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National cholesterol month

I was at a dinner party recently when the subject of cholesterol came up. Every (lay) person around the table turned out to be an expert: “Cholesterol is bad”, said one. “Well actually there’s good and bad cholesterol”, clarified another. “Our cholesterol shouldn’t be higher than five”, volunteered one sage. Five what? They had no idea. Why is cholesterol bad? Not a clue. If ever there were a substance vilified with the utmost ignorance – cholesterol is it.

This month, October, is national cholesterol month in the UK. September was national cholesterol month in the US. Call me cynical, but staggering the months gives one sixth of the year when the increasingly global on-line world is being manipulated to have cholesterol front of mind. Leading the charge in the UK appears to be Heart UK – an organisation masquerading as a charity, which more accurately should be seen as a voice piece of the cholesterol lowering industry. Here are Heart UK’s backers.

This is what we should be told in national cholesterol month and these are the things that my fellow diners should have been saying about cholesterol:

1) Cholesterol is utterly life vital

Every human being would die instantly without cholesterol. Every single cell in the human body depends upon it. We would have no digestion or hormone function without cholesterol. Cholesterol is critical for brain and memory functions – even though the brain is only 2% of the body’s weight, it contains approximately 25% of the body’s cholesterol (Ref 1). Cholesterol is essential for bones and all the roles performed by vitamin D. We could not reproduce without this life vital substance. Hence, not only would humans die without cholesterol, the human race would die out.

2) Cholesterol is so vital that our body makes it

It cannot be left to chance that we would need to get cholesterol from an external source, such as food. One of the key reasons that we need to spend approximately one third of our lives sleeping is to give the body time to produce cholesterol, repair cells and perform other essential maintenance.

3) There is no such thing as good and bad cholesterol

The formula for cholesterol is C27H46O. There is no good or bad version. Ignorant people call HDL ‘good’ cholesterol and LDL ‘bad’ cholesterol. Neither HDL nor LDL are even cholesterol – they are lipoproteins. HDL is High Density Lipoprotein and LDL is Low Density Lipoprotein. HDL is smaller than LDL and is therefore higher in density. Lipoproteins carry cholesterol, protein, phospholipids and triglyceride around the blood stream to undertake vital roles.

4) The cholesterol blood test is a guess

The standard blood test can only measure total cholesterol & HDL. So we have one equation, four unknowns, only two of which can be measured:

Total cholesterol = LDL + HDL + Triglycerides (VLDL)/5

Any GCSE maths student will tell you that this is insolvable.

Your best option is not to get your cholesterol ever tested and then you can never be a victim of the cholesterol lowering machinery that will kick in if your guestimate fails the following test…

5) There is no science behind the number “5”

Even after years of artificial intervention, the average cholesterol level in the UK is somewhere between 5.6 – 6.3 mmol/l (Ref 2) (216-244 mg/dl). The powers-that-be have decided that this should be 5mmol/l (193 mg/dl). This is like saying that the average height for a woman is 5’4” and we have decreed that it should be 5’1”. We could then stop the body from performing a natural function (growth) by administering drugs to stop growth hormones from doing their job. I trust that this analogy disturbs you. It is, however, frighteningly similar to what we are doing with attempts to lower average cholesterol levels.

6) “There’s no connection whatsoever between cholesterol in food and cholesterol in blood. And we’ve known that all along.” Ancel Keys

Dietary cholesterol is only found in animal foods – meat, fish, eggs and dairy. Ancel Keys spent the 1950s feeding humans high levels of animal foods to see if dietary cholesterol had any impact on blood cholesterol levels. He concluded unequivocally that it did not. He never deviated from this view. While exonerating cholesterol, Keys also exonerated animal foods at the same time – and any substance contained therein. If large intakes of animal foods have no impact on cholesterol levels, then neither animal foods per se or any component of these foods (water, protein, cholesterol, saturated or unsaturated fat) have any impact on cholesterol levels!

Unaware of this irrefutable logic, diet ‘experts’ will tell you that saturated fat raises LDL and unsaturated fat raises HDL. They won’t tell you how. I have yet to find a biochemist who can explain how this can happen – let alone that it does. As every food that contains fat contains all three fats (saturated, monounsaturated and polyunsaturated) you cannot consume any food that has saturated and not unsaturated fat, or vice versa.

Even if the very small 3 grams per 100 grams of unsaturated fat in sirloin steak (Ref 3) could raise HDL and even if the even smaller 2 grams per 100 grams of saturated fat in sirloin steak could raise LDL – where would this leave our insolvable equation?!

The US dietary guidelines are due to be re-issued this year. The draft report announced in February 2015 that “cholesterol is no longer a nutrient of concern” (Ref 4). It never was you Muppets!

7) Low cholesterol is associated with higher mortality. High cholesterol is associated with lower mortality

I have analysed cholesterol levels and death rates for all 192 countries for which the World Health Organisation has data. You may need to read this carefully. The lower the cholesterol levels, the higher the death rate; the higher the cholesterol levels, the lower the death rate. This holds for men and women and for heart disease deaths and total deaths from any cause – for all the countries in the world. Knowing how utterly vital cholesterol is to human life, this makes complete sense (Ref 5).

8) Follow the money

Why would humans put so much effort into stopping the body from doing something that it is designed to do – make cholesterol?

Statins are drugs that impair the body’s production of cholesterol. One statin alone, Lipitor, has been worth $125 billion to Pfizer since 1997 (Ref 6). This statin is the most lucrative drug in the world. It is not the only statin.

Thankfully statins don’t work perfectly. If they stopped the body producing cholesterol altogether they would have a 100% death rate.

An entire low-fat spread industry, worth billions, has emerged simply by adding plant sterols to margarines because the brainwashed public will buy anything with “cholesterol lowering” properties. These plant sterols compete in the human body with human cholesterol and the overall impact on heart health is serious (Ref 7). I trust my body to make the cholesterol it needs. I’m not going to replace this with a foreign compound.

