To Statin or not to Statin

Wanga F One said...


Like many have said, that just ain't true.
Food has very little impact. If your body produces high levels of cholesterol and you have family history you are at higher risk. The evidence is overwhelming that statins
Lower risk. Simple as that.

Fat first came under suspicion when research early last century found that the arterial plaques that can lead to a heart attack contain the fatty compound cholesterol. Then came several studies showing that heart attack rates were higher in countries where people ate more fat, especially saturated fat from meat and dairy foods. Fat was also deemed the enemy of people wanting to stay slim, since it has over twice the calories, gram for gram, as carbohydrates and protein. From the 1950s onwards, these ideas crystallised into official dietary guidelines, and the health-conscious started switching to leaner cuts of meat, low-fat milk and swapped butter for vegetable-oil based margarines. And they filled up on starchy carbs. Yet average body weight has continued to climb, as have rates of associated problems such as type 2 diabetes, culminating in what is now arguably a health crisis. In the UK, US and Australia, around two-thirds of the population are either overweight or obese. The orthodoxy was challenged when some dieters adopted the Atkins diet, which caused a sensation in the early 2000s. This urged people to shun fruit and veg and scoff meat, butter and cream. Doctors warned it couldn’t work and all that saturated fat was a heart attack waiting to happen. And yet, research showed otherwise. One trial directly compared 156 women on either the Atkins diet or a low-fat diet. After a year, those following Atkins had lost more weight, and their blood pressure and cholesterol profiles were, if anything, better than those on the low-fat diet. Another trial, which lasted two years, had similar results. The idea that those with type 2 diabetes should ditch carbs has also been led by people defying medical advice. Unwin first learned of it when he called in a diabetes patient who had been missing check-ups. “Her blood tests were amazing,” he says. “They seemed to show that she wasn’t diabetic anymore.” This broke all the rules. Type 2 diabetes is supposed to be progressive and irreversible. It is the result of our cells becoming increasingly resistant to insulin, a hormone made by the pancreas to help with the uptake of glucose from the blood. The pancreas works ever harder until it cannot produce enough insulin to keep blood sugar levels under control. As a result, blood sugar gets too high after meals and this gradually harms blood vessels, leading to a range of nasty consequences such as foot amputations and heart attacks. Newly diagnosed diabetics are usually advised to lose weight with exercise, and by eating less fat and more fibre, including bread, cereals and fruit and vegetables. But like most dieters, they usually don’t succeed, and the majority need oral medication to control their blood sugar within a year of diagnosis. Unwin’s rebellious patient told him she began low-carbing after stumbling across a website that recommended it. As Unwin researched the idea, it started making sense. Diabetics are told to avoid sugar, but starch is basically long chains of sugar and is quickly digested into sugar in the gut. Yet diabetics are told to eat starchy food just like everyone else to help them eat less fat. Fat is the bigger enemy because it leads to heart disease, says Louis Levy, head of nutrition science at Public Health England. And even wholegrain carbs, which are recommended, cause our blood sugar to rise, albeit more slowly than their milled equivalents. A slice of wholemeal bread raises blood sugar the same amount as three teaspoons of pure sugar, according to research due to be published by Unwin and his colleagues in the Journal of Insulin Resistance. A jacket potato – archetypal healthy fare – is akin eating 9 teaspoons of sugar (although how fast it is released depends on what you eat with it – fat or protein lowers the speed). The sugar triggers release of insulin, which stimulates fat storage, and in the long term worsens insulin resistance. Eating fat and protein, in contrast, releases less insulin, and protein is the most filling food group, so will suppress appetite more. People with type 2 diabetes are sometimes told to eat food with a low glycaemic index (GI), a measure of how quickly blood sugar rises. The faster the blood sugar rises, the harder it is for cells to take up glucose quickly enough to avoid a spike. But a strictly low-GI diet can end up being high-fat by default. Startled into action, Unwin took the maverick step of offering weekly meetings on this dietary approach to his patients with diabetes or who were overweight. He put them on a less extreme version of the Atkins diet, telling them not only to cut down on starchy food but also to eat lots of non-starchy vegetables and the less sugary fruits, such as blueberries and raspberries. In place of carbs they should fill up on meat, fish, full-fat dairy products, eggs and nuts (see “Food fight”). Under control It seemed to work. “They weren’t hungry and every week they came back smaller,” he says. Their blood tests showed improvements in glucose control, as well as blood pressure and cholesterol levels. Unwin published the results from his first 19 patients in 2014. It wasn’t a randomised trial, but there have been such studies in the US. In one study of 34 overweight people with type 2 diabetes, those on a low-carb, high-fat diet with no obligation to calorie count ended up with significantly better blood sugar control after 3 months than those following the low-fat guidelines for diabetes. Three times as many low-carbers were able to stop taking at least one diabetes drug as those on the standard diet. Unwin’s unorthodox approach has not gone unnoticed. Earlier this year he received a National Health Service innovator of the year award, partly in recognition of the savings being made at his practice, Unwin says. Their per-patient spend on diabetes drugs is about 70 per cent of the local average.

AndyR said..

The best medicine is food. simple as that.

Toph said..




A good friend of mine is reasonably healthy, eats well and is fit. He is a light to moderate drinker but often goes long periods of not drinking. Never smoked. He has a cholesterol level of 9.... He is a heart attack on legs and there is nothing he can do about it because it is (for him) hereditary.

It is statins for him...