Not any more

Would you like ‘MacStatins’ with your burger?

In Canada on August 17, 2010 at 21:01

Last week, British scientists suggested that cholesterol-lowering statin drugs should be given out with fast-food orders in an effort to erase the heart risks linked with eating fatty foods.

The study, published in the American Journal of Cardiology, concluded that taking a low-dose statin can reduce the risk of suffering a heart attack to the same degree that eating a fast-food meal increases it. What’s more, the researchers reported that statins have a better safety record than fast food and they’re cheap – about the same cost as a packet of ketchup.

Even so, are we really ready to take the easy road and hand out drugs with greasy fast food? In my opinion, doing so would send out the wrong message. And it certainly wouldn’t wipe out all the health hazards associated with frequent fast-food consumption.

Statins, which include Lipitor (generic name atorvastatin), Zocor (simvastatin), Mevacor (lovastatin), Pravachol (pravastatin) and Crestor (rosuvastatin), are used widely to treat and prevent heart disease. They’re given both to people with heart disease and, in more recent years, to those who are at risk for heart disease but who have no history of it.

They work by slowing the liver’s ability to produce cholesterol and increasing the removal of LDL (bad) cholesterol from the body.

In Britain, a generic statin called simivastatin is already available in low doses over the counter in pharmacies. Others are available only by prescription. In Canada, all statins are prescribed by physicians.

In the study, researchers used data from a previous large study to quantify how a person’s risk of heart attack increases with daily consumption of total fat and trans fat. Trans fat is the most dangerous type of fat in terms of heart disease risk – it raises LDL (bad) cholesterol and lowers HDL (good) cholesterol.

They compared this information with the decrease in heart attack risk from different statins, based on an analysis of seven randomized controlled trials including 42,848 patients, the majority whom had risk factors for heart attack such as diabetes, high cholesterol and high blood pressure.

The findings showed that daily consumption of most statins was able to offset the increased heart risk of eating a daily cheeseburger and small milkshake.

The researchers wrote they envision a future when “upon ordering an unhealthy meal, the food will arrive labelled with a warning message, and on the tray, next to the ketchup, will be a new and protective packet, “MacStatin,” which could be sprinkled onto a Quarter Pounder or into a milkshake.”

While this makes me nervous, I do agree with the authors’ belief that the fast food industry should develop healthier menus and encourage regular physical activity and weight control.

Many fast food chains have, in fact, have added a spattering of healthier and lower-calorie options to menus. Results from Health Canada’s Trans Fat Monitoring Program also indicate that the fast food industry is doing a decent job at reducing trans fat in foods to meet regulated limits.

While salads, grilled chicken, snack-sized sandwiches and fresh fruit exist on many fast food menu boards, they continue to be outnumbered by greasy, salty fare. And it seems we still have an appetite for super-sized meals.

Wendy’s Triple Baconator has 1,370 calories, 92 grams of total fat, 39 grams of saturated fat, and 2,380 milligrams of sodium. Burger King’s Quad Stacker – layers of beef and cheese topped with bacon and sauce – weighs in at 920 calories, 63 grams of fat, 28 grams of saturated fat and 1,670 milligrams of sodium.

Add a medium-sized fries and soft drink to your order and you’ll easily consume at least a day’s worth of calories and two days’ worth of cholesterol-raising saturated fat and cholesterol. (Consider the average adult needs roughly 2,000 calories, no more than 20 grams of saturated fat and 1,500 milligrams of sodium per day. Kids, of course, need less.)

Canadians do like their fast food. According to the 2004 Canadian Community Health Survey on any given day, one-quarter of Canadians – adults and children alike – eat something prepared at a fast food restaurant. While that might have been a salad or simply a cup of coffee, 40 per cent said they chose a burger, hot dog, pizza or sandwich.

Even so, that doesn’t mean a side order of Lipitor is the answer. Yes, these drugs are important medications for people with (or at high risk of developing) heart disease. But a study published earlier this year suggested that statins do not save lives in people without heart disease, questioning their use in low risk people.

What about the potential risks of letting people take statins freely, without medical supervision, kids and teenagers included?

What’s more, statins can’t atone for all of the sins of fast food. Putting the emphasis on fat in fast food and blood cholesterol seems short-sighted to me. A steady intake of fast food can cause the development of other potent risk factors for heart disease.

High sodium levels in fast food can promote or worsen high blood pressure. Excessive calories can lead to obesity. And refined sugars in soft drinks, milkshakes and desserts can increase blood triglycerides and depress HDL cholesterol.

Fast food meals also lack fruit, vegetables and fibre, components of a healthy diet that guard against heart disease.

Handing out statins with fast food could provide a false sense of security and detract people from making heart-healthy changes to diet and exercise.

It could also detract from something that’s sorely needed: education on healthy eating starting at a young age. I think we’d be much better off teaching nutrition and cooking skills in schools – as a regular part of the curriculum, versus a brief, one-shot overview of Canada’s food guide – than promoting the notion of a magic bullet.

Leslie Beck, a Toronto-based dietitian at the Medcan Clinic, is on CTV’s Canada AM every Wednesday. Her website is lesliebeck.com.

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