How Well Do Cholesterol-Lowering Drugs Actually Work?

Image Credit: akz / © This image has been modified.

How Well Do Cholesterol-Lowering Drugs Actually Work?

One of the reasons people may undervalue diet and lifestyle changes is an overconfidence in the ability of pills and procedures to prevent disease. For example, people tend to wildly overestimate the power of things like mammograms and colonoscopies to prevent deaths from breast and bowel cancer, or the power of drugs like Fosamax to prevent hip fractures, or the power of cholesterol drugs to prevent fatal heart attacks. Patients believe statin drugs like Lipitor are about 100 times more effective than they actually are in preventing heart attacks. Studies show most people wouldn’t take multiple blood pressure medications if they knew the truth.

For most people, the chance of benefit is normally less than 5 percent over five years for cholesterol, blood pressure, and blood thinning drugs. Patients don’t want to take drugs unless they have at least a one in five chance—even those who just had a heart attack. It’s no wonder, then, that doctors seldom share these figures. Informing patients of the percentage chance of benefit from preventive drug strategies would likely substantially reduce the likelihood that patients would agree to take the drugs every day for the rest of their lives.

For the individual, not being informed of the low percentage chance of benefit from these preventive drug strategies is unlikely to be detrimental; after all, there’s a 95 percent chance it won’t do anything for them. But for the population at large, being informed would make a difference; so, doctors and drug companies oversell the benefits by conveniently not mentioning how tiny they actually are, knowing most patients wouldn’t take them if doctors divulged the truth. To practice non-lifestyle medicine is to practice deceptive medicine. 

The best that cholesterol-lowering statin drugs appear to do is an absolute risk reduction of 3.1 percent over six years. If Dr. Esselstyn’s work can be replicated in a randomized, controlled trial, then a whole foods plant-based diet will have been shown to work twenty times better, an absolute risk reduction of 60 percent after less than four years. In Esselstyn’s study, 99.4 percent of high-risk patients that stuck with the diet avoided major cardiac events, such as death from heart attack.

When we have to decide whether we want to go diet versus drugs, we’re not making a choice between eating healthy to prevent a heart attack or taking a pill to prevent a heart attack. Because in 97 percent of cases in the near-term, pills don’t do anything. We’re risking side effects for nothing, whereas if we treat the underlying root cause of the disease by eating a healthy, cholesterol-free diet, we may even reverse the progression of the disease, as seen in my video The Actual Benefit of Diet vs. Drugs.

If we stop eating an artery-clogging diet, our bodies can start dissolving that plaque away, opening up arteries in some cases without drugs or surgery. A healthy whole food plant-based diet by itself may work 20 times better than drugs to combat our #1 killer.

Now, that’s something doctors may want to tell their patients.

Yes, an ounce of prevention is worth a pound of cure, but a pound isn’t that heavy—why change our diet and lifestyle when we can just wait and let modern medicine fix us up? Turns out we overestimate the efficacy of treatment as well, the subject of my video Why Prevention is Worth a Ton of Cure.

Sometimes, preventive medicine procedures can even be harmful. See Cancer Risk From CT Scan Radiation and Do Dental X-Rays Cause Brain Tumors?

I’ve previously noted how an honest physician-patient interaction might go in Fully Consensual Heart Disease Treatment, Optimal Diet: Just Give it To Me Straight, Doc and Disclosing Conflicts of Interest in Medical Research. What should we be saying? See: What Diet Should Physician’s Recommend?

So why don’t more doctors do it? See Barriers to Heart Disease Prevention and Find Out If Your Doctor Takes Drug Company Money.

More on Dr. Esselstyn’s heart disease reversal study in: Evidence-Based Medicine or Evidence-Biased?

Of course, then there’s just the brute force method: Kempner Rice Diet: Whipping Us Into Shape.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:


Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.

89 responses to “How Well Do Cholesterol-Lowering Drugs Actually Work?

Comment Etiquette

On, you'll find a vibrant community of nutrition enthusiasts, health professionals, and many knowledgeable users seeking to discover the healthiest diet to eat for themselves and their families. As always, our goal is to foster conversations that are insightful, engaging, and most of all, helpful – from the nutrition beginners to the experts in our community.

To do this we need your help, so here are some basic guidelines to get you started.

The Short List

To help maintain and foster a welcoming atmosphere in our comments, please refrain from rude comments, name-calling, and responding to posts that break the rules (see our full Community Guidelines for more details). We will remove any posts in violation of our rules when we see it, which will, unfortunately, include any nicer comments that may have been made in response.

Be respectful and help out our staff and volunteer health supporters by actively not replying to comments that are breaking the rules. Instead, please flag or report them by submitting a ticket to our help desk. is made up of an incredible staff and many dedicated volunteers that work hard to ensure that the comments section runs smoothly and we spend a great deal of time reading comments from our community members.

Have a correction or suggestion for video or blog? Please contact us to let us know. Submitting a correction this way will result in a quicker fix than commenting on a thread with a suggestion or correction.

View the Full Community Guidelines

  1. Thanks doc for the article.
    What about familial hypercholesterolemia ? I follow a plant-based diet, but still my cholesterol is over the roof due to the fact that also my father and grandfather had it.
    I started to take statins but I had collateral effects and I stopped (after consulting a doctor).
    Is there any evidence that a good diet helped this type of high cholesterol condition?
    thank you very much!

