You will recall that some weeks ago, I posted about a study in which the researchers suggested free statins should be offered with fast food to offset the cardiovascular damage. Some of you wondered if the study was tongue-in-cheek. Apparently not. One of the researchers left a comment today. Here is it in case you didn’t see it:
Dear Sirs,
Thank you for your interest in our article. Please let me clarify that we were not writing tongue in cheek, nor were we joking. Heart attacks are serious for our patients and those that suffer them often wish they could have been prevented.
What we are asking is why is it routine in fast food restaurants to have unhealthy condiments provided free (e.g. salt) which have no beneficial properties, and yet no access at that location to statins?
It can’t be because salt (for example) is healthier than statins.
Statins do not prevent many deaths in primary populations, i.e. people who seem healthy. They do convincingly prevent heart attacks but, since heart attacks are usually with modern care not fatal, these prevented heart attacks cannot be expected to translate into lives actually saved in a quantity that would be convincing to a neutral observer.
As for side effects of statin, they are few, when the genuine statin muscle abnormalities are compared to the blank placebo tablets. The power of the human imagination is gigantic: more than most people imagine (if that is not a self-defeating statement).
Daily statin tablets are now routine therapy for patients whose future diet and exercise are considered permanently irreparable; how can that be right and yet an individual statin an individual unhealthy meal be wrong?
How can it be right to hand out salt to people who may have high blood pressure (without checking or even asking), sugar to people who may be diabetic (without checking or asking), and excess calories to people who may be overweight (even obviously obese); and YET wrong to even make available statins for those who wish to exercise their free choice to have them? Let me reiterate that it is not the presence of the former that I object to, nor the lack of the latter, but the conjunction of the former being routine but the latter forbidden.
I do appreciate your good-humoured look at life, and at science. Keep it up. Somebody has to ask awkward questions – and you are definitely doing that. But that, too, is what I am doing in my own way.
Best wishes from London,
Darrel Francis
So there you have it, straight from the source. Statins are better for you than salt, so we should allow people to self-medicate.
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People run into serious trouble with just over-the-counter eyedrops, and they think that stains are okay for self-medication? Watch the number of lawsuits rise once that insane policy is implemented.
Liver damage, muscle damage, cognitive decline … all things we should encourage people to do to themselves.
He has a point. I mean, if someone is too lazy to do research and still wants statins and they are medically available, have at it. However, it’s not the fast food company’s responsibility to keep people healthy! His own words said:
“How can it be right to hand out salt to people who may have high blood pressure (without checking or even asking), sugar to people who may be diabetic (without checking or asking), and excess calories to people who may be overweight (even obviously obese); and YET wrong to even make available statins for those who wish to exercise their free choice to have them?”
Key word – FREE CHOICE. The fat/heart diseased/high blood pressured person that comes into McDonald’s CHOOSES their entree. They can choose a salad just as easily as they can choose a double bacon cheeseburger. Hell, they can choose not to go to McD’s in the first place! McDonald’s has never claimed that the double bacon cheeseburger is healthy (unless I missed a particular ad campaign).
that being said, i maintain my original opinion. If what you are serving is so unhealthy that it requires a medical intervention to prevent permanent damage to your body, I don’t think that’s good company policy. Every ice cream cone should come with an insulin shot. Every cigarette should come with an inhaler.
I’ll point out the obvious: salt is a food. Statins are prescription drugs. Big difference!
While we’re at it, why don’t we just order amphetamines with our morning latte? Or Prozac with our ice cream cone?
Don’t give them ideas.
Statins are NOT better for you than salt. Your body requires sodium to function. It does not require statins to function.
Soon statins will be considered a vital nutrient.
Wow. So Mr. Francis gets to define what statin side-effects are, and everything else is people’s imaginations?
If this is representative of “science”, we’re in big trouble. “Take your pill! We can’t prove that it can work, but you can’t prove that it doesn’t!”
Just keep repeating “Placebo effect … placebo effect.”
As far as I could tell from the brief time I took statins, the only effects were the equivalent of chronic fatigue syndrome, and a substantial impairment of my cognitive skills, both of which I find completely unacceptable. My primary care doc at the VA still tells me every visit that I need to be on statins, and my reply is always that I would rather die of a heart attack, thankyouverymuch.
My mom had muscle cramps and muscle pains, definitely not placebo effect because she had no idea they might be related the statins. Neither did her doctor. She quit the statins, pains went away.
oh … my … god … I … umm … wow …
I am likewise speechless.
