Risk Factors for Diabetes

Written by Dr. Steve Chaney on . Posted in current health articles, Drugs and Health, Health Current Events, Supplements and Health

Are Statins Dangerous?

Author:  Dr. Stephen Chaney

 

statins side effectsSeveral years ago I recall a cardiologist telling my class of first year medical students that statins were so beneficial that we should just put them in the water supply. He said it in a lighthearted manner, but I think he really believed it. [In actuality, statin drugs are so widely prescribed that they already are in the water supply of some major US cities (http://usatoday30.usatoday.com/news/nation/2008-03-10-drugs-tap-water_N.htm).]

The Pros And Cons of Statins

When taken by people who have already had a heart attack, statins clearly save lives. However, as I documented in my eBook “The Myths of the Naysayers” (scroll down to Check It Out if you would like to learn how you can get that eBook for FREE) the benefits of statins are marginal at best in healthy people who have not yet had a heart attack.  So are statins one of the risk factors for diabetes?

Statin Side Effects

In addition, statins have some significant side effects. For example, up to 5% of people taking statins develop muscle pain. For most people the muscle pain is merely an inconvenience, but in a small percentage of cases it can lead to fatal complications.

More concerning are the required label warnings that statins can lead to memory loss, mental confusion, high blood sugar and type 2 diabetes. In other words, they may not kill you, but they sure can make life miserable.

Because of the marginal benefits in healthy people and the multiple side effects, some experts are starting to step up and say that statins may be overprescribed. For example, Dr. Roger Blumenthal, MD, a professor and director of the Ciccarone Preventive Cardiology Center at Johns Hopkins recently said: “Statin therapy should not be approached like diet and exercise as a broadly based solution for preventing coronary heart disease. These are lifelong medications with potential, although rare, side effects, and physicians should only consider their use for those patients at greatest risk…”

Dr. Blumenthal made that statement a few years ago when we thought that statins only increased diabetes risk by 9-22%. The latest study suggests that statins may increase diabetes risk by as much as 46%. That, in my opinion, is a game changer.

Statins And Diabetes Risk?

statins and diabetes riskThe idea that statins increase the risk of type 2 diabetes is not new. Previous studies have reported that statins increase the risk of diabetes anywhere from 9% to 22%. As a consequence, the FDA required that “increased risk of elevated blood sugar and developing type 2 diabetes” be added to the warning label on statin drugs starting in 2012.

The authors of the current study (Cederberg et al., Diabetologia, DOI 10.1007/s00125-015-3528-5) felt that previous studies may have underestimated the true risk of developing diabetes because:

  • Previous studies were often done with patient populations at very high risk of cardiovascular disease. In today’s world statin drugs are often prescribed for patients at moderate or low risk of cardiovascular disease. The authors felt that the effect of statins on diabetes risk might not be the same in these two populations.
  • Previous studies relied on self-reported diabetes or fasting blood glucose levels as the criteria for classifying the study subjects as diabetic. In today’s world there are a wider array of diagnostic tests that are used to confirm a diagnosis of diabetes.

This study looked at the risk of developing type 2 diabetes associated with statin treatment over a 6-year period in a group of 8,749 Finnish men (aged 45-73 years) who were enrolled in the Metabolic Syndrome in Men (METSIM) study. That means that the men had metabolic syndrome (they were pre-diabetic), but none of them were yet diabetic at the beginning of the study. Other important characteristics of the study were:

  • This was a healthy cross-section of the Finnish population. Only 24.5% of the study participants were using statin drugs.
  • The diagnosis of diabetes was based on multiple criteria: fasting blood glucose levels, an oral glucose tolerance test, and hemoglobin A1c (a measure of blood sugar control over the last 6 weeks).

As you might suspect, the increased risk of developing diabetes during the 6-year trial was greatest for those who were older, more obese, less physically active and had more advanced metabolic syndrome at the beginning of the study. What was surprising, however, were the other conclusions of the study.

  • Statin treatment increased the risk of developing type 2 diabetes by 46%, and the increased risk of developing diabetes directly correlated with the dose of the statin drug.
  • Insulin sensitivity was decreased by 24% and insulin secretion was decreased by 12% in individuals on statin treatment. In layman’s terms that means the pancreas was 12% less able to release insulin and tissues in the body were 24% less able to respond to insulin. That’s a double whammy!

Even though this study is a significant improvement over previous studies, it does have some limitations of its own.

