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Different Time Trends of Caloric and Fat Intake Between Statin Users and Nonusers Among US Adults: Gluttony in the Time of Statins?
Study Questions:
Is there a difference in the temporal trends of caloric and fat intake between statin users and nonusers among US adults?
Methods:
Data were obtained in 27,886 US adults, ages 20 years or older, participating in the National Health and Nutrition Examination Survey (NHANES), 1999-2010. Caloric and fat intake were measured through 24-hour dietary recall. The authors calculated a model-adjusted caloric and fat intake using these models and examined if the time trends differed by statin use. Body mass index (BMI) changes were also compared between statin users and nonusers.
Results:
The proportion of statin users from the NHANES 1999-2010 study population in the sample more than doubled, from 7.5% to 16.5% over the decade. In the 1999-2000 period, the caloric intake was significantly less for statin users compared with nonusers (2000 vs. 2179 kcal/d; p = 0.007). The difference between the groups became smaller as time went by, and there was no statistical difference after the 2005-2006 period. Among statin users, caloric intake in the 2009-2010 period was 9.6% higher (95% confidence interval [CI], 1.8-18.1; p = 0.02) than that in the 1999-2000 period. In contrast, no significant change was observed among nonusers during the same study period. Statin users also consumed significantly less fat in the 1999-2000 period (71.7 vs. 81.2 g/d; p = 0.003). Fat intake increased 14.4% among statin users (95% CI, 3.8-26.1; p = 0.007) while not changing significantly among nonusers. Also, BMI increased more among statin users (+1.3) than among nonusers (+0.4) in the adjusted model (p = 0.02).
Conclusions:
Caloric and fat intake have increased among statin users over time, which was not true for nonusers. The increase in BMI was faster for statin users than for nonusers. Efforts aimed at dietary control among statin users may be becoming less intensive. The importance of dietary composition may need to be reemphasized for statin users.
Perspective:
In a PubMed search, I could not find any evidence that statins increase or decrease appetite. And since in the randomized statin trials, there was not an increase in weight in those on statins, the logical explanation for the increase in fat and BMI is that those taking statins are aware of the 30-50% drop in their cholesterol, which gives them the feeling that an increase in dietary fat may not be dangerous.
Keywords: Cholesterol, PubMed, Body Mass Index, Dietary Fats, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Energy Intake, Confidence Intervals
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