Ha, I’m still unsure! Is the comment just more “tongue-in-cheek”???
If so, it’s too subtle for me to recognize. When I found the original paper, they sure came across as serious.
No way in hell this guy is for real.
The email address is his name at his university. If it’s fake, someone did a fine job.
I didn’t realize that statins treat high-blood pressure (salt) or diabetes (sugar). He is being rather narrow-minded in his pharmaceutical whoring. You could replace all the condiments with pills…or you could just go to a place called a pharmacy. Pills are not interchangeable with food no matter how much the pharmaceutical industry wants us to think that way.
Dammit, I still think this all must be ‘tongue-in-cheek.” It has to be…
I’d like to think so, but the paper sure seemed serious.
“How can it be right to hand out … sugar to people who may be diabetic”
But… but the ADA says that sugar doesn’t cause diabetes, and that diabetics should be able to have sugar just like everyone else. They say that “your body doesn’t care if the extra food comes from cookies or beef…” and that “The myth that sugar causes diabetes is commonly accepted by many people. Research has shown that it isn’t true.”
No wonder people are confused.
Will it ever happen? Of course not. But that doesn’t keep people, even educated ones, from saying stupid things.
On the other hand, we do get flouride dumped in our water… (I filer mine out at the meter…)
Keep up the good work.
That’s right. The ADA still thinks dietary fat causes diebetes.
Well, at least Dr. Francis provided transparency into his reasoning process, so we can make an informed decision whether or not to pay him any heed. Too bad more researchers don’t do the same, I expect we’d have a lot more clarity on which publications are worth our attention.
I’ll give him that.
Regarding the above comment: “I mean, if someone is too lazy to do research and still wants statins and they are medically available, have at it.”
If only that same stance could be adopted towards raw milk.
Now you’re talking.
I’m all about self-medication, but statins would not be my preferred prescription drug. Let’s get some more options out there!
“What we are asking is why is it routine in fast food restaurants to have unhealthy condiments provided free (e.g. salt) which have no beneficial properties, and yet no access at that location to statins?”
No beneficial properties? How about this one: I like the way it tastes.
Oh wait a second … Mere enjoyment, since it can’t be quantified and controlled for, can never be considered beneficial.
Not to mention the fact (and it is a fact) that unless you have damaged kidneys, salt is a non-issue.
Why don’t they just bake the statins into the bun? In that way those of us who are low carb can avoid both at the same time!!!
Thank god I live in New Zealand where life isn’t that insane.
They think the burger is the problem, so that’s where they grind it up.
Did everyone just happen to miss the report which called into question every positive result from statins, even in those (rare) populations which used to show a benefit to overall mortality?
http://www.jstage.jst.go.jp/article/jln/19/1/65/_pdf
“Unexpectedly, the combination of the two drugs failed to provide incremental benefits over simvastatin alone, despite a drastic reduction of cholesterol
The numbers of deaths due to worsening heart failure were 191 and 193 in the placebo and statin groups, respectively. Thus, the unequivocal lessons of CORONA were that both drastic cholesterol-lowering and the supposed pleiotropic (anti-inflammatory) effect of the statin had no effect at all in the secondary prevention of CHD in high-risk patients.
CORONA and GISSI-HF therefore provided exactly the same information in two
different populations, namely that cholesterol-lowering does not improve the prognosis for high-risk CHD patients. The theory that the higher the risk — notably in secondary prevention of CHD — the higher the benefit of cholesterol-lowering (28,32-35) should logically be rejected.
Third, it is noteworthy that in SEAS, patients with low cholesterol levels in the
experimental group had more cancers and died more frequently from cancers than those receiving the placebo
Despite a 36% reduction of LDL cholesterol in the statin group compared
with placebo, there was no difference between groups for total mortality (657 deaths versus 644 in the placebo group)”
It looks to me like the last vestige of respectability that the pharma companies had left just went out the window.
To publish a postive result, as in JUPITER, they had to get quite creative with their end-points and stop the study early. And since cancer takes years to develop, I don’t trust a shortened study to enlighten us as to overall health benefits.
It seems he is all too real:
http://www1.imperial.ac.uk/medicine/people/d.francis/
Unless someone hijacked his email, the letter is real.
While we’re at it why don’t we just rename one of New York’s boroughs to Statin Island?
LOL.
God help us. Do all researchers think this way?