Back to the dinner party: While my healthy heart sank at the nonsense being asserted by intelligent acquaintances, there was an upside to their naive acceptance of propaganda: When the cheese course arrived, there was plenty to be enjoyed by the enlightened!


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88 thoughts on “National cholesterol month

  • Thank you for bringing awareness to National Cholesterol Month Zoe! You are right. Low cholesterol can be a major health issue too. I am a life insurance agent and most companies will decline you if your cholesterol is too low, below 120. And who would know better than life insurance actuaries. To add to National Cholesterol Month in October I listed some of the life insurance companies that allow total cholesterol of 300 or less with or without meds and still get the best health class.

    • Hi Scott
      So sorry for the delay in approving this – a month’s worth of comments have just appeared – I wondered why it had gone quiet!

      Many thanks for sharing this. When I do my annual health questionnaire to get a lower premium, it asks how much sat fat I eat. I just think “you idiots”!

      Best wishes – Zoe

      • Hi Zoe,
        I am a 48 year old female 68.5kg weight. My latest cholesterol is 7.5 however LDL = 5.4 HDL = 1.46 and Tryglcerides = 1.32. My doctor thinks I have familial hypercholesterolemina. She is also very concerned because my dad has mixed dementia at age 60+ and is concerned that my cholesterol will push me down same route. I have never taken statins, my BP is excellent and I am in general good health albeit stressed out now about the fact that I may have FH. Your advice would be hughly appreciated.

  • Just in abit of a quandary. My cholesterol level was 6.5 and according to results bad out weighed the good.I decided not to see my doctor as I knew he would put me on statins. I follow Zoe’s principals but do drink white whine and am 2 stone heavier than I should be although have kept a weight loss of 5 stone off for 15years.I recently went for an eye test and they said that they could see a white circle of cholesterol around my eye and To go and see my doctor.I am worried but also worried about my health and so much contradictory information online.statins or low fat diet or what.I’m confused.what should I do.can diet help or should I just accept high cholesterol. Any advice would be welcome.

  • This is both fascinating and reassuring reading.

    I have been taking statins for 25 had a stent fitted 3 years ago following a sudden episode of worsening angina attacks. Your work together with those of Dr Malcom Kendrick and Dr Joanne McCormack have convinced me to reconsider taking statins.

    When the surgeon fitted my stent he told me he had to give a little extra ‘push’ to break through a calcium build up. Having studied the HFLC diet, and now strictly following, I believe that years of misguided and dangerous NHS dietary advice worsened my arterial health leading or contributing to athersclerosis.

    Have we been denied and become deficient in K2 obtained from grass fed meats and diary products like butter and some cheeses. Is it possible that vit K2 and possibly therefore other essential vitamins, minerals and elements, are missing from the mass processed diet we are (were) being advised to take.

    Is the LFHC diet responsible for my blocked arteries or am I way off the mark? Even for those with a stent in situ are they still better off without statins?

  • Hello, This is really interesting I had been ‘sucked in’ to believing Cholesterol was Bad,Bad,Bad but seems not after what I have read in these posts. I have always had high Triglyceride measurements and told that this Bad, can anybody advise their opinions on this, grateful for any replys.

    • In a nutshell, high trigs relate to excess carb consumption. High HDL IN THE ABSENCE OF EXCESS CARBS relates to saturated fat consumption. The ratio of trigs/HDL correlates to insulin resistance, CVD risk and particle size and density of LDL (broken LDL particles don’t work so well). The factors which cause the damage include high blood glucose and high insulin levels, which is what the “cholesterol” is attempting to repair, and which are caused by excess dietary carbs on top of insulin resistance. Try LCHF and see what happens. If you don’t see an amazing improvement you can always stop again.

  • In my research during cholesterol month I came across the following looking for help to understand:
    Why are they now using this “Non-HDL Cholesterol (Non-HDL-C)”? Can someone explain this to me?
    Also there is another HDL to total cholesterol is % terms should be greater than 24%,
    Triglyceride to total cholesterol ration should be less than 2.

    • Hi Bala
      My suggestion?
      ‘They’ tried to blame total cholesterol, but the evidence didn’t stack up,
      So then they tried to invent and blame good and bad cholesterol (there’s no such thing – HDL and LDL are lipoproteins), but the evidence didn’t stack up,
      So then they tried to blame the ratio of one to the other, but the evidence didn’t stack up,
      So then they tried….

      This is just a new effort in keeping the cholesterol scam alive. I have know idea what the heck they think your words above are about. Try to get a believer’s view!

      Best wishes – Zoe

  • Hi Zoe
    I am just reeling after an enormous set to with my mother who has categorically told me that my 71 year old ( extremely active)father cannot possibly come off his statins as it is saving his arteries from furring up. She says that the Dr has told her that there definitely is bad cholesterol and that he should not come off them. My sister and her husband are both consultants in various medical fields and both totally espouse the view. I feel as though my head is going to explode. Why are people so stupid and why do Drs not ask intelligent questions?
    Sorry that this is a bit of a rant!

    Best wishes

    • Hi Annabel – I share your frustration! Just one thought – most statin leaflets have cautions about over 70s taken them as even the drug cos know that lower cholesterol in older people is bad news. Maybe that would convince mum, dad and doc?! Personally I would make a formal complaint about any doc prescribing statins contra to the patient leaflet.
      Best wishes – Zoe

  • What I want to know is what to do about the advice that eating less meat is good for the planet because it takes more energy to grow an animal than grow crops, or that they’re overfished or factory-farmed?
    I quite like eating meat but would consider cutting my consumption because of those factors. When I’m able to make my own buying decisions I’ve told myself I’ll buy organic & non-factory farmed foods….but it’s still a consideration.
    I know that isn’t really your speciality – just wondering what you & others think?

      • Thanks! I’m reading the blog post now and will put the book on my TBR list.

    • Clare, the argument that a plant-based diet is automatically good for the planet is nonsense. Meat can be highly sustainable and crop growing can be intensive and laden with pesticides.

