Statins are a group of medicines that can help lower the level of low-density lipoprotein (LDL) cholesterol, also known as the “bad” cholesterol, in the blood. LDL cholesterol can hike your risk of having a heart attack by clogging up your arteries. In fact, research suggests statin use can be particularly beneficial for those who have already had a heart attack or a stroke but there is one key caveat: the drugs must be combined with a Mediterranean-style diet to confer optimal protection.
This is the key finding of a study published in the International Journal of Cardiology.
“We found that statins and Mediterranean Diet together were more effective, as compared to one or the other considered separately, in reducing the risk of cardiovascular mortality,” said Marialaura Bonaccio, epidemiologist at the Department of Epidemiology and Prevention and first author of the study.
“Likely, a Mediterranean diet facilitated the beneficial effect of statins, which in our real-life study were generally used at low doses.”
The conclusion was the result of an Italian study conducted at the I.R.C.C.S. Neuromed, Pozzilli, Italy. on over 1,000 adults recruited in the Moli-sani Study.
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This is a large prospective cohort study that recruited 24,325 men and women from the general population of the Molise Region, a Southern Italian area, with the aim of investigating genetic and environmental risk/protection factors for cardiovascular and tumour disease.
Researchers also analysed the potential underlying mechanisms of this positive interaction, so far poorly explored, between drugs and eating habits.
“The favourable combination of statins and Mediterranean Diet appeared to act, rather than on cholesterol levels, by reducing subclinical inflammation, a condition that predisposes to a higher risk of illness and mortality,” reported Licia Iacoviello, head of the Laboratory of Molecular and Nutritional Epidemiology of the same Department and Professor of Hygiene at the University of Insubria.
“This finding is of particular interest especially in the light of our observation that a high level of subclinical inflammation doubled the risk of mortality in patients who already had a heart attack or stroke.”
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Commenting on their findings, Giovanni de Gaetano, director of the Department of Epidemiology and Prevention, said: “Our data suggest that we should focus more on the possible interactions between food and drugs, an aspect largely neglected in epidemiological research.
“Of course, controlled clinical trials will be needed to clarify these findings.
“If our data will be confirmed, new therapeutic possibilities could be designed for those who have already had a cardiovascular event, allowing a better modulation of the pharmacological intervention in relation to life habits. This is a new aspect of personalised medicine.”
What is included in a Mediterranean diet?
A Mediterranean diet incorporates the traditional healthy living habits of people from countries bordering the Mediterranean Sea, including France, Greece, Italy and Spain.
The Mediterranean diet varies by country and region, so it has a range of definitions.
“But in general, it’s high in vegetables, fruits, legumes, nuts, beans, cereals, grains, fish, and unsaturated fats such as olive oil,” explains the NHS.
“It usually includes a low intake of meat and dairy foods.”
Alternatives to statins
You can also lower high cholesterol levels by overhauling unhealthy aspects of your lifestyle.
“If you have high cholesterol, it’s most important to eat less saturated fat,” advises the British Heart Foundation (BHF).
Foods that are high in saturated fats are things like fatty and processed meat, pies and pastry, butter, cream, and coconut oil.
According to the BHF, some foods contain dietary cholesterol but surprisingly they don’t make a big difference to the cholesterol in your blood.
“These are foods like eggs, some shellfish like prawns and crab and offal such as liver, liver pate and kidney. They are low in saturated fat and so are fine to eat as part of a healthy diet.”