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August 13th, 2010
05:11 PM ET

Would you like a statin with that?

A new report in the American Journal of Cardiology suggests that fast food restaurants should offer statins – a popular class of cholesterol-lowering medications – alongside their unhealthy food.

"We propose that the fast food industry is well placed to offer advice and supplements to counteract the cardiovascular harm arising from the foods they purvey," the report said. "These companies already have an infrastructure for providing a variety of condiments... A generic statin could be added to the panoply of items in the self-service tray at little additional cost."

The study – which likened taking a statin before eating to putting on a bike helmet before biking – was based on analyses of other scientific studies, and concluded that taking the drugs could offset the risk of eating fast food just enough to render the food harmless.

"Most of the primary prevention statin regimes we examined, with the exception of pravastatin, had the strength to counteract the increase in risk caused by an unhealthy diet; or eating an additional 36 g[rams] of total fat or 2.8 g[rams] of trans fat per day – approximately equivalent to a Quarter Pounder with cheese and a small milkshake," the British researchers said in the study.

But Dr. Ralph Sacco, president of the American Heart Association, says that not only isn't the solution that simple, it could be dangerous.

"There are other things regarding obesity that are important that a statin won't neutralize, such as diabetes and high blood pressure," Sacco said. "Even though we agree statins have a lot of good evidence in reducing cardiovascular and stroke risk, there are certain risks with any medications."

The risks are relatively infrequent but include liver damage, muscle cramps and long-term muscle damage.

The British researchers concluded that the risks of eating fast food are much greater.

"Statins have been shown to be safe even at high doses," the report says. "The documented safety record of statins is substantially better than that of fast foods, which carry not only direct cardiovascular risks, but other risks due to obesity."

But regardless of whether the benefits do in fact outweight the risks,  Sacco says there are far better ways to reduce the negative effects of obesity.

"If you can control it with diet and exercise, that would be our preference rather than having to take a medicine."


soundoff (106 Responses)
  1. Lincoln Brigham

    Seeing as how the cardiology field has flip-flopped like a fish on the question of exactly WHICH foods cause increased risk of heart disease, I don't think they are well-placed enough to put the blame squarely on McDonald's quarter pounder with cheese.

    August 13, 2010 at 17:31 | Report abuse | Reply
    • The_Mick

      They've been pretty consistent on fatty foods doing our hearts and blood vessels in. In the late 90's, I co-wrote the Nutrition Science course curriculum for my county and spent a lot of time at the National Institutes of Health in Bethesda, MD and they were doing numerous confirmation studies then. They had rows and rows of food baskets, containing several variations on fat content, etc. that volunteers, living in the area, picked up weekly and only ate what was contained in them. The kitchen was filled with research assistants weighing out everything to the gram – even to the point of cutting tiny slices off apples because they were a few grams (1/10 ounce) too large!

      August 15, 2010 at 10:10 | Report abuse |
    • Darrel Francis

      Dear Lincoln,

      Thank you for allowing me to highlight that we did NOT pick on the Quarterpounder because we thought it (or its associated company) was a particular offender. We think all junk food is harmful.

      Rather, we picked it because it is widely consumed (i.e. unfortunately, people like the taste of it) and published data are freely available on its content etc. A similar calculation can be done for any food whose unhealthy content is find-out-able.

      August 15, 2010 at 15:13 | Report abuse |
    • Mooseknuckle

      id have to say that there is no good coming from McDonalds...at all. And dont give me any of that "its all white meat" nonsense....it may look white, but from what?

      August 16, 2010 at 10:09 | Report abuse |
  2. Augsbee

    Let me guess, the pharmaceutical companies stand to make millions as do those who claim they grow organic foods and that it is healthier for us to eat organic food. 2 glasses of wine (5oz) per day increases the risk of breast cancer in women by 10%, I don't see anyone complaining about women drinking wine, why??????? Read it at National Cancer Institute; American Cancer Society; National Institute on Alcohol Abuse and Alcoholism; Dietary Guidelines for Americans; Alcoholic Summit; American Heart Association; Columbia University Medical Center in New York and Kaiser Permanente in Northern California.

    August 13, 2010 at 17:32 | Report abuse | Reply
    • BillHHI

      Augsbee, big pharma would not make a nickel off of statins at every fast food franchise. Too many cheap generics – it's the generic manufacturers who would hit it big! Anyway, the whole idea is silly. Statin drugs do not work as being suggested. You can't just take "one" with a burger and fries and expect it to reduce cholesterol. Statins must be taken over time to develop a useful therapeutic window and continued to be of any value. I can't believe AHA is behind this idea.

      August 13, 2010 at 20:06 | Report abuse |
  3. Meryl Dorey

    Adverse reaction reports to statins have increased substantially since they have become 'drug flavor of the month' with the medical community. Apart from that, there is no evidence that they do anything to reduce the risk of heart attack or other vascular disease. So now, instead of spending money advising people about why they should not be eating fast food garbage 5 times a week and ruining their health through the trans-fats, poor nutrition, genetically engineered ingredients, herbicides, pesticides...shall I go on? We now say, eat all the crap you want – but here is a pill that may help you but will definitely be a boon for drug companies. This is – without a doubt – the craziest idea I have heard out of big pharmaland – and believe me – there have been plenty of crazy ideas there before!

    August 13, 2010 at 17:42 | Report abuse | Reply
    • Joe Blow

      Systematic reviews of randomized controlled trials – basically as good as scientific evidence gets – have shown that statins have been one of the greatest drug discoveries ever. The evidence is overwhelming that they reduce bad cholesterol, and elevated cholesterol is a known cause of heart disease. Obviously obesity caused by gorging yourself with junk food is the major reason for this becoming the "drug flavor of the month" – but complaining about how someone will make money from this therapy won't help. These drugs keep people alive for longer than they normally would live. Look at the big picture and review the evidence before saying "there is no evidence"....are you kidding – there are tons of studies looking at different questions concerning prevention/ therapeutic benefits of statins.

      August 14, 2010 at 13:45 | Report abuse |
    • Tandberg

      Joe,

      In actuality, the JUPITER study shows that the RELATIVE risk reduction is high, but the ABSOLUTE risk reduction is rather low. What this means is that you'd need to treat about 100 people in the target group with statins in order for just ONE of them to experience a life-saving benefit, which is presumably why you'd take a drug in the first place. Not exactly stellar performance.... One or more of those 100 would experience side effects, too. There's more to cardiovascular disease and heart attacks than just cholesterol levels.