      1. thanks @disqus_EXJURIXKLQ:disqus ! in part it answers yes, but the doctor is not talking about familial hypercholesterolemia as far as I understood. Another question I have for him (I would love to get his opinion on this!) is: what the doctor is thinking about “sytrinol”, who’s been shown to lower naturally the bad cholesterol?

        thank you very much for the important work you guys are doing!

        1. Alessio Madeyski: I’m glad that moderator Stephanie jumped in as she knows more than I do about this subject. But to explain my reply to you: I was kind of thinking along the lines of Stephanie in that I didn’t know if you really had this familial hypercholesterolemia or if your doctor just assumed without testing.
          My other thought was that even if you have familial hypercholesterolemia (how DO you remember how to spell that???), you would be doing yourself nothing but good to eat the same diet that others would eat to lower cholesterol. If your cholesterol were high “naturally,” you would want to do all you could to keep it as low as naturally possible. Also, while I am just a lay person, I have a theory that if you eat the same healthy diet that someone who has controllable cholesterol levels eats, maybe your risk for harm would be quite low despite the cholesterol levels. I don’t know if there is any proof to this or not, but I heard a well respected plant based doctor once say his belief that cholesterol levels should not be something people should stress over if they are eating an Essselstyn type diet. Again, I don’t know if that is true, but maybe the idea will help you as you make future decisions.
          Now for what you actually asked about: sytrinol. This is the first I’ve ever heard of that. Very interesting idea. I hope that someone will be able to comment on that question.

    1. Hello. Niacin, at a dose of 2 grams a day, is effective at lowering cholesterol. Be aware of the flush. It is a burning reaction, skin tingling, that starts in the forehead and goes to the toes. Niacin lowered my cholesterol and raised my HDL 50 percent. It perhaps could take 500 mg of Niacin a day to maintain a healthy person. Niacin is possibly lost in almost all food processing. Niacin is much more than 5 percent effective. For fifty years it was the gold standard in cholesterol medicines. Niacin in two studies is believed to have longevity extension effects.

    2. Hello,

      “The patient(77 years old) chose, however, to not proceed with surgery and rather she chose to adopt a whole-food plant-based diet, which included all vegetables, fruits, whole grains, potatoes, beans, legumes and nuts. She eliminated all animal derived products, such as eggs, cow’s milk, yoghurt, chicken and beef, and she presented to our cardiac wellness program. She described her previous diet as a ‘healthy’ Westernone.
      Clopidogrel 75 mg daily was added to her medical regimen, simvastatin was replaced by a high-potency statin (atorvastatin80 mg daily) and atenolol was replaced by carvedilol. Within one month of lifestyle change her symptoms had nearly resolved, and she was able to walk on a treadmill for up to 50 min without chest discomfort or
      dyspnea. Her total cholesterol decreased from 5.7 mmol/L to 3.2 mmol/L, and her LDL cholesterol decreased from 3.7 mmol/L to 1.5 mmol/L over three months.”

      You can read the whole study here (very informative read):

      1. Ivail Sve, 80 mg atorvastatin is the strongest dose. I was put on 40 mg and found the side effects so horrific, I end up being referred to several specialists and a pain clinic before tossing them. Alessio Madeyski mentioned in their post that they quit the lipitor after suffering ‘collateral effects’. i am now in the same position as Alexsio.

        @Alessio Madeyski, I am eating a whole food plant based diet , no oil , and exercising daily. My cholesterol is still higher than desirable, LDL 2.56 last check but the doc is happy it stays under 3. Dr Essyelstyn has some info at his website I believe on this topic. btw, I decided to decrease inflammation in my body vs struggling with cholesterol numbers. hcrp went from 2.7 to 0.3. As they say, its the food !

        1. thanks Susan. problem is that my high cholesterol is genetic, so nothing you can do there. Nonetheless, I will keep being vegan, non smoker, non drinker and I have a perfect weight for my height. My doctor said I’m perfect from the point of view of things I can do to improve the situation, but the genetic bit will always be there.
          I’m also seeing there are other cures to lower bad cholesterol (like antibody injections and so on), so I will ask my doctors about these…I really would love to avoid statins, but it might be the only solution.

          keep rockin Susan :)

          1. Alessio, thank you for the reply. I am so happy to hear you are continuing to do ‘all we can do for ourselves. I have heart disease through the whole family and did have bypass surgery.. nonethless, I persue an active lifestyle. I truly believe that if we eat well, exercise, sleep enough/destress, dont smoke , stay fit snd slim, then we’re in a far better situation. The docs here are amazed.
            Antibody injections sound interesting. You’ll have to report back successes in your therapies !
            I did try lipitor 10 mg only two times weekly, and I did not suffer badly. I was told some people have to start slowly . I will not increase the dosage for now. Best wishes for continued good health, susan

      2. Ivail Sve, thank you for posting that link! Well worth reading, and saving to my favorites. It clearly illustrates the power of food and the limitations of the prescription medications we put too much trust in imo. Very clearly written — its a keeper!

