Tuesday, March 18, 2014

Doctor’s Diary: Statins and their side effects

By James Le Fanu

The assertion last week by researchers at London’s Imperial College that statins have virtually no side effects is so contrary to the experience of legions of Daily Telegraph readers over the past few years, it is only reasonable to inquire how they came to this conclusion.

Dr Judith Finegold and her colleagues trawled through the published findings of the 29 drug company-sponsored statin trials and discovered that the number of “serious adverse events” to be similar among those taking the drug as among those on placebo.

I have not discussed Dr Finegold’s findings with her or her team. I do, however, take general issue with the findings of drug companies’ statin trials for various reasons.

First, the companies have a repertoire of strategies for ensuring the participants in their trials have a reduced risk of side effects. This includes excluding those more likely to experience them (such as the elderly) and those unable to tolerate statins, and “under-ascertainment” – that is, not inquiring too closely for the side effects they might cause.

Next, their findings are contradicted by independent surveys that find that muscular aches and pains are a hundred times more frequent than those reported in the clinical trials, while a series of further problems are not even mentioned – decreased energy, exertional fatigue, depression, memory loss, insomnia, reduced libido, etc, etc. It is only to be expected that the drug companies should be reticent about such matters. And it is certainly of interest, as I read via the HealthInsightUK.org, that the arrangements between Big Pharma and academic institutions specifically exclude access to the original data on which the claims for the safety of statins are based.

This latest study does not make me a convert to their wider use.


Living near glut of takeaways doubles changes of obesity

It may come as no surprise but people who live and work alongside dozens of takeaways are more likely to be obese  -- which proves that takeaways locate themselves where the customers are.

Living near to a large number of takeaways almost doubles the chance of being obese, a study has shown.

People who were exposed to 49 or more fast food outlets near their home, office or commuting route were found to eat around 40g of extra fat a week and have a higher Body Mass Index.

Researchers at the Medical Research Council have called on local authorities to limit the number of takeaways in a given area to help combat the obesity epidemic.

Dr Thomas Burgoine, lead author of the study from the UK's centre for diet and activity research, based in the Medical Research Council's epidemiology unit at the University of Cambridge, said: "Our study provides new evidence that there is some kind of relationship between the number of takeaway food outlets we encounter, our consumption of these foods, and how much we weigh.

“The foods we eat away from home tend to be less healthy than the meals we prepare ourselves, so it is important to consider how exposure to food outlets selling these high calorie foods in our day-to-day environments might be influencing consumption.

“Taking steps to restrict takeaway outlets in our towns and cities, particularly around workplaces, may be one way of positively influencing our diet and health."

The research, published online in the British Medical Journal (BMJ), is the first UK study to combine data from home, work and commuting and involved 5,442 adults from Cambridgeshire aged 29 to 62.

On average, people were exposed to 32 takeaway outlets - nine each in their local neighbourhood and on their commute, and 14 within a mile of work. There were around 48 per cent more takeaway outlets and fast food joints near work compared to home, the study found.

Researchers examined how much takeaway food people ate using questionnaires for foods such as pizza, burgers, fried food (such as fried chicken) and chips.

They also measured people's Body Mass Index (BMI) as a measure of their weight.

The results showed that people exposed to the highest number of takeaways were 80 per cent more likely to be obese and 20 per cent more likely to have a higher BMI than those with the lowest number of encounters. They also ate more of these types of foods.

The researchers said: "Compared with people least exposed to takeaway food outlets, we estimate those most exposed consumed an additional 5.7g per day of takeaway food, which would constitute a 15 per cent higher consumption than those least exposed.

"In a week, this translates into an additional 39.9g of takeaway food. This weekly amount constitutes more than half a small serving of McDonald's french fries (typically 71g per serving)."

Over the past decade, consumption of food outside the home has increased by 29 per cent, while at the same time, the number of takeaway food outlets has increased dramatically, the researchers said. This, they argued, could be contributing to rising levels of overweight and obesity.

Tracy Parker, heart health dietitian at the British Heart Foundation (BHF), which helped fund the study, said: "We already know that people are spending more than ever on takeaways and food eaten away from home, and that these foods are often less healthy than the meals we make ourselves.

" While this study can't prove someone's local environment can cause them to become obese, it's vital we have the tools to make healthy choices when eating takeaways or food in a restaurant.”


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