      August 14, 2010 at 14:36 | Report abuse |
    • PharmD

      The benefits of statins in the medical literature are well-documented. The SPARCL trial, for example, significantly reduced the risk of recurrent ischemic stroke, and also reduced the risk of major coronary events as well as revascularization procedures. The Jupiter study that you state offers other benefits beyond a significant impact on mortality, including events, hospitalizations, etc. Statins do offer a mortality benefit, albeit not a great one, but it is significant. However, they offer a much greater benefit in the prevention of future morbidity, which often can be debilitating and pose a substantial strain on our health care system.

      I'm not advocating offering simvastatin as a side dish at every fast food restaurant. The whole notion of popping a statin every time we eat like crap is incomprehensible. Statins have been studied on a once-daily chronic basis, not a PRN basis, and they may offer pleiotropic benefits beyond the concept of LDL lowering. Also, you have the whole issue of people who would experience CPK elevations beyond normal limits, liver enzyme elevations, etc, that no one would monitor for.

      However, saying that statins are the biggest lie ever created by Big Pharma is ludicrous. I'd hate to imagine how poor our nation's life expectancy would be without the availability of statins, beta-blockers, Plavix, and ACE inhibitors, for example. Like any drug, statins come with inherent risks that can be monitored for. Not everyone can tolerate them, yet most will. The same holds true for chemotherapy, HIV antiretrovirals, and big gun antibiotics. They can cause problems, but their benefit significantly outweighs the risks. That being said, I'd trust a statin more then eating a big mac 5-7 times/week for dinner when it comes to my health.

      August 14, 2010 at 21:59 | Report abuse |
    • Darrel Francis

      Dear Meryl
      No doubt about it, after taking statins, patients do get adverse events. But they also do after taking placebo (i.e. nothing). It is the difference between the two sets of adverse event rates that gives us the true information on the adverse consequences of taking a statin. Surprisingly, in randomised controlled trials, where neither the patients nor the doctors know who is taking what, the genuine adverse events _caused_ by the statins are very few. I agree that statins are not the answer to our overeating problem, but I am at my wits end thinking of any other answer to give the people who do not follow standard health advice to eat healthily. What else to do for them?

      Dear Joe – Thank you – we can refer any interested parties to Wikipedia, and from there they can get the raw publications which are stunningly, consistently, overwhelmingly favourable for patients at risk of heart attack.

      Dear Tandberg – You are quite right, that one can only prevent a heart attack that was going to happen. JUPITER looked at low-risk people – the sort of people that had lipid levels that would normally make their doctors beam with happiness and joy. And even in them it was possible to prevent heart attacks. But as you say, very few in the no-statin group had a heart attack and so the number in the statin group who had a heart attack, although lower, was not much lower in absolute terms.

      In the long run, however, I do like to point out to my student that every high risk person was once a low risk person. We accumulate features of risk by getting older, heavier, more hypertensive, smoking more cigarettes cumulatively etc. At what stage we should choose to start using statins to retard the clogging up of our arteries, is not obvious.

      Dear PharmD,

      Thank you. I wonder why so many posters are telling me that I am ridiculous or crazy, but do not say that it is ridiculous or crazy for people to be given free medications such as salt, sugar, etc, to supplement their unhealth directly and indirectly (by increasing their appetite)? Is it because people are really more frightened of statins, which have a well-studied safety history, than of fast food, which so far has only "Supersize Me"?

      August 15, 2010 at 15:27 | Report abuse |
    • Chiro

      If statins were as effective as others have mentioned, without any risk to the person taking them, then why is it that Heart disease is still the #1 leading cause of death in the country with over 750,000 deaths per year. These drugs have done little to nothing to lower the actual risk of heart disease death.

      August 16, 2010 at 12:51 | Report abuse |
  4. R A Williams

    How about building a healthier body by choosing to not eat the greasy, salt-laden, disgusting junk food to begin with? Is that an option?

    August 13, 2010 at 18:21 | Report abuse | Reply
    • Dave

      This type of calm, rational, logical thinking has no place on the internet!

      August 13, 2010 at 19:19 | Report abuse |
    • Dave Spicer

      LOL! Where's the "Like" or the "Recommend" button for Dave's response?

      August 15, 2010 at 12:10 | Report abuse |
    • LOL

      How retarded is this article? Instead of NOT eating the grease, go ahead and eat it but take a pill with it!! HOW GAY IS THIS CRAP?

      August 16, 2010 at 13:26 | Report abuse |
    • nonovyerbeezwax

      I think this is a great idea! No one is going to make me stop eating Mcdonalds. I would eat it morning, noon, and night if I could. I weigh 350lbs and proud of it !

      August 16, 2010 at 19:55 | Report abuse |
  5. bailoutsos

    Do people know that everything being deep fried is being cooked in rancid oils? Once oil is exposed to air, it starts going bad.

    August 13, 2010 at 18:23 | Report abuse | Reply
  6. Bad Patient

    My liver hurt ever since I took lipitor, and I wouldn't trust the American Heart Association any farther than I could throw them. More like a front company for the heart surgery industry. They pump out the worst quality information.

    August 13, 2010 at 19:06 | Report abuse | Reply
  7. tikimama

    Might want to research something a little more thoroughly before enabling people who already make bad food choices to make more of them. http://www.huffingtonpost.com/dr-mercola/the-cholesterol-myth-that_b_676817.html

    August 13, 2010 at 19:09 | Report abuse | Reply
    • newsey

      What an interesting article, thanks for posting it. I need to re-read it, lots of information to go through.

      August 14, 2010 at 20:44 | Report abuse |
  8. Former Statin User

    I took statins to "improve my health" for four years. They worked for a while and then my cholesterol levels started to creep up. The doctors increased the dosage to deal with the increase. About a year after that, I saw dramatic (read scary) changes to my cognitive and neurological health. I virtually lost my short-term memory and started to experience uncontrolled twitching and tremors. I stopped taking the statins. Now, three or four years later, I have regained my cognitive and neurological functions nearly 100 percent. Nearly. A regimen of a more sensible diet, exercise, oatmeal and fish oil has reduced my cholesterol levels to levels comparable to what the statins had reduced them to.

    After stopping the statins we noticed several things. My color improved, I felt better, I no longer experienced any sexual dysfunction and my thinking was clearer.

