This book is not in our library, but I do think it should be. I bought my own copy via Amazon.
Dr Malcolm Kendrick is a Scottish GP, who sets out to puncture, or at least severely dent, the prevailing notion that cholesterol is the villain causing coronary heart disease. And he lays on the facts, thick and fast, with an outrageous and irreverent sense of humour. A small sample of his offerings:
We all know, don’t we (we are told often enough) that saturated fat in our diet causes heart disease – the research shows it? Well it doesn’t actually. The research showing this was carefully “cherry picked” to “prove” the notion and Kendrick provides “twice as much” evidence to prove that the opposite is in fact true.
Well, how about “good HDL cholesterol” and “bad LDL cholesterol.” There are no such substances. There is High Density Lipidoprotein (which contains cholesterol) and Low Density Lipidoprotein (which contains cholesterol) – same cholesterol. (Semantics, I hear you say, but what does this say about the cholesterol theory of heart disease?
OK, but we know that eating a diet high in cholesterol raises our blood cholesterol levels doesn’t it – the research shows it? No it doesn’t actually – on both counts. Our bodies make cholesterol, which is essential to life. If we eat less, our bodies make more and vice versa. The amount of the stuff in our diets makes little or no difference.
So what about the cholesterol/heart disease connection? Surely there is lots of research that shows this? No again. It is clear that cholesterol is present in coronary disease, but the causes are not clear at all. Just because two things occur together does not mean that one is causing the other.
And, of course, there are the cholesterol lowering drugs, the statins, which make, in Dr K’s words, “eye watering profits” for their manufacturers and which, in his opinion are virtually worthless, or downright harmful. Find out why women should never take them and why anyone who has not had a heart attack should not take them. And find out how many statins have been hastily withdrawn from the market for the annoying little side effect of killing people! Find out how often the research data says one thing, but the published outcomes recommend exactly the opposite.
Dr K’s take on the causes of heart disease is that stress is the biggest culprit and he produces lots of data to back up this assertion. I agree, with reservations, (see musings below.)
All this and more. This is a hugely informative and entertaining book, though it does suffer from the lack of an index. I have spent quite some time on the net, looking for something – anything, from someone like a cardiologist, heart foundation, physician, etc, along the lines that Kendrick is talking through his hat, for the following reasons:….. I have not found anything. Perhaps the establishment is treating him with an old medical approach – ignore him and perhaps he will go away.
Dr K is not a lone voice, however – have a look at the Cholesterol Skeptics site for similar information. There is also another book by the same name, written by Anthony Colpo, which I have not yet read.
Further musings, for those who may be interested:
I must confess a vested interest in this subject – my cholesterol levels are in the outer stratospheric range and have been so for the last 40 years. Every time I have a blood test I get panic stricken phone calls from the medical centre, but I flatly refuse to take statins, for the reasons Dr K outlines. A bit galling really as I have always been slim, fit, eat reasonably healthy and have that rugged New Zealand handsomeness. (Well the first three are true and we’ll just ignore the shrieks of feminine laughter in relation to the last one, shall we!)
Statins have nasty side effects, at least for some people. Cognitive (thinking,) problems, memory problems, muscle and joint pain, sleep disturbances, to name but a few – and they can cause a potentially fatal condition known as rhabdomyolosis. I am astonished at the number of people I find taking them who have no real idea of why they are doing so and have never had heart disease. I am equally astonished at doctors who prescribe them and don’t tell their patients about side effects – or worse yet, claim there are none.
Dr K puts forward the notion that stress is the major causative factor in heart disease. He tends to discount (with supporting data) smoking, high fat diets, high blood pressure and a number of other factors and discounts the “protective” factors such as the French diet, alcohol, women’s hormones etc.
I am a psychologist, with a pretty good working knowledge of stress. I think Dr K is quite right – stress can be a killer, but I suspect it is not the whole answer to heart disease. To stress, I would add smoking, trans-fats and damaged rubbish “foods.” I recently had a client whose heart is pretty well stuffed (to use an old medical term.) He was grossly obese and his diet consisted almost entirely of sausage rolls, pies, fries and pizza and he was drinking three litres of coke a day!! You simply can’t do that to your sytem on a long-term basis and get away with it.
There are also different forms of stress and people make different responses. I know lots of people who are very stressed, but they aren’t keeling over with heart disease. The worst forms of stress seem to be those driven by unresolved anger, guilt, anguish and despair. When the stress is unremitting and/or when there is a sense of hopelessness and no way out. Also when there are enormous unexpected shocks in a person’s life. Then there are body, biochemical changes and harmful substances like cortisol get produced, there is inflammation and the likelihood of heart disease soars.
I do think that risk factors can act in combination – stress with smoking; stress with lousy diet; stress with high blood pressure etc. And many of our foods are simply rubbish, or have the superficial appearance of being healthy. Have a look in any supermarket and note the enormous volume of “foods” which are almost entirely for entertainment or distraction – the chips, sweets, biscuits, soft drinks, alcohol, spreads, toppings, ice-creams and so on. And then there are the foods that advertising tries to convince us are healthy – the breakfast cereals, milk and milk products, refined and processed products, fast foods, the so-called healthy oils, margarine type spreads etc etc. For more insights into this sort of thing see The Omnivore’s Dilemma, by Michael Pollan, reviewed on this site.
So apart from eating healthy food, managing stress positively and keeping fit and slim, what am I doing to maintain cardiac health? I drive carefully!
Merlin's Book Reviews 