsure what has happened and I am now really worried because they are so insistent he see me within a few days.

    • Hi Karen – the best thing you can do is to read everything you can on the topic. I highly recommend Dr Malcolm Kendrick’s The Great Cholesterol Con. Uffe Ravnskov Fat & Cholesterol are good for you and/or Ignore the Awkward. Search “Cholesterol” on my site and read all the articles that I’ve written on it.

      Your body makes cholesterol – do you think that it is doing this to kill you?! Your cholesterol will be what your body needs it to be. It’s highest at this time of year because (assuming you’re UK based?) you have had no sunshine for months and sunshine makes vitamin D by synthesising cholesterol in your skin. Hence, in the middle of the winter, your vitamin D levels are low (that should worry you) and your cholesterol levels are high (that shouldn’t worry you). Any injury/illness will cause your body to make more cholesterol to repair you. Stress ditto. Your body is doing the right thing. Drug co’s have persuaded doctors that you should be on statins because they are more lucrative than all the lotteries in the world. One statin alone has ‘earned’ $125 BILLION for Pfizer during it’s lifetime.

      I would advise you never to let a cholesterol lowering product pass your lips again – and that includes these lucrative drinks, yoghurts and spreads. Here is why on that one ( – they are ‘replacing’ your body’s own cholesterol with the plant version. We don’t know that this is safe, let alone healthy.

      Your experiment has shown that it doesn’t matter what you do with your diet (aside from – if you eat a lot of carbs you can impact VLDL – but that’s another story) – your body will carry on making the cholesterol it needs. I would put money on the fact that your doc now wants you on statins. That’s why you’ve got a shed load of reading to do! No doc will ever get me on statins – ever – no circumstances. It’s up to you what happens next to you

      Good luck!
      Very best wishes – Zoe

  • Thank you so much Zoe, I will certainly do some more reading!
    Very helpful


  • Hi
    I have been reading with avid interest all the comments on this site as I have once again been put under pressure to start taking Statins (to which I am highly resistant)! My Total Cholesterol has been measured at 8.1 with LDL at just over 6, this despite the fact that my weight is normal, my BP is also normal I have a very healthy lifestyle and diet – low in processed carbs and fat due to acid stomach problems – but these figures are setting off all the alarm bells and assumed to be due to FH.
    I would be interested to have your opinion as my own “gut feeling” is to avoid starting to take a medication which I know causes me huge stomach problems which in turn will have to be counteracted with a PPI (Lansoprazole). I hate the “one thing leads to another” syndrome
    Many thanks in advance


    • Hi Katharine – keep reading on the subject. I highly recommend The Great Cholesterol Con by Dr Malcolm Kendrick and Ignore the Awkward by Uffe Ravnskov – Chapter 3 of the latter is all about FH. You may also like to read Yoseph & Yoseph – How statin drugs really lower cholesterol and kill you one cell at a time”. Your flipping doctors should read this and they would never prescribe a statin again.

      Check this out as well – – this suggests that the higher your cholesterol level the lower your death rate from heart disease and all cause mortality. For women especially the inverse relationship is very strong. The comments below this post may help too – the one from me about most people suffering heart attacks (the CHEST study) having lower than average LDL etc.

      Your cholesterol could be what it is because you’re recovering from illness or injury? If you have yet to have children never ever take statins before this – you need masses of cholesterol to make a healthy baby. Cholesterol is higher in the winter because the sun is not there to turn cholesterol into vitamin D. Do you get out in the sun as much as possible?

      There’s a page in Malcolm’s book where he says “statins do not save lives in women”, “statins do not save lives in women”, “statins do not save lives in women”, “statins do not save lives in women” and repeats it – asking – how many times do we need to repeat this before doctors get the message.

      I would never let one statin pass my lips – you need to be better informed than your doctor. Having read a couple of blogs on my site you probably will be already. Read Kendrick and no doctor can touch you!