    Statins are not a miracle. I believe they hold many dangers that have not yet manifested. Allowing people to take them unregulated and unsupervised is a recipe for disaster.

    Pharmaceutical companies have lied about the efficacy of statin drugs and were responsible for the the sudden lowering of cholesterol thresholds as a way to encourage more people to spend 30 dollars a month for the rest of their lives taking statins to eliminate a risk that was small in the first place.

    Statins are poison—as poisonous as any Big Mac, large fries and a shake ever will be.

    Sensibility, not medication, is the key to good health and long life. Don't be fooled by nonsense being spewed in the guise of "medical literature" from friends of Big Pharma.

    August 13, 2010 at 19:25 | Report abuse | Reply
    • BillHHI

      You made this up!

      August 13, 2010 at 20:07 | Report abuse |
    • graciegal

      This is because cholesterol is NOT a bad molecule – it is the precursor to brain neurotransmitters (aka your memory issues), testosterone (aka your sexual dysfunction) and your stress hormones that allow you to regulate stress. Taking a drug that lowers your body's ability to make and process cholesterol is a death sentence.

      August 14, 2010 at 12:50 | Report abuse |
    • anna

      I was on statins for two years. And like you things started to go somewhat wrong.....twitching, my legs and arms started to "jump" without my command. I couldn't not lift my two year old anymore as my muscles where deteriorating. I could not remember where I had parked at age 35. Bronchitits became a monthly event and with all the antibiotics that I had to take I was finally on six drugs to cover up the side effects of statins. When I asked my doctor if this could be from statins he responded with a flat out NO. After a dicussion with my dad (in Europe) who had the exact same problem he encouraged me to immidiately stop Lipitor. I did, and within 2 months I was back to normal.

      August 16, 2010 at 07:54 | Report abuse |
  9. Athena53

    My doc recommended Prevastatin. Six months later, I was having attacks of tendinitis so bad I sometimes couldn't eat with my right hand and it was agonizingly painful to bring my arm up high enough to brush my teeth.I threw the darn pills out, watched what I ate, took green tea pills, upped my intake of fish oil pills and started eating oatmeal for breakfast. Two months later I completed a triathlon which required a 1/3 mile swim, and now my cholesterol is down where it was with the pills- except that with the pills I'd be crippled by now.

    August 13, 2010 at 19:35 | Report abuse | Reply
  10. Bill

    Go ahead and add antidepressants, antianxiety meds, ED meds, weight loss meds and diabetes meds to the mix. It will be the merging of Big Pharma and Big Food into the biggest corporation the world has ever seen. God I love capitalism.

    August 13, 2010 at 21:09 | Report abuse | Reply
    • PharmD

      Diabetes meds? You know nothing! Type 1 diabetics shouldn't take insulin even though they can't make it, and die very quickly? Yeah ok.....the average age of onset of type 1 diabetes is mid-teens to early 20s. Would you want you're 16 year old daughter to die of a genetic autoimmune disease because of your principles against "Big Pharma?"

      Never mind the belief that type 2 diabetics did it to themselves. People deserve care and we have options. The options are: oral hypoglycemics that can get blood glucose under 180 mg/dL, still high but liveable, or let these people have sugars in the 300s-500s and die of diabetic ketoacidosis. Do hypoglycemics have risks? Sure. I'm against Avandia, but a lot of old drugs, like metformin, glyburide, glipizide, and glimeperide are cheap, generic, and effectrive.

      August 14, 2010 at 22:04 | Report abuse |
    • Martin

      Actually, it's been proven that even type 1 diabetes can be fixed with diet control, and that type 1 diabetics can go back to not taking insulin if they eat right and exercise.

      There are many documented cases of this.

      I am a type 2 diabetic, and control it solely through diet and exercise now. I realize that type 1 and type 2 are very different diseases, but both can be controlled, type 1 just needs much stricter control mechanisms in place.

      August 14, 2010 at 22:19 | Report abuse |
    • T1D

      Actually, Martin, you're handing out very dangerous misinformation. Type 1 diabetes CANNOT be controlled with diet and/or exercise alone. Type 1 diabetics MUST take insulin in order to live, regardless of what they eat. Even Type 2 diabetes cannot be "cured" solely by diet and exercise; it can only be managed. Take a Type 2 diabetic whose glucose levels have returned to normal because of proper diet and exercise - if that person resumes poor eating habits, the glucose levels will no longer be normal. For a person without diabetes, this would not happen. There is unfortunately NO cure for either type of diabetes. Please stop spreading misinformation; you could seriously harm someone.

      August 15, 2010 at 03:24 | Report abuse |
  11. bronco

    cholestrol lowering drugs tend to make your muscles and joints sore, I wouldn't exactly call them safe,since a punch in the arm can also make your muscles sore.

    August 13, 2010 at 22:45 | Report abuse | Reply
  12. Jim Purdy

    Fast food and statins? Horrible idea ... actually two horrible ideas.

    Two wrongs don't make a right.

    August 14, 2010 at 00:01 | Report abuse | Reply
  13. Russ

    A remarkably silly idea, this. Right up there with mandating that stair climbers and exercise bikes be installed in every McDonalds and the clientele required to exercise x number of minutes before they can order their food. A cheeseburger will cost you 30 minutes climbing stairs or a chocolate shake will run you 1 hour of pedaling, lard butt. Sure, that'll go over well.

    I still faithfully take my Pravastatin every day, and my muscles feel like somebody worked me over with a Louisville Slugger, all day every day. When I get bored with having HDL and LDL levels right on the line, I guess I'll stop using them just to give my body a break.

    August 14, 2010 at 00:07 | Report abuse | Reply
  14. Darrel Francis

    I am the medical researcher responsible for the study. Please do read the actual study (rather than only second-hand reports). The study points out that fast food is unhealthy and that people should NOT eat it, because there is no antidote. A healthy diet and healthy exercise, is exactly what we should all take. But some people ignore that advice, as we all know. Is there really a logical reason why they, with their burgers, are given free salt, ketchup, mayonnaise (regardless of whether they are already overweight, hypertensive, diabetic etc) and yet are NOT given access to a statin if they chose? The study is simply making a calculation, and very carefully sets out many of the points raised by the commenters here. Again, please do read the study carefully. Science progresses by criticism; I am open to any error in our calculations or reasoning. Best wishes, and eat healthily

    August 14, 2010 at 01:46 | Report abuse | Reply
    • Janice

      While I understand and respect the logic behind your study, I think that there is a disconnect behind the scientific world and their studies, and their understanding of how their findings will be interpreted and put into effect. The truth of the matter here is that no matter how well you publicize your findings, and how often you stress a healthy lifestyle, the general population will hear "Free statins @ fast food restaurants to counter-act the bad effects of fast food!" and most people will interpret this as a free pass to eat fast food with a clear conscience. Nobody will read the fine print talking about the chemicals, calories, cholesterol, preservatives and other components of the fast food meal going into their bodies.

