Statin Users Consuming More Calories, Fat

The results of a new study suggest that statin patients may have a false sense of security, leading them to believe the medication can offset the effects of a poor diet and lack of exercise.

Although statins can help reduce cholesterol levels in patients at risk for heart disease, the results of a new study suggest that patients who use the medications may be neglecting important lifestyle changes that could prevent heart disease. The study, published online on April 24, 2014, in JAMA Internal Medicine, found that statin users have significantly increased their caloric and fat intake over the last decade, while intake has not changed among nonusers.

The researchers used National Health and Nutrition Examination Survey data from 1999 to 2010 to conduct a cross-sectional study comparing trends in calorie and fat consumption among statin users with consumption by nonusers over time. Total caloric and fat intake for patients aged 20 years and older were extracted from 24-hour dietary recall interviews, and cholesterol levels and body mass index (BMI) were also analyzed.

Although patients taking statins consumed significantly fewer calories and less fat than did nonusers at the beginning of the study, the results indicated that intake was similar in the 2 groups of patients by the end of the study period. From 1999 to 2000, statin users consumed on average 179 kcal and 9.5 grams of fat less per day than did nonusers, after adjustment for potential confounders. Statin users increased their intake of both calories and fat over time, while consumption remained the same among nonusers. As of 2003 to 2004, there was no longer a significant difference in fat intake between users and nonusers, and in 2005 to 2006, there was no longer a significant difference in caloric consumption between the 2 groups.

From 2009 to 2010, statin users consumed 9.6% more calories and 14.4% more fat than they did from 1999 to 2000. Over the study period, BMI also increased significantly, by 1.3, among statin users, compared with a non-significant increase of 0.4 among nonusers.

In an accompanying editorial, Rita F. Redberg, MD, MSc, suggests that statins give many patients a false sense of security, leading them to believe the medication can offset the effects of a poor diet and lack of exercise.

“This article raises concerns of a potential moral hazard of statin use, in addition to the already known adverse effects,” Dr. Redberg writes. “Focusing on cholesterol levels can be distracting from the more beneficial focus on healthy lifestyle to reduce heart disease risk.”

Although guidelines recommend statin use in addition to lifestyle modifications, the authors of the study question whether statin therapy is always the most beneficial and cost-effective option.

“Particularly in a time when obesity and diabetes have become epidemics and US health care costs have been soaring, we need to consider if it is an acceptable public health strategy to encourage statin use without also taking measures to decrease the likelihood that its use will be associated with increased caloric and fat intake as well as weight gain,” they conclude.