Controlling cholesterol: why statins may not be the answer.

Statins, also known as HMG-CoA reductase inhibitors, work by preventing the pathway to cholesterol production and are generally prescribed for individuals who are at high risk of heart attack or stroke. It seems that, even in healthy people, these drugs can cut the risk of heart attack by around 30%. Good news, you’d think, considering more than six million adults in the UK currently use them to help control cholesterol levels.

However, it would appear that the story is not quite so black and white; it wasn’t too long ago that I commented on a Daily Mail story highlighting the worrying side effects associated with the use of statins for reducing cholesterol. Not only do statins come with side effects that include muscle pain and damage to the liver and kidneys, it is becoming apparent that they may also cause memory loss and depression.

Strange, then, that these drugs are so commonly prescribed when there are natural ways of keeping cholesterol levels in check. Given the overwhelming evidence for the protective role that long-chain omega-3s play in cardiovascular health, it amazes me that this information is not passed on more readily by GPs to their patients. With the huge costs to the NHS for treating cardiovascular disease in secondary care, wouldn’t it be more cost efficient to educate people on preventative methods?

Omega-3 fatty acids not only reduce cholesterol, but can lower triglyceride levels, blood pressure, improve blood flow and reduce the risk of arrhythmia (the abnormal heartbeat that can increase risk of heart failure). Whilst eating oily fish is a good way of increasing omega-3 levels for heart health, supplementation with purified oils is a convenient way of achieving the therapeutic doses needed (which are often as much as 2-4g) to treat specific conditions such as hypercholesterolaemia (very high cholesterol) or hypertriglyceridaemia (very high trigycerides).

The type of fat in our diets needs to be addressed. Dietary fat plays a huge role in the development of cardiovascular disease. Our increased intake of junk food and heavily processed foods means that we consume amounts of saturated and trans fats that are detrimental to our health and these limited food choices are becoming normal for the next generation, as parents are making fewer food choices for their children. Making relatively simple dietary changes can have profound effects on our health and the habits we adopt now will be reflected in those we pass to our children. Choosing fat wisely, moderating saturated fat intake and increasing polyunsaturated fat at an early age may well help our own and our children’s passage to good health long-term, without the risk of side effects from prescribed drugs.

Obesity: don’t feed the problem

The National Obesity Forum (NOF) has announced that National Obesity Week (NOW) kicks off on the 23rd January 2011. Originally established by medical practitioners in May 2000, NOF aims to raise awareness of the growing health impact that being overweight or obese is having on patients and the National Health Service (NHS). Given that obesity is linked to a myriad of health conditions, including metabolic syndrome and type II diabetes, educating individuals in the area of prevention is of key interest to practitioners.

Obesity is a growing problem in the UK, and the most recent estimates for England suggest that some 8.5% of 6 year olds and 15% of 15 year olds are obese. Obese children are more likely to become obese adults and consequently will suffer from a range of chronic diseases in adult life. Whilst changes in patterns of physical activity and the adoption of a more sedentary lifestyle are likely to be important factors behind the growing incidence of obesity, food choice is particularly relevant. Certainly, the development of modern food processing and refining methods means that we now eat very differently from how we did around 50 years ago. Processed food, which is made up of heavily refined ingredients and likely to have a higher ratio of calories to other essential nutrients than unprocessed foods, is now commonplace in our diets. However, our love of junk food, which is high in calories, fat, salt and sugar, and low in any real nutritional value, is having a devastating impact on our long term health. An adult’s choice in food is determined by factors including what is available (for example, seasonal vegetables), what is accessible (how close the shops are), and what is affordable (possibly the greatest influence in some cases). However, a child’s food choice is primarily influenced by what is offered to them; in the early years of life, parents and close relatives are the primary influences on a child’s diet. As children reach nursery and primary school, the variety of foods offered to them will change and expand. For this reason, we should encourage our children to develop an appetite for ‘good’ food that offers them the best nutritional value in the first years of life. Certainly, whilst food habits are not rigid during a person’s lifetime, a base for healthy food habits can be created in early childhood. Any parent is probably aware that children often appear fussy, unwilling to try new foods and new flavours. However, early experience of a particular food is a major determinant in developing a child’s food acceptance pattern, with a child’s food habits influenced by their parents’ food habits and choices. Making children aware of ‘good’ foods and ‘bad’ foods and how these impact on health can be incorporated into meal planning and preparation. Eating together, and eating the same food, is an important element of relationships and the relationship that we have with food. We know that the choices made when we are young can impact on our health as adults; teaching our children about the kind of food we eat is incredibly beneficial in encouraging them to choose the right kinds of food to give them the best chance of enjoying good health later in life. Why not start now?