Wednesday, June 3, 2015

03/06/2015: Statins versus fish

Ioannis Zabetakis, Assistant Professor of Food Chemistry, University of Athens, Greece

First published in International Aquafeed, May-June 2015

Since the study of the seven countries, some unanswered questions still remain as to why cohorts in Greece and Italy had coronary heart disease (CHD) at low frequencies but high levels of serum cholesterol. Although preventable, cardiovascular diseases (CVDs) remain the top global cause of death and stroke. For this reason, the prevention of atherosclerosis is a major objective of modern medical and biochemical investigations into the mechanism of atherosclerosis and how the structure of food components determines their role in the mechanism(s) involved.
  • Is cholesterol involved (and how?) in atherosclerosis and CVDs?
  • Are people with high cholesterol but also high HDL (high density lipoprotein) in their blood in higher risk for developing CVDs?
These two questions remain partly unanswered although we do know today that taking statins to lower cholesterol is not a sufficient medical approach against CVDs.
Image: Haparanda Midnight Ministerial June 2010
The reason is that statins do have many side effects, with the most notable one the onset of type 2 diabetes. In a very recent study [1], published in “Diabetologia”, it was found that statins were associated with an almost 50 percent higher risk of developing type 2 diabetes, even after adjusting for other factors. The study followed up 8749 men aged 45 to 73 years for an average of 5.9 years. They were randomly selected from the population of Kuopio, eastern Finland, and none had diabetes at baseline. The results showed that men taking statins (n=2142) had a 46 percent increased risk of developing type 2 diabetes (adjusted hazard ratio 1.46 (95 percent confidence interval 1.22 to 1.74) over the follow-up period. 

Statins appear to increase the risk of type 2 diabetes in several ways: one is that the drugs can increase a person's insulin resistance, and the other is that the cholesterol-lowering drugs seem to impair the ability of the pancreas to secrete insulin, according to the study. Diabetes risk increased with the dosage taken of the statin drugs simvastatin (Zocor) and atorvastatin (Lipitor), the researchers said. The investigators found that statins decreased insulin sensitivity by 24 percent, and insulin secretion by 12 percent. The more simvastatin and atorvastatin that people took, the more their ability to use and produce insulin suffered.

Taking a different approach, numerous studies have shown that food polar lipids and in fact fish polar lipids do have a strong cardioprotective effect without any side effects that statins have. We know now that fish contains polar lipids that can inhibit the onset of atherosclerosis and therefore the development of CVDs [2]. So, why are we taking statins if we can just barbeque a sea bream or sauté a juicy salmon fillet? 

Further reading
[1] Increased risk of diabetes with statin treatment is associated with impaired insulin sensitivity and insulin secretion: a six year follow-up study of the METSIM cohort. Diabetologia, 2015,

[2] Food security and cardioprotection: the polar lipid link. Journal of Food Science, 2013,

Read the magazine HERE.

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