Tuesday, 31 August 2010

Brisk walks ‘could prevent 10,000 breast and bowel cancers’

source: Times
About 10,000 cases of breast and bowel cancer could be prevented every year in Britain if people quickened their walking pace and became more physically active, researchers say. Scientists believe that up to 4,600 bowel cancer cases and about 5,500 breast cancer cases could be avoided by more brisk walking and other forms of moderate activity, which causes the heart to beat faster and increases breathing.

Physical activity is also known to reduce the risk of endometrial cancer, which affects the womb, as well as helping people trim waistlines. Being overweight or obese is a known risk factor for several types of cancer, as well as heart disease and type 2 diabetes, according to the World Cancer Research Fund (WCRF). 

Rachel Thompson, deputy head of science for the fund, said: “You don’t have to go to the gym every day to benefit. “You can reduce your cancer risk just by making small changes and this is highlighted by the fact that so many cancer cases could be prevented through something as simple as brisk walking. “By taking up walking as a hobby or even walking to the shops instead of taking the bus or car, people can make a real difference to their health.” Dr Thompson said that there was “a lot of work to do” in raising awareness because few people were aware of the link between exercise and cancer risk. Each year, about 13,000 people in Britain die of breast cancer and 16,000 of bowel cancer. 

The WCRF recommends being physically active for at least half an hour a day. However, according to government figures, only 37 per cent of men and 25 per cent of women manage this. 

The latest figures came from a WCRF report that suggested up to 40 per cent of all cancers could be prevented by adjusting lifestyle factors such as losing weight, cutting down consumption of red meat or alcohol and doing more exercise. 

Previously studies have shown that moderate exercise can have a protective effect against breast and bowel cancer and can reduce the risk of lung cancer by as much as 40 per cent.

Friday, 27 August 2010

Traffic Light Adopters & Guideline Daily Amounts (GDA)

reposted from: via

From the Marks & Spencer label, the Guideline Daily Amounts (GDA) are:
Cals - 2028 (365*100/18), Sugar - 91g, Fat - 69g, Saturated Fat -  20g, Salt - 6g

From McCain, GDA differ

Cals - 1936 (213*100/11), Sugar - 80g, Fat - 76g, Saturated Fat -  17g, Salt - 5g

This is strange since surely the GDA does not differ eg M&S work out at 6g salt and McCains 5g salt. Whats up?

The European review of labelling reference intake values - Scientific Opinion of the Panel on Dietetic Products (1), (detail pdf) recommended Daily Guideline Amounts:- Energy 2000 kcal, Total fat 70g (31.5 E%) of which Saturated fat 20g (9 E%), Carbohydrate 260g (52 E%) of which Sugars 90g (18 E%), Salt 6g.

(1): Scientific Opinion of the Panel on Dietetic products, Nutrition and Allergies on a request from European Commission on the review of labelling reference intake values for selected nutritional elements. The EFSA Journal (2009) 1008, 1-3


The proposed labelling reference intake for energy (8400 kJ or 2000 kcal) corresponds to the recommended energy intake for a moderately active woman. 

Total fat 

The proposed labelling reference intake for total fat (70 g) corresponds to 31.5 E% for a 8400 kJ (2000 kcal) diet. This value is within the range of the upper limits of intake of fat (30 – 35 E%) recommended for individuals in the general population in EU countries and by other authorities. It is at the lower end of the range of average total fat intakes in adults observed in EU countries (about 30 - 47 E%). 

Saturated fat 

The proposed labelling reference intake for saturated fat (20 g) corresponds to 9 E% for a 8400 kJ (2000 kcal) diet. This value is consistent with the upper limits of intake of saturated fat (8 - 10 E%) recommended for individuals in the general population in EU countries and by other authorities. It is at the lower end of the range of average saturated fat intakes in adults in EU countries (about 9 - 18 E%).


The proposed labelling reference intake for carbohydrate (230 g) corresponds to 46 E% for a 8400 kJ (2000 kcal) diet. This is less than the lower limits of intake of carbohydrate (generally 50 - 55 E%) recommended for individuals in the general population in EU countries and by other authorities. 

The Panel proposes that the labelling reference intake for carbohydrate be 260 g (corresponding to 52 E% for a 8400kJ or 2000 kcal diet) which is within the range of lower limits of recommended intakes for individuals in the general population and close to the upper end of the range of average carbohydrate intakes in adults in EU countries.  