      I live near a national park in Yorkshire. It’s beautiful, but much of the land is hilly and rocky. The only ‘crop’ that can be grown is sheep. We’ve had sheep here since the Romans and there are 30 sheep for each person living in the national park. Sheep eat grass and provide meat and wool. I’d say that’s as sustainable as anything gets. The sheep also roam the countryside, largely unfettered. It’s as natural and ethical as anything we eat. You could make a similar argument for venison, rabbit and the better end of beef production.
      So, meat production can be highly sustainable, but that doesn’t matter to people who don’t eat it for ethical reasons. I respect those reasons, but I don’t share them. Most people don’t, which is why the vegetarian movement adds ‘health’ and ‘sustainability’ to its reasons to persuade more people into eating mostly “plant-based food”. I think some vegetarians know these arguments are wrong, but when you believe “meat is murder” any argument that helps becomes justifiable.

      I accept that some meat production can be grain fed and industrial. I don’t buy that sort of meat. However, it would be good to hear a vegetarian concede that some meat is completely sustainable and the only practical use of our moorlands and rocky uplands. Crops grown in huge mono-culture waste lands with the aid of pesticides and water extraction, then transported across the world, are way less ‘sustainable’ than animals grazing in local fields, but never generate a word of criticism.

      Meat or crops can be good or bad. This is where consumers can influence the market by buying decently produced meat. Meat eaters have far more influence on producers than vegetarians, who would really like to close the industry down.

      Vegetarianism is a moral stance and an identity. It has nothing to do with nutrition or ‘sustainability’

      • You also have grouse, which attract the rich to go shoot them but are eminently edible. Down here in the lowlands many farmers grow a “second crop” of pheasants and partridges, and the crops they sow to feed them are also used by many wild birds which eat pests and weed seeds and reduce chemical bills. We have more hares than rabbits, which I don’t eat, as they are generally uncommon, but the rabbits from not far away are fair game (pun intended). Culling the deer is essential and provides yet another food source principally from woodland which they would otherwise destroy in their current numbers. If some trendy restauranteur would put rape-stuffed pigeon on their menu, farmers would weep for joy!

        On the other side of the coin,a farmer’s wife was driving the combine in rape when it started to malfunction and she was unable to adjust it. She rang the farmer who went out and discovered the entire works was gummed up with the squished remains of slugs and snails – it had to go back to the yard to be steam cleaned. So much for the ethics of “heart healthy vegetable oil”. . .

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    • Hi Oliver – this is really unhelpful from your part namesake! Jamie has a massive following. His heart is absolutely in the right place. I can’t knock him for his efforts to be a real foodie, but his nutrition knowledge is all over the place. He’s been wrong on sat fat for some time (in his defence, he’s wrong alongside the majority). This latest carb stuff is just really unhelpful. It’s doing the rounds on twitter suggesting he needs some carb advice. Fat too while he’s there!

      Still better someone trying to do the real food thing than an eatbadly plate devotee :-)

      Best wishes – Zoe

  • There are two factoids I keep in my back pocket for those who think my real-food, LCHF, sugar-free diet is magically going to make my heart explode. First is that my triglycerides are so low (~50 mg/dl or .56 mmol/l) that the LDL calculations are invalid (even though 99 mg/dl or 2.56 mml/l is nothing to worry about, it’s still very likely an egregious overestimation). There is absolutely no way for anybody to dispute the low-carb / low-TG connection for me.

    Second, I simply point out all the wonderful things cholesterol does (hormones, cell function, etc. etc. etc.) and how statins destroy not only cholesterol, but a host of downstream dependencies – and how that quite nicely explains most side effects of statins like random muscle pain.

    Nice to see the commenting activity on this post, btw. I do think the general understanding of cholesterol is slowly but significantly changing for the better.

  • I’m on a statin as part of the repurposed drugs to manage cancer trial being conducted by the Care Oncology Clinic in London. So not for the supposed cholesterol lowering effects of statins but their anti-cancer effects. I found this article, and all the comments, very interesting – I’ve been a LCHF fan for a while so have no issues with eating saturated fat. Just a little freaked by what the statin might be doing to my body (like lowering cholesterol) when all I really want it to do is manage my cancer. It would seem I can’t even eat lots of saturated fats to counteract the statin. Any thoughts?

    • Hi Gaynor – this is really interesting. I read about this recently and I thought – do you know what? That’s possibly the first valid use for statins that I can think of! This post may help explain why ( The Yoseph book explains how statins kill cells – likely cancerous and healthy cells in a person with cancer. Maybe killing healthy cells is a price worth paying to kill cancerous cells?

      The statin companies like to claim an association with low cancer and taking statins. Uffe Ravnskov explains this well – cholesterol is a protective substance in the body. People with high cholesterol are therefore less likely to have cancer but more likely to be on statins. I don’t think for one minute that statins protect against cancer, but I can see how they could kill cancer cells. Would this be any different to chemotherapy? Would I rather kill cells with a statin than chemotherapy? Thankfully I don’t have to make that decision at the moment but I think the trial you’re a part of is an interesting one.

      On the cholesterol – you have to hope that your body does its best to make as much as possible to counter the statins. You could artificially raise your cholesterol by eating carbs (raises VLDL) but that isn’t going to help with general health at all and VLDL is not what you want more of.

      Good luck with your treatment and may you beat cancer soon
      Best wishes – Zoe

    • Gaynor, whichever course of treatment you decide upon I hope that you make a full recovery.

      I hesitated in replying to your comment as I have no wish to make you feel even worse than I suspect you already feel with a diagnosis of cancer. It’s something anyone would dread hearing.

      I do not know which company is sponsoring the trial in which you are participating but I suspect it is a drug company (directly or indirectly). If it was a new cancer drug then I wouldn’t be commenting but it’s not – it’s a statin. Because of that I would ask to see the evidence that statins are a suitable treatment for your particular cancer – or any cancer. I suspect that this is just another attempt to spread these poisons into yet another area of medicine on the back on very questionable research. Everything that I have read from reliable sources says the exact opposite – statins increase the risk of cancer.
      Dr Kendrick covered this very subject a few months back and so did Uffe Ravnskov plus there’s this .