      Our society needs to make a fundamental change to get away from all the chemicals and processed JUNK we eat. We need to stop treating the symptoms of a lazy, unhealthy lifestyle and exercise and eat healthy, unprocessed foods.

      August 14, 2010 at 10:22 | Report abuse |
    • graciegal

      Darrel, I have to say it seems pretty obvious that you do not understand cholesterol chemistry in a functioning cell and whole-body environment. It is one of the most important molecule sin the body and to alter the way it is produced and modified interferes with brain chemistry, reproductive chemistry, and stress chemistry. Really... it's simple stuff.

      August 14, 2010 at 12:53 | Report abuse |
    • Darrel Francis

      Janice – thank you, I do agree. (1) You are right, many readers have jumped to the conclusion that I say that people can eat anything and get away with it. In fact, our paper says the opposite, but you correctly observe that some people sometimes read the bits they want. But I am not in power over anyone. People are free to present alternative calculations – that is how science progresses.
      (2) Yes, it would be far, far preferable to fix the problem at source: healthy diet and regular adequate exercise. But I see many of my patients for whom whatever I say, whatever I do, I can't think of a way to guide them any better than now. There are many millions in the same boat. Should we desert them until we can think of a definitive fix?

      GracieGal –
      You are right, I do not have a detailed knowledge of cholesterol chemistry. I am only a cardiologist and I routinely use statins with my patients based on the trials which focused on at the end-result effects (see the paper for the full trail of details). These effects are broadly favourable in patients who are at risk of heart attack (but may not be favourable if patients are at near-zero risk).
      As to whether single doses of statin are any good, please let me have your comments after reading the paper. In short, if a single dose of statin doesn't do 1/365th the good of a year of daily statin
      (a) At what stage does the statin treatment start to take effect? One week? One month? And at that stage, there must be a catchup surge of benefit so that the year's worth of benefit is achieved. The trial data does not suggest such a catchup effect, nor a delay to onset of benefit
      (b) Does it matter that the heart attack a statin tablet is preventing is not the same heart attack that the hamburger caused? I don't know. I suggest it might not, just as the refund one gets in a shop on returning an item does not have to be the exact same notes and coins one paid with...

      Anyway I am glad both of you took time to respond carefully. (I can send you a copy if you email me at the Imperial College address)

      August 15, 2010 at 14:34 | Report abuse |
    • Rajiv

      Can you please email me the copy of your research paper @ rajiv_austin@yahoo.com

      Thanks,
      Rajiv

      August 16, 2010 at 13:17 | Report abuse |
  15. William

    I take Lipitor daily at bedtime for the past 5 years and so far have not had any problems with Liver, Muscle Spasms or any
    other abnormal reactions. I also maintain a low fat diet prescribed by my Primary and Cardiologist Doctors since my Quadruple Operation and exercise 30 minutes daily by walking, Bowflex and periodically Biking. As I stated, so far there have no side affects, however, my Primary Doctor orders a checkup at 6 month intervals just to be sure. I personally believe
    that a proper diet, exercise and in my case one Statin daily have helped me. Thanks for reading this.

    August 14, 2010 at 03:17 | Report abuse | Reply
    • Amit

      @ William, You should strongly consider a switch to generic simvastatin. It is much cheaper than Lipitor (about $13 for 100 tabs at Costco – cash price, without insurance). We have been able to switch a huge chunk of our patients over to the cheaper drug (generic for Zocor). Just make sure LDL stays below <70!

      August 14, 2010 at 16:42 | Report abuse |
    • PharmD

      Glad to see. With regards to the other comment, yes simvastatin is cheaper and available as a generic, but Lipitor will be generic next year. Lipitor is certainly the more powerful statin of the two, with Crestor (Gorillastatin) the clear winner. That being said, there is some evidence that simvastatin has a higher risk of myalgia and rhabdomyolysis, albeit still very low, compared to other statins. With the fact that you would have to take higher dose of simvastatin to get the same level of LDL lowering, and also combined with your significant history (quad bypass), if you have no problems affording Lipitor, stick with Lipitor and watch it become generic.

      To the other comment, I totally respond with respect to your idea and yes I offer that kind of advice many times to my patients. In this case though I think Lipitor is the better choice for this reader. That is just my professional opinion though.

      August 14, 2010 at 22:10 | Report abuse |
  16. Robert Wilson

    YEAH!!! McPharmacy coming to a city near you. Can't wait to see the law suits this would bring around after someone has an health issue because they took the medication.

    August 14, 2010 at 08:48 | Report abuse | Reply
  17. St-Louis

    We have to realise that healthy people are not obese and sedentary American gorging on statins. Healthy people are fit, active and have normal weight. Such people have far less cardiovascular disease without taking statins than obese sedentary people gorging on statins.

    August 14, 2010 at 09:05 | Report abuse | Reply
  18. Janice

    Why does the government/medical industry even bother to spend millions on campaigns to exercise and eat healthy and then consider options like this?

    This nation needs to realize there are no drugs or quick fixes to our obesity and health problems. REAL SIMPLE SOLUTION folks....get off your butts and move, and eat healthy chemical-free foods.

    August 14, 2010 at 10:12 | Report abuse | Reply
  19. russ

    They can PO – I am 65 and in good condition with a BMI on the low end of normal. I love my fires when I eat then – about every two weeks.

    The fat pigs just have an elbow problem – don't bend it and no problem.

    August 14, 2010 at 12:55 | Report abuse | Reply
  20. Krush

    I wonder where the funding for this report came from... could it be from the pharmaceutical companies that stand to make even more billions if statins are offered with fries? How about we teach people to mostly skip fast foods instead? Oh, wait, that would be true prevention and makes sense.