The proposed labelling reference intake for (total) sugars (90 g) corresponds to 18 E% for a 8400 kJ (2000 kcal) diet. The proposed value is at the lower end of the range of average intakes of total sugars in adults in EU countries (about 17 - 26 E%). Total sugars include both indigenous (sugars naturally present in foods such as fruit, vegetables, cereals and lactose in milk products) and added sugars. There are generally no recommended intakes for total sugars. Some authorities have recommended upper limits of intake of added sugars (generally 10 E%) for individuals in the general population, while others recommend that intake of added sugars, or certain foods containing added sugars, be limited but do not recommend an upper limit. 

It has been estimated that indigenous sugars provided by recommended daily intakes of fruits, vegetables, cereals and dairy products would amount to about 45 g in adults. Assuming that the remaining 45 g of sugars (up to the 90 g proposed for the labelling reference intake) are added sugars, this would correspond to 9 E% for a 8400 kJ or 2000 kcal diet. 

Thus the Panel considers that the proposed labelling reference intake of 90 g for (total) sugars is compatible with a recommended upper limit of intake of added sugars of 10 E% for individuals in the general population as proposed by some authorities. 


The proposed labelling reference intake for salt is 6 g. This value is within the range of the upper limits of intakes of salt (generally 5-8 g) recommended in EU countries and by other authorities. It is less than the lower end of the range of average salt intakes in adults in EU countries (about 8-11 g). 

Published: 4 May 2009 

From a table in the detailed efsa report eg Total Fat 70g x 9 kcal/g = 630 kcal which is 31.5% of a 2000kcal diet. Note: 
  • the 230g (46 E%) carbohydrate was substituted for 260g (52 E%) in the final report.
  • big differences (last column) between men and women eg saturated fat 20g for women / 30g for men

Wednesday, 25 August 2010

Crabsallover Liver Function tests - Serum alanine aminotransferase & Serum total bilirubin

Crabsallover Tested July 2010 (Twin Oaks)
Alanine transaminase (ALT)
  •  Serum alanine aminotransferase: Crabsallover: 25 iu/L (range ex.Twin Oaks : 0-35 iu/L) aka Alanine transaminase (ALT)
    • NOT PRESENT: but if were...elevated levels of ALT suggest viral hepatitis, congestive heart failure, liver damage, bile duct problems, infectious mononucleosis, or myopathy. 
    • NOT PRESENT: but if were.. elevated ALT levels due to liver-cell damage can be distinguished from biliary duct problems by measuring alkaline phosphatase. Myopathy-related ALT levels can be ruled out by measuring creatine kinase. 
  • Range via Reference ranges for blood 0.15-1 ukat/L
no levels guidance given

  • Serum total bilirubin: Crabsallover: 18 umol/L and 20 umol/L on 3/11/11, range (ex. Twin Oaks): 0-17 umol/L 

    •  5.1-17umol/L and some sources 1.5-25umol/L total bilirubin (Reference range for blood tests)
    • Bilirubin is the yellow breakdown product of normal heme catabolism found in hemoglobin. Bilirubin is excreted in urine and is responsible for the yellow color of bruises & urine.
    • High levels of bilirubin in the blood may be caused by:
      • infections eg infected gallbladder, or cholecystitis. 
      • inherited diseases eg Gilbert's syndrome (affects how liver processes bilirubin)
      • Diseases that cause liver damage eg hepatitis, cirrhosis, or mononucleosis. 
      • Diseases that cause blockage of the bile ducts eg gallstones or cancer of pancreas. 
      • Rapid destruction of red blood cells eg sickle cell disease 
    • To elucidate causes of jaundice or increased bilirubin liver function tests (eg alanine transaminase, aspartate transaminase, gamma-glutamyl transpeptidase, alkaline phosphatase), blood film examination (hemolysis, etc.) or evidence of infective hepatitis (e.g., hepatitis A, B, C, delta, E, etc.)
    • high Bilirubin levels can result from red blood cell breakdown or liver disease. Two different chemical forms of bilirubin—direct (or conjugated) and indirect (or unconjugated) bilirubin are tested. If the direct bilirubin is high there may be some kind of blockage of the liver or bile duct, perhaps due to gallstones, hepatitis, trauma, a drug reaction, or long-term alcohol abuse. If the indirect bilirubin is increased, haemolysis (undesirable breakdown of red blood cells) may be the cause.
Seek further medical opinion - 18 umol/L bilirubin is outside the range (Twin Oaks): 0-17 umol/L

Crabsallover Glucose levels - Diabetes test

November 2011: 4.4 mmol/L (Savage, twin oaks)
July 2010: Glucose 5.2mmol/L (Twin Oaks)
October 2008: Glucose 4.8 mmol/L (Lloyds Pharmacy)
November 2006: Glucose 6.1 mmol/L with a fasting retest: 5.9 mmol/l. (Sharon 4.9 mmol/L, November 2006).

