Hard scientific evidence of the effects of diet, pharmaceutical drugs & lifestyle on health from over 1,400 studies from research centers, universities and peer reviewed scientific journals.

My aim is to make this website the No: 1 worldwide go to place to access the actual scientific papers on the subjects of statins, cholesterol and saturated fat.

Research by David Evans

Friday, 17 April 2015

Plant sterols might be an additional risk factor for coronary heart disease

This study was published in Metabolism 2002 Dec;51(12):1519-21

Study title and authors:
Serum plant sterols as a potential risk factor for coronary heart disease.
Sudhop T, Gottwald BM, von Bergmann K.
Department of Clinical Pharmacology, University of Bonn, Bonn, Germany.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/12489060

The lead author of the study, Dr Thomas Sudhop, notes that in patients with the inherited disease of phytosterolemia, elevated concentrations of plant sterols (eg, campesterol and sitosterol) (think Benecol and Flora proactive) have been implicated as a risk factor for premature atherosclerosis.

This study examined the role of plant sterols in patients (with plant sterol levels in the normal range) admitted for elective artery coronary bypass graft surgery. The study included 53 patients of which 26 reported a family history in their first-degree relatives for coronary heart disease.

The study found:
(a) Patients with a positive family history for coronary heart disease had a significant 31% higher plasma levels of campesterol compared to patients without a family history of coronary heart disease.
(b) Patients with a positive family history for coronary heart disease had a significant 29% higher plasma levels of sitosterol compared to patients without a family history of coronary heart disease.
(c) Patients with a positive family history for coronary heart disease had a significantly higher ratios of sitosterol to cholesterol and campesterol to cholesterol compared to patients without a family history of coronary heart disease.

Dr Sudhop concluded: "These findings support the hypothesis that plant sterols might be an additional risk factor for coronary heart disease".

Monday, 13 April 2015

Statin users of ten years have a 30% increased risk of colorectal cancer

This study was published in Pharmacoepidemiology and Drug Safety 2008 Sep;17(9):869-76

Study title and authors:
Chronic statin therapy and the risk of colorectal cancer.
Yang YX, Hennessy S, Propert K, Hwang WT, Sarkar M, Lewis JD.
Division of Gastroenterology, University of Pennsylvania, Philadelphia, PA 19104-6021, USA. yangy@mail.med.upenn.edu

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/18412290

The study sought to clarify the association between long-term statin therapy and the risk of colorectal cancer. This study was conducted among patients aged 50 years or more and with five or more years of colorectal cancer-free initial follow-up. The study included 4,432 colorectal cancer patients and 44,292 control subjects.

The study found:
(a) Those who had been taking statins for five or more years had a 10% increased risk of colorectal cancer compared to non-users of statins.
(b) Those who had been taking statins for ten years had a 30% increased risk of colorectal cancer compared to non-users of statins.

Thursday, 9 April 2015

Sitosterol, a constituent of Benecol and Flora proactive, is associated with an increased occurrence of major coronary events

This study was published in Nutrition, Metabolism and Cardiovascular Diseases 2006 Jan;16(1):13-21

Study title and authors:
Plasma sitosterol elevations are associated with an increased incidence of coronary events in men: results of a nested case-control analysis of the Prospective Cardiovascular Münster (PROCAM) study.
Assmann G, Cullen P, Erbey J, Ramey DR, Kannenberg F, Schulte H.
Leibniz-Institut für Arterioskleroseforschung an der Universität Münster, Domagkstrasse 3, 48149 Münster, Germany. assmann@uni-muenster.de

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/16399487

Phytosterols such as sitosterol are inserted in high quantities (at 841 times than the average vegetable) in plant sterol based margarines such as Benecol and Flora proactive.

This study was conducted to evaluate if sitosterol levels seen in the general population are associated with the occurrence of coronary events. The ten year study included 159 men who suffered a heart attack or sudden coronary death (major coronary event), who were compared with 318 control subjects.