      This is a book which provides useful information without raising false hope. You may find it of value. Anticancer: A new Way of Life by Dr. David Servan-Schreiber ISBN-13: 978-0718156848.

      Wishing you the very best.

    • Hello Gaynor, I’ve read a number of times that if you’re taking statins, a Co-enzyme Q10 supplement is necessary because it puts back an important enzyme that statins unintentionally remove. I saw them on sale today in Sainsbury’s.

      Also, the LCHF diet would seem to be helpful as cancer feeds on glucose, so low carb is logical.

      You might find Thomas Seyfried’s talks on YouTube interesting. He’s a professor of biology in America and doing work on low carb/ketogenic diets to treat cancer. Here’s a short introduction.

      Very best wishes.

    • Gaynor, some more information for you (mentioned by Mike Cawdery on Dr Kendrick’s blog): It’s long but worth seeing (knowledge is power). Plus a book by Travis Christofferson, Tripping Over the Truth: The Metabolic Theory of Cancer ISBN 9781500600310.

  • Zoe, they seem to have moved the goalposts in the case against Professor Noakes. It’s now not about his low-carb advice, but the propriety of advising over the internet.

    The same thing happened with Jennifer Elliot in Australia. The case was clearly about her low carb advice to diabetics but the Diatitians Association now say it was about competence.

    I think this tells us that they’re very nervous about fighting on the science and would rather move onto procedural issues that most people couldn’t care less about. When I think of the scandalously bad nutritional advice given by the NHS and official dieticians’ bodies in the UK, US, NZ and Australia, I think it must be very hard for people like you, battling for sanity against ancient dogma.

    I can’t help wondering about your type 2 friend. She does well on your advice, gets terrible advice from the NHS, follows it and gains 70lbs in weight. Yes, it was convenient, but didn’t she notice the results were the opposite of those achieved when following your advice? It’s hard to help some people.

    • Hi Stephen – yes – friend did notice but she’s an addict at the end of the day and if an NHS dietician gives her the green light to indulge her addiction, that’s what she will do. It’s just so awful to watch :-(
      Best wishes – Zoe

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  • Hello,
    I started reading Health Unlocked and Heart UK sites three years ago after learning from my blood test that I have high cholesterol and elevated blood glucose. Life style change, regular exercise and LCHF food intake is giving me a healthy life style.
    After reading your dinner story I did a post at Heart UK site so other members car read and learn.
    Now I am a “restricted” member!.
    All I wanted was other people to read the dinner story and learn from it but the Heart UK web policing team got me!
    Will always search for your stories on the Internet as there is a lot to learn.

  • We had a similar experience recently, attending a dinner at restaurant where everyone ordered off the menu. It was an “Italian Steakhouse,” a tradition in our community, where normal steakhouse entrees are served as well as pasta dishes. We ordered rib-eye steaks, and were told that because this was a large group, we had no choice of side dishes and that everything would be served with salad, baked potato, and mostaccioli. We declined the potata and pasta. We had been engaging in conversation about diet and health throughout the evening and couldn’t help but explain our LCHF lifestyles and of course got all of the usual questions about cholesterol and were contradicted in all we had to say about ignoring cholesterol with the same sort of nonsense about good and bad cholesterol. When our dinners arrived, we were amazed to find we were the only ones who had ordered steaks, and everyone around us received spaghetti or lasagna along with their potato and pasta sides. As we began eating, several men next to me shared with each other the dates of their by-pass operations and one mentioned his Type II Diabetes. Are you ready for the punchline? This was a gathering of a 40-year Medical School school class reunion. All of the attendees were retired or still practicing physicians and their spouses.

    • Hi Peggy – lovely story! Many thanks for sharing this :-)
      Best wishes – Zoe

  • In this morning’s newspaper: Associate Professor treated a cockatoo. X-rays revealed its heart was clogged with cholesterol after living on fatty sunflower seeds. The vet prescribed a low fat, high protein diet. I suspect the real cause was bread and chips.

  • am pleased to read this seeing as my Dr went into a panic when my cholesterol came back at just under 8. I then got told avoid eggs & saturated fat. I was told if not I’d have to end up on statins. Another has recommended red rice yeast tablets to lower the numbers/levels. At the back of my mind I remembered reading somewhere that high cholesterol is not as bad as everyone says. That doesn’t stop you from worrying, thinking you could be heading into heart attack/stroke area etc! VERY confusing & scary…

    • Hi Sarah
      a) doc clearly doesn’t know the cholesterol in food makes no difference fact – worrying, but not unusual

      b) you may like to ask doc for the evidence for primary prevention in women (do let me know if this elicits anything!)

      c) you may like to ask doc – best case – for how long your life might be extended (and, by the way, that would be from the anti-inflammatory properties of statins – the cholesterol lowering is a serious side effect). The answers are in this blog and the original article below:

      and then get doc to talk you through the serious side effects (they’re on the patient leaflet) and see if s/he would like to rethink?

      Best wishes – Zoe

  • Hey Z. You know this already but I post it here for others to take inspiration from. As a vegan who ate no cholesterol for over 20 years, I had 9.2 cholesterol. As a HFLC meat eater it’s 5.1. Now, I don’t care – for all the reasons you state, but you should have seen the doctors face when I had this test done – and I had it done purposefully to humiliate him, knowing what it would show. Know what he said? “It must be a testing error” He denied it could happen and told me to stop eating saturated fat. I laughed and told him he was wrong. He told me not to believe everything I read on the internet. I told him not to believe everything he’s taught in medical school.

    • Hi John!
      Many thanks for sharing this here – laughed out loud!
      Good to see you’re still on top (fat) form ;-)
      Bye for now – Zoe

    • Hahahahaha brilliant comeback!

