Vascular surgeon Dr Haroun Gajraj was put on statins in 2005 to reduce his sky-high cholesterol even though he had no history of heart disease. Gradually he became convinced that he was taking the pills unnecessarily so he came off the drugs and changed his diet and lifestyle. As he wrote in the Daily Press in April, his astonished GP agreed that his heart disease risk was lower than when he'd been on the statins and that he no longer needed to take them. Here the founder and director of the Vein Care Centre near Yeovil explains the things he did to stay off the drugs about to be prescribed to most over-50s.
I ignore my cholesterol levels
There are plenty of reliable warning signs that you are at risk of heart disease. High blood pressure and a large waist circumference should definitely ring alarm bells.
Other risk factors show up in a blood test. Triglycerides, a type of blood fat, are a particularly accurate indicator, as is c-reactive protein (CRP) – a protein which rises in response to inflammation.
Total white blood count is another marker of inflammation. And high levels of glycated haemoglobin (A1c), fasting blood glucose and serum ferritin (iron stores) are also good indicators of risk.
I have dramatically reduced all these risk factors with diet and lifestyle changes. My overall cholesterol levels have almost halved at the same time and my ratio of so-called "bad" cholesterol to "good" cholesterol dropped, but I no longer believe that cholesterol itself actually causes heart problems any more than paramedics causes car crashes just because they are present at the scene.
Cholesterol is an essential molecule that is needed by every cell in your body, especially the brain. Indeed high cholesterol in women and the elderly is associated with longevity. Simply lowering cholesterol, as statins do, without making lifestyle changes makes no sense to me
I don't have a glass of apple juice for breakfast.
It's taken me half a lifetime to realise that apple juice contains more sugar than Coke.
A glass of 100 per cent pressed Tesco apple juice contains 30g of sugar – a third of your recommended daily allowance – compared with 27g in a glass of Coke. Fresh orange is only marginally better.
We all like to think that the sugar in fresh juice is more natural. But sugar is sugar.
A multitude of recent studies and international reviews of historic studies have shown that sugar, not saturated fat, is the cause of our obesity, heart disease and diabetes crisis. Fruit such as raspberries, strawberries and blueberries are relatively high in fibre which helps the body cope with a sugar hit. But as s soon as you juice and strain fruit, however, you strip away that all-important fibre. I stick to my cup of tea or coffee these days.
I've binned the breakfast cereal.
A bowl of cereal is an easy way to start the day and for years I bought the low-sugar varieties thinking they were healthy.
I was wrong. Cereals, even those with no added sugar, have a high glycaemic index (GI) which means they release lots of sugar glucose into the bloodstream very quickly. Cornflakes, for example, have a GI of about 80 out of 100.
The body responds by releasing considerable amounts of the hormone insulin to prevent this spike in blood sugar reaching a dangerous level. Insulin also stimulates the liver to produce fat and lowers the body's ability to burn fat as a fuel. Excess insulin is believed to increase the risk of type 2 diabetes and heart disease.
Of all the grains, rolled porridge oats has the lowest GI, in the 50s. But I've lost weight and feel better after ditching breakfast cereals altogether.
I have started eating loads of eggs
Nowadays I'm more likely to start the day with an egg.
Eggs are cheap, readily available and an excellent low-calorie source of minerals, proteins and fatty acids that can lower the risk of cardiovascular disease.
But because they contain a lot of dietary cholesterol, they have been demonised for years and the average Brit eats just two or three a week.
This is ridiculous.
A 2012 meta-analysis published in the British Medical Journal concluded that higher consumption of eggs is not associated with increased risk of coronary heart disease or stroke. If I don't eat them I'm more likely to eat sugary or starchy snacks that will probably do my heart more damage.
I've started eating more saturated fat
Contrary to what we've been told for decades, scientists now say that saturated fat does not cause heart disease.
Researchers at Cambridge University recently analysed 72 studies involving more than 600,000 people from 18 countries and found that saturated fat, whether measured in the diet or the bloodstream, showed no association with heart disease.
Lots of these low-fat foods are stuffed with sugar (including syrup and honey) to make them taste good. I now head straight for the steaks, fish, butter, cream and Greek yoghurt. I've cut out rice, pasta, potato and bread – even wholegrains
For years I tried to lose my middle-aged spread, knowing it put me at risk of heart disease.
Government advice still maintains that a third of our diet should be starchy foods. A starchy diet is great if you're a committed athlete. But I'm not. Like millions of us around the world, I got fatter. As soon as I cut these carbohydrates down to near zero I lost inches around my waist, reducing my risk of heart disease. Controversy still rages over low-carb diets but it works for me.
I eat plenty of oily fish
Study after study shows that oily fish such as salmon and mackerel are excellent for heart health. Evidence is clear that the omega 3 fats in these fish lower blood pressure and heart rate and protect against the development of potentially deadly heart rhythms.
Some research suggests that omega-3 supplements have little or no benefit, but because of growing concern about mercury contamination, the NHS advises that we eat no more than four portions of oily fish a week,
I try to eat wild Alaskan salmon certified by the Marine Stewardship Council as well as sardine and herring. But I do top up with fish oil supplements.
I do high-intensity interval training and resistance exercise
Getting your heart pumping is probably the single best thing you can do for it.
I've always gone running and tried to keep fit. But I'm a recent convert to both resistance training (muscle-strengthening exercise such as weight-training) and high intensity interval training (short bursts of intense exercise followed by resting periods) both of which have been associated with weight loss and overall heart health.
I don't drink alcohol
Yes, a small glass of red wine a day is good for your heart. If you can stop at one small glass, go for it. I can't.
I've stopped taking multivitamins and started giving blood.
Three months after coming off statins, I asked my GP for a blood test.
My blood pressure was down. I was slimmer around the belly. My triglycerides, fasting blood glucose, total white blood count, glycated haemoglobin (A1c), and c-reactive protein (CRP) were all at optimum levels.
The only thing that was too high was my serum ferritin (my iron stores), high levels of which have been associated with heart disease. For years I had been taking a daily multivitamin with iron, so I immediately stopped taking this. I've also started to give blood regularly and my serum ferritin is down to below the recommended maximum.
I believe coming off statins was the right choice for me. However, I am a qualified doctor who has never been diagnosed with heart disease and don't have a family history of it. I would strongly advise people to consult their GP before making decisions about their own prescriptions.