    3. High cholesterol is also a sign of inflammation or infection and produced by your liver to combat these ailments. If eating a low fat whole food plant based (no nuts, no avos, no fat, no oil) diet does not solve your cholesterol problem there is most certainly something else causing the inflammation . Find the cause.

      There are also elimination diets, like eating just potatoes or just rice and then slowly adding different food types… See Dr. McDougall for more info. Might be of some assistance.

      1. Thank you Riaan De Winnaar – I have naturally high cholesterol too (with blood pressure 105/65, resting hr of 48, but a little overweight although very fit) – this is the second time in my life my cholesterol has gone through the roof while being very low fat whole food plant based – the other time I was on a Pritikan diet, the lowest weight I’d ever been as an adult, just 26 years old and very fit! It is perplexing! However, my view is the cholesterol is being made by my body for a reason – repairs, to fight infection or inflammation as you mention, making hormones, etc. I got tricked (like a lot of people) into the low carb thing for the last ten years, off the back of 20 years of elite athlete training and a pretty good case of adrenal fatigue – low carb is very bad for the adrenals – I ended up last year in hospital with a shut down metabolic system, crashed out hormones, ruptured ovarian cyst, I had shingles just before that and I’ve had glandular fever (mono) since. I started WFPB low fat in January, I have lost about 6kg (14 to go), but more importantly I can feel my body healing! I suspect that the cholesterol thing may stay relatively high but eventually even out as I am fully healed (20 years of ridiculous elite athlete training and 10 years of ridiculous low carbing to recover from – it will take time). If everything else is good – weight, fitness, blood pressure, blood sugar, diet, general health, sense of wellbeing, then having “high” cholesterol may not mean much….

        1. On the road to recovery tho. Like Dr Greger always says – once you stop hitting yourself with that hammer…

          The human body like all herbivores is designed to hold on and preserve to cholesterol. We evolved on a diet poor of saturated fat and thus we need to use the little cholesterol we produce in house efficiently. You could see us as cholesterol traps unlike carnivores that have mechanisms to excrete their excesses.

          It might take years, but quality of life improves daily when you eat a biologically appropriate diet.

    4. Hi Alessio Madeyski. Just because your father and grandfather had high cholesterol does not necessarily mean that you have familial hypercholesterolemia. Familial hypercholesterolemia refers to people who lack cholesterol receptors and therefore the cholesterol remains in the blood (that’s a loose description). People who have this condition may have cholesterol levels in the 300s mg/dl or higher. A very small percentage of the population actually has this condition. What is more common is multiple family members with high cholesterol due to common eating patterns. I know you said you follow a plant-based diet, however are you limiting your intake of fatty foods? Oils, nuts, seeds, avocados, and coconuts, for example, are high-fat plant foods which will raise your cholesterol. Since your cholesterol is high despite being on a plant-based diet, I suggest you take out the above foods and see how that affects your cholesterol.

    5. I’m not actually believe in 1/2 of “family” or “genetic” or “autoimmune” disease, very often it’s just a way to say “relax and don’t look for real reason of it and don’t try to be free from it.”.

      I see people who treat such diseases very well, so the doctors end with smth like: “Oh! it can’t be true, we just made a mistake with diagnose”
      So don’t give up and try to treat it.

      1. @Helga @NFmoderatorStephanie:disqus thanks both. Yeah, I’m not giving up :) indeed I didn’t take any genetic exams, it’s just an hypothesis. My cholesterol is around 300 indeed, even if it’s been years I’m vegan (and non smoker, non drinker and not overweight). I also don’t eat many of the fatty foods. Nuts only every now and then (4 brazilian nuts a month + some small weekly doses of other type of nuts), I don’t use coconut oils or other coconut stuff (I don’t like it!) , I eat avocados (for a maximum of 4-5 a month, but I can easily get rid of them) and as for seeds I’m eating flax seeds daily in my breakfast and that’s about it. So I can say I’m very limiting the intake of fatty food. Also, I tend to avoid all fried foods (maybe once a month when I eat some fries with my vegan burger :) ).

        So again, I’m not saying that my cholesterol is genetic for sure, it’s just a possibility. What I know is that even with my diet, it’s not getting better :) the only good results is that bad cholesterol is a bit lower from the time when I was eating meat and all kind of crap. :)

    6. I think you will find Dr. McDougall’s article, Cholesterol – When and How to Treat, in his September 2002 newsletter of interest. Given that Dr. McDougall touches on the issues that clinicians wrestle with. Unfortunately we don’t know the Number Needed to Treat for your population. We do have a better handle on the Number Needed to Harm for the statins. In short we need more studies. Keep tuned to as the science keeps coming. Have a good upcoming holiday season.

    7. Familial hypercholesterolemia is actually rare, absolutely does not mean you have it because your family has it. It is a rare gene, but even if you have it does not mean you will have hypercholestrolemia, but that you have the tendency, its not like the absolute genes, like – ‘my parents have brown skin therefore I will also have brown skin’.
      (See below for the BTW on doctors telling their patients they have Familial Hypercholesterolemia….)
      Anyway –
      Each of us have 100’s of genes in our DNA, that when given the right abuse or lifestyle, can stimulate any one of 100’s of diseases. Its like the breast cancer gene, only 20% of breast cancer patients have that gene, the gene is only a tendency not an absolute, there are many habits that can increase the risk for that gene to tell breast cells to go cancerous.
      Check your DNA at 23& or someplace similar, but I have to say, it can be scary to see how many horrible diseases you could unleash if you life a abnormal human lifestyle, like sitting 12 hours a day, or consuming dairy (one of the leading high risk behaviors for breast cancer).