Normal Glucose Range: 4.4 - 6.1 mmol/L (source)

Diabetes is diagnosed by fasting plasma glucose level >7.0 mmol/L. At 5.6 to 6.9 mmol/L levels is 'impaired fasting glucose' (IFG) a pre-diabetic state, associated with insulin resistance and increased risk of cardiovascular pathology. 50% risk over 10 years of IFG progressing to overt diabetes - average time for progression as less than three years.[1] IFG is also a risk factor for mortality.[2]

Since November 2006 5.9mmol/L, IFG crabsallover glucose levels have become normal: 4.8 mmol/L (October 2008) and 5.2 mmol/L (July 2010) and  4.4 mmol/L (November 2011)

NB. =5.2 x 18 = 93.6 mg/dL source:

Saturday, 14 August 2010

Why women live longer than men

reposted from: Psychology Today - Unedited

Why women live longer than men

It's all about risk management

The average woman on the planet can expect to live about five years longer than the average man. Comparison with other species suggests that females live longer because they are primary caregivers for children. Yet, the real reason women outlive men may be that they take better care of themselves.
The caregiver theory
In every society, women do more of the child care than men. According to the caregiver theory, women live longer than men because they are more essential to the survival and well-being of children. Because motherless children had poor survival prospects, natural selection ensured that ancestral women were good at surviving. This meant avoiding unnecessary risks.

Males of some other primate species are more involved in care of offspring than men are and this gives them an advantage in terms of life expectancy (1). If care giving duties are about equal, males live as long as females in the case of siamangs (a type of ape) and titi monkeys.

The star exhibits here are owl monkeys, -- a South American species in which the male does most of the carrying from birth onwards. Fathers hand off their charges to the mother only when they are being nursed. The father is critical for survival of owl monkeys: if the male dies, the female refuses to carry the infant except when it is being nursed.

Male owl monkeys are more likely to survive than females and this survival advantage becomes noticeable at about the age they begin to raise young. The care-giver explanation thus looks convincing but it is not the only game in town. Its masculine counterpart is the notion that sexual competition favors risk-taking by males thereby reducing masculine life expectancy.

The risky lifestyle explanation
Males are generally more boisterous and reckless than females and experiments on monkeys find that the difference is explainable in terms of prenatal exposure of the brain to testosterone.

Evolutionists generally attribute male riskiness to male-male competition over mates. Analysis of human mortality statistics supports the risky lifestyle theory. Women take much better care of their own health and men are much more likely to die from violence, and accidents, and from neglecting their medical care.

According to researcher Will Courtenay (2), risky lifestyle accounts for most of the human gender difference in life expectancy, suggesting that any fixed biological differences (e.g., metabolic rate, Y-chromosomes, exposure to testosterone versus estrogens) make only minor differences.

Evolutionary Synthesis
How does one reconcile the care-giving theory and the risky lifestyle theory? Perhaps the two explanations are really just different facets of the same idea. Risk taking is elevated by sexual competition in men but riskiness is reduced by care giving for women.

Women are more risk averse than men and this risk aversion is particularly noticeable if they have young children. Married men are also much lower on risk-taking than single men and even produce less testosterone. Married men have much lower mortality rates than their single counterparts (3).

Women live longer than men mostly because they avoid a risky lifestyle. They avoid risk because they are primary care-givers. Men lead shorter lives because they take greater risks, particularly if single and dating. Specific risks are described in a future post.

1. Allman, J., Rosin, A., Kumar, R., & Hasenstaub, A. (1998). Parentingand survival in anthropoid primates: Caregivers live longer. Proceedings of the National Academy of Sciences, 95, 6866-6869.
2. Courtenay, W. H. (2000). Behavioral factors associated with disease, injury, and death, among men: Evidence and implications for prevention. The Journal of Men's Studies, 9, 81-142.
3. Waite, Linda J., and Maggie Gallagher. 2000. The case for marriage. New York: Doubleday.