    August 14, 2010 at 14:12 | Report abuse | Reply
    • AJ

      Stop the nonsense. Statins are generic and dirt cheap. Walmart has 2 statins on their $4 per month drug plan. The study never said they recommended offering brand name Crestor or Lipitor, so no big pharma is making billions... Clearly you are not a physician.

      August 14, 2010 at 16:45 | Report abuse |
    • Darrel Francis

      Dear Krush

      Good question – you are wise to ask. But we did it in our spare time. No animals or humans were experimented upon, only evaluation of well-known previously-published research. Email me at Imperial College if you want to read the actual paper. I am not allowed to put it online due to copyright restrictions etc.

      August 15, 2010 at 14:40 | Report abuse |
  21. BillHHI

    To: Graciegal,

    I understand your comments about cholesterol and body chemistry. We are talking about excess cholesterol, not normal levels required for the functions you indicate. If your LDL was over 300 would you just go merrily on your way or do you think you might consider a therapeutic intervention? Diet is only good for about 10 – 15% reduction; not enough. What would you do? [This comment is not meant to support the "statin at a fast food place."]

    August 14, 2010 at 16:37 | Report abuse | Reply
    • Darrel Francis

      Dear BillHHI
      Even your partial support for my calculations, but not conclusions, are enough to make you my new Best Friend!
      Darrel

      August 15, 2010 at 15:04 | Report abuse |
    • Former Statin User

      Dear Sir,

      I am the guy who you falsely accused of "making up" my earlier comments. You, sir, are entirely incorrect about your assumption here and I am living proof.

      You state, "Diet is only good for about 10 – 15% reduction; not enough."

      My doctor said the same thing. However, during the past two years, I managed to reduce my cholesterol levels 45-75 percent through diet alone. My doc says in 30 years of medicine, he's never seen anything like it. My cholesterol levels are now seven points higher than they were when I was taking statins. That's slightly elevated over what is considered "healthy," but I'll live with that much more readily than I will with the side effects of statin drugs that I described above.

      In fact, with the side effects of statins, I think I would rather experience a heart attack than lose my faculties. This is not hyperbole.

      I appreciate that, as a cardiologist (or maybe a plant by Big Pharma), you have your position on this issue. Please understand that for me and (I am now finding), the myriad patients who have experienced utterly surreal and debilitating side effects of statins, my position is much different. It is possible to live in good health without statins. It takes some self discipline and real work, but then again, what doesn't.

      Thank you for considering my comments. Perhaps you will explore some other options for your patients and you (like my doctor) may be amazed and realize that statins may be one answer, but not the only answer, to ensuring the long-term health of your patients.

      August 16, 2010 at 14:37 | Report abuse |
  22. Lugi

    Of course EVERYONE should be on Statins, my dog and parakeet should be on statins, lets not forget all the wild animals in the forests and of course all the fishes in the sea.
    I trust the pharmaceutical companies because they care about me SO much.
    Log on to DR Douglas and read the real story

    August 14, 2010 at 19:12 | Report abuse | Reply
  23. Common Sense

    Regardless if the Darrel Francis in the comments section is the researcher involved in this study, he makes a ridiculous point in the comments above. He correctly observes that 1) people make bad health decisions (like eating "bad" foods which raise cholesterol) & 2( warnings aren't very effective deterrents. The natural alternatives (correcting one's diet and engaging in exercise) are often neglected because of the effort involved, so there needs to be an easier way to address this. So he proposes placing something at the site of dietary sin to "cancel out" its negative effects. This simplistic solution causes more problems than it fixes.

    As someone already pointed out, statins don't work like that- one can't take a statin at each binge of bad food and expect the statin to prevent the rise of cholesterol. Statins require regular, daily administration for a while. Moreover, the suggestion of the study's authors effectively brings a prescription-only drug into the realm of over the counter drug, despite its potency (to both heal and harm). Further, it allows the patient to "self-medicate", which doctors oppose. Statins have different dosages- who's to know (apart from doctor supervision &/or blood tests) how much their cholesterol would rise (thus, what dosage of statin he needs)? Or perhaps the restaurant can remedy this by having a doctor on staff to grant the prescription, dispensing, and oversight of statin use? (And if you want to compound the ridiculous- wouldn't this be a conflict of interest for the doctor?)

    Mr. Francis spoke of diners "not [being] given access to statins", as if restaurants are neglecting or usurping the rights of diners. Barring lack of any medical coverage (or internet access, if you catch my drift), it's hard to say with a straight face that someone can't "access" statins.

    The study authors may believe that the inconvenience of medical appointments discourages healthy decisions or timely correction of health problems (a point I agree with), but there's no reason this should sanction non-prescription/ease of access to statins above other drugs.

    August 14, 2010 at 20:21 | Report abuse | Reply
    • Darrel Francis

      Dear Common Sense,

      Right now, I can't imagine anyone daft enough to want to pretend to be me! 😎

      I am glad you agree with some of my points (email me at my Imperial College address if you want the full paper – I am not allowed to post it online).

      Whether a single dose of statin does any good is a funny question. At first, one might expect the answer to be "no" – since I (like all doctors) prescribe only regular prescriptions. But when does it take effect? There does not appear to be a delay to the onset of benefit, which many doctors, including me, find somewhat distressing – but when one's mental map does not agree with reality, it is one's mental map, not reality, which is wrong. It may well be that they work through an anti-inflammatory effect which can take effect within hours or days.

      In any case, the idea is to reduce heart attack risk (there is no way to reduce the risk of diabetes etc) and to do so to the same extent that one unhealthy meal increases it. Just as one tablet of statin cannot have the same effect as a daily statin, but rather about 1/365 of it, I believe that one junk meal is not as bad as a year of the ghastly stuff, perhaps about 1/365 as bad. That's the basis of the calculation.

      I understand your concern about self-medication, but here in the UK simvastatin is available from pharmacies without prescription. But the type of character that is eating a burger is not likely to nip out to the pharmacy. The idea is to make statins as available, instead of less available, than the unhealthy food which seems to be available round-the-clock (near my hospital, anyway).

      I agree the restaurant will not have anyone supervising the statin (they might limit it to one per person per meal, but that would not stop a dedicated "statin abuser" – if such a person could exist). However, who does the restaurant have stopping overweight people adding to their girth? Or hypertensive people salting their fries above their standard already-too-salty level? Or getting a cholesterol-rich milkshake when their blood is already overflowing with lipid? And if nobody is stopping those from happening, why should the first priority be to stop people getting statins?

