NEW YORK (Reuters Health) – Among hypercholesterolemic men, a modified Mediterranean diet enhances simvastatin therapy and counteracts the increase in fasting insulin levels seen with simvastatin therapy, which is linked with simvastatin use.
The findings come from a randomized crossover trial, reported by Dr. Antti Jula from the Research and Development Center of the Social Insurance Institution, Turku, Finland, and associates, in the February 6th issue of the Journal of the American Medical Association.
After a 4 to 6 week placebo run-in period, 120 hypercholesterolemic men, 35 to 64 years of age, who had never been treated, were randomized to a usual diet or to dietary treatment in a crossover fashion. Each treatment period lasted 12 weeks. The men in each group were further randomized to 20 mg/day simvastatin or placebo.
The treatment diet reduced the intake of saturated and trans-unsaturated fats to no more than 10%. These fats were replaced with monounsaturated and polyunsaturated fats rich in omega-3 fatty acids. The diet also included an increased intake of fruits, vegetables and fiber.
Diet modification and simvastatin had the expected salutary effect on serum lipids and other parameters. For example, with diet therapy, total cholesterol was reduced by a mean of 7.6% (p < 0.001), LDL cholesterol by 10.8% (p < 0.001), and serum insulin by 14.0% (p = 0.02). Simvastatin alone reduced total cholesterol by 20.8% and LDL cholesterol by 29.7%, and increased serum insulin by 13.2% (p = 0.005), Finnish team notes.
"The effects of dietary treatment and simvastatin were independent and additive," they add.
Dr. Jula and colleagues comment that the dual approach to lowering cholesterol Is "clinically sound, and the importance of diet as an integral part of statin treatment of hypercholesterolemic patients should be emphasized."