Only the ones advising doctors.
Is he suggesting people should have unrestricted and unmonitored access to statins, and that statins should be dispensed by fast food staff?
Or that fast food places should start employing pharmacists?
There are always healthy alternatives to what they serve in fast food joints, but you have to go elsewhere for them. I don’t see why statins should be any different.
The healthy alternative is to eat at home, or at least toss the bun and skip the french fries. Can’t imagine letting people take statins in restaurants.
I guess my father-in-law “imagined” his chronic muscle pain, cola-colored urine and near miss of permanent kidney damage. Good thing he complained to us, and we alerted him to the symptoms of rhabdomyolysis so his Dr could take him off statins, for a little while at least. Unfortunately, he’s back on statins again (lower dose) but still complaining about muscle pain, and still recovering from his SECOND bypass surgery. Oh yeah, statins are so effective and benign (Grrr).
Tom, your posts of late have been smokin’! Good job.
My mom imagined a lot of muscle pain too. She’s a creative type.
According to LD50 data, glyphosate is better for you than salt. Lets put that on the condiment stand.
Tom, didn’t you say in Fat Head that people eat more when they eat at a conventional restaurant than at a fast-food restaurant? For example, a steak, baked potato and basket of fluffy bread and dessert vs. a burger, fries and Coke? Shouldn’t the statins be offered by a maitre d’ instead of Ronald McDonald?
Very good point. Another recent study confirmed the same thing: in sit-down restaurants people consume bigger, higher-calorie meals than in fast-food joints.
I also find it frightening that we allow teenagers to hand out sugar satchets with coffee willy nilly. I can just picture some pimply faced kid interrogating a crotchety old man and get smacked over the head with his cane.
What about when there are interactions? There was a statin that was pulled off the market because of interactions and the results of those interactions: People died.
From Wiki on Baycol:
During post-marketing surveillance, 52 deaths were reported in patients using cerivastatin, mainly from rhabdomyolysis and its resultant renal failure.[1] Risks were higher in patients using fibrates, mainly gemfibrozil (Lopid), and in patients using the highest (0.8 mg/day) dose of cerivastatin. Bayer A.G. added contraindication about the concomitant use of cerivastatin and gemfibrozil to the package 18 months after the drug interaction was found.
I was on it for a few months, then was switched to Pravachol. After that made me feel like crap, I told the doctor, no more. Haven’t touched it since.
If we give out statins with fast food and people suffer reactions, they’ll get a free refill.
Really, was this supposed to be satire? Because the world has gotten so crazy that I just can’t tell anymore.
We know that there are many salts, not just NaCl, and that people with HBP can eat too much of it, but please, tell me this guy is kidding. If we don’t have salt, we die. I would describe that as a benefit.
If he’s joking (his email address is legit), they’ve kept the joke going a long time now.
Well you can’t argue with logic like this: “The power of the human imagination is gigantic: more than most people imagine.”
I guess I just can’t imagine my own imagination! Mind you, it is not the presence of the former that I object to, nor the lack of the ladder, but the conjunction of the former being routine but the latter forbidden.
I understand what he was saying completely. I often can’t rise to my own height.
Salt has no beneficial properties? Seriously?
Welcome to the future of nutritional science.
The future is now.
This is exactly why people like this shouldn’t be involved in setting public policy. This is just ridiculous.
What we are asking is why is it routine in fast food restaurants to have unhealthy condiments provided free (e.g. salt) which have no beneficial properties, and yet no access at that location to statins?
SALT ISNT FREE. It is factored into the costs of running the business. But you wouldn’t know that because you haven’t operated in the freemarket and can’t understand a simple supply / demand argument.
How can it be right to hand out salt to people who may have high blood pressure (without checking or even asking), sugar to people who may be diabetic (without checking or asking), and excess calories to people who may be overweight (even obviously obese); and YET wrong to even make available statins for those who wish to exercise their free choice to have them? Let me reiterate that it is not the presence of the former that I object to, nor the lack of the latter, but the conjunction of the former being routine but the latter forbidden.
Statists always cloak violence in the language of voluntary exchange..
Why can’t McDonalds just give away free statins?
Oh you mean why can’t the government threaten them with fines and arrest if they don’t buy statins and then pass the expense on to their customers in the form of higher prices?
Or maybe you can convince Lipitor to give McDonalds all these “free” statins. Since that is apparently the morally “right” course of action.
