The Pharmaceutical Journal
Vol 268 No 7185 p197-203
16 February 2002

This article
Reprint
Photocopy

News summary

Related websites
Journal of the American Medical Association (jama.ama-assn.org)

Dietary intervention offers additional benefits to statins in high cholesterol

Combining a Mediterranean-type diet and statin treatment has dual benefits in patients with hypercholesterolaemia, researchers have found. The effects of dietary intervention and simvastatin treatment on lowering total cholesterol and low-density lipoprotein (LDL) were independent and additive. Dietary intervention also counteracted elevations in fasting insulin levels that were associated with simvastatin treatment.

Researchers studied the effects of diet and simvastatin treatment on serum levels of lipids, antioxidants and insulin in 120 men with hypercholesterolaemia. The patients were randomly assigned to either a dietary treatment or their normal diet.

They were further randomised to receive either 20mg simvastatin daily or placebo for 12 weeks followed by a crossover to the other regimen. Dietary treatment involved eating leaner meat products, low-fat cheese, skimmed milk and to increase intake of fish, fruit, vegetables and fibre.

For dietary treatment alone, simvastatin treatment alone and the treatments combined, LDL levels were lowered on average by 10.8 per cent, 29.7 per cent and 40.5 per cent, respectively.

Dietary intervention and simvastatin had opposite effects on insulin levels which were increased by simvastatin. Simvastatin treatment was associated with a 13.2 per cent increase in fasting serum insulin levels and a 14.1 per cent increase in insulin resistance. This increase was fully counteracted by the dietary treatment.

Other differences between the two groups included simvastatin decreasing the concentrations of three antioxidant vitamins — alpha-tocopherol, beta-carotene and ubiquinol-10 — by between 16 and 22 per cent compared with dietary treatment which only caused a small decrease in alphatocopherol.

However, the researchers comment that whether these changes have any impact on biological functions needs to be investigated.

The researchers conclude: "The importance of diet as an integral part of statin treatment of hypercholesterolaemic patients should be emphasised." (JAMA 2002;287: 598).

Back to Top