A high cholesterol diagnosis used to lead people to accept the reality that they needed to modify their diets and exercise more, or potentially die. The introduction of statin prescriptions was supposed to make it easier for people to lower their cholesterol and improve their health. In recent years, however, statin users are no longer modifying their diets. Many are using the statin pills as a gift-wrapped enabler for continuing their bad eating habits rather than bow to a new health reality, according to a new study.
People taking statins to lower their cholesterol consumed more calories and fat in 2009-10 than consumed by those who took statins a decade earlier, researchers found. Is the statin prescription creating a false sense of security that those with high cholesterol can just pop a pill and do not need to modify their eating habits?
Researchers used information garnered from nearly 28,000 adult participants in the National Health and Nutrition Examination Survey. They reported what they ate using 24-hour dietary recall with the help by trained interviewers. The researchers found that in 1999-2000, people who took statins consumed fewer calories, (an average of 179 less per day) and less fat than people who did not take statins. Over time, the dietary differences shrank and, by 2005-06, the difference in diets from statin users and non-statin users was insignificant.
By 2009-10, the study found that statin users had actually increased their calorie consumption by 9.6 percent and their fat intake by 14.4 percent over the decade. Their body mass index (BMI), a widely used measure of obesity that compares weight and height also increased.
Those not taking statins continued to maintain the same basic dietary habits. They also did not have as much of a change in their BMI.
The study, which will be published soon in JAMA Internal Medicine, was presented Thursday at the annual Society of General Internal Medicine meeting. The researchers poised questions about use of diet modifications and prescriptions in preventing heart disease. “We may need to re-emphasize the importance of dietary modification for those who are taking these medications,” noted Takehiro Sugiyama, who led the research while he was a visiting scholar at the UCLA David Geffen School of Medicine, in a statement.
Statins are now used by about one-sixth of adults. However, the researchers noted that ethical considerations call for raising patients’ awareness that diets must change, too, when statins are prescribed. The goal is to decrease patients’ risks of cardiovascular disease if that cannot be achieved without medications, Sugiyama noted, “not to empower them to put butter on steaks”
One concern is the new guidelines issued by the American Heart Association in November. They recommend that more people be prescribed statins as preventive measure. However, the study raises a question whether the people who would now be taking statins as a preventive measure will interpret them as a license to not make changes in their lives. Over-relying on a remedy wrapped in a statin bow may encourage many to continue their bad eating habits.
By Dyanne Weiss