Ben Goldacre explains the placebo effect

reposted from: NHS Choices
Ben Goldacre, doctor and author of Bad Science, explains what the placebo effect is and describes its role in medical research and in the pharmaceutical industry - 5 minute video here.


The placebo effect is the extraordinary phenomena of people getting better

even when they've only had a dummy or a sham treatment.

That can mean a sugar pill, but it can also mean sham ultrasound,

where somebody holds a machine to your body, but doesn't switch it on.

Or even a fake operation,

where somebody makes the incision, then just pretends to operate.

And the fascinating and amazing thing is,

it turns out when people get these fake, sham treatments,

they often get better.

What's interesting about the placebo effect

is that it shows the amazing power of the mind over the body.

Not in a flaky, New Age way,

but in a very real sense we really can make our pain better,

we really can improve our own symptoms

through our beliefs and expectations.

All of the magazine adverts you've ever seen

have built up in your memory

and have increased your expectation of a brand-name packaged pill.

What's interesting is that the placebo effect seems to work on everybody.

It doesn't matter if you're a sceptic,

and even children and animals respond to the placebo effect

because the people around them have higher expectations

of the dummy treatment they've been given.

It's natural to expect that your children, certainly,

would react to your expectations that they would get better.

There are some fascinating examples.

The most interesting ones compare one dummy treatment with another.

Because that's what shows that it's the placebo effect at work.

So for example we know that four sugar pills a day, four dummy pills

are better than two sugar pills a day at clearing gastric ulcers.

An outrageous finding, in some respects.

Gastric ulcers are a very good thing to study,

because they're very easy to diagnose.

You put a camera with a light on it down the throat

and take a photograph of the stomach lining.

You can see the ulcer is either there or it's gone.

Four sugar pills a day clear gastric ulcers faster than two a day.

We know that the colour of pills is important.

It turns out that people experience green or blue pills as being sedating

and red or orange pills as being alerting.

And the pharmaceutical industry know this too.

If you look at the packaging on anti-depressant or anti-anxiety pills

that tends to be green and white or blue and white.

Whereas stimulant pills or antibiotics tend to come in bright red pills.

There have been several different studies of pain,

looking at the placebo effect.

They show that a saltwater injection with no active ingredient in it,

is a more effective treatment for pain than a dummy sugar pill.

A pill that looks like a painkiller.

So the saltwater injection doesn't have any drugs in it,

the dummy sugar pill doesn't have any drugs in it,

but an injection feels like a more dramatic and serious treatment.

And that's why people experience more pain relief from a dummy injection

than they do from a dummy pill.

The interesting thing about all research is what you do with it.

And with the placebo effect you are in an interesting ethical hole.

The research shows that lying to your patients, misleading them,

can help them get better.

And a patient given a placebo sugar pill

isn't exposed to any physical side-effects,

so people might say, maybe we should give placebo treatments commonly.

But I think that's problematic. I think that's wrong.

Because to give a placebo treatment to a patient

requires that you lie to them.

And I don't think that doctors or anybody working in the NHS

can lie to patients.

I think it's ethically wrong but also, in the long-run,

when you lie to people paternalistically like that,

eventually word gets out and you undermine the credibility

of everything that you say.

Even though we don't want to lie to patients

there is an ethical way that we can use the placebo research.

Because what this research tells us is

that the way you give a treatment, can affect how effective it is.

So we know, for example, that if we give treatments

in a much more healing environment with a greater sense of positivity

with happier, more confident people in the NHS, in nicer settings,

then that's not just wishy-washy,

that really genuinely improves the outcomes of our treatments.

And I think that's the real key,

to use all of the placebo effect research I've described,

to find ways of taking treatments which we know are effective,

and make them even better.

Lower your cholesterol

source: NHS Choices
Eating a lot of the wrong type of cholesterol can increase your risk of heart disease and stroke.