  • The study population was exclusively white, Finnish men. The conclusions may not apply to other population groups.
  • Simvastin (Zocor) and atorvastatin (Lipitor) were the most widely used statin drugs in this study (84% of the study participants taking statins were on one of these two drugs). These two statins clearly increased the risk of developing diabetes in a dose-dependent manner. There were not enough subjects on the other statin drugs to evaluate their effect on diabetes risk, but previous studies have suggested that other statins may be less prone to increase diabetes risk.

Should You Take Statins If you are Diabetic or Pre-Diabetic?

statins and diabetesLet’s start by identifying the symptoms of metabolic syndrome or pre-diabetes. They are:

 

  • Abdominal obesity (waist size of greater than 35” for women & 40” for men)
  • Slightly elevated triglycerides (greater than 150 mg/dl)
  • Low HDL cholesterol (less than 50 mg/dl for women and 40 mg/dl for men)
  • Slightly elevated blood pressure (greater than 130/85
  • Slightly elevated blood sugar (greater than 100 mg/dl fasting blood glucose)

If you have three or more of these symptoms, you likely have metabolic syndrome or pre-diabetes.

The medical profession and the pharmaceutical industry are circling their wagons and assuring us that the benefits of taking statins clearly outweigh the risks – even if you are diabetic or pre-diabetic. I’m not so sure

The problem is that the benefits of statin therapy in healthy individuals who have not had a heart attack are modest at best. This sets up a real “Catch 22” situation. Diabetes and pre-diabetes increase the risk of heart disease, so current guidelines recommend that statin drugs should be prescribed for individuals who are pre-diabetic or diabetic. However, we now know that those very same statin drugs increase the risk of you becoming diabetic if you are already pre-diabetic. Because they decrease insulin production and increase insulin resistance they may also make your diabetes worse if you are already diabetic, but that has not been directly tested.

That is concerning because diabetes can lead to very serious complications such as neuropathy (numbness in the extremities), kidney disease & kidney failure, high blood pressure and stroke, and cataracts & glaucoma. Of course, you can always use diabetes medications to counteract the diabetes-enhancing effect of the statins, but those medications also have serious side effects. The pharmaceutical merry-go-round continues!

Are There Alternatives For Reducing the Risk Of Heart Disease?

alternative is eat healthyIf statins are only modestly effective at reducing the risk of heart disease in otherwise healthy individuals and they significantly increase the risk of developing diabetes, it is perhaps prudent to ask whether there are alternative, non-drug approaches that can significantly reduce your cholesterol levels and allow you to avoid statins altogether?

According to the National Heart Lung & Blood Institute the answer to that question is a resounding yes! They call it Therapeutic Lifestyle Change or TLC (http://www.nhlbi.nih.gov/health/resources/heart/cholesterol-tlc). The TLC recommendations are:

  • Eat less than 7 percent of your daily calories from saturated fat
  • Eat less than 200 mg a day of cholesterol
  • Get only 25–35 percent of daily calories from total fat (this includes saturated fat calories)
  • Other diet options you can use for more LDL lowering are:
    • Add 2 grams per day of plant stanols or sterols
    • Add 10–25 grams per day of soluble fiber
  • Consume only enough calories to reach or maintain a healthy weight
  • In addition, you should get at least 30 minutes of a moderate intensity physical activity, such as brisk walking, on most, and preferably all, days of the week.

The NHLB Institute recommends that the TLC approach always be tried first, and that statins only be used if the lifestyle approach fails – a message that seems to have gotten lost in the translation in many doctor’s offices.

I have also discussed some natural alternatives in my previous articles such as “Does An Apple A Day Keep Statins Away?” (https://healthtipsfromtheprofessor.com/apple-day-keep-statins-away/) and “Is Fish Oil Really Snake Oil?” (https://healthtipsfromtheprofessor.com/fish-oil-really-snake-oil/).

What Should You Do?

Perhaps it is time to have a serious discussion with your doctor about following the National, Heart Blood & Ling Institute’s TLC recommendations – either as an alternative to statins or as something that will allow your doctor to reduce the amount of statins that your need to take.

I also recommend that you make lots of fresh fruits and vegetables and either oily fish or fish oil supplements part of your regular diet.

The old professor is just like the rest of you. My cholesterol gets a bit high from time to time and my doctor suggests going on a statin. Instead I ramp up my exercise, watch what I eat a bit more carefully, and use a supplementation program that includes stanols, sterols and omega-3 fatty acids.