      August 15, 2010 at 14:55 | Report abuse |
  24. Martin

    It looks to me like the cardiologists have given up on trying to get Americans to change their eating habits, and have gone for the quick fix instead.

    I wonder how many of these cardiologists are funded by the Pharmaceutical industry?

    "It's okay to just keep going on doing what you're doing, there's always a pill for everything that you have to take for the rest of your life".

    No wonder this is the first generation in history where kids will live shorter lives than their parents, and where we need specially designed double wide coffins for burial.

    Did you know that morbidly obese people don't even decompose natually because of all the preservatives they eat? True story! Even after death, their bad eating habits continue to cause them problems.

    August 14, 2010 at 22:15 | Report abuse | Reply
    • Darrel Francis

      Dear Martin,
      I can sympathise with your concern that I have given up giving good advice on diet and exercise. But my patients will tell you I am clear and voluble on the fact that nobody needs to have a statin or BP medication, if they lived truly healthily. But unfortunately virtually nobody does, despite the nagging by me and every other doctor on earth. So what do we do? Just be happy billing them for advice that they don't take? Or try to find ways of potentially helping our patients and (even more needy) people who don't come to us at all because they know our advice will be unpalatable?

      August 15, 2010 at 15:57 | Report abuse |
  25. PJ

    My mother took cholesterol drugs and she still had 95% blockage to an artery to her heart. So those things dont prevent anything. And along with that the degree of muscle affects has been awful. She is totally changed in personality, slow minded, forgetful, foggy, aching painful joints. Even ordinary movements cause her to become harmed to the point of resting a leg, hip, arm or other part for a few days til it improves. Her forearms have no muscle tone. her mother at 94yrs had better looking arms. This being a 20yr age difference. I will NEVER take these drugs. They are linked to sudden hearing loss too. Look up the info on it online. An astronaut who was also a doctor took lipitor and lost a whole weekend, ended up in ER. He wrote a book about it. "Lipitor: Theif of Memory". Medicine has turned into a pill popping enterprise. Instead of adjusting our diest and lifestyles they want us to pop pills. But they do dish out these pills like it is fad medicine. I will NEVER use these dangerous drugs. Read the blogs online about people's experiences while using them and yo uwill find many people who went from walking to being ina wheelchair. Same thing about asparatame(nutrasweet) which is linked to brain tumors, cancer, and causes seizures. read up. dont just pop pills

    August 15, 2010 at 02:42 | Report abuse | Reply
  26. ds123 aas

    If you eat out ANYWHERE, you are going to be taking in right around 1000 calories regardless of where. That's assuming of course, you aren't just ordering salad or grilled chicken. For example, Chipotle's burritos with sour cream and cheese are right at 1000 calories... it's right there on the website's nutrition calculator. Yet people think keep thinking as long as they avoid fast food they are staying healthy.

    August 15, 2010 at 03:11 | Report abuse | Reply
  27. JUDY C.

    Statin drugs are dangerous to your health....period. Most people don't even need them at all, big pharma is pushing their deadly drugs and pushing doctors to prescribe them after all they donate a lot to doctor's college funds and to the colleges and want to be paid back..........AT YOUR EXPENSE both in health & money. Lipitor destroyed my husbands muscles in his legs and he lives with pain, the muscles were damaged. His cholestrol level wasn't even high.....I eat what I want, I am not on any goofy diet or drug and my total cholestrol is only 153. You see statins are worthless and dangerous, I take natural supplements (the ones you don't hear about from your doctor for obvious reasons) and natural works great and doesn't damage your muscles. Your "bad" health keeps big pharma rich and of course they have all kinds of other dangerous drugs to treat the side effects of other dangerous drugs. I will stick to my natural alternatives.

    August 15, 2010 at 04:21 | Report abuse | Reply
    • Darrel Francis

      If people ate healthily and exercised well, virtually nobody should ever have a heart attack or stroke and (therefore) there would be virtually no justification for giving people statins or other heart attack prevention medication. You are a good example of what can be achieved. Other countries (other than UK and USA) have many people in that bracket of living healthily – and throughout history heart attack and stroke were rare causes of death.

      There is no rational argument against the position that these drugs would not be needed if people behaved healthily. The problem is, in a free society, they choose not to. And it is typically not CNN readers, university lecturers, or doctors who fall most deeply into this trap, but rather, less educated people. What can we do? Should we discard them from our minds?

      August 15, 2010 at 15:01 | Report abuse |
  28. JC

    Statin drugs require monitoring of liver functions and have numerous side effects, thsi is why the are prescription drugs and require medical supervison when taking them. It is my understanding that when one stops taking statins medical supervsion and monitoring is also required during the bodies "withdrawl" procress which can be a dangerous affair going cold turkey. So which drug comapany paid for the writing of this article. With Lipator going generic next year do you think perhaps that a new market for mass distribution would not be wanted to cover the lose in revnues as the hhigh price of Lipator gets wacked by 50-75%.

    August 15, 2010 at 09:43 | Report abuse | Reply
  29. AGuest9

    Typical... Boomers looking for a quick fix to undo their lives of wretched excess and gluttony...

    August 15, 2010 at 10:06 | Report abuse | Reply
  30. Mike

    It couldn't be simpler: eradicate junk and fast food from your diet. Then you don't need to spend your life savings on health care.

    August 15, 2010 at 12:24 | Report abuse | Reply
    • Tanya

      Don't forget to eradicate junk science from your diet as well...

      August 15, 2010 at 12:35 | Report abuse |
    • Darrel Francis

      MIke – Definitely, you are right.

      Tanya – I am open to any reasoned criticism of the methods or calculation or reasoning in the paper. I can email you a copy if you like, via my imperial college email address. But so far nobody that has contacted me has found any fault with the calculations etc. They are just unhappy with the outcome.

      August 15, 2010 at 14:44 | Report abuse |
  31. Cipher3113

    Seriously?! These fast-food corporations can't be trusted with public health now! What would ever make you think that allowing them to dose us with statins would be a good idea?! Obesity today isn't just about eating fast-food – it's about eating the wrong types of foods and not exercising. Get rid of the fast-food in your diet. Get rid of everything with High Fructose Corn Syrup. Start eating healthy, whole foods, take non-mercury laced fish oils, and get on a workout plan.