      It’s just like the old story of the village shop. When a customer asked if they would stock something, whe shopkeeper said
      “No, because there’s no demand for it”

      The customer was insistent

      “I told you there’s no demand for it, just like I told the other three people who asked for the same thing today!”

      Cognitive dissonance. It’s easy to dismiss symptoms as psychiatric, psychosomatic or hypochondria. HOW you can generate psychosomatic test results deserves research . . .

  • i have been put on every statin going,which all have given me bad leg /joint pains,i am now on a tablet that reduces “bad cholesterol”.Apparently my bad cholesterol is 1.9 and should be 1.8,but my total cholesterol is 8.4.i cant see why they are giving me tablets to reduce the so called bad cholesterol?i am now in a bit of a panic awaiting to have a stroke,surely this is wrong ??

    • Pauline, yes it is wrong but not unusual. I recommend that you follow Zoé’s advice regarding cholesterol and diet. Don’t take any statins – they are poison – if your cholesterol level is high then it’s most likely because your body is trying to correct a problem. If you address the problem your cholesterol will stabilize at whatever level is correct for your body. Cholesterol is your friend and not your enemy. Strokes are associated with low cholesterol. Rather than worry about your cholesterol level you should ensure that what you eat is correct for your body and that isn’t what you are likely to be told by your doctor (doctors have about zero nutritional education in their training) or official (government sites such as NHS). In general terms you should bias your diet towards Paleo and in particular avoid processed foods – basically anything that is in a cardboard packet, paper bag or a tin plus sugar in all of its guises – and that includes fruit with the exception of berries (berries won’t spike your blood sugar). Carbohydrates only supply energy and will increase your triglyceride level. What you should aim for is food that provides nutrition (the substances that your body needs to maintain itself) and not just something that stops you feeling hungry.

      • Hi Barry & Pauline
        Just for clarity – I don’t and can’t offer advice. I can point people in the direction of things to read (not least to counter the 99% of messages that try to uphold the status quo) and I can offer my (strong and researched) opinions on statins and cholesterol – from a position of independence, not the industry financial conflict. I can also say that I agree with everything Barry says about food :-)

        Best wishes – Zoe

        • Hi Zoé, my apologies for any inconvenience caused by my reply to Pauline. I should have said read your books and blog for information. I understand your position regarding direct advice. Ironic, is it not, that those that know can’t and those that don’t can? Not true in all cases but one only needs to see the rubbish on the NHS sites regarding diet to realize there is a huge problem.
          Pauline, you have to make your own decisions regarding diet, drugs and supplements. My approach is to aim for a low carbohydrate diet, keeping it simple and, most of the time, just eating natural foods that you would find at a traditional greengrocer, butcher or fishmonger that are not tainted by preservatives or destroyed by industrial processing. The occasional piece of cake etc. is then acceptable. I also take a range of supplements to compensate for what is lacking in food due to modern production techniques plus, at this time of the year, vitamin D as there is insufficient UVB between September and May to provide it naturally.
          Regarding cholesterol you can find more information than you probably want at and if in any doubt about the damage that can result try and read Duane Graveline’s account of what happened to him.
          When you look at where statins work in the mevalonate pathway then it very clear that nothing good can result. As you know from your own experience many people experience noticeable adverse effects but I believe that even those who claim not to experience them are in fact doing themselves harm – they just don’t realize it.

          • Hi Barry – many thanks for understanding. We have the crazy situation where Professor Tim Noakes, one of the world’s best thinkers and author of c. 1500 academic papers? is on trial for unconventional advice! WTF?! And, as you say, the ignorant are freely giving advice to all and harming them – IMHO.

            My T2D friend was doing really well after I gave her a selection of books (Montignac, mine, other real food/low carb) – 70lb down and full of energy. Then she got into the system – put on statins, BP meds, metformin – assigned a dietician who showed her the eatbadly plate and told her to graze on carbs all day long. This female (60s) LOVES carbs, so this was advice made in heaven. Friend followed it – regained 70lb and then some. She’s now exhausted. in agonising joint pain and I reckon about 10 years have been lopped off her life.

            The Duane Graveline leads are great ones for Pauline and many others. Completely lost his mind did poor space doc!
            Best wishes – Zoe

  • Thank for your dinner storey. Very interesting cheese course!
    Have read many more stories from you web site.
    Life style change, food intake control, regular exercise can help towards a healthy life.
    One life, quality of life rather than length of life, we all have to go one day, enjoy life without medication.

  • what a fasinating read since being diagnosed with diabetes several years ago my quacks have repeated tried to force statins down me and made me feel like an idiot when I have repeatedly refused I never felt as ill as when I am taking the damn things and truly believe I would rather live in comfort for as long as I naturally have than have extended life span they claim to offer with constant leg pains they produce

  • LOL!!! “The draft report announced in February 2015 that “cholesterol is no longer a nutrient of concern” (Ref 4). It never was you Muppets!”

  • Zoe, so good to see somebody talking sense on diet and in particular cholesterol.

    I was casually reading through some of the comments on your blog and it is clear that despite your excellent advice and the mass of evidence elsewhere that people (No disrespect intended towards anyone commenting on this site) still find it hard to accept that cholesterol is not a problem. It demonstrates just how powerful a lie is if repeated often enough. Even more worrying is the fact that supposed specialists with an in depth knowledge of biochemistry also appear blind to data that doesn’t fit to their beliefs. It brings to mind a Leo Tolstoy quote:

    “The most difficult subjects can be explained to the most slow-witted man if he has not formed any idea of them already; but the simplest thing cannot be made clear to the most intelligent man if he is firmly persuaded that he knows already, without a shadow of doubt, what is laid before him.”

    Of course this only applies to those that genuinely believe the cholesterol myth and not those whose “belief” has been bought.
    My father-in-law is on statins and they are clearly having an effect on him. I have tried many times, with masses of evidence, to show him that they are not necessary and that they will do him immense harm. He just will not listen because I’m not a doctor and his doctor says they are necessary to help prevent a heart attack. Whatever happened to first do no harm?

