Heart disease has become our nation's number one killer, with coronary heart disease being the most common type of heart disease, causing more than 385,000 deaths per year. This results in a heart attack occurring within every 30-40 seconds. Having a high cholesterol level is one of the main risk factors contributing to heart disease. When blood tests reveal elevated cholesterol levels, we're faced with the decision of whether or not to start cholesterol lowering medications. Most physicians today are quick to suggest cholesterol-lowering prescriptions, including statins, which can have many adverse side effects. Before starting drug therapy, we should first compare the risks and benefits associated with statin use to a whole foods, nutrient-dense, plant-based diet. Although statins can benefit those high risk patients with significant history of coronary disease; for the majority of patients, nutritional excellence proves to be just as effective (and even better) at lowering cholesterol, while offering numerous health benefits as well.
Dr. John McDougall addresses the benefits and risks in his May 2007 McDougall Newsletter. He states: "Statins do reduce cholesterol measured in the blood, but what is unclear is the real benefit for the patient—will the patient live longer and/or healthier? Or will he or she simply have a fatal heart attack the same day (as would have occurred without the medication), but with a lower blood cholesterol level? The decision to take these medications should not be made lightly. This is a lifetime commitment and for a young person this could mean 50 years of drug-therapy with the potential of serious side effects." Dr. McDougall lists some of the risks and warnings associated with statin therapy here.
Which Patients Can Benefit from Taking Statins?
Dr. McDougall explains in more detail which patients benefit the most using statins, "Cholesterol-lowering medications do have value. Statins have been shown to reduce the risk of death among individuals with strong clinical histories of coronary heart disease: patients who have had heart attacks, angioplasties, and/or bypass surgeries. Because these patients are at a very high risk of having another event in the very near future, benefits can be seen in this group from statins. However, for people with a lower risk of an impending heart tragedy (the average American with elevated blood cholesterol levels), cholesterol-lowering medications are so ineffective that benefits cannot be detected. Plus any benefits present may be overshadowed by the harms caused by these drugs."
"Patients with the greatest risk of a future tragedy," Dr. McDougall clarifies, "should receive the most intensive treatment with diet and/or medications, because they will experience the greatest benefits with reduction of heart attacks and strokes, at the most reasonable costs. The risk of future tragedies is predicted by observing signs, called risk factors. These include high blood pressure, cholesterol, triglycerides, uric acid, and blood sugar, as well as, being overweight. Information on family history, alcohol use, exercise, and smoking is also important. An even more reliable predictor of future problems is a person's history of having problems with his or her arteries. Thus, people with a history of a heart attack, stroke, bypass surgery, and/or angioplasty are at the highest risk and the ones most likely to benefit from statin therapy."
Cure or Suffer and Die With Better Looking Numbers?
Dr. McDougall emphasizes that, "The arteries, and the rest of the body, are diseased from the toxic effects of the "free" vegetable oils and animal-foods (meat, dairy, eggs, fish, etc.) consumed by affluent people. The Western diet also lacks the health-supporting ingredients found in plants that allow the body to heal and stay healthy. Cholesterol-lowering drugs do simply that: they lower blood cholesterol levels. But they do not correct the underlying disease (the atherosclerosis). The end result is that people suffer and die with better looking numbers. The sick arteries stay sick until the cause is removed."
"When the arteries of patients taking statins are studied over time," Dr. McDougall adds, "regression of the underlying artery disease, atherosclerosis, occurs in only a minority of patients, even if cholesterol drops profoundly under the influence of powerful medications. Because of the enthusiastic and dishonest promotion of these high profit drugs, many patients actually believe they are "cured" of their health problems—as a result they may see no more need to make beneficial diet and lifestyle changes, which in truth make a far greater difference than any medications."
Can a Starch-Smart System Reverse Heart Disease?
Dr. McDougall's starch-based diet supports the "natural health and healing capabilities of the body." According to Dr. McDougall, "A no-cholesterol, low-fat diet (The McDougall Diet) is the first step to lowering elevated cholesterol and cleaning out the arteries. With a change in diet, not only does the cholesterol drop, but the artery disease heals. This is referred to as "reversal," and can be seen in 82% of people by the first year. After the first year, the benefits continue with even more reversal and healing seen." A patient eating Dr. McDougall's starch-centered diet can "expect a reduction in cholesterol by 20% to 45% with strict adherence." Generally, those with higher initial cholesterol levels will see a greater reduction after changing their diet. Unlike statin usage, there are no side effects using a dietary approach. Dr. McDougall concludes, "This is the same diet that benefits the rest of the body by causing loss of excess weight, relieving aches and pains, regulating bowel function, lowering other common risk factors (blood pressure, blood sugar, triglycerides, etc.), and reducing the risk of future diseases and prolonging life. Regardless of the patient's chances of benefits and risk from medications, diet and lifestyle changes should be the first and most enthusiastic prescription made by all doctors for their patients. Only then, as a last resort, the patient and the doctor should look into medications."
