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 Researchers found that U.S. adults taking statins in
1999-2000 were eating fewer calories than people not taking the
drugs, but statin users were eating about the same amount as
non-users by 2009-2010.
"We believe that physicians need to reemphasize the importance of a
healthy lifestyle to statin-users," Dr. Takehiro Sugiyama told
Reuters Health in an email.
He is the study's lead author from the University of Tokyo in Japan.
Eating excess calories and fat would not only compromise the
cholesterol-lowering effect of statins, he said. It would also
increase a person's risk of becoming obese and developing diabetes.
Statins — such as Lipitor, Zocor and Crestor — inhibit the
production of cholesterol, which is used to build new cells and keep
the body functioning. Too much cholesterol increases a person's
chances of developing heart disease and fatty deposits in blood
vessels, however.
Under new recommendations from the American College of Cardiology
and the American Heart Association, the number of U.S. adults
eligible to take the drugs may reach 56 million (see Reuters story
of March 19, 2014 here: http://reut.rs/QFtJxR.)
The new guidelines deemphasize the use of LDL or "bad" cholesterol
as a measure of when to put people on the drugs. Instead, doctors
are encouraged to take several risk factors into account to target
people at high risk for heart attacks or strokes (see Reuters story
of November 12, 2013 here: http://reut.rs/QFucA3.)
Previous studies had found no evidence that statin users eat more
after being prescribed the drugs, the authors write in JAMA Internal
Medicine. Use of the drugs has increased substantially since those
studies were conducted, however.
For the new study, the researchers used data from a national survey
of U.S. adults that's conducted every two years.
They found that statin users were consuming about 2,000 calories per
day in 1999-2000, on average, compared to about 2,179 calories per
day among non-users.
Sugiyama writes that it would be expected that stain users eat less
in an attempt to control their cholesterol and weight.
Calorie consumption among the statin users increased as time went
on, however. By 2005-2006 there were no differences between the two
groups.
Overall, calorie consumption among statin users increased by about
10 percent during the decade. Statin users significantly increased
the amount of calories they got from fat during the study period,
too.
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Meanwhile, calorie and fat consumption remained unchanged among
people not taking statins.
Sugiyama said there could be two explanations for the findings.
"We suppose (patients) noticed the potency of the statin
treatment because their LDL-cholesterol level would drop drastically
regardless of no change on diet," he said. "Through this process,
statin users may learn that they do not need to restrict their diet
to achieve the LDL-level goal."
Alternatively, doctors may have started prescribing statins to
people who tend to eat more and they may not be as reluctant to
prescribe the drugs to people who don't control their diets.
"Because of the study design, we were not able to disentangle the
mechanism," he said.
The research also can't say for certain that statins caused people
to eat more as time went on. There could be another unknown factor
that influenced the results.
"I think the biggest impact of this trial is that as physicians when
we put patients on statins it shouldn't be the end of the discussion
about other lifestyle interventions," Dr. David Frid said.
Frid is a staff cardiologist at the Cleveland Clinic in Ohio. He was
not involved with the new study.
"Even on a statin, you do need to continue following your dietary
recommendations," he told Reuters Health.
Sugiyama agreed that statin use should be paired with lifestyle
modification.
"Over-relying on medication would cause side effects, unnecessary
medical costs and perhaps an ethical concern," he said. "I think
physicians need to reemphasize the importance of dietary control for
statin-users." ___
Source: http://bit.ly/1k1CVFl
JAMA Internal Medicine, online April
24, 2014.
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