    Fast-food + no exercise = just plain lazy.

    August 15, 2010 at 12:26 | Report abuse | Reply
  32. A.J.

    I happen to be part a family that has had problems with Statins. I experienced severe eye muscle pain. My father
    also experienced muscle pain. My grandmother was hospitalized with a complication from Statins. It has taken her
    one year to recover from neurological conditions from Statins.

    August 15, 2010 at 13:28 | Report abuse | Reply
  33. NaoOkami

    I love how it always comes down to the fast food places being at fault. If you don't know that what you are eating is killing you that is your problem for not being knowledgeable on the subject. I remember thinking how stupid that case was where the fat girl was trying to cash in on McDonald's making her fat. McDonald's did not make her fat, she made herself fat by eating McDonald's all the time. You make the choice to be fat and you make the choice to stay fat. I am tired of the whining, if you don't want to be fat get off your a$$ and do something about it. There is no one to blame but yourself. I also hate how we are supposed to feel bad for these fatties. Like they have some kind of disease or something. No, they are fat and lazy. If they don't want to be called "Wide load" they should work on losing some weight.

    August 15, 2010 at 14:08 | Report abuse | Reply
    • Cipher3113

      Well said.

      August 15, 2010 at 14:31 | Report abuse |
    • Darrel Francis

      It is true that people over-eat through choice. But try as we might to dissuade them, they carry on doing it, both in the USA and (where I am) in the UK. I don't blame fast food companies, but we only singled them out as places which have a convenient infrastructure. Obesity seems to be a sad consequence of free choice and effectively no financial limit on the food we eat.

      August 15, 2010 at 14:42 | Report abuse |
  34. Eric Willy

    This is the worst idea I have every heard, I was placed on statin drug and the statin interfered with my Coenzyme Q transferance of oxygen to the muscles. I would not have stopped taking it had I not spoken to a family member. The lack of oxygen would have degenerated my heart and complete muclular system. This is why commercials for pharmeceuticals should be removed from TV, where Americans are coming up with symptons to match what they see on TV.

    August 15, 2010 at 14:38 | Report abuse | Reply
    • Bob

      Get these drug commercials off of TV.

      August 15, 2010 at 22:03 | Report abuse |
  35. BillHHI

    Darrel,
    Thank you! I very much appreciate your "new best friend" comment. I am privileged to have many friends in the field of cardiology and cardiovascular disease in general. Now I have another!
    Bill.

    August 15, 2010 at 16:41 | Report abuse | Reply
    • Darrel Francis

      A pleasure. I am surprised by the levels of anger and hostility, which appear to be directed at me. We live and learn!

      I have had a modest amount of what one might consider "hate email", if one wanted to classify these missives. Interestingly, most of these correspondents calmed down and said they understood my position, once they read the actual paper (which I am happy to send any interested parties – just email me at Imperial College).

      Best wishes

      August 15, 2010 at 19:58 | Report abuse |
  36. Anon4242

    I was on a statin for several years. Over time my joints were killing me and I walked with a limp. My memory was being destroyed – I couldn't remember the simplest things and I once drove down my street (where I lived for over 17 year) and for 10 min I had no idea where I was. When I stopped taking the statin, my joints stopped hurting and my memory problems went away completely withing 2 weeks. It might help some people, but the side effects for other people is worse than the high cholesterol. It's a quality of life issue and that medication was destroying mine. My mother had a similar reaction. Handing this stuff out like candy to everyone is not a good idea.

    August 15, 2010 at 18:04 | Report abuse | Reply
  37. Mike

    Joe Blow wrote: Systematic reviews of randomized controlled trials – basically as good as scientific evidence gets – have shown that statins have been one of the greatest drug discoveries ever.

    Just talk a look at their ads and the pages of SIDE AFFECTS Joe Blow. My dad, a physician , used to say the same thing (how great stains are) until he fell victim to stains side effects.

    But thte main point is why would a health professional not demand that the unhealthy behavior stop? Or limit it? Instead of taking a pill to counter the bad behavior. Its all part of a failed medical system that encourages pills and prodcedures to counter bad behavior. And the proof is here.. Americans are fatter and unhealthier than ever. Statins should only be used by those that have chronic high chol that is not been brought down by exercise and a modified diet. If people with high chol. are still eating at fat food places they deserve a heart attack....

    August 15, 2010 at 18:18 | Report abuse | Reply
    • Darrel Francis

      Hi Mike

      I do demand of my patients that unhealthy behaviour stop, or be limited. But people are free to disregard medical advice. What do we do then? Ignore them? Nobody deserves to have a heart attack.

      I treat, as emergencies, day and night, people having heart attacks and (as I am sure you realise) they are regretful for past misdemeanours, universally. Is there anything, practical, we can do to help in advance?

      August 15, 2010 at 19:45 | Report abuse |
  38. Bob

    Instead of eating healthy Big Pharma and the Medical Establishment wants to offer you pills with your fies! If anything why not offer Fish/flaxseed oil with your fries! Anything for money?? I can see McDonalds offering these satin drugs with your happy meal on TV.. followed by the warning may cause blindness, cancer or in some cases death.. Do not take Satins or eat a happy meal if you are pregnant, in diapers etc.. .. Do not eat with alcohol or other medications.. These jerks in the medical establishment you spend their time advocating healthy diets, not drugs!! Magic Pills for sale!!

    August 15, 2010 at 21:20 | Report abuse | Reply
  39. Darren

    Big Problem: Cholesterol drugs have only been proven to lower cholesterol test results. There is no link to a reduction in the incidence of heart disease. Furthermore, the cholesterol isn't really the problem, it is a symptom. The cholesterol is there because something is triggering its production, plus the bit you get just from your diet. The statins just make your test results look better at the expense of your wallet, side effects, and possibly damaging your body. Taking cholesterol drugs for high cholesterol in most cases is like being prescribed makeup for a nasty looking patch of melanoma. Giving out cholesterol drugs with fast food won't fix anything besides their cholesterol test results.

    August 15, 2010 at 21:31 | Report abuse | Reply
    • BillHHI

      I would suggest you find a good pathologist and have a discussion with him or her.

      August 16, 2010 at 07:45 | Report abuse |
  40. sytmie

    I think we should deep fry the statin and offer it as a dessert!