      Good luck
      Best wishes – Zoe

  • Just stumbled upon your site and I love your views on diet and nutrition. I created a paleo website ( I am planning to share one of your articles on my Facebook tomorrow. I know that it will spark a lot of bickering and upset a few vegetarians, so I am looking forward to it :)

  • Hi Zoe

    My cholesterol was 5.5 six years ago, I was 41 years old then. My Doctors told me this was too high, because I had heart disease in the family, i.e. my Farther died of his fourth heart attack, this needed to be lower. After 6-7 years on statins my cholesterol level last March was 4.9.
    After being on the Harcombe diet for the past 6-7 weeks I had my cholesterol re-checked, it’s now 4.2, just goes to show that fatty food really does not increase the cholesterol level.
    One of your blog readers have suggested that statins made her irritable and short tempered, and since she has stopped taking them and her attitude has changed, I have only stopped taking them in the last week or so and I also feel the same, calmer, and with more patience.
    May I add that I has lost 16Ibs and reduced my Blood Pressure, not only that I have eliminated one of my BP meds.
    Keep up the good work Zoe, and Thanks


    • Hi Darran – thanks so much for sharing this. When you know that even though the brain is only 2% of the body’s weight, it contains approximately 25% of the body’s cholesterol, it helps make sense of the mind symptoms that statin users experience. Hands off our bodies and minds!
      Best wishes – Zoe

  • Zoe, I can’t help but notice that your argument that diet does not affect cholesterol levels is based on the fact that dietary cholesterol does not much affect blood cholesterol. True enough. I’m with you there.

    However there seems to be abundant evidence that *saturated fat* (NOT CHOLESTEROL) does lead to raised cholesterol levels in many people. Note — I am not saying *cholesterol* intake raises cholesterol. I’m saying something different. I’m saying *saturate fat* raises cholesterol. I’m being so elementary here because I can’t help notice that at every suggestion that saturate fat raises cholesterol, your response is “No-no choleserol does NOT raise cholesterol”. You see what I’m saying?

    In addition to research that seems to be solid enough to support my assertion, there is plenty of anecdotal evidence on the net even from devoted low-carb fans. Which is why the cholesterol argument has moved on to: is increased cholesterol even bad at all?

    THAT’s the real battleground of ideas pertaining to choleserol now, and you may be missing it. There is strong eveidence that high cholesterol is not bad, and that *low* cholesterol is worse. Our “Get with the Guidelines” research paper published recently in the US badly surprised it’s masters by revealing that the average cholesterol level among people being admitted to the hospital for cardiovascular problems was 30 points BELOW popoulation average (by US reckoning, 175 versus population mean 203 or thereabouts).

    You may know of Peter Attia’s excellent work on the “Eating Academy” blog (formerly in which he recounts the research suggesting that essentially the only cholesterol-related metric that tells us much is LDL particle count, which is likely to go down (reducing risk) if one avoids carbs. Choleteral levels be damned. (This in turn being largely driven by triglycerides.)

    • Hi Kevin – many thanks for this interesting comment. I am of course aware of the claimed association (not causation) between saturated fat and blood cholesterol levels and I am aware of the arguments you’re talking about. Here are some points on this:

      1) Only animal foods contain cholesterol (meat, fish, eggs, dairy). All animal foods also contain saturated fat (and both unsaturated fats). Ancel Keys spent the 1950’s (Ancel Keys, J. T. Anderson, Olaf Mickelsen, Sadye F. Adelson and Flaminio Fidanza, “Diet and Serum Cholesterol in Man: Lack of Effect of Dietary Cholesterol”, The Journal of Nutrition, (1955)) trying to show that raising dietary cholesterol raised blood cholesterol and concluded that it did not. He never changed his view on this. The only way in which he could increase the dietary cholesterol of his human subjects was to feed them animal foods. This made no difference to their blood cholesterol levels. So Keys exonerated animal foods (and any fat contained therein) at the same time.

