Slamming Statins & Stents, Supporting Saturated Fats: Aseem Malhotra



so I got to show you this clip this duck Aseem Malhotra in one presentation attacks stents for prevention saturated fat concepts that you know the concept of saturated fats are bad and statins he takes on all three of these topics again all in one video I will give you a link to that video but I'm gonna describe that a little bit first before we do here's the thing for the most part I agree with him I think he just barely he didn't quite make it to the finish line with statins but he's I think he's clearly correct on stents and saturated fats and he's almost there on statins so let's before we take a look let me give you some background today we're gonna do a video on an iconoclast a seem mal rota who will talk about that in just a minute wait a minute what what's in that kind of class hi Joey boombox on when it was commenting on my video scaremongering the dubious diagnosis editorial by Charles pillar where I'd debunked that to a large extent and he called me an iconoclast medical pharmacology pharmacological kind of class Ford Breuer doing God's work god bless him and his family well thank you again mr. boombox very very much I don't have the personality of an iconoclast and in fact I didn't quite remember the term I had to look it up again it's I kind of classed as a person who attacks cherished beliefs or institutions yeah I guess some of that's correct in fact there groups of people like the Anna Kony ISM aniconism iconic lives have I kind of class them anyhow whatever where there's a social belief that there that it's important to destruct icons and other images or monuments most frequently for religious or political reasons so I don't really have that kind of personality I'm just trying to do my job and my job is big enough I'm trying to wipe out heart attack stroke dementia most blindness kidney disease because most of it's preventable so I'm not nearly as again thanks for the I'll take it as a compliment and thanks very much for it but I don't have quite the I love me a little bit more conflict avoidant I just am trying to do my job now here's a seem mal rota he's a physician is it he's been an interventional cardiologist at the UK so he's done plant plenty of stents he's now with a local hospital NHS Foundation Trust author and clearly in iconoclasts and he clearly appears to enjoy conflict you can see that from the title of some of his work killing for profit now I'm gonna cover a video of his because he in one presentation takes direct aim at stents for preventive serve purposes saturated fats and statins and I'll go ahead and give you the the punchline I think he's right clearly correct about stents stents I've done a series on them where they don't work for prevention the new england journal JAMA plenty of other journals the leading journals in medicine have made it very clear stents help with with an event some events you can treat you know a heart attack a clot you go in you can often remove it with a stent and do good work there but the vast majority of stents are being done to quote prevent the heart attack and the literature is really clear that they don't how about saturated fats another very ghal item in our space and he says the same thing in fact I think he says the sugars tended to go a long way towards killing his own mom who was a vegetarian and I see that all the time I mean you hear you we've got other videos you've seen the video maybe you've seen the video with Chuck Smith where Chuck lost 50 pounds on a vegan diet and then had a heart attack and then after reviewing this channel and some others realized that there was a sugar problem his triglyceride / HDL was 5 now here's the one place where I don't entirely agree with dr. malar malhotra and its own statins I think he's mostly correct but I don't think he goes far enough he talks about statins being the devil being very bad and he goes into this David diamond phenomenon of relative risk versus full risk now I've done a ton of videos on on statins and again pardon me if I'm getting to the punchline too early but I want to get it out there a lot of people only watch the first 30 seconds of the video anyway yes I would agree and I've said this multiple times the vast majority of statin prescriptions most of them are classically for atorvastatin or lipitor high-dose and most of them are focused on dropping the cholesterol cholesterol is rarely the problem I mean it is sometimes but it's not usually the biggest issue the biggest issue is cardiovascular inflammation and you don't need high dose and lipitor is not really the best for managing that although it does help it helps far less with people with diabetes which is the vast majority of the cases and for women so you go with low dose and go with something that either doesn't increase insulin resistance like a low dose Crestor receivest n 5 milligrams per day or less or go with a lavalla it's now become been shown that llevarlo does actually decrease cardiovascular inflammation as well as insulin resistance oh maybe way too much let's go actually and look at his video so let me just give you one example here so I trained as an interventional cardiologist so essentially having done cardiology i sub-specialize where i was doing in layman's terms keyhole heart surgery on patients and I've done thousands of angiograms where you diagnose people coronary artery disease from from this procedure but also we do something called stents now many of you may know if stents essentially it's a procedure where we unblock people's arteries by passing a tube into the arteries and inflating a balloon and in deploying a small metal scaffold but the reality is although it's life-saving for people having a heart attack and I'll tell you exactly how life saying that is later for people who are not having a heart attack people have stable heart disease it does not prevent heart attack so prolong life and we have very good extensive evidence for many many years that it doesn't do that but it's estimated in America almost half of all the procedures for stents on many many patients costing millions and millions of dollars actually you know is carried out is of questionable value the one place I would disagree is it's a point it's way over half despite this body of evidence but most importantly 88% of patients undergoing the procedure thought they were having the procedure for the very purpose which it doesn't benefit them and when anonymously asked 43 percent of cardiologists said they would still go ahead and do the procedure even if they felt it would not benefit the patient now this is not procedure that doesn't come with harms so at the end of 2000 and 2013 and then falling on several months later I wrote two consecutive editorials by coincidence the first one was in the BMJ call too much angioplasty and the second one was in JAMA internal medicine so he goes on to describe that issue so next he starts getting into the whole issue of relative risk versus absolute risk that's the David diamond argument about statins okay so misunderstanding of health statistics it's also a major risk factor for misinformation so many doctors surprisingly don't understand health statistics and therefore cannot evaluate evidence for and against a treatment so in one study several years ago 150 go he goes on to talk about other examples let's skip over and and hear what he has to say about actually he's very correct about this issue Doc's don't understand statistics they just and that's a problem Oh in the next clip he takes a shot again some accurate information number one he makes the point that eighty percent of heart attack and stroke prevention is lifestyle again I would think maybe a little bit more than that the other thing you starts to take on is this issue about saturated fats and again I've done several videos on those this I'll give you the information on how to find this clip as you may see in here it's from a fellow named Santino Ryder it's a small Channel but again a great a great clip and they said there was no mortality benefit in other words he will not live one day longer from taking a statin but also he suggested actually we should be concentrating more on lifestyle changes eighty percent of heart disease is related to lifestyle diet exercise that kind of thing smoking reduction and but by coincidence and the same in the same paper in the same Journal of the BMJ I also wrote an editorial which was called saturated fat is not the major issue and that was that editorial was press release by the BMJ and became a big news story it was front page of three newspapers so again very interesting video I'll put a link to it and in my description like I said he's a real iconoclast he's got the snailed afford he loves the appears to love the conflict most of the information he's putting out there I would agree with again he he he missed the issue about cardiovascular inflammation and I can tell you from studying him he's not that much aware of it and load those statins that they deal with that like receive a statin and pitous ten thank you again for your interest if you hit the like button and for sure if you subscribe or share the algorithm reads that is the strong message that humans think this is interesting and important information and the algorithm can share it more than any of us humans speaking of sharing the one of the best ways of sharing is on social media we've got active Facebook Instagram and LinkedIn activities going on right now we've recently started up things in Pinterest and Twitter so we'd love to see you there check us out finally with over 500 videos a lot of people are saying I can't find this video or that video our new social media manager Kim Hermosa is starting to work on ways to help with that so join the community you can click on the links below and you can get a little bit better access thank you again for your interest

