A Statin-Free Life: A revolutionary life plan for tackling heart disease – without the use of statins

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I’m not against medications by any means, but I absolutely support informed consent—and most people taking statins are not fully informed. When it comes to heart health, diet and lifestyle are at the forefront of prevention and disease reversal, and we need to think about sugar, triglycerides, HDL cholesterol, and other markers in addition to LDL cholesterol. Simultaneously, "if the damage and repair mechanisms in the body are overridden - if there’s more damage than repair - then within the heart arteries you can develop these deposits that are full of cholesterol, actually a response to the injury - but also inflammatory immune cells." Today on The Doctor’s Farmacy , I talked to Dr. Aseem Malhotra about the real data on statins, heart disease, metabolic syndrome, and so much more.

About one in 250 people in the UK have familial hypercholesterolaemia (FH), an inherited condition that causes high levels of cholesterol and which can also be treated with statins. Consequently, "meditation, yoga or something that reduces your stress levels will have a big impact." He cites an Indian study that found forty minutes of daily mediation had the strongest impact on heart disease reversal – "more than diet, more than exercise." Yeah. I think that’s right. And I think the lifestyle stuff is so huge. And you talked about the Pioppi diet, I talk about the Pegan diet. It’s essentially focusing on quality. So whatever you’re eating, the key concept is it should be high quality, meaning nutrient dense, unprocessed, whole real food. And you can kind of go up the chain, eating a filet steak is better than eating, for example, a bunch of bread, right? But it’s not as good as eating wild elk or eating a grass fed steak. So you can keep going deeper in the quality chain. The second is to really understand that food is medicine and that everything you’re eating is regulating your biology in real time. And three, it’s personal. Everybody’s biologically different and some people may be more carbohydrate tolerant than others. Some people may be more fat intolerant than others, and there are ways to figure that out, which is really important.We now know that heart disease is linked to two biological processes, he says: "Insulin resistance and chronic inflammation." Insulin resistance is when cells don’t easily absorb glucose from your blood – from sugar and high GI foods – so it’s chronically raised. "Insulin itself directly damages the inner lining of the heart arteries," he says. In terms of the prevalence markets, very interesting. I mean, data varies from say, anything from if you trust the industry sponsor trials, they say like 1% of people may get muscle aches or fatigue. And then in my practice, I don’t know. I mean, it goes from 20%, 30%, whatever. So there’s- Yeah. And Matt, so I caveat in that. What’s interesting is these are also most likely the patients that tolerated the statin and didn’t get side effects because those people are somehow weeded out of the trials. Often we have something called the pre-randomization running period before a randomized control trial starts where patients who don’t tolerate the drug or are non-compliant, they use this word, non-compliant, okay? Which doesn’t make sense to me to because if you’re enrolling in a trial and you volunteered, you are likely to be somebody who’s enthusiastic about taking a drug, right? So that doesn’t make sense to me, but very likely the people with side effects are weeded out within the first few weeks of a trial and then you then report on the results on the people who tolerate the drug, okay? So this is still a bias. So I talk to [inaudible 00:16:11], well, it’s more like those one and 83, one in 39 figures are people that tolerated the drug and were able to take it for five years. Ultimately, whether you choose to take statins or not, Dr Malhotra says, "Please, please, please do not neglect the lifestyle aspect, because eighty percent of heart disease is environmental and lifestyle related." He hopes people will read his book, consult their open-minded medical experts, and make informed decisions.

Absolutely, absolutely. And we also know it now has been established about 1% of people who take statins will develop type 2 diabetes because of the statin, right? So there’s a lot of information that people aren’t being told and would change their decision making process and that’s really where we need to change the conversation across the whole of medical practice. And it’s taking time. I think people are becoming more aware. Doctors are becoming more aware. I think one of the concerns and issues I’ve had and I’ve campaigned on in the UK is that when you financially incentivize doctors to meet certain targets of cholesterol lowering or targets of treating certain people at certain risk, then it’s more like to bias a conversation and the patient really is the one that suffers at the downstream because they’re not really getting involved in fully informed consent. And that for me is ethically dubious. It’s a useless biomarker in terms of predicting someone’s risk of heart disease and therefore we shouldn’t obsess about lowering it," he says. Instead, he believes the best predictor of the risk of heart disease is reached by measuring the ratio of total cholesterol to HDL, or 'good' cholesterol. Dr Malhotra rejects this, and says, "The most important message is let’s have that transparent, honest communication with patients – explain to them the absolute benefits, respect their decision, give them alternatives." Consequently, “meditation, yoga or something that reduces your stress levels will have a big impact.” He cites an Indian study that found forty minutes of daily mediation had the strongest impact on heart disease reversal – “more than diet, more than exercise.”CVD is a general term that describes a disease of the heart or blood vessels. It's a very common cause of death in the UK. He is a pioneer of the lifestyle medicine movement in the UK and in 2018 was ranked by software company Onalytica as the number 1 doctor in the world influencing obesity thinking. It feels like a war, with bitter accusations of misinformation and ‘fake news’ flying on both sides. If you look at the average increase in life expectancy from taking statins from industry sponsored data, so we take that with a pinch of salt because industry sponsored studies, which are most of the statin studies in general are designed and the results are geared to kind of exaggerate the benefits and minimize the harms. But if we take that at face value, okay? Even- Dr Aseem Malhotra FRCP is an NHS-trained consultant cardiologist and visiting Professor of Evidence Based Medicine, Bahiana School of Medicine and Public Health, Salvador, Brazil. He is a founding member of Action on Sugar. In 2015 he became the youngest member to be appointed to the board of trustees of UK health charity The King's Fund.