      2) If you check out the graphs in this post ( you can see the evidence for all 192 countries in the world for low cholesterol and high heart deaths and high all deaths for men and women. This is not 7 handpicked countries but all the World Health Organsiation data available.

      3) At the end of this post I go through what happens when we eat something containing fat ( Someone who believes that saturated fat can (let alone does) impact blood cholesterol levels needs to explain how exactly.

      4) The room that we have for heated agreement is that we have confused sat fats with carbs. The Seven Countries Study called cakes and ice cream sat fats. They are processed carbs. The UK NHS calls cakes, biscuits, pastries, ice cream, confectionery, savoury snacks saturated fats. They are processed carbs. The Dietary Guidelines for Americans list ice cream, sherbet, cakes, cookies, quick breads, doughnuts, potatoes chips, popcorn and yeast bread as saturated fats. They are processed carbs. Do I think these foods can disrupt the mechanism by which the body makes cholesterol? Yes – look at Acetyl-CoA – the starting point in the cholesterol production pathway and a by product of the Krebs cycle – the mechanism by which carbs are turned into energy. As people who have studied VLDL (Elizabeth J. Parks, “Effect of dietary carbohydrate on triglyceride metabolism in humans”, The Journal of Nutrition, (2001)) and carbohydrate will confirm.

      So I don’t care about blood cholesterol levels – we should all care about carbohydrate intake and particularly processed carbohydrate intake as this is messing up every working mechanism we have in the body from glucose to cholesterol.

      Best wishes – Zoe
      As a p.s. – because all of this sat fat cholesterol nonsense is aimed at implicating sat fat in heart disease – Dr. Malcolm Kendrick did two Seven Country Studies of his own. He analysed the World Health Organisation data again (the MONICA information was from 1998, or within two years of this date if 1998 were not available) and his first seven countries were those with the lowest consumption of saturated fat. These were Georgia, Tajikistan, Azerbaijan, Moldova, Croatia, Macedonia and the Ukraine. Kendrick’s second seven countries were those with the highest consumption of saturated fat. These were Austria, Finland, Belgium, Iceland, Netherlands, Switzerland and France. Every single one of the seven countries with the lowest consumption of saturated fat had significantly higher heart disease than every single one of the countries with the highest consumption of saturated fat. This concludes the exact opposite of the Keys’ Seven Countries assertion.


    • Hi Majella – The article above says that bacon tends to be processed. The book explains how to find the stuff that isn’t. I’ve copied the Q&A on bacon as a reminder. The processed aspect of meat is more a health issue than a weight issue – ose’s aside, preservatives have little if any impact on weight but processed meat is not good for health
      Best wishes – Zoe

      Q) I’m finding it difficult to get bacon – all the bacon in supermarkets has preservatives – any tips?
      A) Bacon/packaged meats generally are a challenge. Preservatives are actually OK. The key thing to avoid is sugar and all the things with ‘ose’ – dextrose is the main one that they slip into ham and bacon. The bacon over the counter should be just cut meat, or go for any packaged bacon without an ‘ose’ in it.
      The best place to get bacon is from your local butcher. You want to be buying (short) back bacon – not smoked or sweetened – just the plainest cuts that you can buy. Real bacon is quite pale in colour and goes off quickly. If you are in any doubt about the source of your bacon, have sliced pork instead – you can grill or fry it in the same way.

  • Dear Zoe,

    Thank you very much for your comment which is very helpful.

    I’m not suffering from FH but I unfortunagely got a statin after my CVA for post-prevention.
    Given the fact I’m strongly and in diverse ways harmed by the statin. I’d be very interested to read more about what happens when there is too little LDL in cells all over the body. So far I know the statin takes away a lot of Q10 and that seems to be the fact why I’m so very tired and suffering from lack of muscle strenght, suffering from quite strong cognitive impairment (I did not suffer from in those ways and that strongly after my CVA!) as well as among others a very sick/nervous colon which earlier produced extreme pain.