      Regarding your high cholesterol. It is easy to eat a high fat plant-based diet and have high cholesterol, not all Vegans have perfect health, we have lowered our risk for 90% of chronic and deadly diseases, but not all, is not a get out of jail free card.

      What you may think is a healthy plant-based diet may be far from it. Take cholesterol, our bodies make all the cholesterol we need from the fat that is in the plants we eat. The trouble comes when you add Any Kind of oil or fat to your plant-based diet. This is when the fat can become toxic, causing hypercholesterolemia, an acidotic state, both together and you have cholesterol levels and plaque skyrocketing in your body. Consuming unnatural fats, such as oils and fats away from a whole plant, also triggers diabetic type two illness.

      Think about what you eat thru your day, do you add any type of fat or oil to your foods? Do you fry any kind of fat or oil, than your cholesterol will be higher than if you did not regardless of what your genes. Even worse is if you heat the oils, as you heat oil you will change it at a molecular level to become even more of a sticky substance in your body. Any kind of oil, even olive oil, can increase your cholesterol level.

      Remember our human bodies were never designed to eat pure oil or high fat, but only designed to cleanly process the fats in plants, which are at a far lower level and include all the plant biology that will help you process it in a healthy way.

      -Think about a horse, he is a totally plant-based animal, will never develop hypercholesterolemia, but if you forced a horse to consume pure oils or fats separated from the original plants at the percentage that we do, it would indeed develop some of the chronic and fatal diseases we as humans do. Only the carnivores and omnivores can eat oils or fats and Not develop hypercholesterolemia.

      BTW, familiar hypercholesterolemia is just a term doctors give you to write a statin script. The standard in medicine is to first prescribe a DASH diet and increase movement, but really it is not good enough to make a healthy body, it will improve it, but you will eventually still need statins, high B/P meds, and Metformin. I was told in school that there is no need to bother even telling a patient to go on a DASH diet or any diet, as most Americans are not disciplined enough to do it, we were told then to skip the diet plan and go ahead and write the script, the patient will be happier, and you now have developed their return business for life. In order to cure these illnesses yourself, you need to go on an added fat-free, whole food, plant-based diet and get up a move more than usual. Life long and prosper :)

  2. The language in this article is very speculative regarding the benefits of a whole plant based diet. That’s the honest route, I guess, which is good.

    So can I sum this as: “drugs don’t help as much as you think, but diet might help a whole lot more (and also might not help at all)”?

    Is there any controlled research being done to try and prove the benefits of such a diet for thus specific cause?

    1. I think it has been well established by Dr Ornish’s published studies and Dr Esselstyn’s studies. Dr McDougall has studies as well. Then, of course, T Colin Campbell did a turnaround from thinking we all need animal protein to the opposite over many years of his research and published studies while at Cornell, though his work focused mostly on cancer prevention and turning cancer growth on and off with different quantities of animal protein consumption.

    2. The whole purpose of this website and Dr. Gregers work, as far as I can tell, is to document, disseminate and promote the information that a WFPB diet is proven effective at preventing and reversing many of our most common western diseases. Just watch a few videos and read a few articles on the area of your interest. Better yet, read “How Not to Die”.

  3. Why you Michael, write in good English with correct English. The language you use is just non-understandable. Did M.Sc in biochemistry, D. Pharm, studied wren and Martin , and much more. But unable to understand you ‘nonsense and ‘non-grammatical’ language. Why don’t you people just use UK English? Is any ego problem?
    Why you are ignoring that your posts are being read by people worldwide? It is just you use UK English.

  4. Why don’t you Michael, write in good English with correct English grammar? The language you use is just non-understandable. Did M.Sc in biochemistry, D. Pharm, studied wren and Martin , and much more. But unable to understand you ‘nonsense and ‘non-grammatical’ language. Why don’t you people just use UK English? Is any ego problem?
    Why you are ignoring that your posts are being read by people worldwide? It is necessary that you just use UK English.

      1. I have absolutely no problem understanding Dr Greger’s spoken or written english and my main language is not English. The above post must be a joke.

    1. I’m actually Russian and I don’t understand only when Michael add some medical irony in his movie, because I so much used to antihuman behavior of our Big farma, so I don’t get it when he just joke on such things.
      All other things are good to me.
      So may be it’s your problem with English, not his?

  5. Yet another side effect of capitalism: profit motive trumps ;)) public health. Food/drug/recreation corporate bosses are in the business of profiteering, maintaining their lifestyles (even at the expense of knowingly killing others). Public health is ruled by a huge drug cartel…Thank you for being a beacon of light in the swamp of profiteers…

  6. Well, I have been on a statin and in 3 months I went from 189 to 108 total cholesterol. Much lower triglycerides and higher HDL. Seems to work great! Much better than the plant based diet I tried.

