May 7, 2014
Are Unhealthier Eating Habits Related to Statin Prescriptions?

Los Angeles—Are increasingly unhealthy eating habits by statin users caused by an unwarranted sense of security that their cholesterol is under control?

That is the question raised by a new University of California Los Angeles study that finds that patients taking statins in 2009-2010 consumed more calories and fat than those who used statins 10 years earlier. Nonstatin users had no similar increase in caloric and fat intake during that decade, researchers point out in the report, published online recently by JAMA Internal Medicine.

In 1999-2000, statin users consumed fewer calories and less fat than nonusers, but that is no longer the case. In fact, increases in body mass index were greater for statin users than for nonusers, according to the study.

“We believe that this is the first major study to show that people on statins eat more calories and fat than people on those medications did a decade earlier,” said the study's primary investigator, Takehiro Sugiyama, MD, MSHS, who led the research while a visiting scholar at the David Geffen School of Medicine at UCLA. “Statins are used by about one-sixth of adults. We may need to reemphasize the importance of dietary modification for those who are taking these medications, now that obesity and diabetes are important problems in society.”

The study, subtitled “Gluttony in the Time of Statins?,” also was presented in April at the annual meeting of the Society of General Internal Medicine.

For the study, data from the National Health and Nutrition Examination Survey was used to compare fat and caloric intake among statin users and nonusers in 1999-2000 and 2009-1010. Researchers found that caloric intake among statin users had risen by 9.6% over the 10-year period, while fat consumption increased 14.4%.

In 1999-2000, however, statin users engaged in healthier eating habits that nonusers in 1999-2000—with an intake of 180 kilogram fewer calories and 9 fewer grams of fat each day.

Sugiyama suggested the differences could be explained by a false sense of security by statin users. In addition, he said, doctors may be more likely to prescribe statins for patients who eat and weight more, but he cautioned that a longitudinal study will be required to definitively answer the question.

“Regardless of the mechanism, there are problems, because eating more fat, especially saturated fat, will lead to higher cholesterol levels, which will undermine the effect of statins and may lead to unnecessary cost of medications,” Sugiyama said. “Being overweight also increases the risk of diabetes and hypertension, which also are risk factors for heart disease and stroke.

“Ethical considerations should be included in the discussion. We believe that when physicians prescribe statins, the goal is to decrease patients’ cardiovascular risks that cannot be achieved without medications, not to empower them to put butter on steaks.”

U.S. Pharmacist Social Connect