    Please keep up the good work.

    • Hi Barry
      A GP sent me this yesterday – Atorvastatin/Lipitor is not even marketing authorised (their terminology for approved) for secondary prevention, let alone primary. I did not know that!
      Maybe that would convince FIL or even his doc?!
      Best wishes – Zoe

  • Hi Zoe
    Love the website but just a quick point about the measurement of LDL. The NHS (and other clinical departments worldwide) use the friedewald formula to calculate LDL, not because they can’t but because it’s too expensive and the equation is a fairly good approximation for the overwhelming majority of the population. The assay is very simple and operates using the same principle as the HDL assay namely by using a reagent that selectively masks the LDL fractions (using an antibody or detergent depending upon the manufacturer). Your own department at UWS has the ability and equipment to perform this LDL measurement (and small dense LDL if required).

  • A great post, Zoe. Bob’s story about his daughter is shocking. Don’t they need consent?

    A change of tack. Jennifer Elliot is the Australian dietitian sacked for recommending a low carb diet to diabetics, although the Dietitians Association of Australia (DAA) now deny that. I sent a letter on Elliot’s behalf and got the sort of standard reply one might expect. There was no meaningful comment on the paper on carbohydrate restriction for diabetics that I forwarded (Feinman and Pogozelski et al.) or the Credit Suisse report on fat.

    The following is part of their response:

    “According to Diabetes Australia, very low carbohydrate diets are not recommended for people with diabetes. The organization states: ‘If you eat regular meals and spread your carbohydrate foods evenly throughout the day, you will help maintain your energy levels without causing large rises in your blood glucose levels’ (Diabetes Australia website, 2015). Diabetes Australia recommends people with diabetes eat moderate amounts of carbohydrate and include high-fibre foods that also have a low glycaemic index (GI). . . . People with diabetes may also be misled by the idea of replacing some carbohydrates with foods high in saturated fat – however, research shows this can actually increase insulin resistance.

    Foods high in saturated fat include:

    • Many biscuits, cakes, pastries, pies, processed meats, commercial burgers, pizza, fried foods, potato chips, crisps and other savoury snacks
    • Butter, cream, cooking margarine, coconut and palm oil.

    The Australian Dietary Guidelines have been designed for healthy populations and suggest people have from 45%, and up to 65%, of their total energy intake from carbohydrate foods.

    Consistent evidence indicates that in general, dietary patterns higher in plant-based foods such as vegetables, fruits, wholegrains, legumes, nuts and seeds, and lower in animal-based foods are more beneficial for overall health. This type of diet also has a lower impact on the environment and is therefore more environmentally sustainable as a recommendation for the population.”

    Isn’t it strange that when they talk about saturated fat it is in the context of biscuits, cakes, pastries, pizza and potato chips? Eggs, meat, milk and cheese don’t get a mention, except that meat is clearly bad. Butter somehow belongs in the same category as ‘cooking margarine’.

    The disproportionate influence of vegetarians is again evinced. Australians should clearly get rid of all those sheep farms in the arid outback and have a go at growing ‘healthy whole grains’. I wonder how sustainable that would be?

    As for diabetics, no discouragement at all from eating carbohydrates, but a warning that saturated fat can increase insulin resistance. In addition, their dietary guidelines state, “Saturated fat increases our risk of heart disease.”

    The sad thing is that Australia has slavishly copied every mistake we’ve made and are inching, ever-so-slowly, away from. At some point in the future, I suspect they’ll be the last bastion of the low-fat diet.

    One of the DAA’s sponsors is Coca Cola, those well known guardians of public health.

  • I had a heart attack 4 years ago, while on 40mgs of Atorvastatin per day. I am still taking those statins. Supposedly to protect me against a heart attack. BUT, they didn’t do the job first time around. How can I rely on then now. I need to stop the statins, but I am a bit scared of taking this step against the advice of my doctor. Such a dilemma.

  • Hi. Is there ever such a thing as too high cholesterol? I’m 55 and my TC is 12. Have been on statins 20 years but recently just binned it. I’m an academic and my brain function is important to me (as it should be for anyone). What do you think?

    • Hi Irma
      Interesting one. You’re probably into Familial Hypercholesterolemia at 12 while on statins! I can only share opinions and suggested reading. My own view of FH is part way down this post:
      And you can see what I think of statins generally with this.

      Dr Uffe Ravnskov – who has FH himself – has been fascinated by it all his life and has written lots about it. His book Ignore the Awkward (chap 3 from memory) is about FH. It’s on open view somewhere but our broadband is currently doing snail imitations, so I can’t search for it.

      Dr Malcolm Kendrick is the other one who’s done lots in this area. I think the presentation linked to at the end of this blog covers a really interesting (not published!) study

      Dr David Diamond and Uffe have a paper in progress, but these things are never easy to get published. The drug cos want you on statins. Hope this gives some leads if not help
      Best wishes – Zoe

      • Thank you much for the links to these studies! Will go look for them immediately. Best of luck with your future work!

          • Hi

            Just wanted to thank you for the reference to Ravnskov. I bought his newest book on kindle and read it in a day. What a pleasure to read someone who writes clearly, simply and obviously with authority. I have decided to stop worrying about cholesterol. And I’m old enough not to care what the cardiologist says. :)

            Thanks for your help!


          • Pleasure :-)

  • Thank you, Zoe, for all your hard work on these issues. I really appreciate your thoughtful, well-reasoned, logical and science-based approach to this area. I especially enjoy the way you deconstruct the misleading statistics. And the way you point out the conflict of interests in the scientific community. I’m excited to see your work in the future, post-PHD. :) I’m sure you have some exciting projects planned.

    Also, by the way, your diet is great and easy. Thank you!