    But, I’d also like to learn how are cells damaged by too little LDL. Especially the brains need lots of LDL to function well. My brain has so much more difficulty to function well since I was given the statin by which my LDL went down – while my LDL was just a bit above what’s seen as healthy by the mainstream. What’s happening to body cells getting too little LDL? It would be great if you might be able to explain.

    Many thanks beforehand!
    bw, tanja

  • Hi Zoe
    I have had various diets over the years but like everyone else I lost wait but always put it back on through boredom or lack of enthusiasm. Yours is the first ever ‘diet’ that has answered all my fears and distrust of taking statins and eating processed food. My father died in his early seventies from a heart attack and always cooked using lard so I have tried over the years to wean myself off of fat in general as my cholesterol went up to 8 and my doctor put me on Simvastatin 40g. Most of the things I have felt and quietly believed has been answered by your comments and I have embraced the diet wholeheartedly but ,and its a nagging but,my brother has had a stent put in and is on 80grams of statin and is extremely concerned at my giving up taking my statins.
    I feel a little bit as I have stepped off a cliff but on the bright side I have lost over a stone and feel so much better as I believe it is more a change of lifestyle rather than a ‘diet’.Should I have cut back slowly on the statins instead of stopping them straight away? Is there any side affects that you know of following statin withdrawal or am I a little anxious if I have done the right thing as I have been bombarded by others to reinstate the statins Your recipes are excellent by the way.

  • A great, informative post Zoe – as usual!

    There’s something I’d love to see you address on your blog or in a YouTube video, and that’s the issue of “hypercholesterolaemia” – *can* it every be a problem, or has it been entirely wrongly pathologised? Several people close to me have this condition (with cholesterol levels of 7.5+) and are on statins as a result.

    It occurs to me that the in individuals with a *very* high cholesterol level, the risk of oxidization of that cholesterol (and the damage that could cause) could be higher? Of course, it’s not the cholesterol that’s the issue, but an inflammatory lifestyle – in which case, I’m guessing that adopting a low-inflammation diet of real foods is the best thing to do in any event.

    What do you think?

    • Hi Brian – my view on FH is as follows:

      Familial Hypercholesterolemia (FH) is a genetic condition caused by a gene defect on chromosome 19. The defect makes the body unable to remove LDL from the bloodstream, resulting in consistently high levels of LDL. Bearing in mind that FH is rare to start with – one in 500 people – in some cases of FH the LDL receptors work to an extent (just not very well); in other cases the LDL receptors work barely at all.

      My logical consideration of FH suggests to me that the problem is that the LDL receptors don’t work properly and therefore the LDL (lipoproteins) cannot get into the body’s cells in the way that they are supposed to. This means that cells don’t get the vital LDL, carrying the vital protein, lipids and cholesterol needed for the cell’s health. LDL in the blood stream is high because the LDL has stayed in the bloodstream and has not been able to get into the cells – where it is supposed to go. Hence high LDL blood levels are the sign that someone has FH. The high LDL levels are, however, a symptom and not a cause or a problem per se. The problem is that the health of every cell is compromised by LDL not getting to the cell. This includes heart, brain and muscle cells – all cells. An FH sufferer can therefore have heart problems – because of too little LDL reaching the heart cells – not because of too much LDL! How differently things can be seen when one is not blinded by thinking that cholesterol or lipoproteins are bad.

      This also explains why high HDL would be seen as good. HDL is the lipoprotein that carries used lipids and cholesterol back to the liver for recycling. If the LDL were not able to get to the cells to do its job then there is little for HDL to carry back to recycle. Hence HDL would be low and this would be seen as bad with impaired understanding as to why.

      When someone takes statins, the cells are impaired from making cholesterol so they try to take the cholesterol from the blood stream. The LDL receptors on each cell go into overdrive and try to ‘receive’ more LDL from the blood stream to compensate for the fact that the cell can’t currently make as much itself. This lowers the cholesterol in the blood stream. Ignorant doctors are happy – they know not what they have done.