People in academia are economic morons and ethical morons. Unwilling to accept that their careers and research are paid for by theft. And perfectly willing to blur the moral lines of voluntary interaction and the initiation of violence.
/rant
Good rant.
We live in a wacky world. I’m a dentist and they won’t let me prescribe ten prescription pain pills for myself. But they’re happy to put statin shakers on the tables.
Hi again, Tom!
A little update from the country of Santa Claus… =)
I was told a while ago that my step-father was prescribed statins (his total cholesterol was like 8,1…). He got prescribed the drugs on his first visit!
Things have really changed here in Finland. My mother, who is a nurse, told me that she had to monitor her blood pressure for like 10 years and try to lose weight and change her diet before they gave her the pills…
Well, anyway, the side effects of statins reached my step-dad really fast, and he was complaining about muscle pain and generally not feeling well. Thankfully my mom read him about the side effects and he quit them. Now he feels well again. But how could statins cause side effects.
The problem with Finland is that no one reacts on the government’s decisions or policies, and the doctor is ALWAYS right. ALWAYS. Like my mom said, if the doctors would stop giving out pills to every little thing, there would be a chaos. People expect to get some sort of pill, not “Change your eating habits, perhaps exercise more”.
There are 5,3 million people in Finland. A researcher told in an article in May that 660.000 Finns are already prescribed statins, and the amount goes up by 50.000 people EVERY YEAR! That’s a lot for a country this small. But no one talks about the statins or the side effects. Instead, our commercial breaks on TV are filled with ads by Unilever who want you to check the age of your heart (which is BS), Danone’s pro-pre-whatever-biotic yoghurts, of course Activia, the miracle yoghurt by Danone, pills for heartburn, creams and pills for aches and so on. I’m actually happy if I see one ad for a mascara or perhaps a supermarket!
I read somewhere that in 2008, Unilever went on a nation-wide cholesterol-themed tour where they would measure your total cholesterol and tell you to eat their margarine if it was over 5.0… Why didn’t they do it in Finland, here’s the proper audience for that! And people do buy those horrible “wannabe-butters”.
Well, that’s all for me. I just had to get this out of my system…
Thanks for a great blog, as always!
/Milla
I assume Santa Claus is on statins and eating a lot of wannabe butter, then. He won’t be jolly for long.
A statement like that from a licensed, practicing M.D. should call into question his suitability for both clinical and research activity. Either way, he’s going to do the very thing he swore an oath not to – harm people.
Sad thing is, they actually believe what they say: statins are wonder drugs.
Would be interesting to know what MacDonalds thinks of this. They’re keeping pretty quiet (as far as I know). Probably the wisest move. Any publicity is good publicity I guess. I’m a kfc girl myself and I don’t even take the coating off!!
Well, I’ll keep eating salt over a statin any day. Oh and BTW, there are other real causes of high blood pressure
High intake of fructose seems to be the most likely culprit.
I wonder how much $$$ Mr. Francis gets from big pharma?
I’d like to know that myself.
Since dietary saturated fat has kinda been exonerated as being the cause of heart disease, it seems to me like the ’cause’ has morphed into the LACK of statins! Peter over at HYPERLIPID has a post called ‘ Best ever statin study comment’ from Feb. 19, 2008. It’s short and a must read. The cause of heart disease just might be triglycerides, too much insulin (from dietary carbs), low-fat, vegetarian eats, diabetes, wheat proteins (all EASILY corrected with simple, joyous modifications to the afflicted’s diet), but no. Now we’re being asked to believe that the cause of heart disease is that there are no or not enough statins in our blood. It’s bad enough the charade that they prevent heart disease.
Pretty soon, there will an RDA for statins.
Dear Darrel,
Please show me your evidence that eating a single McDouble increases my risk of an MI. Please also show me your evidence that if I take a statin along with my McDouble that I will not have an MI.
Also, can you please explain to me how it is possible for my friend Jimmy to have eaten lunch at McDonald’s every day for the past 30 years. He is 76 years old and has never taken a statin or had an MI. How can this possibly be?
Thank you
Here is a healthier choice. Heavy physical activity may significantly reduce heart disease deaths, especially after age 45:
http://healthcorrelator.blogspot.com/2010/08/heavy-physical-activity-may.html
In the article reviewed in the post above, the reduction in the 65-74 group was rather dramatic. And they were not comparing folks doing heavy physical activity with completely inactive people. All were dock workers.
