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Pill
can't substitute for dietary changes
July 29, 04
Suzanne Havala Hobbs
On
a recent visit to my sister’s farm in Montana, I witnessed
a scene that no doubt plays out regularly in kitchens all
over America.
Whipping up a Big Sky breakfast of bacon and farm-fresh eggs,
my sister chuckled that she’s enjoying her eggs all
the more these days – several per day, in fact, fried
in butter – now that she’s on a cholesterol-lowering
statin drug.
I’m sure plenty of other folks see it the same way.
And given this month’s news, I wonder if even more are
likely to join her in this illusory dietary freedom.
A report issued by the federal government and leading health
groups, published in the journal Circulation, recommended
substantially lower levels of LDL or “bad cholesterol”
for people at high risk of coronary artery disease and endorsed
a greater role for cholesterol-lowering statin drugs such
as Lipitor, Zocor, Mevacor and others.
The recommendations emphasized that drugs should be used in
conjunction with lifestyle changes – including diet
and exercise.
But the entirety of that message is easily lost given the
relative ease of popping a pill.
The power of statin drugs is impressive – up a to 45
percent drop in blood cholesterol levels when treatment is
initiated, according to the report. If that doesn’t
do the trick, subsequent increases in dosage yield far lower
results. But that introduces increased risks of side effects,
not to mention higher costs.
That’s where lifestyle comes in.
“It’s very important that Americans understand
the value and necessity of adhering to a good diet,”
said Dr. Sidney Smith, an author of the report, professor
of medicine at UNC-Chapel Hill and former president of the
American Heart Association.
“Proper diet may permit a lower dose of statin, reduce
the cost and potential side effects, and result in a safer
health profile,” said Smith. “The correct diet
does more than just lower LDL. Achieving proper weight may
help prevent diabetes and help in controlling hypertension.”
“An appropriate diet was an important part of these
recommendations for all patients and especially among those
where the target LDL level has been lowered,” he said.
Consumer groups and others have warned about relying on drugs
to do all the work.
“I’m pro-statin, but I don’t want to go
beyond what the evidence says,” Dr. Beatrice Golomb
told The New York Times after the statin study came out. Golomb,
a statin researcher at the University of California at San
Diego, said: “There’s a multibillion-dollar industry
ensuring that you hear all the good things, but no corresponding
interest group ensuring that you hear the other side.”
What can you do to maximize the impact of lifestyle and reduce
– or dodge – your dependence on cholesterol-lowering
drugs?
* Lose extra pounds. My husband dropped ten pounds over a
couple months, just by cutting out his nightly dish of ice
cream.
* Eliminate offending fats. Zero in on saturated fat, trans
fats, and cholesterol and weed them out. Prime sources: cheese,
butter, eggs, red meat, processed foods, and commercial baked
goods.
* Substitute healthy fats. The good guys: olive oil, canola
oil, other vegetable oils and the oils found in nuts and avocados.
* Bulk up. Add cholesterol-lowering soluble fiber to your
diet by eating copious amounts of fruits, vegetables, beans,
and oats. Switch from a Big Sky breakfast to a Big Bowl of
Oatmeal.
* Skip the meat. Substitute soy products, fish, and meatless
entrees for red meat and poultry. Eat low-dairy, vegetarian
meals as often as possible.
* Get moving. Begin to think of yourself as an active person,
and you’ll become one. A long evening walk is a better
stress-reliever than a trip to the spa. Save money, lose weight,
and boost your “good cholesterol” all at the same
time.
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