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Fruit and veg form the backbone of a healthy diet, but those taking certain medications need to exercise care, specialists warn, owing to natural substances that might interfere with how their prescribed treatments work.

A staggering 5.3 million people in England were given cholesterol-busting statins or ezetimibe in 2023/3, according to GP records, hitting a record peak – a substantial rise from figures recorded just the previous year. With roughly seven to eight million UK adults routinely taking statins, they've emerged as a vital weapon in preventing heart disease.

However, Dipa Kamdar, a senior lecturer in Pharmacy Practice at Kingston University, has warned of the risks posed by grapefruit intake for patients on such treatments. Writing in The Conversation, she explained: "While there are many benefits that can come from following a healthier diet, it's important that any diet changes are made carefully. This is especially true if you're someone who takes a prescription drug, as many health food staples can negatively interact with them."

Kamdar broke down theparticular problem with grapefruit juice: "To break down some prescription drugs in the body, the liver uses enzymes called cytochrome P450. But grapefruit juice contains chemical compounds called furanocoumarins which can block the action of these enzymes. If this happens, some drugs can accumulate in the body.

"This includes ciclosporin, a drug that's commonly used to prevent organ transplant rejection and manage symptoms of rheumatoid arthritis and skin conditions such as psoriasis. A build-up of ciclosporin can cause many side-effects, ranging from mild nausea and vomiting to kidney and liver damage."

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Regarding the cholesterol-busting medication, she went on to explain: "Statins, often used to treat high cholesterol levels and prevent heart attacks and strokes, can also be affected by grapefruit juice through the same mechanism. Increased statin levels in the body can raise the risk of side-effects, including muscle breakdown, which is rare but serious.

"Many other drugs can potentially interact with grapefruit juice as well – including amlodipine (a common high blood pressure drug) and sildenafil (an erectile dysfunction drug). If you take any of these prescriptions drugs, it's best to talk to your doctor or pharmacist before drinking even small amounts of grapefruit juice. It may even be best to avoid it altogether."

The NHS has issued a warning: "Grapefruit juice can affect some statins and increase your risk of side effects. A doctor may advise you to avoid it completely or only consume small quantities."

The British Heart Foundation states: "You may be told to avoid eating and drinking grapefruit while taking certain statins. This is because it can increase the amount of statin in your blood, which can increase the risk of side effects."

The health organisation recommends: "Do not eat or drink grapefruit if you're taking simvastatin. If you take atorvastatin, you can have grapefruit and grapefruit juice, but have it only occasionally and not a large quantity. If you take another type of statin, grapefruit is not thought to be a problem."

Statins help lower the cholesterol level in your blood. This helps lower your risk of heart and circulatory conditions, such as:

• coronary heart disease and angina (chest pain and discomfort)
• heart attack
• stroke.