Must you change your diet if statins are doing the job?

Posted by heycal @heycal, Jul 5 1:50pm

Why must one eat healthier if statins are working? If one is fit, active, with good BP and cholesterol numbers, is diet modification really necessary from a medical standpoint to decrease risk of heart attack or stroke?

Is there some other measure besides cholesterol that tells you "hey, lay off the pizza and pick up the broccoli?"

I would think that as long as all your indicators for health are doing well, diet details shouldn't matter.

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@lp77

The point was along with statins eat a Mediterranean diet and get 150 weekly .
This is recommended by cardiologists .

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@lp77 And you think posting that that somehow answers any of the questions I asked?

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@heycal

Hey PB: Can you clarify what you mean by this sentence? Giving your body an opportunity to use lipids vis exercise also a priority but we don't have a direct measurement of that effect."

Also, how do we measure saturated fat levels?

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Your original Post was well written, so i assume some education and some ability to do basic research. So I’m not sure if you are entertaining yourself or what but here’s the easy to find answer to the question of how saturated fats are reflected in your lipid profile.

Saturated fats (SFAs) can affect a lipid profile by increasing levels of low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C).

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@pb50

Your original Post was well written, so i assume some education and some ability to do basic research. So I’m not sure if you are entertaining yourself or what but here’s the easy to find answer to the question of how saturated fats are reflected in your lipid profile.

Saturated fats (SFAs) can affect a lipid profile by increasing levels of low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C).

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Sorry, I'm not stupid, I hope, nor joking, but your answer still doesn't really make sense to me. I could google if I knew what I was looking for.

If there is some way that diet adversely affects heart health beyond what is measured by cholesterol levels, Blood pressure, and fitness levels, I'd like to know what way that is, and how we might know it.

You use the terms LDL-C and and HDL-C. Are those different from LDL and HDL, and if so, is there some seperate test not generally included when one gets their cholesterol checked?

Googling my initial question generally results in answers along the lines of "taking a statin doesn't mean you can stop exercising, smoke cigarettes, and get fat!" and doesn't really address my question.

I will actually be speaking to a cardiologist friend this afternoon, and hopefully he can answer the question.

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You: '..Is there some other measure besides cholesterol that tells you "hey, lay off the pizza and pick up the broccoli?"...'

Yes, CAC, A1C, APOB, for starters. They are mostly related to your dietary consumption, but can also be endocrine markers.

Please reread my earlier reply...I do think I adequately addressed your question of dietary changes vis a vis statin use and LDL markers. Statins are prescribed as a dosage, and that dosage is dependent on your circumstanced, including blood assay results and any imaging/diagnostics of your degree of ischemia or atherosclerosis. So, if you eat steak morning and night, plus eggs in the morning, and your original statin dosage is insufficient to keep your triglycerides and LDL in the appropriate range, you'll be advised to increase your dose of statins. Or, just modify your diet.

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@gloaming

You: '..Is there some other measure besides cholesterol that tells you "hey, lay off the pizza and pick up the broccoli?"...'

Yes, CAC, A1C, APOB, for starters. They are mostly related to your dietary consumption, but can also be endocrine markers.

Please reread my earlier reply...I do think I adequately addressed your question of dietary changes vis a vis statin use and LDL markers. Statins are prescribed as a dosage, and that dosage is dependent on your circumstanced, including blood assay results and any imaging/diagnostics of your degree of ischemia or atherosclerosis. So, if you eat steak morning and night, plus eggs in the morning, and your original statin dosage is insufficient to keep your triglycerides and LDL in the appropriate range, you'll be advised to increase your dose of statins. Or, just modify your diet.

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Let me focus on the last part of your resonse, @gloaming, which is the part I most understand. You're saying if you eat steak and eggs all day long, you might need to increase your statins or modify your diet, correct?

And if one chooses the increase statin route over the diet modification route, are they more or less likely to suffer from a heart attack or stroke someday than if they had chosen the diet modification route?

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I don't know the answer to that. Presumably, increasing the statin clamps down on the liver even more. I know of a woman whose liver is so active at LDL production that she is on 100 mg twice a day!! This level of intervention must have some empirical value behind it, even more than shrugging by the physician and saying, 'Why bother with a statin at all? It isn't helping to reduce your numbers. Go get your affairs in order.'

Or, if you stay with your 40 mg of statin daily, but cut out most sugars and sweeteners, and reduce carbs, get more aerobic effort activity, one should expect the LDL numbers to drop out of sight....no? That's what I would expect. So maybe the answer is that statins, alone, can't overcome a bad diet, any more than walking 20 km each day can if your goal is to shed a few.

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So I just had a chance to talk with my cardiologist friend. He said that bad food does short term damage to arteries that doesn't show up on tests -- expanding the arteries or some such thing -- and that you don't want to be doing that to your body repeatedly with a bad diet.

So I guess there's my answer (though I will ask my actual cardiologist the same question when I see her next week).

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A poor diet will result in inflammation of the lumen of the veins and arteries. Most of this comes from rancid plant and seed oils which is often found in 'fast' foods, or 'comfort foods'. Rancid seed and plant oils cause the body to produce arachidonic acid, which the body uses as part of its inflammatory response to disease. You don't want inflammation if you can help it because it is very hard on specialize tissues. Inflamed endothelium and lumen tissue tends to help calcium and cholesterol to adhere better, and it begins to gather at that site. Before long, you're simply stenosed, even seriously enough that you need stents or bypass. Statins are actually pretty good at inhibiting inflammation.

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@heycal

Let me focus on the last part of your resonse, @gloaming, which is the part I most understand. You're saying if you eat steak and eggs all day long, you might need to increase your statins or modify your diet, correct?

And if one chooses the increase statin route over the diet modification route, are they more or less likely to suffer from a heart attack or stroke someday than if they had chosen the diet modification route?

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You seem to be disappointed in the support being offered here. I have found that diving into the topic and doing the research myself has helped me get the answers for my individual situation. This is an incredibly supportive and generous group. I hope that you find it so.

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@gravity3

You seem to be disappointed in the support being offered here. I have found that diving into the topic and doing the research myself has helped me get the answers for my individual situation. This is an incredibly supportive and generous group. I hope that you find it so.

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@gravity3 I wasn't looking for support here, just information. Plus I almost always start with Google. I may not not be the world's best researcher, and Google seems less and less helpful in recent years, but had I found the answer there I wouldn't have come here.

I did find a couple of helpful responses, particularly Gloaming's last one, for which I'm appreciative. But I have little patience in forums like these when people post responses that completely ignore the specific questions posed. It's like these folks like to hear themselves "talk" or something, regardless of whether they have anything to contribute. Others almost address the question but don't really answer it.

Having said that, the vast majority of people in this group and others are just trying to help, so I suppose I just need a bit more patience, A trait that would probably help my heart health as well:)

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