My cholesterol gets back to where it is supposed to be. My doctor is happy, and I am happy.

 

The Bottom Line

  • The news about statin drugs keeps getting worse. Not only are they only marginally effective in healthy people who have not yet had a heart attack, but the latest study suggests that they may increase the risk of developing diabetes by up to 46%.
  • That is concerning because the complications of diabetes can be quite serious, and diabetes drugs have side effects of their own.
  • In addition to the TLC program I recommend lots of fresh fruits and vegetables, oily fish or fish oil supplements, and a supplement that provides the TLC-recommended 2,000 mg of plant stanols and sterols.

If you have been prescribed statin drugs, it may be time to make a serious commitment to the TLC lifestyle change and have a discussion with your physician about reducing or eliminating your statins. This is especially true if you are already pre-diabetic or diabetic.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Comments (5)

  • Doreen Harrison

    |

    I think your ‘Health Tips From The Professo’r is fantastic., I hope you don/t mind that I use a lot of your info in my newsletters to my downline.
    I quote you as the authority with your qualifications.
    Keep these coming – the world needs to know. Too many drugs are being used these days. Just make people sicker.

    Reply

    • Dr. Steve Chaney

      |

      Dear Doreen,
      I don’t mind you using my health tips as long as you acknowledge the source and do not change the content. Something as simple as leaving a few words or a sentence out can sometimes substantially alter the meaning.
      Dr. Chaney

      Reply

  • Bruce

    |

    Excellent article and worthy of being read by all. As a cancer survivor of 17 years I wish the mainstream media would print articles like this on a regular basis – we are not told the facts by the media – they are afraid of losing revenue from advertising. Would the government (us) ever provide this information – only in a place that no consumer ever goes to. We need more good articles like this.

    Reply

  • Caroline

    |

    I remember my mother calling to say she had been 2 weeks in hospital due to overdose. In questioning her, I found the SAME doctor had her on 14 meds. I called him direct and told him no way, Jose, and he then reduced her to two and finally to one. As a health consultant, I find it insulting that Big Pharma has such control of doctors, etc. As a health consultant and acupuncturist, it makes me even madder and sadder because Western Medicine is not well informed on so many health issues, i.e., hormones, or even the fact that for over 3 years we have known that the older patients (55+) need to have their BP at 140/90 to get blood to their heads to avoid imbalance, headaches, poor memory, dizziness and/or vertigo, while in Chinese medicine this is known as blood def. and we take care of it. Every medicine is a possible danger in one way or another, but combining them is pure stupidity and to me, homicide if not suicide of a patient.

    Reply

  • Deb Villarese

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    ….and may I add that if you have senior parents, it is essential that you advocate for them. When my Dad was on 9 with an optional 2, and I “demanded” after passing out 3 times that they pick the (2) that would benefit him and get rid of the rest for a while the DR reluctantly went along with it because I was just adamant. 10 days later, We meet with the physician and he outwardly says to me, ” you know, I actually see that your Dad is doing better…. this really surprises me because i thought the medications were benefiting him and I thought I would be proving a point that he needed them” WOW! He’s only on 3 today…and he’s doing so much better. Be a voice for those you love… you might save their life.

    Reply

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Latest Article

Omega-3 Benefits: Lower High Blood Pressure

Posted July 16, 2019 by Dr. Steve Chaney

What Does the FDA Say About Omega-3 Benefit Claims?

Author: Dr. Stephen Chaney

 

 

Among omega-3 benefits is lower high blood pressure.  That claim can be made according to the FDA. 

lower high blood pressureHeart Disease is still the number 1 cause of death in this country. And, while deaths from heart disease have been declining in recent years, deaths due to high blood pressure have been increasing.  That is concerning because:

High blood pressure is a killer! It can kill you by causing heart attacks, strokes, congestive heart failure, kidney failure and much more.

High blood pressure is a serial killer. It doesn’t just kill a few people. It kills lots of people. The American Heart Association estimates that high blood pressure directly or indirectly caused 410,000 deaths in 2014. That is almost 1 person every second and represents a 41% increase from 2000. It’s because high blood pressure is not a rare disease.

  • 32% of Americans have high blood pressure, also called hypertension, (defined as a systolic blood pressure of 140 mm Hg or more or a diastolic blood pressure of 90 mm Hg or more).
  • Another 33% of Americans have prehypertension (systolic blood pressure of 120-139 mm Hg or diastolic blood pressure of 80-89 mm Hg).

