Millions of Americans are prescribed statins to lower cholesterol and prevent cardiovascular diseases. A new study shows users' diets may have changed from those who used them 10 years earlier.

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People taking statins to reduce cholesterol may feel a false sense of security and overindulge in unhealthy foods, according to a new study.

Statins are prescribed to reduce cholesterol and as a preventive measure for heart diseases. Millions of Americans are prescribed statins each year, either after a stroke or a heart attack.

Statin users' caloric intake increased by 9.6 % in 2009-2010 compared with those on statins in 1999-2000, according to a UCLA led study published on the JAMA Internal Medicine site. Researchers compared the intake of calories and fat and measured body weights among statin users and non-users over a 10-year period, using data from the National Health and Nutrition Examination Survey.

In 1999-2000 the intake of fat and calories was lower in statin users than in non-users. The difference of caloric intake became smaller over time, and by 2005-2006 there was no difference between the groups. By 2009-2010, fat intake was up by 14.4%, and the body weights of statin users had also increased, while non-users saw no significant increase.

Under new guidelines by the American Heart Association implemented in November, more people may be recommended statins as a preventive measure.

The change in the last few years could be driven by several factors, according to Takehiro Sugiyama, a clinical fellow at the National Center for Global Health and Medicine in Tokyo, who led the research while a visiting scholar at UCLA.

"Statin users check their cholesterol levels regularly, so they may learn they do not need to restrict their diet to achieve (cholesterol) level goals," says Sugiyama.

As Americans' waistlines increase, physicians may be prescribing statins to people who also eat more, says Sugiyama.

Cardiologists usually recommend statin users change their diets. The worry is that people on statins may feel like the pill allows them to continue eating as they choose. Robert Eckel, an endocrinologist, and professor at the University of Colorado Denver School of Medicine, says that while he would like to see the study validated in another population, the study highlights that statins shouldn't be thought of as a free pass.

"It's pretty clear people who eat heart-healthy have less strokes and heart disease," Eckel says. "This doesn't mean you can't have birthday cake at your son or daughter's birthday, but the overall diet is what counts."

While there isn't currently a link between dietary modification and statin effectiveness, Sugiyama says when doctors prescribe statins they want to decrease cardiovascular risks and obesity. He says the message is that doctors should continue to stress nutrition with patients on statins.

Sugiyama says another long-term study will be needed to identify the different dietary intake trends of the users, including whether the group began eating more because they started taking statins or if the users were more likely to eat and weigh more prior to treatment.

"Extrapolating from our study result, we can predict that statin users in the future will eat and weigh more than current statin users do," Sugiyama says. "This change will offset cholesterol-lowering effect of statins to some extent."

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