Friday, February 03, 2012

Statins give you diabetes?

The study below is large so the results should be fairly robust. And the effect was fairly large as such effects go. These results may go some way towards explaining the apparent rise in diabetes incidence in recent years. The doctors hand out statins like jellybeans these days.

Given the pervasive side-effects of statins, it seems likely that the statins did cause the increase in diabetes observed but it must be noted that we are again here dealing with correlational data -- which is not capable of supporting causal inferences by itself
Arch Intern Med. 2012;172(2):144-152.

Statin Use and Risk of Diabetes Mellitus in Postmenopausal Women in the Women's Health Initiative

By Annie L. Culver et al.


Background: This study investigates whether the incidence of new-onset diabetes mellitus (DM) is associated with statin use among postmenopausal women participating in the Women's Health Initiative (WHI).

Methods: The WHI recruited 161 808 postmenopausal women aged 50 to 79 years at 40 clinical centers across the United States from 1993 to 1998 with ongoing follow-up. The current analysis includes data through 2005. Statin use was captured at enrollment and year 3. Incident DM status was determined annually from enrollment. Cox proportional hazards models were used to estimate the risk of DM by statin use, with adjustments for propensity score and other potential confounding factors. Subgroup analyses by race/ethnicity, obesity status, and age group were conducted to uncover effect modification.

Results: This investigation included 153 840 women without DM and no missing data at baseline. At baseline, 7.04% reported taking statin medication. There were 10 242 incident cases of self-reported DM over 1 004 466 person-years of follow-up. Statin use at baseline was associated with an increased risk of DM (hazard ratio [HR], 1.71; 95% CI, 1.61-1.83). This association remained after adjusting for other potential confounders (multivariate-adjusted HR, 1.48; 95% CI, 1.38-1.59) and was observed for all types of statin medications. Subset analyses evaluating the association of self-reported DM with longitudinal measures of statin use in 125 575 women confirmed these findings.

Conclusions: Statin medication use in postmenopausal women is associated with an increased risk for DM. This may be a medication class effect. Further study by statin type and dose may reveal varying risk levels for new-onset DM in this population.


Now it's sugar fanaticism

Sugar 'is toxic and must be regulated just like cigarettes', claim some scientists. A common food suddenly morphs into a poison!

Lustig has long been quite obsessed by fructose but it seems that he is now down on all sugars. I guess that's because a good answer to his anti-fructose campaign is that all sugars contain it. There's a more balanced article here, though it is more respectful of epidemiology than it should be

Sugar is a poison and its sale should be as tightly regulated as cigarettes and alcohol, scientists say. They warn that sugary foods and drinks are responsible for illnesses including obesity, heart disease, cancer and liver problems.

And they claim it contributes to 35million deaths a year worldwide and is so dangerous it should be controlled through taxation and legislation.

In an article entitled The Toxic Truth About Sugar, published in the journal Nature, the scientists add: ‘A little is not a problem but a lot kills – slowly.’

The U.S. authors warn obesity is now a bigger problem than malnourishment across the world, and that sugar not only makes people fat but also changes the body’s metabolism, raises blood pressure, throws hormones off balance and harms the liver.

The damage done mirrors the effects of drinking too much alcohol – which the scientists point out is made from distilling sugar.

The authors, led by Robert Lustig, a childhood obesity expert at California University, say that, like alcohol, sugar is widely available, toxic, easily abused and harmful to society.

They say teaching children about diet and exercise is unlikely to be effective and instead the answer lies in taxes and restricting availability.

The study recommends using taxation to double the price of fizzy drinks, restricting their sale to those over 17 or 18, and tightening regulations covering school vending machines and snack bars.

Dr Laura Schmidt, also of California University, said: ‘We’re not talking about prohibition. We’re not advocating a major imposition of the government into people’s lives. ‘What we want is actually to increase people’s choices by making foods that aren’t loaded with sugar comparatively easier and cheaper to get.’

The article also reveals that consumption of sugar has tripled in the past 50 years and that there are now more obese people than malnourished ones across the world.

It concludes that responsibility lies with the food companies, saying that while they may resist change, shifts in policy are possible if the pressure is great enough. Examples include the ban on smoking in public places and the fitting of airbags in cars.

The article ends: ‘These simple measures are taken for granted as tools for our public health and well-being. It’s time to turn our attention to sugar.’

However, other scientists have described the essay as ‘puritanical’, saying sugar is only toxic when eaten in unrealistic amounts.

Barbara Gallani, of the Food and Drink Federation, which represents the UK food and drink industry, said that while urgent action was needed to beat heart and other diseases, it was wrong to focus on sugar alone. She added: ‘The causes of these diseases are multi-factorial and demonising food components does not help consumers to build a realistic approach to their diet.

‘The key to good health is a balanced and varied diet in a lifestyle that includes plenty of physical activity.’


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