Good for cholesterol:

  • Olive oil
  • Rapeseed oil
  • Avocado
  • Almonds
  • Cashews
  • Peanuts
  • Pistachios
  • Herring
  • Mackerel
  • Pilchard
  • Sardines
  • Salmon
  • Fresh tuna
  • Porridge
  • Beans
  • Lentils
  • Fruit
  • VegetablesNot all cholesterol is bad. Cholesterol, a waxy substance produced by the liver from fatty foods, is vital for the normal functioning of the body.
Cholesterol travels around the body encased in proteins. There are two types:
  • high density lipoprotein (HDL) is the so-called good cholesterol, and
  • low density lipoprotein (LDL), known as bad cholesterol
Cholesterol is deposited in the arteries where it is needed and the good cholesterol takes the excess bad cholesterol back to the liver, where it is either broken down or flushed out of the body.
Too much bad cholesterol can lead to gradual build-up of fat in the arteries. Over time, this can increase your risk of developing cardiovascular disease, such as coronary heart disease, as well as diabetes and stroke.
In England, cholesterol levels are above the recommended level of 5mmol/litre. Men have an average cholesterol level of 5.5mmol/l, and women have a level of 5.6mmol/l.
To ensure you have a healthy heart and arteries, your body needs a low level of bad cholesterol and a high level of good cholesterol.
“The most common cause of high cholesterol in the UK is eating too much fatty foods,” says Denise Armstrong of Heart Research UK.

Bad for cholesterol:

  • Butter
  • Hard cheese
  • Fatty meat
  • Meat products
  • Biscuits
  • Cakes
  • Cream
  • Lard
  • Dripping
  • Suet
  • Ghee
  • Coconut oil 
  • Palm oil
Good food
A healthy diet can significantly help reduce your cholesterol level.
Fat in food is made up of a combination of saturated fats, monounsaturated fats and polyunsaturated fats.
Saturated fats can increase the level of bad cholesterol in the blood and increase the risk of narrowed arteries.
Foods high in saturated fat include butter, hard cheese, fatty meat, biscuits, cakes, cream, lard, suet, ghee, coconut oil and palm oil.
Monounsaturated fats can lower bad cholesterol, while maintaining good cholesterol. Polyunsaturated fats reduce total cholesterol.
Foods high in unsaturated fats include olive oil, rapeseed oil, sunflower oil, nuts and seeds (walnuts, pine nuts, sesame seeds), some margarines and spreads.
Armstrong recommends using rapeseed oil for cooking at a high temperature, such as frying or roasting.
“Olive oil burns at high temperatures and becomes unhealthy,” she says. “Use olive oil in salad dressing, mashed potatoes or to add flavour to dishes.”
Omega-3 fat is a particular type of polyunsaturated fat that can help to reduce fatty deposits in the blood, prevent blood clots and regulate the heartbeat.
Tips to reduce your cholesterol level:
  • Cut down on saturated fats and replace them with small amounts of monounsaturated and polyunsaturated fats.
  • Avoid fatty foods such as pastries, crisps, cakes and biscuits and replace them with healthier options such as fruit or vegetables.
  • Eat oily fish at least once a week. Oily fish such as herring, sardines, salmon, trout and fresh tuna, are the richest source of omega-3 fats.
  • Foods high in soluble fibre such as porridge, beans, pulses, lentils, nuts, fruits and vegetables can help lower cholesterol.
  • The cholesterol in eggs, liver and kidneys and some types of seafood, such as prawns, don’t have a great effect on cholesterol levels. It’s the saturated fat content that can cause problems.
“If you need to reduce your cholesterol level, it’s much more important that you eat foods that are low in saturated fat,” says Armstrong.
Substances called plant sterols and stanols, added to certain foods including margarines, yoghurts and milk drinks, can also reduce the level of bad cholesterol.
“Even if you do eat sterol-enriched foods, it’s still important to make sure you follow a healthy diet,” says Armstrong.
Get moving
An active lifestyle can help to improve healthy cholesterol levels. Activities can range from low-impact brisk walks and cycling to more vigorous exercise such as running and dancing.
Thirty minutes of physical activity at least five days a week can help to improve your cholesterol levels.
“You can do the 30 minutes all in one go or in shorter bouts of at least 10 minutes a time,” says Armstrong.
“For it to count, you need to be active enough to make you feel warm and slightly out of breath but still able to have a conversation.
“At least 30 minutes of moderate-intensity physical activity on five or more days a week is all it takes for you to feel the health benefits.”
Armstrong says that inactive people achieve more immediate benefits from taking up exercise than those who are already fit.
Last reviewed: 29/07/2009

Burger, fries and statins on the side? Don't dish out statins like ketchup says NHS Choices

further to my McStatin blog yesterdayNHS Choices says statins 'should not be dished out like ketchup':-

Fast-food restaurants could “dish out anti-cholesterol drugs to fight the effects of fatty grub,” the Daily Mirror has reported. The news story is based on a research paper arguing the case for handing out free cholesterol-lowering statin drugs whenever someone buys fast food. Its authors say that providing 'MacStatin' tablets would cancel out the health risks of high-fat food and offer customers cardiovascular benefits. They based this on calculations comparing some of the harms of fast food against the benefits of statins.