That’s over 65% of Americans with abnormal blood pressure!

High blood pressure is a silent killer. That’s because it is a very insidious disease that sneaks up on you when you least expect it. Systolic blood pressure increases 0.6 mm Hg/year for most adults over 50. By age 75 or above 76-80% of American adults will have high blood pressure.  Even worse, many people with high blood pressure have no symptoms, so they don’t even know that their blood pressure is elevated. For them the first symptom of high blood pressure is often sudden death.

Blood pressure medications can harm your quality of life. Blood pressure medications save lives. However, like most drugs, blood pressure medications have a plethora of side effects – including weakness, dizziness, fainting, shortness of breath, chest pain, nausea, diarrhea or constipation, heartburn, depression, heart palpitations, and even memory loss. The many side effects associated with blood pressure medications lead to poor compliance, which is probably why only 46% of patients with high blood pressure are adequately controlled.

You do have natural options. By now you are probably wondering whether there are natural approaches for controlling your blood pressure that are both effective and lack side effects. The answer is a resounding YES! I’ll outline a holistic natural approach for keeping your blood pressure under control in a minute but let me start with the FDAs recent approval of what they call “qualified claims” that omega-3s lower blood pressure.

 

What Does the FDA Say About Omega-3 Benefits?

omega-3 benefitsIn my book “Slaying The Supplement Myths” I talk about the “dark side” of the supplement industry. There are far too many companies who try to dupe the public by making outrageous and unsubstantiated claims about their products.

Only the FDA stands between us and those unscrupulous companies, and they take their role very seriously. That is why it is big news whenever the FDA allows companies to make health claims about their products.

Even then, the FDA is very cautious. They allow what they call “qualified” health claims. Basically, that means they are saying there is enough evidence that the health claim is probably true, but not enough evidence to say it is proven.

Of course, if you understand the scientific method, you realize there will always be some studies on both sides of every issue. That is why the only health claims the FDA allows are qualified health claims.

With that background in mind, let’s look at the qualified health claims the FDA allows for omega-3 benefits.

  • Since 2004 the FDA has allowed the qualified claim “Supportive but not conclusive research shows that consumption of EPA and DHA omega-3 fatty acids may reduce the risk of coronary heart disease.”
  • A few weeks ago, they added five qualified health claims about omega-3s and blood pressure. The 5 claims are very similar, so I will only list two below for the sake of brevity.
  • “Consuming EPA and DHA combined may reduce blood pressure and reduce the risk of hypertension, a risk factor for CHD (coronary heart disease).”
  • Consuming EPA and DHA combined may reduce the risk of CHD (coronary heart disease) by lowering blood pressure.
  • Of course, they add the usual wording about the evidence being inconsistent and inconclusive.

 

Omega-3 Benefits?

measure omega-3 benefits levelWe’ve known for some time that omega-3 fatty acids help lower blood pressure, but two recent studies were instrumental in convincing the FDA to allow these qualified health claims. These studies have highlighted just how strong the effect of omega-3s on lowering blood pressure is.

The first study was a meta-analysis of 70 randomized, placebo-controlled clinical trials of long chain omega-3 (EPA + DHA) supplementation and blood pressure (Miller et al, American Journal of Hypertension, 27: 885-896, 2014 ).

This study showed:

  • In the group with normal blood pressure at the beginning of the study EPA + DHA supplementation decreased systolic blood pressure by 1.25 mm Hg.
  • Given that systolic blood pressure rises an average of 0.6 mm Hg/year in adults over 50, the authors estimated that omega-3 supplementation alone would delay the onset of age-related high blood pressure by 2 years.
  • In the group with elevated blood pressure not taking medication at the beginning of the study, EPA + DHA supplementation decreased systolic blood pressure by an impressive 4.51 mm Hg and diastolic blood pressure by 3.05 mm Hg.
  • The authors noted that this decrease in systolic blood pressure could “prevent an individual from requiring medication [with all its side effects] to control their hypertension” or decrease the amount of medication required.

However, the doses of omega-3s used in these studies ranged from 1 to over 4 grams/day (mean dose = 3.8 grams/day). That sparked a second study (Minihane et al, Journal of Nutrition, 146: 516-523, 2016) to see whether lower levels of omega-3s might be equally effective. This study was an 8-week double-blind, placebo-controlled study comparing the effects of 0.7 or 1.8 grams of EPA + DHA per day (versus an 8:2 ratio of palm and soybean oil as a placebo) on blood pressure.