41 Comments

  1. Well…think about THE PROFIT MOTIVE for docs! It's VERY GOOD for their POCKETBOOKS to keep us fat, sick and stupid. There IS NO MONEY IN HEALTHY PATIENTS! Are docs some kind of virtuous superheroes who are ABOVE THE PROFIT MOTIVE?? They SEEM TO WANT US TO THINK THEY ARE! What do you think?

  2. I attended an event here in Australia (31/3/19) when Dr Malhotra visited and presented. I’m very happy I attended.

    Aseem Malhotra is very clear in his presentations and presents information very well.

    I don’t get the message from him that “statins are bad” what I do understand from him is that the information used to promote statins or “push them” is not sufficient to warrant their large scale adoption since cvd is for most (except FH) and who’ve not had an event, a lifestyle and diet/nutritional disease and now we learn more openly the dental hygiene connection.

    I also love the job you’re doing Dr Brewer and appreciate your contributions.

  3. As a relatively young person who was diagnosed with hypercholesterolemia and just had double-bypass surgery last year, should I be climbing on this anti-statin, saturated fats are good bandwagon- again? I was firmly in this camp before. I ignored my doctor's statin prescription, ate grass fed this and grass fed that… was on mostly an Atkins diet, and it almost killed me. I've swung in the opposite direction now- trying my best to follow a low-fat vegan diet and I'm taking a maximum strength atorvistatin.

