Imagine this: order a cheeseburger and fries, and pick up a free cholesterol-busting statin tablet along with the other free condiments, that’s what a group of UK researchers suggests you should be able to do at fast food outlets as a way to offset the increase in heart attack risk from eating junk food.

You can read how the team from Imperial College London arrived at this suggestion, which at least one group of experts says should not be taken literally, in a study published this week in the American Journal of Cardiology.

Senior author Dr Darrel Francis, from the National Heart and Lung Institute at Imperial College London, told the media that:

“Statins don’t cut out all of the unhealthy effects of burgers and fries. It’s better to avoid fatty food altogether.”

“But we’ve worked out that in terms of your likelihood of having a heart attack, taking a statin can reduce your risk to more or less the same degree as a fast food meal increases it,” he added.

However, experts from the British Heart Foundation say that “McStatin” is not the antidote to junk food. Their medical director, Professor Peter Weissberg, said in a statement that:

“The suggestion that the harmful effects of a junk food meal might be erased by taking a cholesterol-lowering statin tablet should not be taken literally.”

Statins are widely used drugs that reduce the amount of unhealthy “LDL” cholesterol in the blood. A mountain of evidence, much of it from clinical trials, claims they are highly effective at lowering heart attack risk.

Statins also have one of the best safety profiles of any medication, the researchers said in a statement. Very few regular statin users experience side effects: 1 in 1,000 report problems in the liver and 1 in 10,000 in the kidneys.

One statin, simvastatin, is already available in low dose form (10 mg) over the counter, ie you can get it from a pharmacy without a doctor’s prescription. The others, which are only available on prescription, have fallen in cost so dramatically, that the cost of seeing the doctor is more than the cost of the tablet.

Francis said it was ironic that we are free to consume as much unhealthy food in fast food outlets as we want, but we have to get our statins, which are beneficial to heart health, via a doctor’s prescription.

In their paper, Francis and colleagues calculate that the reduction in cardiovascular risk offered by a statin is enough to compensate for the increase in heart attack risk from eating a hamburger with cheese and a small milkshake.

They used data from a previous large cohort study to quantify the increase in heart attack risk that a person incurs with their daily intake of total and trans fat. They compared this to the decrease in risk calculated for various statins from a meta-analysis that pooled data from 7 randomized controlled trials covering a total of nearly 43,000 patients.

They found that that most statin regimes (the exception was pravastatin) are able to compensate for the relative increase in risk from eating a cheeseburger and a small milkshake.

The researchers concluded that:

“Statin therapy can neutralize the cardiovascular risk caused by harmful diet choices.”

They drew parallels between eating junk food and risky pursuits such as motorcycling, smoking, and driving: they all pose risks to health, yet in the latter we are compelled to minimize risk with filters, seatbelts, and safety equipment, so why not the same with unhealthy food?

“Routine accessibility of statins in establishments providing unhealthy food might be a rational modern means to offset the cardiovascular risk,” they wrote, pointing out that fast food outlets “already offer free condiments to supplement meals”.

“A free statin-containing accompaniment would offer cardiovascular benefits, opposite to the effects of equally available salt, sugar, and high-fat condiments,” they commented.

However, they did stress that such a strategy was “no substitute for systematic lifestyle improvements, including healthy diet, regular exercise, weight loss, and smoking cessation”. But at little cost, the offer of a complimentary statin would be just one “positive choice to a panoply of negative ones”.

They also pointed out that while their study focused on cheeseburgers, they were not suggesting that this particular food was any more unhealthy than any other food with the same fat and trans-fat content.

However, adding to the argument as to why giving out free statins is not the answer, Weissberg said we should also remember that 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. These are all risk factors for life-threatening health problems such as heart disease, type 2 diabetes and stroke.”

“Statins are a vital medicine for people with — or at high risk of developing — heart disease. They are not a magic bullet,” he added.

The researchers also noted that further studies should be done to assess the potential risks of giving people free statins without medical supervision, and suggested the packets should carry a warning pointing out that no tablet can replace a healthy diet, and that people should seek advice from their doctor.

“Can a Statin Neutralize the Cardiovascular Risk of Unhealthy Dietary Choices?
Emily A. Ferenczi, Perviz Asaria, Alun D. Hughes, Nishi Chaturvedi, Darrel P. Francis
American Journal of Cardiology, 15 August 2010, Vol. 106, Issue 4, Pages 587-592.
DOI: 10.1016/j.amjcard.2010.03.077

Sources: Imperial College London, BHF.

Written by: Catharine Paddock, PhD