Don't Informed Consumers Make Better Decisions?
Dr. Pam Popper also responds to this issue, saying: "One of my major complaints about medicine and health is that consumers are not making informed choices. I'm convinced and my experience has shown that many people will choose to adopt a program of dietary excellence and optimal habits if they are shown both efficacy of that plan, as well as the dangers of pharmaceutical intervention. The problem is that most people are not being given this information. This is particularly true for statin drugs, prescribed for lowering cholesterol. Statin drugs are known to cause liver damage. Millions of patients are given these drugs in high doses, which means that hundreds of thousands of patients are likely to develop liver injuries, some of them permanent, as a result. The same held true with muscle pain and weakness, a condition known as rhabdomyolysis. The rate of rhabdomyolysis, which can also cause kidney injury, kidney failure and death, was more than 7 times greater with high-dose Zocor than lower doses. The most disturbing correlation, however, was statin use and cancer. The risks associated with statin drugs are significant and unnecessary, in view of the fact that cholesterol can be lowered as quickly and sometimes more so with diet and lifestyle."
According to Dr. Popper, "Cholesterol-lowering drugs are some of the most widely prescribed drugs by doctors, who rarely talk to their patients about lowering cholesterol through diet and lifestyle. Most medical professionals continue to hold onto the false beliefs that elevated cholesterol is hereditary, that diet and lifestyle are not sufficient to lower it, and that people will not make the changes necessary to lower their cholesterol through diet and lifestyle. I think more of them would if they knew that the risks of taking statin drugs are quite serious."
Shouldn't Lifestyle Education Come First?
Equally important, Dr. Michael Greger also agrees that dietary and lifestyle changes should be recommended first to treat high cholesterol, yet "Many physicians jump right to cholesterol-lowering medications such as statins that can have an array of adverse side effects." Dr. Greger discusses this in more detail in this short video clip.
Plant-based nutrition has been scientifically proven to be as powerful as drug therapy and surgery as seen in this short video clip by Dr. Greger.
Are there Side Effects Associated with Statin use?
The U.S. Food and Drug Administration (FDA) recently gave their approval on "Important safety label changes for the class of cholesterol-lowering drugs known as statins. These changes were made to provide the public with more information for the safe and effective use of statins." Some of the side effects that have been added include reports of increased blood sugar and hemoglobin HbA1c levels. Cognitive side effects such as memory loss, confusion, forgetfulness and amnesia have also been seen. Unusual fatigue, weakness, loss of appetite, abdominal pain, dark-colored urine, or yellowing of the skin or the whites of the eyes they report, can be an indication of liver inflammation.
Dr. Greger updated his video clip reflecting the new FDA warning labels "citing risks of confusion, memory loss, new onset diabetes and muscle injury. Even people who don't experience pain or weakness on cholesterol-lowering statin drugs" he points out, "may be suffering muscle damage."
Additionally, Dr. Joel Fuhrman agrees that, "A high nutrient diet rich in unrefined plant foods can reduce cholesterol to the same extent as statin drugs." He goes on to say that an excellent diet lowers the small dense LDL cholesterol, which initiates the formation of atherosclerotic plaque and increases cardiovascular risk.
Dr. Fuhrman points out that, "All medications have side effects, most of them potentially serious. Typically a drug has to be on the market for many years to discern all the long-term risks. Recently, news has come out exposing serious adverse effects of two types of drugs that are used to treat high cholesterol and high blood pressure – statins and angiotensin receptor blockers. The pharmaceutical industry performing their own "research" has a long and consistent record of covering up discovered dangers of their products and embellishing the advantages. Of course, physicians also give the impression that drugs are necessary, when in fact they are not." Research shows that moderate to serious liver dysfunction and muscle function, acute renal failure, and cataracts have been associated with the use of statin therapy. Studies have also shown that statin usage increases the likelihood of being diagnosed with diabetes.
Are We Suffering From a False Sense of Security?
"Widespread statin use," Dr. Fuhrman firmly believes, "will continue to give Americans a false sense of security, that they are protected from cardiovascular disease when they are only treating a single symptom. Only excellent nutrition, not drugs, can provide complete protection against heart disease. With widespread use of statins, the nutritional causes of heart disease are not addressed, and a significant number of liver dysfunction, renal failure, myopathy, and cataract cases will be produced."
"Any way you look at it, drugs kill millions of people and drug-centered health care is the problem, not the solution to our health crisis and tremendous medical suffering."
Given these points, in addition to an aggressive plant-based dietary approach, as Dr. McDougall mentions, cholesterol-lowering medications can be helpful in those high-risk patients with a history of serious cardiovascular disease. For the majority of patients however, dietary and lifestyle changes alone offers significant cholesterol level reduction while providing numerous health benefits as well.
For more details, see:
1) Caldwell Esselstyn Discusses the Problems with Statin Drugs - Forks Over Knives the Extended Interviews