  • Hi

    Very interested in this. Have been on statins for the last 8 years, consistently have a high reading despite this and the low fat dairy regime. This is genetic, as both parents had this problem.
    Am seeing my doctor tomorrow to question why I am bothering. I actually discontinued taking the statin about 3 weeks ago, and my hip and joint pain have decreased. Also have started LCHF diet – love to lose that 10kg sitting around my middle.

  • The best overview on misconceptions about cholesterol. I am a statins victim and I can not agree with the views more.

  • I’m so confused by Cholesterol. I’ve had “high cholesterol” since I was 22(7.9 when my first test was done)and have been told I must be on tablets for the rest of my life…I have never taken for more than 1 week at a time as I forget to take them at night. I am now 46 and I’m still 7.9. The GPs tell me that now I’m peri menopausal I am unprotected by my lowering oestrogen levels and my cholesterol is now going to cause a heart attack if I don’t sort myself out quick smart… I am eating healthily with the occasional hiccup but the scare mongering gives my nightmares. I wish someone in Australia could give me a true answer but surely we’re not too different to the rest of the world….Thanks for listening to my rant & giving me something of substance to read…
    Jo xx

    • Hi Joanne
      I could commit a crime when I read stuff like this! grrrrrrrrrr…

      1) 7.9 is not high – it is entirely normal

      2) This is what statins do:

      3) Read this carefully – Higher cholesterol is associated with lower deaths – from heart disease and all causes
      Especially strong inverse relationship for women.

      In my view – your only problem is a wicked industry for whom a lifelong statin patient is the ultimate goal. That $125 billion for Lipitor alone remember?! You may be interested in this link too ( This drug does not even have marketing approval for secondary prevention, let alone primary prevention. Secondary prevention is where someone has already had a heart attack (that’s not you I assume?!)

      I’d sue the arse off someone if this were me!
      Sorry – but it makes me that angry that you’ve been half scared to death for no reason whatsoever.
      Best wishes – Zoe

      • Hi there – My reading was 7.5 and my life insurance company refused my application. I am 60 years old and was put onto statins. 3 months down the line I had another blood test and my reading came back as 6.3 so they doubled the medication. About to go for a further blood test and hopefully will be able to go off statins as I am now following the LCHF way of life. Do I wait for the doc to tell me to go off or just go off after the blood tests. They will probably keep me on them as they will think it is the statins that have lowered my reading. I am a walking disaster waiting for an accident to happen according to the ins company. This was due to a very high BP which I had no side affects but that is under control now as well.

        • Hi Dael
          I personally think that this is criminal (and stupid) – an insurance company insisting on drugs to achieve an arbitrary picked out of the air number.

          You may like to read this ( but it sounds like you already don’t much care for statins. Sunbathing will naturally lower cholesterol (vitamin D is made by skin cholesterol being synthesized by sunshine). Docs differ on diet – most would probably worry if anyone is eating anything other than the gov LFHC diet advice. LCHF should lower your BP naturally a) as you’re more likely to reach natural weight and b) because you don’t have constant carb water retention.

          LCHF will lower triglycerides (carbs again) but who knows where your reading will be. It’s completely inaccurate anyway ( Your body is trying to make what it needs and the docs are trying to stop this happening. Are there no sensible insurance companies? I guess you’re American?

          Good luck finding an oasis of sense in this mad world
          Best wishes – Zoe

  • Finally bothered to get a lipid panel after several years of super high fat (80%+) mostly carnivorous diet (plus booze):

    Cholesterol: 7.5/290
    HDL: 2.97/115
    LDL: yeah right
    Chol/HDL ratio: 2.5
    HbA1c: 24/4.3

  • Hi Zoe,

    You state:

    “The standard blood test can only measure total cholesterol & HDL”

    This not actually the case. Triglycerides are measured directly in the serum sample. Only the LDL-c is calculated.


    The Friedewald equations are then used to estimate the LDL-c:

    VLDL-c = Triglycerides/5
    LDL-c = Total cholesterol – (HDL-c + VLDL-c)

    The Friedewald equations are used as a surrogate because direct measurement is still very expensive.

    Calculating LDL-c using the Friedewald equations is of course a hack and has known limitations at both very high and very low TAG levels.

    • Hi Kurt
      Many thanks for this. I had a fuller passage in my 2010 obesity book:

      “The fasting blood cholesterol test is the traditional way to measure the level of LDL, but it doesn’t measure LDL directly. We can only measure total cholesterol and HDL with the standard blood test and Triglycerides (VLDL) and LDL are together assumed to account for the difference. The estimation is refined further using the Friedewald equation (named after William Friedewald, who developed it). This uses the fact that VLDL is 22% cholesterol to establish the equation:
      Total cholesterol = LDL + HDL + Triglycerides/5 which leads to:
      LDL = Total cholesterol – HDL – Triglycerides/5. (EH Mangiapane, AM Salter, Diet, Lipoproteins and Coronary Heart Disease: A Biochemical Perspective, Nottingham University Press, (1999).)”

      Your first link confirms what I’ve researched – in the standard cholesterol test – VLDL-C is calculated (not measured) using the Friedewald equation. I understand that there are more sophisticated tests that can be done to try to measure triglycerides, but the standard one has 4 unknowns and 2 actually measured. Plus the test is so wildly inaccurate anyway – 19% out as Fraser and Fogarty showed here (

      Best wishes – Zoe

      • More seriously, there’s the Iranian Equation which better calculates LDL with low trigs but high total cholesterol. Interestingly my GP used to use a lab which actually *measured* LDL and my result fell neatly between the Friedewald and Iranian values.

        There’s a recalculator here

        In restrospect I passed my first gallstone in the early seventies when I was suckered into an Ornish-style high carb low fat grain based diet. I was told categorically that I did not have gallstones for years before my gallbladder was removed, full of gravel. Anecdotally I’ve seen numerous people who developed gallstones on a HCLF diet, it was only when I read a post on Andreas Eenefeldt’s Diet Doctor blog that I realised how commonplace this was.

