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Diet Tips for Patients on Blood Thinners or Statins

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Millions of Americans are on blood thinners and statins for the prevention or treatment of cardiovascular disease, but they may be unaware of the effect certain foods can have on their medications or their health outcomes. Here are some quick tips to share with your patients to keep them safe and healthy.

Foods to Avoid on Statins

Statins have many benefits, including lowering LDL cholesterol and decreasing the risk of heart disease and stroke. Patients on statins should watch out for the following foods in their diets:

  • Grapefruit and grapefruit juice: Certain statins—atorvastatin (Lipitor), lovastatin (Mevacor), and simvastatin (Zocor)—can be affected by a chemical compound in grapefruit called furanocoumarin. This compound deactivates an enzyme needed to break down some statins and can lead to higher levels of the drug circulating in the bloodstream. As a result, there is an increased risk of serious side effects, including liver damage, neurologic symptoms, and rhabdomyolysis, which can lead to kidney failure.
  • Seville oranges, pomelos, and tangelos: These citrus fruits can have the same effects as grapefruit on statins.
  • Saturated and trans fats: These “bad” fats increase LDL cholesterol and lower HDL cholesterol. The American Heart Association recommends that those trying to lower their cholesterol reduce saturated fat to less than 6% of total daily calories and eliminate trans fats completely.
  • Foods with high cholesterol: Patients may be surprised to learn fats have a greater impact on their cholesterol levels than dietary cholesterol. However, it’s advised to keep cholesterol intake under 200 mg per day. Examples of high-cholesterol foods include red meat, baked goods, and full-fat dairy products.

Foods to Avoid on Blood Thinners

The most commonly used blood thinner warfarin (Coumadin, Jantoven) works by blocking vitamin K from being used to make clotting factors. Sudden swings in the amount of dietary vitamin K can affect its ability to work as it should. Patients should be counseled to keep a steady amount of vitamin K in the foods they eat. Foods with high vitamin K include:

  • Kale
  • Swiss chard and chard
  • Spinach
  • Collard greens
  • Turnip greens
  • Mustard greens
  • Broccoli
  • Brussels sprouts
  • Green tea

It’s also important to discuss the risks of drinking alcohol and grapefruit juice with patients on any blood thinner.

Diets for High Cholesterol

The Mediterranean diet is often touted as a heart-healthy diet. It may help lower cholesterol, reduce atherosclerosis, and decrease the risk of cardiovascular disease. The diet limits food items containing saturated fats, processed foods, and refined grains, while placing an emphasis on:

  • Soluble fiber: Whole grain foods like oatmeal, and legumes like kidney beans and lentils help decrease the absorption of cholesterol.
  • Unsaturated fats: Olive oil, avocado oil, and other plant oils are included, as well as nuts and legumes.
  • Fruits and vegetables: A multi-colored variety of these add important micronutrients, as well as plant sterols and stanols to the diet to help reduce cholesterol.
  • Fish, poultry, and eggs: These provide important protein without excessive saturated fats. Fish also contain omega-3 fatty acids, which help reduce triglycerides and may improve HDL cholesterol levels.

Diet is a key component for people taking statins and blood thinners, so make sure your patients know to keep these strategies in mind.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Dec 30
  1. Grapefruit Juice and Some Drugs Don’t Mix. U.S. Food and Drug Administration.
  2. Atherosclerosis, Cholesterol, Nutrition, and Statins- a Critical Reviews. German Medical Science.
  3. Beyond Statins: Emerging Evidence for HDL-Increasing Therapies and Diet in Treating Cardiovascular Disease. Advances in Preventative Medicine.
  4. How to Lower Cholesterol With Diet. Medline Plus.
  5. The Skinny on Fats. American Heart Association.
  6. Interaction Between Dietary Vitamin K Intake and Anticoagulation by Vitamin K Antagonists: Is It Really True? Medicine.
  7. The Mediterranean Diet And Cardioprotection: Historical Overview And Current Research. Journal of Multidisciplinary Healthcare.
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