  4. I have patients come in and I know they've read a lot in the internet
    about Statins and 90% of the time they have a Very negative attitude
    toward them. And I don't necessarily disagree with some of the things
    they tell me they've read but a lot of these iconoclastic web sites and
    blogs are one sided and not the least bit nuanced because that's not
    going to get them noticed!! Negativism and contrarianism sells!! It's so
    easy to just blindly bash pharmaceutical companies. That is
    self-serving and dangerous for the people they claim to want to help or
    'steer in the right direction'. Bottom line is that Statins can save,
    and have saved a lot of lives! Now it may be that it wasn't by lowering
    cholesterol levels but rather by reducing arterial wall inflammation but
    no matter there is benefit to be had there for the right patient with
    relatively little risk.

  5. Dr. Brewer I got the spelling. Livalo It is 1-4 mg a day. i am taking 2.5 Rosuvastatin two times a week like you said. if i take Livalo how much should i take? its just for inflammation. thanks

  6. could you spell that one lavalor or is that correct?

  7. how do you still have godlike hair at your age doc ?

  8. He is 100% right, statins do not help, they actually do damage to the heart muscle via their side effect.

  9. Hello, good information thank you for sharing! You made a brief comment on lipitor not being the best for woman nor does it help with inflammation, but I could not understand the one that you suggested did and do the others make your body ache?

  10. Thank you Sir, I respect you, I can call you doctor, because I can feel that you care about human being more than money, but others they have already sold their self for money and they got scared from big farmas even they know they are hurting others.

  11. I'm so confused. Many say take statans after a stroke, others say not to. Which Am I to do? Or not do. I take em for awhile then stop because of this confusion

  12. Dr. FB is a “breaker of idols.” A high compliment even if you are a little too polite for my taste. Obviously you were taught manners.

  13. I hear Iconoclast and think the Byzantine heresy.

  14. Thanks. Im am amazed at how cholesterol as the danger is still hanging on in the mainstream.

  15. Great video and I'm glad that you mentioned sugar in it.  I ran into a retired doctor today that I've know for over 30 years. He is 66 years old and grossly obese at 6' tall and probably 350 pounds.  Seeing him reminded me of our conversation a couple of years ago where he told me that my low sugar, low carb, low grain and high quality saturated fat, grass fed beef, wild-caught salmon and veggie diet, which helped me lose 30 pounds, was bad for me and that I shouldn't go overboard with it.  I wish that I could sit down with him and tell him that whatever he has been doing for the last 30 years isn't working and that maybe he should pay attention to what I'm doing.

  16. He makes the same mistakes (or, is willfully ignorant in the same way) as other statin/cholesterol denialists. Nothing terribly interesting there. I'll just add that Zetia is very underutilized. The combination of a low-dose statin plus Zetia will get you the same reduction in LDL-P and ApoB as the "terminator statins," e.g. Lipitor 80 mg or Crestor 40 mg.

    The French, the Swiss, the Icelanders, and the Kitavans eat a diet where 15-20% of the calories come from saturated fat and seem to do fine with it. Sounds like a sane amount to me. Putting a stick of butter in one's morning coffee is just silly.

  17. What inflammation markers and values would prompt you to prescribe a low dose statin?

  18. Where is the Chuck Smith ex vegan video please?

  19. The low carb space is full of iconoclasts. The debate is so dogmatic, it’s hard to trust anyone’s motives. One of the reasons I like this channel is that you seem to have a balanced approach. I can only think of one other doctor in the low carb space that would say statins can be beneficial: Bret Scher. All the rest want to claim that ApoB particles are either benign or beneficial. This is just telling the audience (keto & LCHF dieters) what it wants to hear.

  20. Stents are band-aids, in which is a quick fix…but the end results are still the same. I agree with your assessment in preventative medicine. A quick personal issue…my Dad died, due to a stent collapsing on him. Stop the blood flow to his brain and died. This was based on the autopsy report. I wasn't there, this info was given to me by my step-mom.

    Maybe if my Dad learned, like the rest of us about D3 +K2 to reverse the calcification of arteries, he still could be alive, but in reality. The majority of doctors, excluding yourself are pushing the pills and surgeries, to make money…Of course each case is different. IMO, surgeries should be a last resort to correct behaviors, not a constant cash flow for the insurance and medical field.

    Again…this is my opinion. I have my own personal issues with my VA Health System to have such claim with my own personal struggles and misdiagnosis. Lets put it this way, why do I have to figure this out…a guy with a TBI to see it.