    1. My brother had great numbers after 2 years on statins when he died at 55 from atherosclerosis. My belief is that the dramatic improvement in numbers from the statins gave him permission to ease up on the lifestyle modification part of the equation.

    2. Iam Sparta, I know it must seem like the statin is “working” when your cholesterol or triglyceride levels drop significantly. However, just because your numbers look better, doesn’t mean you are actually healthier. When Dr. Greger refers to the chance of benefit being less than 5% from those types of drugs, he is referring to prolonging life (click on the link in the article to see the study). Just because your cholesterol numbers look better on paper from taking drugs, they give little benefit in terms of preventing heart attack, stroke, or death. Sorry to burst your bubble.

      1. It’s a common problem with “treating numbers, not people” – when your analysis OK but you feel bad – it’s not a doctor’s problem.
        They even can say that you are faking symptoms or even mad? rather then agree that treatment doesn’t help ((it is still happens to people with hypothyroidism)

    3. Mainstream medical advice is also to use statins only if lifestyle modifications don’t work

      “53.If lifestyle modification is ineffective or inappropriate offer statin treatment after risk assessment.”

      Perhaps your plant based diet was not rigorous enough? I know that when I went down this road, moderate adherence didn’t work. It was only going totally WFPB and emphasising cholesterol lowering foods like oat (bran), nuts, apples etc that my numbers started to move. And that takes time too.

      The fact is that by using drugs to lower cholesterol you are really only managing the symptoms You are not addressing the causes of the problem represented by raised cholesterol. It’s a bit better than using cough medicine to manage one of the symptoms of TB but the principle is similar.

      1. Great post! Indeed the WFPBD is working at the most essential level of our physiology and I would dare to say our psychology to optimize our body’s ability to heal itself. We are eating life energy, not corpses.

  7. Isn’t there an expectation that if a drug does less than a placebo, it doesn’t go on the market? A few years ago I read or heard somewhere that placebo averages 30% effectiveness. Was that just bunk? Of course, if that was the practice most drugs – especially chemotherapy drugs – would be pulled from the pharmacy.

    1. I hope someone with more knowledge weighs in on this but I think the 30% you’re looking at for placebos is subjective self-reports from patients like pain relief or mood for example. Placebo doesn’t have as large of an impact on physiological objective measures.

          1. “There is no standard degree of placebo effect (approximately 30% is often given) and its extent depends upon numerous factors including:”

            So my vague memory did recall the 30%.

      1. Yes and no. I think it depends on the disease and the context. However, placebos can be very effective in eg treating depression

        “Annual rates of suicide and attempted suicide were 0.4% and 2.7% with placebo, 0.7% and 3.4% with active comparators, and 0.8% and 2.8% with investigational antidepressants, respectively. Symptom reduction was 40.7% with investigational drugs (n=4510), 41.7% with active comparators (n=1416), and 30.9% with placebo (n=2805). These data may help inform discussions about the use of placebo in antidepressant clinical trials”

        In terms of hard endpoints like suicide and attempted suicide, therefore, placebos seem even more effective than active drugs (and of course have fewer side effects).

        And anybody who has studied social science will be familiar with the Hawthorne Effect which at its base is essentially the placebo effect wearing a different hat.

    2. up to 55% for many cases and it’s grown up from year to year, which actually makes a lot of problems to farma – they can’t beat this result.
      I have a lot of fun about it :)

  8. What about other factors which can prevent heart disease? Is there any evidence that DIET only is the most important. Please, share the facts and studies with me.

    1. Well you could have a look at what the National Institutes of Health say

      or the Mayo Clinic

      So, sure, if you have a perfect diet but smoke like a chimney, drink like a fish, do drugs, have poor hygiene and a high stress lifestyle, don’t exercise and are grossly overweight, then you are probably at high risk of heart disease.

      However, according to the World Health Organization
      “Up to 80% of cases of coronary heart disease, 90% of type 2 diabetes cases, and one-third of cancers can be
      avoided by changing to a healthier diet, increasing physical activity and stopping smoking”

    2. Hi, Rachael! I am Christine, a NF Volunteer Moderator. There is a lot of information on this site about risk factors for heart disease, and links to cited studies are included for all of them. You might find this interesting I don’t think that Dr. G. claims that diet is the only important factor, but it is certainly one of the most important ones. I hope this helps!

  9. Many people today believe in the ritual of doctor visits. But with shown poor performance, is faith in white coats a modern version of tribalism designed to part you away from your money?

  10. There are some great discussions on this page right now. I’m impressed that people are hanging out on this site tonight instead of being glued to election coverage. Cheers to your health!