        At the time this was blamed on eating “too much fat”.I was told I had low HDL, high LDL and very high trigs, but that this would not be a problem as long as I kept my LDL down by eating a low fat diet, which I dutifully did.

        Ten years later I *still* had low HDL, high LDL and very high trigs, and was told by a dietician to eat even less fat and even more carbs.

        When this made my lipid panel *worse* I was obviously accused of “failing to comply” with the diet.

        IMO the most important part of a lipid panel is the trigs/HDL ratio which relates to insulin resistance, particle size and density of LDL and cardiovascular risk. This is no coincidence, it’s the hyperinsulinemia and hyperglycemia which are the actual culprits, the LDL is the body’s attempt to deal with the resulting inflammation.

        I actually like getting a full lipid panel as it is an indicator of a functional metabolism. I doubled my HDL and reduced my trigs to 1/10 of what they were simply by eating the EXACT OPPOSITE of what the dietician told me, ie. low carb high fat. This is so commonplace as to be unremarkable. In fact many people achieve higher HDL than LDL.

        Curiously when I had hypERthyroid it had exactly the same effect in lowering LDL as a statin, what the hell is that all about?

        In restrospect I have spent most of my life with alternating hyper and hypoglycemia with hyperinsulinemia and insulin resistance, much of which is genetic from one specific line of my family. IF I had only been told how to deal with this earlier I might not be going to die prematurely from CVD. I have no doubt that the belief in the “cholesterol hypothesis” and the “diet heart hypothesis” is visiting this fate on a huge minority if not a majority of the population.

        • “Curiously when I had hypERthyroid it had exactly the same effect in lowering LDL as a statin, what the hell is that all about?”

          Thyroid hormone increases the uptake of cholesterol, which is why it lowers LDL. Eating foods rich in iodine (such as kelp) will stimulate thyroid hormone production and give a similar result.

          Apparently, GPs are supposed to check for thyroid problems when they see high LDL before prescribing statins, but none of them do.

          Have a look at Chris Masterjohn’s work over at the Daily Lipid:

          • Hi Brett
            Very interesting – many thanks for this.
            Best wishes – Zoe
            p.s. I do love CM’s work :-)

          • Well some of them do! My TSH has remained resolutely around 1 on all previous tests until the thyroid suddenly exploded. My only surprise is that this was not (yet!) blamed on “not enough starch” or “too much fat”. I’ve seen the opposite with hypOthyroid which is much more common. Chris Masterjohn is on my “will read soon” list: so many blogs so little time . . .

  • Ever wonder how many of the other things you’re told are lies? Zoe, you know all about cholesterol and the biochemistry of nutrition; but if you read in the media that (for example) Russia is causing all sorts of harm in Syria, for malicious selfish reasons, you might accept that just as the other guests at the dinner party believed what they had been told. Or that if the UK leaves the EU our world will fall apart. Or that the banks and the Treasury know exactly what they are doing. (Actually, it turns out that economists know even less about economics than the lipid hypothesis’ advocates know about nutrition).

    In this fast-moving, complicated world we have to trust others to inform us accurately and truly. But how can we assess their credibility – and, even more, their motives? That is a serious and difficult problem, given that at any stage anyone who stands to gain (mostly money) can slip in some disinformation.

    • Yeah – like Iraq has weapons of Mass destruction able to hit the UK in 45 mins!?

  • For me, my cholesterol level (TC, HDL) tracked whether I was in a low fat/high carb diet or low carb/high fat diet. I had lower TC and HDL with low fat and higher TC and HDL with low carb. In fact, the only way I could increase my HDL (exercise did not help) was to keep on a low carb diet and also use periodic fasting (both of which supposedly reduce insulin resistance). My opinion is that low TC and HDL are markers for insulin resistance.

    By the way, in the US, the pediatricians are going to give my daughter (who is 8) a cholesterol test. Yes, a cholesterol test. How many long-term randomized, controlled trials have they done on testing children for cholesterol and any outcomes (whether it’s using diet to “lower” cholesterol, testing what cholesterol levels children have and how they change with age, or anything else)? I guarantee it’s none.

    • OMG! I would absolutely refuse to allow any doc near my child with a cholesterol test in mind. What happens if they don’t like the number? statins? end of normal growth for your daughter? end of grand-parenthood for you?!
      This is a scandal…

      • Zoe, I honestly don’t know what they’re going to do with this information. They just told my wife at the last yearly appointment that cholesterol testing was coming up. Luckily, I wasn’t at that appointment, or I would’ve exploded on the poor doctor (who is just following guidelines — as stupid as the guidelines are). If I can remember, once they take the cholesterol test and give us any results or recommendations, I’ll post.

        But I think all doctors have been bamboozled by the system. My TC and HDL have been low for 20+ years due to eating low fat/high carb. When I finally got around to trying LCHF, and then convincing myself to continue eating this way (which took years), my TC is higher than 200 (US units) and my HDL is finally above 40. To me, this is great news, knowing as I do (and as you’ve stated above) that low TC is associated with higher death rates from all causes, but my doctor is freaking out telling me that I have to address this with “diet”.

        • In the US a lot of primary care doctors are in “Pay for Performance” contracts with HMOs. The HMO tells them which tests to do on which patient population. The doctor gets paid a “bonus” (which can be a significant part of their remuneration)for getting a certain percentage of that population to take the test. (92% of children between age 3 – 6 getting their annual well child screening, 75% of women between 40 & 72 getting a mammogram every 2 years, 40% of girls between 16 and 21 getting chlamydia screening, etc.)

          Failing to meet these targets can result in the HMO refusing to accept the doctor, which means they won’t get paid at all for seeing HMO members.

          As always in American medicine: Follow the Money

  • Excellent overview of the most misunderstood subject in modern health and medicine. For years my doctor kept pressing me to take statins, and I told him I simply did not believe the hype. It was clear to me that my cholesterol level reflected my weight, higher if I gained, lower when I lost. Before this century ends med students will view the current medical stand on cholesterol like the ones now view the bloodletting of a century or more past.

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