It is difficult to know how seriously to take this study. 

The high sugar, salt and fat content of junk food has many negative health consequences beyond just increasing cholesterol. Taking a statin pill while continuing with an unhealthy diet will not address all of these. Most importantly, statins are designed for longer-term use under medical supervision. They should not be dished out like ketchup.

Where did the story come from?

The study was carried out by researchers from Imperial College London and Imperial NHS Trust, London. No information is given about funding, although one of the authors is supported by a grant from the British Heart Foundation. The study was published in the peer-reviewed American Journal of Cardiology. The study was reported widely and fairly in the media. Several newspapers quoted the opinions of external experts, including some from the British Heart Foundation who were critical of its argument

What kind of research was this?

The authors say that cardiovascular disease (CVD) remains a leading cause of illness and death, with the greatest problems lying with the “at risk” segment of the population that are unaware of their condition. Given the frequency of fast-food consumption and its adverse health consequences, they argue that the fast food industry is well-placed to offer advice and supplements to counteract the harm arising from the foods they sell. They propose that, like salt, ketchup and other sauces provided free of charge, a statin could be added to the items in the self-service tray, in combination with other healthy lifestyle suggestions. Their study attempts to compare the risk increase involved in eating fast foods with a high fat content against the risk reduction in taking statins daily. They constructed a model to juxtapose these two risks and attempted to compose a “tariff” comparing the level of statin needed to neutralise the cardiovascular risk from eating fast food.

What did the research involve?

To quantify the cardiovascular risk of a higher dietary fat intake, the researchers looked at a large cohort study of nearly 47,000 men.

The study found that the relative risk of heart attack and coronary artery disease was 23% higher in the men with the highest fat intake (top 20% of the group). They consumed 89g total fat a day, while those in the bottom 20% with the lowest fat intake consumed 53g total fat a day. A similar trend was observed for trans fats. 

To determine the relative risk reduction due to statins, the researchers used a recent meta-analysis of statins in the primary prevention of coronary artery disease, which included seven randomised controlled trials and covered nearly 43,000 patients.

The combined relative risk reduction across all the trials with use of statins was just under 30%. They also quote a further study to show that statins taken regularly reduce the relative risk for a major cardiovascular event by 20-70%, depending on which drug and what dosage is taken. 

The researchers then plotted the reduction in relative risk associated with different statin trials, against the increase in relative risk associated with consumption of foods of increasing total fat and trans fat content.

They used a quarter-pounder burger (19g total fat), a quarter-pounder with cheese (26g total fat) and a small milkshake (10g total fat) from a fast-food chain as a proxy for foods with a high-fat content. 

They juxtaposed the high-fat content of these foods with the extent to which statins might offset the increased risk for cardiovascular disease associated with an unhealthy lifestyle.

What were the basic results?

The researchers calculate that: The reduction of cardiovascular disease (CVD) risk associated with daily consumption of most statins (with the exception of parvastatin) was, on average, around 30%. The daily extra fat intake associated with a fast-food quarter-pounder with cheese and a small milkshake was calculated to increase the risk of CVD by just over 20%. On this basis, the researchers say that the CVD risk-reduction of a statin pill is greater than the risk increase of CVD after eating these foods.

How did the researchers interpret the results?

The researchers say their calculations show that statins can neutralise the increased risk for cardiovascular disease associated with the regular consumption of unhealthy foods. Individually, most of the statin regimes had the strength to counteract the risk caused by eating an additional 36g of total fat per day, with similar results found when they calculated consumption of transfats separately. 

They argue that the fast-food industry could provide a “McStatin” sachet that could be sprinkled onto a burger or into a milkshake at no extra charge. Food would also carry health warnings in the same way as cigarettes do currently, and advice on healthy lifestyle.


The study’s comparison of the risks associated with a high-fat diet with the risk reduction for statins is interesting.

However, there is no evidence to support its main contention that a statin taken every time someone has a fast-food meal would reduce the risk of heart disease. 