    1. I think my story belongs around here. too long but the low lights might be interesting. Now 82 1/2 had, bypass surgery at age 65. never had a heart attack but had angiograms at age 42 and 44 both thought to be due to HA but turned out to be paricarditis due to viral infection from flu. I was on atenelol for 15 years and a statin. Didn’t have any symptoms or a doctor of much help. I continued to eat pretty crappy. Worked at a fairly physical job requiring being outdoors until I was 60. Only issues were 2 hip replacements after the bypass. I was ok and worked at home alot of sitting. At age 75 retired. I had stress tests and yearly follow ups and some changes of meds It wasn’t until 7 years ago I started having.aches pains some shortness of breath on walks, stopped the atorvastatin until I saw the cardiologist and my Cholesterol was 186 from 110, LDL from 120 from 51, HDL has never been 36 last 5 years and only went to 33 after I stopped. The doctor wanted me back on a low dose of Prevastatin. After starting it again Cholesteol in just 3 months went 139, LDL to 74, HDL to 36.Triglycerides are 145 My weight is 152, I am eating much healthier. rarely any beef, turkey & chicken a couple times month, alot of veggies, no dairy.I did read Dr. Esselstyns and Dr. McDougall books. I should have after the bypass. I wish I had more energy but short walks and some treadmill. My Dad died at 72, heart disease in his 60’s and then cancer. I’m taking supplements, Omega 3, Magnesium, baby asprin, COQ1O. Started on Arterial Protect and K from Life Extension.I took myself off Statin, hoping my diet can reverse the bad numbers.Probably too late but.worth trying.

  11. “When we have to decide whether we want to go diet versus drugs…”

    I’ve been on statins for about 25 years, and on a WFPB oil-free diet for four.

  12. The Sun recently had a headline extoling the virtues of Statins. It quoted a professor of The British Heart Foundation stating the since heart disease is incurable, statins can at least slow it down. This runs contrary to the wisdom of the good Dr Greger who suggests in his latest highly readable book, How Not to Die, that a vegan diet may actually reverse the clogging of coronary arteries. When a top academic gets quoted like this in the UK’s best selling newspaper, I can understand how Mr Average like me with heart disease can be deflated after the apparent good news from Dr Greger. Such mixed messages. Surely the professor of such a respected institution cannot apparently dismiss the hard evidence that I assume is behind Dr Greger’s assertion?

    1. chris1003: You raise a question that so many people ask. I have two thoughts for you.
      First, there is indeed hard evidence that a low fat, whole plant food based (WPFB) diet can reverse heart disease. At least one of the videos on this site talks about the studies where we have “before” and “after” pictures of blood vessels of people put on a healthy diet. The after pictures show the previous clogged vessels as having opened up after the diet change. The low fat WPFB diet is the *only* diet proven to reverse heart disease. And while medication may help prevent some heart attacks, it does not actually reverse the disease. There is only one method proven to reverse heart disease and that method is a low fat WPFB diet. It is easier to prevent a problem than to reverse it. A healthy diet is not guaranteed to work for every heart disease patient. But it works for lots of patients, even the sickest of the sick–as long as they stick to a very strict diet.
      The second thought addresses: How does this professor dismiss such data? It’s entirely possible that the man is unaware of the data. There are several videos on this site covering the lack of nutrition education for medical doctors. What’s more, several medical students have reported on this site that they are taught in class that diet does not affect heart disease. In other words, what little nutrition is taught in medical schools is often incorrect. I don’t know where this professor got his education, but it is entirely possible that he did not get an education in nutrition or what little he was told was false.
      Being a Ms Average myself, I totally sympathize with your feelings regarding such news paper coverage and the completely inexcusable misinformation spread by the British Heart Foundation that heart disease is incurable. (Though it may depend on what they define as a “cure”. It is a misleading statement for most lay people to read.) All we can do is our best to be role models and educate people. I wish you all the luck with your situation.

    2. I think the reason is that, unless the studies concerned are (ideally blinded) randomised controlled trials, they are not considered strong evidence. Since the Esselstyn etc studies cited by Dr G did not have controls, were often quite small, and/or included other interventions – exercise, stations, meditation etc – they are considered methodologically weak.

      Therefore, the mainstream position is that there is no convincing evidence that heart disease can be reversed by diet. You will have to look at the studies concerned and make up your own mind. Personally, I find them very persuasive especially when considered in the broader context of the general health benefits of high levels of fruit, vegetable and whole grain consumption.

  13. Great article. I exercise and watch my diet but still have elevated Cholesterol (240-260) and high Triglyceride levels. Statin side effects were not pleasant. My mother and her sisters all had elevated levels as well. They lived very well into their high 90s.
    What the heck???

    1. Greg: Sometimes life is so unfair. You mention that you watch your diet and exercise. Both things are great. Sometimes the devil is in the details. When you say you watch your diet, are you eating the Daily Dozen? Do you abstain from meat, dairy, eggs and oils? You don’t have to answer that here. I’m just bringing up some details that may affect your cholesterol levels.
      Here’s a page I like to refer people to when they have trouble with their cholesterol levels: What Can I Do To Lower My Cholesterol? It Seems I’ve Tried Everything. Also, the following page is a summary of the information on this site regarding cholesterol. You can see that there are a set of foods shown to lower cholesterol levels. You might consider tweaking your diet to include more of these foods:
      Good luck!

    2. Have you had the lipid particle size test? Bigger is better I think. Doesn’t stick so readily to artery walls. Might explain how your mom and sisters defied their high numbers. Mine are in the middle range of 3 possible.

        1. So noted. I was grasping for an explanation of his family members’ enviably long lives in spite of high-ish cholesterol and triglyceride numbers.