      Ironically, the most serious form of Familial Hypercholesterolemia would receive no benefit from statins anyway. As the extreme form of FH is characterised by LDL receptors working barely at all, even the body going into crisis mode, and trying to take LDL from the blood stream with increased LDL receptor activity, will not work if the LDL receptors are not working well enough in the first place. Hence the LDL will stay in the blood stream with an extreme sufferer of FH and yet the statin has reduced what little chance the FH sufferer’s body had of making cholesterol within the cell. The FH sufferer should ideally be given medication (if anything existed) to stimulate cholesterol production within the cell, so that the cell would at least get the vital cholesterol it needs, even when it couldn’t get it from the blood stream.

      That’s my view on FH! Best wishes – Zoe

  • Thank you Evinx. I recently lost 50 lbs and was in amazing medical shape with ever test except that my cholesterol went way up (LDL +25 pts) My doctor advised that I take another test in a few months and if it wasn’t better, look into drugs. I am going to hold that off until I am done – only about 20 lbs.

  • Here is what Volek & Phinney state in their book, “The Art and Sciencee of Low Carbohydrate Living.”(Chapter 13).

    “There is one anomaly in clinical testing that physicians and patients should be award of: a transient rise in serum total and LDL cholesterol that can occur with major weight loss. We reported this in 1991 [101], and our research revealed the cause. It turns out that along with the triglyceride stored in adipose tissue, our fat cell also contains a small amount of dissolved cholesterol. After about 30 pounds of weight loss, the shrinkage of these cellular fat droplets proceeds to the point that some of this cholesterol has to be released into the serum. The amount of cholesterol involved is 100-200 mg per day in someone losing 2 pounds of adipose tissue per week. Interestingly, although this represents ‘reverse transport’ back to the liver, this cholesterol rise appears in the LDL fraction. But once a person’s weight loss ceases, this expulsion of cholesterol stored in adipose tissue stops and serum LDL cholestrol returns to its new post-weight-loss baseline.

    So if you or your patient experience a rise in serum LDL cholestrol as the scale passes 30 or more pounds of weight loss, don’t panic. This is a sign that your body is dumping previously accumulated cholesterol. Since this situation typically lasts only a month or two,whereas it takes decades of elevated LDL cholesterol to cause blood vessel damage, the probability of any clinical risk is very small.”

    • Nice one Richard! I’ve got that book on my shelf – it’s great!

  • I am comforted somewhat by your rebuttal but I can’t help the nagging feeling that rising cholesterol isn’t good either. Since adopting low-carb higher fat my cholesterol has increased steadily. Last test it was 7mmol/L. And my reading of other blogs and forums suggests I’m not alone. I would love your opinion of why this may be so.

    • Hi Mitsouko – 7 is not high in any way. The current ‘norm’ is 5-6 and it used to be higher than this before we started drug interventions to artificially lower this figure. We have progressively lowered what is ‘normal’ (as per my height analogy) – exactly so that people with a completely naturally normal cholesterol level of 7 start to worry and become more inclined to take statins.

      Cholesterol in food makes no difference to cholesterol in blood. The one study that compared the Atkins diet to the American so called heart healthy diet found the following (extract from my book The Obesity Epidemic: What caused it? How can we stop it? is at the end of this note:) Hence your diet has not changed anything – if you have cut back on carb, you would have likely lowered blood cholesterol as carbs can impact cholesterol production.

      So many things can impact your cholesterol level, you may as well have the doc count the hairs on your leg! It will be higher if you have been injured or ill recently; it will be higher if you have had less sunshine recently (as vit D is made by sunshine on the skin synthesising cholesterol); it will be higher if you’re stressed at the moment or were running late for the appointment or didn’t fast beforehand. Did you know that the blood cholesterol test can only measure total cholesterol and HDL? Did you know triglycerides and LDL are guessed? Did you think this was accurate?!

