An editorial in the current issue of the American Journal of Cardiology proposes that fast food restaurants consider giving out a cholesterol-lowering statin drug with each meal, just as they give away little packets of ketchup. The authors are British, and those crazy Brits gave us "Monty Python's Flying Circus," so maybe these guys are just pulling our leg? If so, it's very deadpan humor indeed; there is no indication the editorial is a joke. But it ought to be!
The authors contend that fast food mainstays -- French fries, hamburgers, etc. -- deliver a variety of stressors to the cardiovascular system in the form of saturated fat, trans fat, salt and sugar. A robust literature indicates that statin drugs can mitigate this risk, and indeed can do so acutely. Thus the proposal: when you eat this food, take a pill to protect you from its harms.
In the widespread media coverage of this proposal, the only obvious objection raised is that there may be harms of fast food not fully addressed by a statin. (Maybe there should be a whole pill box on the condiment table, then?) Are we really supposed to be OK with this?
Food is the fuel that runs the human body. It is actually supposed to be GOOD for us! It is the construction material -- the ONLY construction material -- a child uses to grow his or her developing body. It is the source material for replacing the tens of millions of cells an adult body turns over daily. It is what we use to build our hormones, and replenish our neurotransmitters. Are we really supposed to be OK with food so bad for us that we need to take a pharmaceutical antidote along with it?
What appears to be missing entirely, both from the editorial, and from the media reactions to it, is any well-justified outrage. If the food we are talking about -- food widely sold to children as well as adults -- is actually bad enough for us that it warrants a pharmacotherapy chaser, should that even be legal, let alone acceptable to society?
Where is outrage at the idea that we should ignore the powerful influence of food choice on health, and then rely on the pharmaceutical industry to fix it? Where is the outrage that this proposal to combine drugs with dinner is blind to the fact that pregnant women eat this food; five-year-olds eat this food. Are they, too, supposed to get a statin drug?
Where is the outrage at a military-industrial establishment that profits from selling us food with the potential to make us sick, and profits further from selling us drugs to blunt the immediate risk of eating that food? This calls to mind the hospitals that house fast food restaurants, as if to say: "sure, you can super-size that -- the CCU is just upstairs!" Maybe we can extend the idea in this editorial just a bit, and reverse the scenario; maybe fast food franchises can set up angioplasty centers in a back room.
This would really be funny if it weren't so sad.
Yes, it is wrong to think a statin could undue the full range of potential harms from eating bad food. But it is wrong at a far more fundamental level to sanction the sale of so-called 'food' in the first place that is bad enough even to invite such a consideration. This is like letting children play in a park full of venomous snakes, and providing them syringes of anti-venom to administer in case of snake bite. How about we not have venomous snakes in children's parks to begin with?
Of course, in the context of a healthful diet, you could eat a fast food meal on rare occasion and suffer no meaningful harm. But then you wouldn't need a statin drug to defend against it, either! The very point of this editorial -- and it's a valid point -- is that enough fast food is consumed to constitute a meaningful threat to the health of the average customer.
That is true, but better living through pharmacotherapeutic self-defense is not the answer. Better food is the answer!
Respect for the significance of feeding our bodies is the answer. Recognizing that food can be 'fast,' and tasty, and convenient, and economical, and still good for us, is the answer. Learning to love food that loves us back, rather than loving foods that attack us so vigorously an immediate antidote is warranted, is the answer.
Food, well chosen, can do for health what no drug can do: build it from its very foundations. Food IS medicine, and the very best of medicine at that. As I have asserted many times before, diet pattern, along with physical activity pattern and avoidance of tobacco, is among the leading determinants of health outcomes. Feet, forks, and fingers are the master levers of medical destiny. Statins are highly effective drugs -- but they certainly do not make this list!
Folks, the notion that our society sanctions the peddling of food poisonous enough to warrant an anti-toxin on the condiment table is nothing with which we should be 'OK.' It is, in a word, an outrage. I am outraged.
I hope I'm not alone.
Follow David Katz, M.D. on Twitter: www.twitter.com/DrDavidKatz
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Hyla Cass, M.D.: Is Your Medication Robbing You of Nutrients?
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David Katz, M.D.: Lifestyle Changes vs. Medication: When Each Is Right
Health Buzz: Fast Food Chains Should Offer Free Statins ...
If fast-food chains were required to do anything, it would be to improve the nutritional value of their food; however, the bottom line is that individuals are responsible for their health. It follows, then, that those who refuse to maintain their health should be taxed at the drive-throughs, so others don't pay for their preventable chronic diseases in the form of insurance premiums or taxes.
If people stopped eating the junk served up at fast-food restaurants, they would go out of business.
Orwell and Huxley would have loved the statin-fast-food idea. Our modern truth once again outdoes their fiction.
fanned & faved
Like you, though, Big Pharma does not have a place in my heart.
Good for you, sir.
Then do not eat the food. I am outraged that people are able to consume mayonnaise and able to feed it to their children (it is a clear case of child abuse). I am outraged that parents allow their children to play with plastic toys (another case of child abuse). I am outraged that there are fatties.
It all means nothing though.
"That is true, but better living through pharmacotherapeutic self-defense is not the answer. Better food is the answer!"
Is it? Well where is your "better" restaurant that serves this "better" food? I am sure that Yale is paying you pretty well so you can afford it.
"Where is the outrage at a military-industrial establishment that profits from selling us food with the potential to make us sick, and profits further from selling us drugs to blunt the immediate risk of eating that food?"
What? This is actually pretty scary. Not what you wrote. That is insane. What is scary is that this guy actually has some influence based on his position and he is clearly not a rationale person.
You are right. Dr. Katz is not a "rationale" person (like you).
He is a rational person.
HP member "thereisonlyoneparty" seems to feel that the Doctor is wrong, and that you should shovel down as much unhealthy food as possible.
But maybe he is a Monsanto or ADM stock holder.
Why not just shut em all down? Everything. Any place who serves food of any kind whatsoever get closed down and everyone who was too lazy to learn how to cook at home will quietly or not so quietly starve to death. Problem solved.
Do you disagree with any of that?
Your rant has nothing whatsoever to do with the content of the article about which you are supposedly commenting.
And as for your $20 tofu burger nonesense, as I said to another commenter earlier today:
Tell you what. You can eat junk food until it kills you. I don't care. But I resent the fact that I am paying for you to kill yourself extra cheaply.
Everyone's tax dollars go toward massive subsidies to big corporate agriculture that make the prices artificially low for everything from the corn syrup in your 60 ounce cup of fizzy empty calorie Coca-Cola, to the un-natural feed for the dead cows in the double all beef patties you gobble down in a stupor.
The only business that is being minded here is the corporate profits from this garbage, which are propped up by the public at large by tax policy. But I don't hear you complaining about that, Scarlett Mullins, just whining about the fact that a doctor has written an article about proper nutrition, and the insanity of a proposal to pass out drugs with hamburgers.
Grow up.
There is a school of thought that the connection between cholesterol and saturated fat with heart disease is a "myth" and, if you adhere to that school of thought, then of course using medication to lower cholesterol never makes sense. If you accept the traditional science that says high cholesterol is a risk factor, statins are effective for most of the people who take them.
I am "agnostic" on the whole subject; I find that the science is murky, and that we still have much to learn. But it is clear the statins do lower cholesterol levels much more often than "rarely."