          1. gopvegetarian: I hear you. For what it is worth, here is my 2 cents: When it comes to nutrition and disease, we are usually talking about disease risk, not fortune telling. Here is an apt analogy: smoking raises the risk of getting cancer. It is not a guarantee that someone will get cancer. In fact, we have probably all heard of people who live to be 100 and never get cancer and yet smoked every day of their adult lives. Some people are lucky. They can beat the odds. On the other side, there is a sizable portion of people who have never smoked and yet they still get lung cancer. Some people are unlucky. Despite these outlier examples, the science tells us that smoking is strongly linked to lung cancer and people smoke at their own risk.
            The same is true of nutrition and risk factors like high cholesterol. Some people luck out. That doesn’t mean that it is wise to play the averages.
            That’s just me putting into perspective in a way that makes sense to me. Thanks for participating and trying to help others.

      1. Thanks GO. I do stay in shape but could lose 10-15 pounds of lard. If i did lose the weight i may be able to once again dress with the lights on. It is interesting that my Triglyceride level is 280-300 which bothers me as much as the high cholesterol. I have never heard of testing lipid particle size! Bigger is better? Oh Great another ego buster. Gees. For what test should ask?

        1. My particle size score sheet says at the top under TEST PERFORMED:

          Cardio IQ(R) Lipoprotein Fraction Ion Mobility
          (That’s what they call the test in house at Quest Diagnostics. Could go by other names elsewhere I suppose)

          The results break down into the following line items:

          LDL particle number
          LDL small
          LDL medium
          HDL large
          LDL pattern
          LDL peak size

  14. Dr Greger your approach,diagnosis,solutions.suggestions for our diseases free Health are revolutionary,unconventional.I have no doubt.
    But tell me how well they can relate to meat and dairy eating majority of the world.New Zealand’s whole economy depends upon two animals,Cow & Sheep–their dairy products,beef etc.This economy will collapse.

  15. Dr Greger I just happened to read/hear something about LECTINS and Dr Gundry.It negates legumes,lentils (Daals in India),ground nut,beans……I am confused.It goes against your recommendation.Throw some light please.

  16. Dr Greger there is a lot of talk on Cholesterol these days.It is said Cholesterol is not the real culprit that causes heart problem.Rather it is very essential for the body.So it is wrong to worry about it.
    Your opinion please.

    1. Hello Amarjit,

      Yes the world of cholesterol can be very confusing these days with conflicting information in every direction, but seeks to clear up that confusion. The problem is that the food industry has great influence in media and research and Dr. Greger has made videos highlighting how these industries design studies to promote consumption of foods high in saturated fat and cholesterol. Below I have linked a blog post Dr. Greger made about misleading studies on saturated fat as well as a video on the cholesterol studies that the egg industry funded.

      Blog Post (saturated fat):
      Egg Industry Studies (cholesterol):

    1. Hello Amarjit,

      I have reviewed the video you linked and I believe I can clear up the confusion for you.
      On the topic of cholesterol, Dr. Wallach shows a case study of a single 88 year old with supposedly normal cholesterol levels. There are a couple problems here. For starters, a single case study of one individual does not discount nearly a century of research including the meta analysis I linked below, which is the gold standard, showing that eating cholesterol absolutely raises your cholesterol levels. However, if you are already consuming a fairly high cholesterol diet (eg. most Americans), then adding more cholesterol will have a much smaller effect on your cholesterol levels. Secondly, it is important to note that “normal” cholesterol levels are not “optimal” cholesterol levels. In America, the “normal” level is one that will promote heart disease since the most likely reason anybody in America will die is due to heart disease. The level that is optimal and does not promote heart disease is below 150mg/dL and an LDL below 50-70mg/dL as outlined in the video I linked below. The last point I want to target is the testosterone myth. Dr. Wallach states that because testosterone is made from cholesterol that consuming more eggs leads to higher testosterone levels. Dr. Wallach does not reference any research for that claim. Dr. Greger has written up a great article which talks about vegan men having higher testosterone levels than their meat-eating counterparts. I have linked that article below as well as a NutritionFacts video displaying how the egg industry can design misleading studies to confuse the public.

      I’m glad you’re a member of and are able to receive this information without corporate mishandling of the research. I hope this information is useful.


      Meta-analysis cholesterol:
      Optimal cholesterol levels:
      Egg Industry Studies:

  17. Dr Greger I want to draw your attention to the lowering of readings for diseases like hypertention,diabetes and cholesterol related ones.
    I know you stick to the readings given in the medical fraternity like 120/80 for BP,100 for diabetes and around 150 etc for cholesterol,and impress upon attaining these readings through diet,life style.
    I have come across info given by American College of Physicians,Cochain Library …..
    They have come out with figures 250 for Diabetes,250 ( sis+dias ) for BP,and 250(total) for cholesterol means the patient has no disease and he needs medication if readings go higher than these
    I request your comments .

  18. Without a citation to the actual published research data, I can’t comment on what you saw. What I can tell you is the overwhelming evidence that we have to date is that the numbers that Dr. G quotes offer the lowest risk of disease and death. It all goes up from there. If you choose to be satisfied with total cholesterol and blood pressure higher than Dr. G’s values, from the evidence that we’ve seen, you’re significantly increasing your risk of premature death. It’s like walking on the edge of the Grand Canyon. I would not feel comfortable walking within 100 feet of the edge, but some people walk within a few feet of the edge and get away with it. Then there are the ones that walk too close and fall off. The amount of risk you’re willing to take is up to you.