This study showed:

  • In the group with normal blood pressure at the beginning of the study, EPA + DHA supplementation caused no significant decrease in blood pressure. This could be due to the smaller number of subjects or the lower doses of EPA + DHA used in this study.
  • In the group with elevated blood pressure not taking medication at the beginning of the study, EPA + DHA supplementation decreased systolic blood pressure by 5 mm Hg and, the effect was essentially identical at 0.7 grams/day and 1.8 grams/day.
  • The authors concluded “Our data suggest that increased EPA + DHA intakes of only 0.7 grams/day may be an effective strategy for blood pressure control.”

 

A Holistic Approach to Lower High Blood Pressure

holistic approach to lower high blood pressureThe FDA’s allowed claims about omega-3s are good news indeed, but that’s not the only natural approach that lowers blood pressure. You have lots of other arrows in your quiver. For example:

  • The DASH diet (A diet that has lots of fresh fruits and vegetables; includes whole grains, low fat dairy, poultry, fish, beans, nuts and oils; and is low in sugar and red meats) reduces systolic blood pressure by 5-6 mm Hg. [Low fat, low carb and Mediterranean diets also lower blood pressure, but not by as much as the DASH diet].
  • Reducing sodium by about 1,150 mg/day reduces systolic blood pressure by 3-4 mm Hg.
  • Reducing excess weight by 5% reduces systolic blood pressure by 3 points.
  • Doing at least 40 minutes of aerobic exercise 3-4 times/week reduces systolic blood pressure by 2-5 mm Hg.
  • Nitrates, whether derived from fresh fruits and vegetables or from supplements probably also reduce blood pressure, but we don’t yet know by how much.

If you’ve been keeping track, you’ve probably figured out that a holistic lifestyle that included at least 0.7 grams/day of long chain omega-3s (EPA + DHA) plus the other omega-3 benefits in the list above could reduce your systolic blood pressure by a whopping 18-22 mm Hg.  What

That’s significant because, the CDC estimates that reducing high systolic blood pressure by only 12-13 mm Hg could reduce your risk of:

  • Stroke by 37%.
  • Coronary heart disease by 21%.
  • Death from cardiovascular disease by 25%.
  • Death from all causes by 13%.

 

A Word of Caution

While holistic approaches have the potential to keep your blood pressure under control without the side effects of medications, it is important not to blindly rely on holistic approaches alone. There are also genetic and environmental risk factors involved in determining blood pressure. You could be doing everything right and still have high blood pressure. Plus, you need to remember that high blood pressure is a silent killer that often doesn’t have any detectable symptoms prior to that first heart attack or stroke.

My recommendations are:

  • Monitor your blood pressure on a regular basis.
  • If your blood pressure starts to become elevated, consult with your doctor about starting with natural approaches to bring your blood pressure back under control. Doctors are fully aware of the side effects of blood pressure medications, and most doctors are happy to encourage you to try natural approaches first.
  • Continue to monitor blood pressure as directed by your doctor. If natural approaches are insufficient to bring your blood pressure under control, they will prescribe the lowest dose of blood pressure medication possible to get your blood pressure where it needs to be.
  • Don’t stop making holistic lifestyle choices to reduce blood pressure just because you are on medication. The more you do to keep your blood pressure under control with a healthy diet and lifestyle, the less medication your doctor will need to use (That means fewer side effects).

 

The Bottom Line

Heart Disease is still the number 1 cause of death in this country. And, while deaths from heart disease have been declining in recent years, deaths due to high blood pressure have been increasing. That is why anything we can do lower blood pressure naturally is important. What does the FDA say about omega-3s and blood pressure?

  • Since 2004 the FDA has allowed the qualified claim “Supportive but not conclusive research shows that consumption of EPA and DHA omega-3 fatty acids may reduce the risk of coronary heart disease.”
  • A few weeks ago, they added qualified health claims about omega-3s and blood pressure. For example, they now allow the following claims.
  • “Consuming EPA and DHA combined may reduce blood pressure and reduce the risk of hypertension, a risk factor for CHD (coronary heart disease).”
  • Consuming EPA and DHA combined may reduce the risk of CHD (coronary heart disease) by lowering blood pressure.

For more information on the studies that convinced the FDA to allow claims about omega-3s and blood pressure and for a discussion of holistic natural approaches for lowering blood pressure, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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