The Mediterranean diet is ‘as effective as statins’ in reducing heart attack risk, according to a report by leading doctors.
The paper, which is to be published on Monday 7 September, stress that heart disease risk should be lowered through a healthy diet and plenty of exercise, rather than automatically relying on drugs to fix the problem. The National Institute for Health and Clinical Excellence (NICE) is singled out for criticism for relying on medication to cut heart disease risk in its guidelines.
“For most middle-aged people wishing to avoid heart disease, a healthy diet offers a far more powerful, sustainable and enjoyable plan that lifelong statin tablets,” said Professor Simon Capewell, Vice-President of the UK Faculty of Public Health.
It is estimated that seven million people in the UK are currently taking statins, with the numbers set to arise as NICE lowers its criteria for statin suitability. Previously, people with a 20 per cent chance of a heart attack in the next 10 years were considered suitable for statins; the new threshold is reduced to 10 per cent.
The authors of this paper believe that not enough is done to inform patients about the risks and benefits associated with statins use; neither do doctors fully explore the possibilities of making lifestyle changes to reduce the risk of heart disease.
“Patients should be counselled about the nature and value of a healthy diet,” the authors write. “A Mediterranean diet in moderatio, with as little processed food as possible, is a cardiovascular intervention tested in randomised trials and shown to reduce cardiovascular disease (CVD) events.”
“Patients should know that physical activities, particularly enjoyable ones, can lead to important, lasting health and quality of life benefits.”
Such measures are often less convenient than simply prescribing drugs, but they “rarely include significant harm risk, can prolong life, and have the added benefit of substantial non-cardiovascular benefits.”
Statins have become an increasingly controversial subject over the last year or so. They have been repeatedly linked to a higher risk of type 2 diabetes, and their efficacy has come into question. Some research shows that “only…a limited percentage of patients benefit” from statins. The actual number of people who prolong their life through statin use is estimated as being somewhere between one in 50 and one in 200.
“We should not make treatment dependent on crude thresholds that handle patients in a cold, statistical manner,” said Dr. Chaand Nagpaul, chair of the BMA’s GP committee.
“Any decision on treatment should look at wider factors, including lifestyle, and empower patients to make informed choices about their own healthcare choices.”
The paper is published in Prescriber.

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