The study found:
(a) Men with the highest sitosterol levels had a 1.8-fold increase in the risk of a major coronary event compared to men with lower levels.
(b) Among men with a high risk of a major coronary event, high sitosterol concentrations were associated with an additional 3-fold increase in the incidence of coronary events.
(c) Men with a high sitosterol/cholesterol ratio had a 3-fold increase in the incidence of coronary events.

Assmann concluded: "Elevations in sitosterol concentrations and the sitosterol/cholesterol ratio appear to be associated with an increased occurrence of major coronary events in men at high global risk of coronary heart disease".

Tuesday, 31 March 2015

Plant sterols, found in Benecol and Flora proactive, are associated with an increased risk of coronary artery disease

This study was published in Steroids 2015 Mar 23

Study title and authors:
Increased plant sterol deposition in vascular tissue characterizes patients with severe aortic stenosis and concomitant coronary artery disease.
Luister A, Schött HF, Husche C, Schäfers HJ, Böhm M, Plat J, Gräber S, Lütjohann D, Laufs U, Weingärtner O.
Klinik für Innere Medizin III¸Kardiologie, Angiologie und Internistische Intensivmedizin.

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/25814070

Phytosterols are present in very small quantities in fruit and vegetables. The phytosterol content of plant sterol-enriched margarines (Benecol, Flora proactive etc) are higher by an order of magnitude of up to 841 times than the average vegetable (see here). Campesterol and sitosterol are types of phytosterols.

Oxyphytosterols are phytosterols that have gone rancid.

Cholestanol is a derivative of cholesterol.

The aim of the study (of 104 patients) was to evaluate the relationship between phytosterols, oxyphytosterols, lathosterol, cholestanol and cholesterol in patients with severe aortic stenosis (artery blockages), some of whom also had coronary artery disease who were scheduled for elective aortic valve replacement.

The study found:
(a) The ratio of campesterol-to-cholesterol was increased by 26% in plasma of patients with coronary artery disease compared to those without coronary artery disease.
(b) Sitosterol concentrations were increased by 38.8% in the tissues of patients with coronary artery disease compared to those without coronary artery disease.
(c) Campesterol concentrations were increased by 30.4% in the tissues of patients with coronary artery disease compared to those without coronary artery disease.
(d) Oxidized sitosterol-to-cholesterol ratios were up-regulated by 22.7% in the plasma of patients with coronary artery disease compared to those without coronary artery disease.
(e) Oxidized campesterol was increased by 17.1% in the aortic valve cusps (the triangular fold or flap of a heart valve) of patients with coronary artery disease compared to those without coronary artery disease.
(f) Neither cholestanol nor the ratio of cholestanol-to-cholesterol was associated with coronary artery disease.

Luister concluded: "Patients with concomitant coronary artery disease are characterized by increased deposition of plant sterols, but not cholestanol in aortic valve tissue. Moreover, patients with concomitant coronary artery disease were characterized by increased oxyphytosterol concentrations in plasma and aortic valve cusps".

Is it wise to consume margarines high in phytosterols (such as Benecol and Flora proactive) when the study suggests that phytosterols are associated with a higher risk of coronary artery disease?

Rhabdomyolysis occurring under statins after intense physical activity in a marathon runner

This paper was published in Case Reports in Rheumatology 2015;2015:721078

Study title and authors:
Rhabdomyolysis Occurring under Statins after Intense Physical Activity in a Marathon Runner.
Toussirot É, Michel F, Meneveau N.
Clinical Investigation Center for Biotherapy, CIC-1431, FHU INCREASE, University Hospital of Besançon, 25000 Besançon, France

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/25815236

This paper reports the case of a marathon runner who developed rhabdomyolysis.