  21. Great video!

  22. Anything is provable.

  23. I used to watch Dr. McDougal and other vegans on YouTube preach that meat, cholesterol, and saturated fat is bad, because it impairs circulation and clogs arteries. I now think that there is more to heart disease than that. About statins, is it true that they lower testosterone in men making erectile dysfunction worse?

  24. Along with Rosuvastatin you mention another drug that sounds like "Lavala?" I can't find anything on this. Please spell it for me. Thanks.

  25. Saw Dr. Malhortra's video a few months ago. I'm sure glad you did too, for your analysis to validate his opinions. Thanks Doctor Brewer!

  26. I am an RN who works with the elderly on a daily basis and this information is excellent. Thank you for what you do I really appreciate it!

  27. Thanks Doc. I have to say you've changed the way I view certain things in medicine. I thought one of my strongest points were my research skills but you put me to shame.. you make my life easier that's for sure as I do not have to do 1/4 of the research that I used to

  28. I'm glad my doctor listened to me and switched me over to rosuvastin because of your recommendation but he doesn't want me to go any lower regardless of good or bad inflammation panel. I just hope 10 mg. is not raising my diabetes risk. And I will certainly keep my eye on further studies with the pitavastatin. Keep up the good work Doc! With a coronary calcium score 500 I don't want to take any chances I'm not taking the right dose.

  29. This is a little off topic . I decided to give my mom with alzheimer's medical cannabis and after a month she now remembers my name wants to go places ect . Not a cure for sure but do you think cannabis has anti inflammatory properties? Should it be used as a prevention as it clearly to me has slowed down progression . Thank you . Oh I give her edibles and oil no smoking 😉

  30. Excellent video. It’s interesting that you find some unique benefits in statins and yet present the statistical problems with the research. Crestor study was stopped early (supposedly because it was so darn good, but as an investor I’d say they were looking to lock in gains before the side effects started to rack up) and also they showed a mere 1% absolute improvement in avoidance of death if I recall correctly the JUPITER results.

    Parting point- perhaps you feel saturated fat doesn’t play a role in atherosclerosis or perhaps you feel it is a part but there do seem to be multiple negatives for health in foods like meat and dairy- the estrone hormones, the TMAO production which is carcinogenic, the heterocyclic amines created when doing anything but boiling meat and chicken.

    As a preventative doctor who steers clear of seemingly all meat eggs and dairy in favor of only salmon, perhaps you should highlight the inherent health risks of these foods when the opportunities arise, because most laymen will hear you say saturated fat is fine and then eat a burger.

  31. Thank you! I believe the same doctor also addressed Parliament. Ivor Cummins posted the video.

  32. Hello again Dr. Brewer,
    Vey good info and well done on your part as well.
    I've highly recommended your channel to many as it's the best to clear the air and make sense in terms of our health issues.
    I've moved out to a very remote part of Arizona off grid and have trouble getting wifi here but always look forward to catching up on your videos when time and signal allow.
    My Mechanical engineering at Abbott is paying it forward as I teach folks how to grow their own food develop their own energy sources and radically change their lifestyle to maximize their health.
    I'm inspired by the work ethic you have as I thought I was the guy putting 48 hours into a 24 hour day but you have exceeded that with your passion for your profession.
    Thank you for your no nonsense point of view and inspiring life.
    Respectfully,
    Charles Hugh. Bryan

  33. Thank you for this presentation. I'll check out the links. Sounds interesting.

  34. really informative and well presented! thank you!

  35. Endothelial Microvilli might be the initial failure that leads to multitude of secondary symptoms. Really interesting studies on NIH.

  36. It is very rare to see cardiologists talking about cardiovascular inflammation in the first place, so no wonder missing the low statin dose, but It is great to see more and more doctors speaking out

  37. Good info Doc! I had watched that video a while back as well as others by Dr. Malhotra. Very good speaker & he does "tell it like it is" for the most part. I agree with you about the Statin issue as well. The anti-inflmmatory effects of Statins is certainly their strong points. When I see my Cardiologist on the next visit, I am going to ask that he switch me to low does Crestor rather than continuing on Lipitor. Thanks for your videos on this vitally important subject!

  38. Supporting saturated fats is ok but if you are a carrier of the APOE e3/e4 or e4/e4 genotype then they can do lots of harm to your lipid profile.

  39. Thank you for the perspectives you provide. Most doctors just can’t or don’t spend time with patients helping them understand these topics.

  40. Thank you once again for your informative videos. Just an FYI his last name is pronounced mul-hot-tra

  41. Thanks Dr. Brewer.

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