    August 15, 2010 at 21:39 | Report abuse | Reply
  41. Bob

    It will help the profits of the Drug Companies.. Each company can now merge with a food company. Why don't they just put satins in the drinking water with the fluoride??

    August 15, 2010 at 22:01 | Report abuse | Reply
  42. mmi16

    If you don't like the medical pronouncements on what you eat....wait a couple of months and the 'experts' will change their opinions.

    August 16, 2010 at 01:21 | Report abuse | Reply
  43. Caitlin

    Dr. Francis:

    I'm just interested to know what components of the "junk food" meal meal you are considering the most dangerous. No doubt the preservatives, etc. are unhelpful to our health, but have you seen recent research showing no link between saturated fat and CVD? I hope you are still reading the comments, I'd like your take on it.

    August 16, 2010 at 08:40 | Report abuse | Reply
    • Darrel Francis

      Dear Caitlin, this is an excellent question and one which we spent a lot of time thinking about. We know that our epidemic of cardiovascular disease must be related to poor diet and/or little exercise, since no other explanation fits the observations over time and between countries (given that genes have not changed much; and identical ethnic groups suffer massively different event rates through accident of geographic situation). We picked out fast food joints as an example of an as-yet unused mode of delivery of statins because
      (a) They are internationally widely distributed already and provide a relatively consistent service quality (whatever we may, individually, think of it!)
      (b) They are open long hours by comparison to most elective health care services
      (c) They have the will and economies of scale to provide free addons such as salt, sugar etc
      (d) They are there when we are not: at the time a harmful dietary act is taking place
      (e) They have, presumably, evaluated the need for medical checks on persons asking for a high calorie meal (blood pressure? cholesterol? diabetes? or even just weight? waist-to-hip ratio?) and have decided that these are unnecessary. In that context they should have no reason to decline the potential to produce a generic statin cheaply, and deliver it to people who have already shown they disregard the good advice that their doctors, scientists, and CNN commenters have given.

      I do not know which element of junk food is the most junk, i.e. harmful. The link between diet and CVD is hard to prove because
      (i) It is almost all observational (except a few trials such as DASH, which were positive)
      (ii) People don't know what they eat, so they can't tell us
      (iii) People know what they eat, but tell lies to their doctors
      (iv) It takes a very long time to accumulate the obesity, diabetes, hypertension, and ultimately heart disease to the point where we can detect it. It is easy to lose track of the tens of thousands of patients over such decades, that would be needed to prove that point.

      But it remains an interesting question. Where do our metabolic problems come from, if not through overactivity of our mouths and underactivity of our legs? Can't be the genes – they have served us well for 10's of thousands of years without CVD being so prevalent, and continue to serve well those who live in more economically frugal environments.

      August 18, 2010 at 03:28 | Report abuse |
  44. Umno

    Since I am allergic to statins I am thinking NO on this one.

    August 16, 2010 at 08:59 | Report abuse | Reply
  45. captainb gort

    Ha- do you think that Statins will offset this junk food just because your cholesterol numbers are artificially reduced? That's like cutting the wire to your illuminated "check engine" light to make you feel better about your health status. This is Big Pharma
    sucking you in. Go ahead- YOU take it. Not me. I'll avoid junk foods adn do my exercise instead.....

    August 16, 2010 at 11:13 | Report abuse | Reply
  46. Frank

    The only time I take statins are two weeks before I get my blood work done. My doctor doesn't gripe at me and my back doesn' t get as sore as it use to. I quit taking them the day I go to the doctors office. I guess from this article we should get an appointment for coranary by-pass when we eat that steak smothered in oinions and mushrooms.
    The comment about waiting a few weeks and you will see a different outcome reached is right on the money. The health "Officials" can't even get the coffee discussion right since week after week they just change their collective little minds.

    August 16, 2010 at 11:22 | Report abuse | Reply
  47. Mary Joyce

    In '05, before my primary physician put me on Lipitor, my cholestrol was 178, triglycerides 87; HDL 55, LDL 97. Now my cholestrol runs around 149 and everything else the same. I have gotten a big belly and cannot make my legs be still at night for sometime. He insists everyone should take at least 10 mg. of Lipitor. I want to stop. How can I do it?

    August 16, 2010 at 11:38 | Report abuse | Reply
    • BillHHI

      With an HDL of 55 and LDL of 97 you are well withing the 4:1 ratio prior to treatment. If you are concerned I would find another physician and get a second opinion. Preferably, a board certified cardiologist.

      August 16, 2010 at 14:06 | Report abuse |
    • Greta

      I lowered my cholesterol WITHOUT DRUGS by taking flax seed oil and eating oatmeal. No joke. The doc wanted to put me on a pill and a friend of mine told me this method had worked for him so I tried it. I was skeptical at first but I kid you not that my cholesterol went down by 30 points!!!! TRY IT FIRST.

      Doctors will never tell you about the power of foods because it does not line their pockets with dough. Screw doctors and take care of your health.

      August 16, 2010 at 14:32 | Report abuse |
    • Dan

      Simple. Stop taking the stupid pill.

      August 16, 2010 at 17:50 | Report abuse |
  48. 0nanism0

    How misleading! Don't these people know that fries have been cooked in vegetable fat for who knows how many decades, and therefore contribute ZERO cholesterol? So offering statins with fries as if fries cause higher cholesterol is SO FAULTY!

    August 16, 2010 at 12:40 | Report abuse | Reply
  49. Rajiv

    WoW! How irresponsible and big money in action. Lipitor plays with your harmones and causes muscles to go weak. Since heart is a muscle...anything that weakens a muscle can not be good for the heart, long term. Cholestrol is an indicator of a metabolic disorder in the body. Destroying the indicator is not a wholistic way to help heart. As soon as lipitor and other statins are running out of patent period big pharma has started coming out with new cholestrol lowering drugs to take one pill a day to keep their coffers full...and it goes on and on.

    > This type of ideas are just as bad as the quarterpounders themselves as they give masses some wrong ideas that statins are the holy drugs and they can eat anything and a pill would fix it.
    > You can eat anything in moderation. Once a month or once every other week is probably ok if thats what you really like. But exercise and eat healthy rest of the time to earn your fast food(again if thats your weekness).

    August 16, 2010 at 12:58 | Report abuse | Reply
  50. em

    How about we nip the problem in the bud and just avoid fast food in the first place. Problem solved.

    August 16, 2010 at 13:16 | Report abuse | Reply
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