    Dr. Ben

    1. Many Thanks Dr Ben for your reply.
      Now I would like to go part by part of the matter I have raised.I thought it was a common knowledge what the latest recommendations of the very prestigious institution like the AMERICAN COLLEGE OF PHYSICIANS are on DIABETES Type 2.I cite the relevant site :

      I hope it is a genuine piece of information.

      You may like to comment.

  19. Dr Greger I value your approach to health. But I am curious to know that billions are on non-veg diet but only some millions are afflicted with deadly diseases.

  20. Dr Greger
    How significant is Fasting in :

    a. Lowering Blood Sugar
    b. Enhancing HGH (Human Growth Harmon)
    c. Improving General Health,Life.

  21. Dr Greger
    Does PBD mean-No Ice Cream,No Chocolate,No Kheer(most delicious Indian Dessert),No Samosa(Most internationally Favourite Snack,No Beer,No Whisky…….)
    If so the World would be very Poor.Do you think the World would accept this Deprivation ?

  22. You would die without sugar. You were designed evolutionarily to eat about 80% of your calories from sugar. It (and ketone bodies during starvation) are the only substances your brain can use for energy. The issue arises in how that sugar gets into your body. It needs to be wrapped in fiber (as fruit) or as starch and fiber (like sweet potatoes) so that your body absorbs it slowly which allows you to use it effectively. If you eat something like soda or other refined sugar product, you absorb the sugar too rapidly, so its turned into fat by your liver. Refined carbs foods like soda are associated with disease and premature death. Keep in mind that you cannot absorb starch. Your body must break it down into it’s components (sugar) before you absorb it.

  23. Hi Dr Greger
    I keep learning a lot from you.As I am much interested in the subject of nutrition and I come across a lot of ideas,some very novel some very challenging,I immediately want to check their truthfulness and find no better way than to have your opinion. One such approach is in the following video :

    You may kindly find time to comment.

  24. Amarjit,

    I took some time to review the website and the YouTube.

    I was unable to find any study of their product, Just multiple references to many testimonials and yes there is no lack of isolated study of the herbal components, in many reputable journals.

    Some considerations when I saw the website is the red flags included not finding the label easy to assess. What’s in the product including excipients is important.

    I was also looking for specific manufacturing information regarding their checking for toxin metals, solvent residues and other aspects of their products production. As you may be aware there have been multiple issues with Ayurvedic medicines and toxins in past years, hence my question.

    See: and

    The other concern is the application for literally all health ailments. Sorry but my scientific validity meter gets trashed when I hear extrapolation in all areas of medicine, without proof. I was unable to find even one clinical study on the website to satisfy my questions. Are there consistent and rising issues with blood sugar relevant to many disorders worldwide, absolutely.

    My opinion is that there are excellent manufacturers of quality Ayurvedic products that will supply you with their assays, addressing the above concerns. Should you use herbs in your food, without question. Keep in mind that your use of a concentrated herbal product is very different than their original form, as a food.

    So…. as a student of nutrition I would encourage you to continue to ask questions and dig deeper into anyone’s statements. Are they backed up by some level of evidence and to what extent and to whom do they apply.

    Dr. Alan Kadish moderator for Dr. Greger

  25. I have not read The China Study.But I am curious to know that -can there be a region or community,especially rural, on this earth where human beings were not consuming Dairy Products ,were excluding Milk,butter,Ghee,Lassi etc from their diet.I can concede that there can be Vegetarians but not doing without Dairy Products.Secondly I think eating eggs if not chicken or meat should be very common.

  26. Dr Greger, I love yogurt,paneer (cottage cheese ),kheer (a delicious Indian dessert ),Kulfi (Indian Ice cream ).Have I to avoid them or can do with reducing quantity ?

    1. Hi Amarjit,

      I am a volunteer for Dr. Greger. Thank you so much for your question.

      Dr. Greger has a variety of videos suggesting that dairy may be slightly harmful, but certainly doesn’t appear to be as harmful as red or processed meats or perhaps highly processed foods. Typically, the greater the dietary (or other lifestyle changes) one makes, the more health benefits they will see. For example, exercising 10 minutes per day is better than 0, but exercising 60 minutes per day is much better than either. The same goes with dairy–evidence does not appear to show any net benefit from consuming dairy products, but does seem to show a slight net risk (especially for Parkinson’s disease and prostate cancer, and perhaps for overall mortality/death). Therefore, the less dairy is consumed, the lower the risk appears to be for chronic disease and death.

      One final thing to mention is that there are benefits associated with dairy intake (although primarily only with low-fat dairy, so cheese and other high-fat dairy sources are not necessary associated with these benefits). However, the benefits of dairy seem to be from the protection of colorectal cancer due to the high calcium content. There are other foods rich in calcium (dark green leafy vegetables!) that can provide calcium to decrease the risk of colorectal cancer without increasing the risk of prostate cancer or other risks mentioned above. Dr. Greger explains this more in detail here:

      I hope this helps to answer your question!

Leave a Reply

Your email address will not be published. Required fields are marked *

Pin It on Pinterest

Share This