Statins versus Good Intentions with Diet

Statins 2Health care providers might be wondering whether their patients will use statin therapy as an excuse to change their diet—for the worse. No need to worry, say researchers from Mount Sinai, Columbia University, Veterans Affairs Medical Center and New York University, and Weill Medical College, all in New York; and the Mayo Clinic in Rochester, Minnesota.

Seventy-one patients with new prescriptions for statins to prevent cardiovascular disease were interviewed, first at the time of prescription and then again three and six months later. The investigators observed no evidence that taking statins had a negative effect on patients’ reported dietary intake.
At the start of treatment, 54 patients (76%) wanted to reduce dietary fat. Only five patients said they thought statin use would allow them to eat more fatty food, but 45 patients believed that taking pills was easier than correcting their diet.

At baseline, 59 patients (83%) believed that diet control would be effective, and 53 patients (75%) were motivated to either restart or continue a low-fat diet. Most patients said they preferred to try controlling their own diet before starting a statin, but only half reported actually trying to modify their diet.

It is interesting that some patients felt rushed into starting statins: 28 (39%) received a prescription even though they had said they wanted to change their diet first, and 31 (44%) thought their physicians didn’t give them enough time to try changing their diet. This apparent discordance may contribute to poor adherence, the researchers suggest, and “may reflect an unintended consequence of the increasing medicalization of hyperlipidemia.” They see a need for improved communication before and after statin therapy starts.

Over time, attitudes toward both dietary change and statin therapy tended to become more positive. Further, the researchers saw a definite trend among patients who reported lower adherence to statins—a trend toward a healthier diet, cutting back on fats, and boosting their intake of fruits, vegetables, and fiber.

Source: Mayo Clin Proc 2007