This argument is based on the following unproven assumptions: In an unhealthy diet, each unhealthy meal eaten contributes directly to the increase in CVD risk. Each statin tablet taken individually provides a reduction in CVD risk. However, statins are designed for use in long-term cholesterol management programmes and virtually all studies on statins have looked at regular, rather than one-off use. 

The way that lifestyle, in addition to other medical and genetic factors, affects the risk of heart disease is more complex than this study suggests. For example, there are several established risk factors for heart disease, including lifestyle habits such as diet, exercise and smoking. In turn, medical risk factors that may in part be influenced by these lifestyle factors include high body mass index, high blood pressure, high cholesterol and diabetes. Further complicating these relationships is the influence of factors that cannot be modified, including family history, age and gender. Doctors usually consider all of these, as well as the risks attached to particular medications, when deciding with their patients whether drug treatment is appropriate.

When all of these things are taken into account, it is unclear how the researchers can conclude that statins taken only occasionally (rather than prescribed regularly) might help anyone.

Dishing out a statin with every burger also does not seem to be a responsible measure when you consider that they are not suitable drugs for everyone, including those with liver disease, those who drink alcohol excessively, and pregnant and breastfeeding women. Statins are also not without adverse effects, which can be severe in rare cases. 

Links to the headlines

Statins and chips please. Daily Mirror, August 13 2010
Doctors want statins served with fast food. The Independent, August 13 2010
McStatin with your burger? The Daily Telegraph, August 13 2010

Links to the science

Ferenczi EA, Asaria P, Hughes AD et al. Can a Statin Neutralize the Cardiovascular Risk of Unhealthy Dietary Choices? The American Journal of Cardiology Volume 106, Issue 4, 15 August 2010, Pages 587-592

Thursday, 12 August 2010

McStatin with your burger?

'Give out statins with junk food'

BurgerBurgers are loaded with fat
Fast food outlets should consider handing out cholesterol-lowering drugs to combat the effects of fatty food, say UK researchers.
Taking a statin pill every day would offset the harm caused by a daily cheeseburger and milkshake, the Imperial College London team said.
It would only cost 5p a customer - similar to a sachet of ketchup.
But the British Heart Foundation warned an unhealthy diet does more harm than just raising cholesterol.
Writing in the American Journal of Cardiology, Dr Darrel Francis and colleagues said it was about reducing harm in the same way that people who smoke are encouraged to use filters and those who drive are told to wear seatbelts.

Start Quote

A junk food diet has a wealth of unhealthy consequences beyond raising cholesterol”
Professor Peter WeissbergBritish Heart Foundation
They took data from trials of almost 43,000 people to calculate whether the statins could override the effects of eating a junk food diet.
A statin a day can neutralise the risk of cardiovascular disease linked to a daily intake of a 7-oz cheeseburger and a small milkshake, they calculated.
The researchers said there could be no substitute for leading a healthy lifestyle, including eating a good diet, but that a complimentary statin would be at least one positive choice among a sea of negative ones.
For those only eating junk food once a year, an annual one-off statin dose would have little effect, but for those who partake more regularly it would have a greater opportunity to neutralise that risk, they added.
Heart risk
Statins are already taken by millions of Britons to reduce the risk of suffering a heart attack or stroke by lowering levels of bad cholesterol in the blood.
They are thought to be fairly safe, although some experts have raised concerns about side-effects.
One low-dose statin - simvastatin - is available in a low dose to buy from the pharmacist.
"Importantly, even partial adherence to statin therapy conveys a mortality benefit, suggesting that statins do not need to be taken daily to have some protective effect," said Dr Francis.

Related stories

But he pointed out that statins would not affect all the negative effects of an unhealthy diet.
"It's ironic that people are free to take as many unhealthy condiments in fast food outlets as they like, but statins, which are beneficial to heart health, have to be prescribed," he said.
"It makes sense to make risk-reducing supplements available just as easily as the unhealthy condiments that are provided free of charge."
But Professor Peter Weissberg, medical director at the British Heart Foundation, said the suggestion should not be taken literally.
"A junk food diet has a wealth of unhealthy consequences beyond raising cholesterol.
"It can cause high blood pressure through too much salt, or obesity through eating meals loaded with calories.
He added: "Statins are a vital medicine for people with - or at high risk of developing heart disease. "They are not a magic bullet."

The researchers note that studies should be conducted to assess the potential risks of allowing people to take statins freely, without medical supervision. They suggest that a warning on the packet should emphasise that no tablet can substitute for a healthy diet, and advise people to consult their doctor for more advice.