Would You Like Some McStatins With That?

I don’t blame Ronald McDonald for the rise in obesity and diabetes.  I made that clear in Fat Head.  But if he starts handing out statins with the burgers and fries, I may have to track him down and punch him right in his red nose.

No, scratch that.  It wouldn’t actually be Ronald’s fault.  I should track these people down and punch them in the nose instead:

Fast food outlets could provide statin drugs free of charge so that customers can neutralise the heart disease dangers of fatty food, researchers at Imperial College London suggest in a new study.

In a paper published in the American Journal of Cardiology, Dr Darrel Francis and colleagues calculate that the reduction in cardiovascular risk offered by a statin is enough to offset the increase in heart attack risk from eating a cheeseburger and a milkshake.

Those must’ve been some amazing calculations.  After several major clinical trials that lasted for years and cost hundreds of millions of dollars, researchers have been left with contradictory results.  At best, they can say that among people with previously identified heart disease — and no one else — statins might prevent one heart attack for every 100 people who take them.

And yet this group in Britain fired up a copy of Excel and precisely calculated that one dose of statins offsets the coronary damage from a Double Quarter Pounder and a chocolate shake.  Their study (ahem, ahem) should’ve been laughed into instant oblivion.  Instead, it appeared in the American Journal of Cardiology (which next month will publish a study examining the heart-protecting effects of standing outside naked and howling at passing aircraft).

Good grief.  We’re finally seeing major media outlets like the Los Angeles Times openly question the supposed benefits of statins, and in the same week we’ve got doctors suggesting Ronald McDonald should serve them as a side dish … at least in Britain, where statins are already an over-the-counter drug.  Here’s part of what they wrote in their paper:

Routine accessibility of statins in establishments providing unhealthy food might be a rational modern means to offset the cardiovascular risk. Fast food outlets already offer free condiments to supplement meals. A free statin-containing accompaniment would offer cardiovascular benefits, opposite to the effects of equally available salt, sugar, and high-fat condiments.

Yeah, fabulous idea:

“Salt?  Ketchup?  Statin?” 

“How much is the statin?”

“They’re free, sir.”

“Really?  They cost money at the pharmacy.  Give me a dozen.”

An article about the study (ahem, ahem) in today’s Science Daily was so full of bologna, I ingested three days’ worth of saturated fat merely by reading it.  Here are some quotes:

Statins reduce the amount of unhealthy “LDL” cholesterol in the blood. A wealth of trial data has proven them to be highly effective at lowering a person’s heart attack risk.

What “wealth of trial data” would that be, exactly?  Let’s review what the Los Angeles Times said on the topic:

In the first of three studies published in the Archives [of Internal Medicine] last month, medical researchers found that, contrary to widely held belief, statins do not drive down death rates among those who take them to prevent a first heart attack.

Perhaps those researches forgot to limit their study group to people who’d just consumed a Big Mac.  But it’s not just the Archives of Internal Medicine that’s knocking statins lately.  In a paper published in a French medical journal, researchers examined the clinical trials and came to same conclusion:  several recent studies have been conducted to test the effects of cholesterol-lowering drugs.  Most were disappointing or inconclusive, some were stopped early (and never published) because the results weren’t flattering, and the only one that declared a clear benefit for statins — JUPITER — is highly suspect.  That’s the one where the investigators moved their end-point back in time to get a result they liked.

But back to the Science Daily article:

“It’s ironic that people are free to take as many unhealthy condiments in fast food outlets as they like, but statins, which are beneficial to heart health, have to be prescribed,” Dr Francis said.

Doctor, I’m going to step out on a limb here and suggest that any substance that messes with your basic biological functions probably ought to be prescribed.  And if they aren’t prescribed, people should be given all the information about them.  Before we put a dish of statins next to the ketchup dispenser, can we at least talk about side-effects?

Statins have among the best safety profiles of any medication. A very small proportion of regular statin users experience significant side effects, with problems in the liver and kidneys reported in between 1 in 1,000 and 1 in 10,000 people.

AAAARRGGHHH!!  No, damnit, I mean the real side effects!  One in a thousand?  Are you kidding me?  Dr. Beatrice Golomb has been tracking statin side-effects for years and says the rate could be closer to 30%.  Most doctors just don’t attribute the side effects to the statins they’re handing out.  My mom’s doctor certainly didn’t.

Studies have shown a clear link between total fat intake and blood cholesterol, which is strongly linked to heart disease.

So we’re back to that same old @#$%.  If A is linked to B and B is linked to C, then A must cause C.  Just one little problem:  nobody can produce a single study that shows that eating saturated fat causes heart disease.  Recent studies have concluded exactly the opposite:  there is no link between the two.

Recent evidence suggests that trans fats, which are found in high levels in fast food, are the component of the Western diet that is most dangerous in terms of heart disease risk.

No kidding.  Too bad the goofs in white coats convinced us we had to stop frying in tallow and lard … you know, like we did back when heart disease was rare.

Even if you buy the theory that saturated fat raises cholesterol and elevated cholesterol causes heart disease, this proposal is still almost charmingly stupid.  Heart disease is a chronic condition.  It develops over years.  To the minor extent that statins prevent a second heart attack, they do it over the long term.  They’re not condoms for your arteries. If you have the occasional one-nighter with a milkshake, you can skip the protection without receiving a surprise phone call a few months later.

But apparently these researchers are convinced that saturated fat clogs your arteries the way tobacco stains your teeth:  a little bit with every dose.  Eat a burger, grow some plaque — unless, by gosh, you pop a statin immediately to halt the process.

If, heaven forbid, we start serving fast food with a side of statins, here’s what will happen:  five or 10 years from now, you’ll see headlines about a new study that links fast-food consumption to muscle weakness, depression and memory loss.  The blame, of course, will be assigned to the burgers.  Michael Jacobson of CSPI will seek out the nearest TV camera and declare Quarter Pounders “Alzheimer’s in a bun.”

The researchers note that studies should be conducted to assess the potential risks of allowing people to take statins freely, without medical supervision.

This is coming from the same people who think it’s “ironic” that we dispense free ketchup in restaurants but require a prescription for statins?  What a nice little note of caution.

They suggest that a warning on the packet should emphasise that no tablet can substitute for a healthy diet, and advise people to consult their doctor for more advice.

No thanks.  The way doctors give out statins these days, I think white coats should come with a big warning label on them.