Statin use associated with poorer diets, weight gain

Patients who use statins are consuming more calories and fats than a decade earlier, increasing the risk of obesity, diabetes, and cardiovascular disease, according to a study published online in JAMA Internal Medicine.

UCLA researchers found that patients taking statins from 2009 to 2010 had poorer diets and greater weight gain than individuals on statins in 1999 to 2000. Non-statin users did not experience the same increase in caloric and fat intake during that time period.

The researchers speculate that statin users might not feel the urgency to modify their diets or to lose weight because statins were able to lower low-density lipoprotein cholesterol (LDL-C) dramatically. In addition, patients who agree to statin therapy may not want to restrict their diets, whereas those who don’t want to initiate pharmacotherapy may favor dietary recommendations, the authors noted.

“All providers should emphasize the importance of healthful diets,” said Martin F. Shapiro of UCLA, one of the study’s authors. “Medicines are not a substitute for eating healthfully.”

In 1999 to 2000, statin users consumed about 180 kcal per day less than non-statin users. In addition, statin users had a lower fat intake of about 9.5 g per day compared to non-statin users. However, that changed a decade later. Statin users in 2009-2010 had a higher caloric and fat intake than non-users, although it was not significantly higher.

Researchers used data from the National Health and Nutrition Examination Survey for the comparison of diets among statin users and non-users during the two time periods. Among statin users, the researchers found that caloric intake climbed 9.6% (95% CI, 1.8-18.1; P=.02) in 10 years and that fat consumption increased 14.4% (95% CI, 3.8-26.1; P=.007). In contrast, caloric and fat intake by non–statin users were not significantly different over the 10-year period.

Body mass index (BMI) was also measured and showed a 1.3 increase (95% CI, 0.2-2.1; P=.001) among statin users compared to a 0.4 increase (95% CI, -0.1-1.0; P =.10) among non-statin users during the study period.

Because of the design of this study, the researchers were not able to determine the mechanisms driving the observed trends. Longitudinal study will be required to understand this.

The study was funded by the National Institutes of Health, the National Center for Global Health and Medicine (Japan), and the Honjo International Scholarship Foundation (Japan).