(i) A 50 year old man healthy man started to take atorvastatin but soon suffered from severe muscle pain. He then was prescribed rosuvastatin.
(ii) The patient was a regular long-distance and marathon runner. He was preparing for an international competition.
(iii) On the day of the competition and while being still under rosuvastatin, the patient experienced progressively worsening muscular weakness. At the end of the race, he suffered from severe pains in the lower limbs similar to diffuse cramps associated with generalized muscle contraction.
(iv) Muscle enzymes (creatine kinase) were tested two days after the race and were at 2631 IU/L (normal levels 300) and he was diagnosed with rhabdomyolysis.
(v) One year later, (without taking the statins), for another marathon, the patient felt no muscle weakness at all or muscle contractions after the race.

Toussirot concluded: "Intense physical activity, as performed by statin treated athletes (whether professional or not and particularly during long-distance races) could have adverse consequences on muscles".

Sunday, 29 March 2015

Acute exacerbations and infections increase in patients with chronic obstructive pulmonary disease who take aspirin and statins

This study was published in the International Journal of Medical Sciences 2015 Mar 2;12(3):280-7
 
Study title and author:
No Significant Detectable Anti-infection Effects of Aspirin and Statins in Chronic Obstructive Pulmonary Disease.
Yayan J.
Department of Internal Medicine, Division of Pulmonary, Allergy and Sleep Medicine, Saarland University Medical Center, Homburg/Saar, Germany.
 
This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/25798054

Chronic obstructive pulmonary disease is the name for a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease.

This study examined  the effect of using aspirin and statins in the exacerbation and infection in patients with chronic obstructive pulmonary disease. The study included 300 patients, average age 69 years, with chronic obstructive pulmonary disease.

The study found:
(a) Patients taking aspirin and statins were 40% more likely to develop an infection than not develop an infection.
(b) Patients taking statins alone were 230% more likely to develop an infection than not develop an infection.
(c) Patients not taking either aspirin or statins were 40% LESS likely to develop an infection than develop an infection.
(d) Patients taking aspirin and statins had a 16% increased risk of acute exacerbation of chronic obstructive pulmonary disease compared to patients not taking either aspirin or statins.
(e) Patients taking statins alone had a 56% increased risk of acute exacerbation of chronic obstructive pulmonary disease compared to patients not taking either aspirin or statins.

Yayan concluded: "In this study, the number of acute exacerbations and infections increased in patients with chronic obstructive pulmonary disease who took aspirin and statins compared with those who took neither aspirin nor statins".

Thursday, 26 March 2015

Women who consume diet drinks have a higher risk of cardiovascular disease

This study was published in the Journal of General Internal Medicine 2014 Dec 17

Study title and authors:
Diet Drink Consumption and the Risk of Cardiovascular Events: A Report from the Women's Health Initiative.
Vyas A, Rubenstein L, Robinson J, Seguin RA, Vitolins MZ, Kazlauskaite R, Shikany JM, Johnson KC, Snetselaar L, Wallace R.
Division of Cardiovascular Medicine, University of Iowa Hospitals & Clinics, 200 Hawkins Dr., Int. Med. E316-1 GH, Iowa City, IA, 52242, USA, ankurvyas7@gmail.com.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/25515135

This study aimed to evaluate the relationship between diet drink intake and cardiovascular events. The study included 59,614 post-menopausal women, average age 62.8 years, who were followed for 8.7 years.

The study found:
(a) Women who consumed two or more diet drinks per day had a 30% higher risk of cardiovascular disease events compared to women who consumed 0-3 diet drinks a month.
(b) Women who consumed two or more diet drinks per day had a 50% higher risk of cardiovascular disease deaths compared to women who consumed 0-3 diet drinks a month. 
(c) Women who consumed two or more diet drinks per day had a 30% higher risk of overall deaths compared to women who consumed 0-3 diet drinks a month.

Vyas concluded: "This analysis demonstrates an association between high diet drink intake and cardiovascular disease outcomes and mortality in post-menopausal women".