      Don’t worry about cholesterol! Worry about people trying to lower your cholesterol in pursuit of $billions!

      Best wishes – Zoe

      The BBC Horizon programme, about The Atkins Diet (August 2004), interviewed Dr. Gary Foster who had recently led a study comparing the Atkins diet with the standard USA government low fat advice of the time. The programme wanted to see if the Atkins diet were more effective for weight loss and, in the words of the programme transcript, they wanted to test “The scientists’ biggest criticism of the diet was that the high fat would lead to high cholesterol which would clog the arteries and kill.” (Please note this example of typical media language on the subject of fat).

      This was an important and probably overdue study. As Foster noted “Despite the popularity of the low-carbohydrate, high-protein, high-fat (Atkins) diet, no randomized, controlled trials have evaluated its efficacy”. Foster and his team set out to rectify this and randomly assigned 43 women and 20 men to either the Atkins diet or a low-fat diet, for a one year duration. The Atkins diet started with a carbohydrate intake limited to 20g per day for two weeks and the group following this diet were given a copy of Dr. Atkins’ New Diet Revolution to follow thereafter. The low-fat group followed The LEARN Program for Weight Management, which was consistent with the dietary recommendations provided by the registered dietitian for the study and with the American food pyramid. The women in the latter group were allowed 1,200-1,500 calories a day, the men 1,500-1,800. The intake was designed to be approximately 60% carbohydrate, 25% fat and 15% protein. The calorie intake in the Atkins group was not limited.

      Noting that “adherence was poor and attrition was high in both groups” (although a higher proportion of the low carbohydrate group managed to stay on the diet), the conclusions were that “subjects on the low-carbohydrate diet had lost more weight than subjects on the conventional diet”. They had, in fact, lost twice as much. At three months the Atkins group had lost, on average (mean) 6.8% of their body weight vs. 2.7% for the low-fat group. At six months the comparator numbers were 7.0% vs. 3.2% of body weight. The difference at 12 months was described as not significant, but I’m not sure the slimmer group would have been so dismissive. At 12 months the Atkins group had lost, on average, 4.4% of their body weight vs. 2.5% for the low-fat group.

      Turning to cholesterol, the programme’s interview of Foster recorded him saying “My first reaction was could this be, this doesn’t make a lot of sense. Not only were there no bad effects of the diet in terms of cholesterol, but actually there were quite positive ones.” Triglyceride readings for the Atkins group showed an 18.7% fall at three months, compared with a 1.1% rise for the low-fat group. This was sustained with the 12 month readings showing a 17% fall vs. a 0.7% rise for the low-fat group. That means, even if the low-fat group results had fallen by 0.7%, the Atkins reduction would still have been 24 times greater.

      The journal notes that the study was funded by the National Institutes of Health. Taubes notes in a question and answer session, in one of his presentations featured on YouTube, that no further funding was offered after the results of this study were published. “If you want to do a study that you think can show that this (government recommended) diet is unhealthy, you won’t get funding. Not from the NIH, not from the American Heart association.”

      – Gary Foster et al, “A randomised trial of a low-carbohydrate diet for obesity”, New England Journal of Medicine, (May 2003).
      – The Horizon programme transcript says that 120 people were involved in the study, half on Atkins, half on low fat. This was not accurate. There were 63 participants in the Foster study. The programme also mentioned and interviewed Dr. Eric Westman, who had done a study with 51 subjects placed on a <25g per day low carbohydrate diet – not dissimilar to Atkins, but not strictly Atkins and there was no low fat comparator group. This was presented in the American Journal of Medicine, (July 2002).
      - Atkins RC. Dr. Atkins' new diet revolution, revised edition, Avon Books, (1998).
      - Brownell KD, The LEARN program for weight management 2000, Dallas: American Health Publishing, (2000).

  • Outstanding information, apparently based on extensive research. It still amazes me and contributes to the all around confusion when doctors and other scientists disgree on what seems to be so appartent! No wonder that we in the general population are confused!

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