My weight-lifting sessions looking more and more like a true cardiovascular fitness program.
OT: Tom, I would love to see you do a debunking of the pseudoscience that says that fresh raw milk from grass/hay fed cows can make people sick. I could do it, but it wouldn’t be funny.
It’s on my list.
“How can it be right to hand out … salt …sugar…”
There’s the basis of the whole argument. Restaurants do not “hand out” these things, they sell them. People ingest them because they want them and have paid for them. The whole argument comes from a faulty premise, so we can just ignore it.
And, of course, the drumbeat for more widespread use of statins has NOTHING to do with the patents running out very soon. Bawahahahaha.
Unless you are in a small minority of the population, salt has no effect on blood pressure. This myth has been dis-proven time and time again, yet doctors like this don’t keep up with the news…
“.. Dietary sodium restriction for older hypertensive individuals
might be considered, but the evidence in the normotensive population
does not support current recommendations for universal dietary sodium
restriction. ”
http://jama.ama-assn.org/cgi/content/abstract/275/20/1590
“There is no evidence that limiting NaCl consumption to 6 g/day, as
recommended by a number of health agencies, poses any health risk.”
http://ajpheart.physiology.org/cgi/content/full/276/5/H1807
“low-salt diets had virtually no effect on people with normal blood
pressure, a vast majority of the population, and, at best, resulted in
only a small drop in the systolic pressure of people with high blood
pressure.”
http://query.nytimes.com/gst/fullpage.html?res=9401E7DA1039F931A15756C0A960958260&scp=2&sq=salt&st=nyt
Exactly. Recent research indicates that salt is only an issue for people whose kidneys are damaged.
…As serious as a heart attack. RobR is on the money; the moral reasoning is we all should share the cost of culture on Statin Planet.
Give me liberty, RX sprinkles and my dentist taking ten potent painkillers.
Tom, you are clinically imaginitive…what can they give you for that?
I’ve found that reading the 2010 U.S. Dietary Guidelines dulls the imagination quite effectively.
Poor grammar and word choice suggest “fake”.
http://health.yahoo.net/news/s/afp/healthusobesityresearchbritain
Exercise cuts genetic obesity risk by 40 percent: study
Here’s a headline for you to ponder. Health reporting at it finest again! A quick glance at that headline and the average joe would think that folks that have a genetic risk for obesity would be 40% less likely to become obese if they exercise. They’d be wrong.
http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000332
What did the researchers find?
The researchers found that each additional BMI-increasing allele was associated with an increase in BMI equivalent to 445 g in body weight for a person 1.70 m tall and that the size of this effect was greater in inactive people than in active people. In individuals who have a physically active lifestyle, this increase was only 379 g/allele, or 36% lower than in physically inactive individuals in whom the increase was 592 g/allele.
I calculate that to be a difference of 0.4lbs per allele.
Yep – 10 genetic variances and you have a whapping 4 lb diffference in weight.
Makes you want to run to the treadmill, no?
That’s why they like to express their findings in percentages. 40% sounds a lot more impressive than 4 lbs.
There was a piece on KevinMD by Dr. Eric Van de Graaff extolling the values of statins last week. He dismissed even the possiblity of side effects or danger from these drugs. Of course, he did not disclose any ties to the drug companies…
Predictabaly, most (but not all) of the docs who responded agreed with him. What was really sad was the number of patients who commented and thought that statins had saved their lives.
Most doctors are frighteningly uninformed about the side effects. My mom’s doctor had no idea a statin could be causing my mom’s muscle pains.
If this is real it may be time to give up, NOT. I can just imagine a bunch of idiot PhD’s reading the recommendation to serve statins wherever fats and salt are sold and nodding their heads wisely.
It’s crap like this that can get momentum and move politicians (maybe not one this ludicrous) but you never know these days.
Keep doing what you do and don’t get discouraged. Thanks for making it entertaining at least.
You’ve got to laugh to keep your sanity these days.
Well, ok, let’s run with his viewpoint for a moment….Why pick on McDonalds? Why not just attach a statin to all junk food? Shouldn’t a bag of Oreo’s, a Dr. Pepper or a PopTart come with statin? A statin packet would be the perfect prize for a box of sugary cereal. If you’re dumb enough to eat that way then you’re going to get side effects from your diet, what’s a few extra?
Just wait, they’ll be lobbying to put statin powder in the mix for all “junk” foods.