Do You Want a Side of Statins with Your Burger?

An article in The Guardian reports that some cardiologists think that fast food restaurants “should offer diners free drugs to compensate for the risk of heart disease” associated with the food they serve.

Darrel Francis, MD, a cardiologist at Imperial College London’s National Heart and Lung Institute, and colleagues have published an article in the American Journal of Cardiology that asks “Can a Statin Neutralize the Cardiovascular Risk of Unhealthy Dietary Choices?” The authors “compared the increase in relative risk for cardiovascular disease associated with the total fat and trans fat content of fast foods against the relative risk decrease provided by daily statin consumption from a meta-analysis of statins in primary prevention of coronary artery disease.”

They found that “the risk reduction associated with the daily consumption of most statins, with the exception of pravastatin, is more powerful than the risk increase caused by the daily extra fat intake associated with a 7-oz hamburger (Quarter Pounder®) with cheese and a small milkshake.”

Comparing people who make unhealthy dietary choices (such as, presumably, partaking too frequently in a delicious-but-bad-for-you fast-food meal) to those who indulge in other risky pursuits (such as “motorcycling, smoking, driving”), the authors posit that fast-food aficionados should also be “advised or compelled to use measures to minimize the risk” (ala the “safety equipment, filters, seatbelts” foisted on the previously mentioned daredevils) associated with their dietary choices.

Their solution? “Routine accessibility of statins in establishments providing unhealthy food might be a rational modern means to offset the cardiovascular risk.” That’s right: fast food restaurants should include statins along with the ketchup packets and other condiments they offer. The authors claim that “A free statin-containing accompaniment would offer cardiovascular benefits, opposite to the effects of equally available salt, sugar, and high-fat condiments.” And although such a measure would be “no substitute for systematic lifestyle improvements, including healthy diet, regular exercise, weight loss, and smoking cessation,” the study authors feel that “complimentary statin packets would add, at little cost, 1 positive choice to a panoply of negative ones.”

According to The Guardian, this idea (however partially tongue-in-cheek it may have been [hopefully?] intended) has come in for criticism from other cardiologists, who have said “the study could encourage ill-health by prompting even greater consumption of junk food and increasing the belief in ‘a pill for every ill.’” The article said that Professor Steve Field, chairman of the Royal College of General Practitioners, has denounced the proposal, saying that “we should be encouraging healthy lifestyles, not pill popping. This is an unwelcome addition to the 'pill for every ill' attitude that's already much too common. The danger of this research is that some people will become even more complacent about eating fatty food and high calorie food, and might even increase their intake of them."

Additional reading:

Press release accompanying the AJC article that notes “statins have among the best safety profiles of any medication” and points out the irony 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.”