Diet Can Lower Bad Cholesterol Like Statin Drug

Load up on fiber and vegetables: They lower cholesterol almost as much as cholesterol-lowering statin drugs, Canadian researchers report.

Here's your shopping list: Cholesterol-lowering margarines containing plant fats such as "Benecol" or "Take Control", soy proteins and soluble fibers like oats, barley, psyllium (search), plus all kinds of vegetables, including eggplant and okra (search).

It's important news for people who cannot tolerate statin drugs because of side effects, writes researcher David Jenkins, PhD, with the Clinical Nutrition and Risk Factor Modification Center at St. Michael's Hospital (search) in Toronto, Ontario, Canada.

His report appears in the American Journal of Clinical Nutrition.

Diet Matches Statin Drugs

Both the diet and statin drugs can work in cutting heart disease and death. But for many people, changing their diet just hasn't worked well. Since statin drugs have been on the market, it's been hard to beat the ease (and effectiveness) of popping a pill.

Newer research on so-called "functional foods" has shown that plant fats (stanols or sterols), soy protein, and soluble fibers found in fruits, vegetables, and nuts all work to reduce "bad" LDL cholesterol (search). In fact, the FDA has approved these foods to carry a health claim that they reduce the risk of heart disease.

Each of these foods lowers cholesterol by up to 7 percent. Combined, they cut cholesterol nearly as much as the statin drug Mevacor (search), writes Jenkins.

In their study, Jenkins and his colleagues asked 34 adults — all with high cholesterol — to try three different diets for one month each. Between diet programs, the volunteers had a few weeks off.

The diet programs:

The control diet: A very low-saturated-fat diet, which replaced saturated fats with polyunsaturated and monounsaturated fats. When replaced in a diet, these fats have been shown to decrease "bad" LDL cholesterol. The components of the diet included plenty of skim milk, fat-free cheese, yogurt, egg substitute, egg white, safflower oil, sunflower oil and fiber from whole-wheat breakfast cereal.

The statin diet: A very low-saturated-fat diet plus 20 milligrams of Mevacor.

The portfolio diet: A diet high in vegetables, soy protein foods (soy milk and soy burgers), almonds and high-fiber foods (from oats, barley psyllium, okra and eggplant). Fats were delivered from plant sterol and stanols — naturally occurring substances that can lower cholesterol.

After everyone had tried all the diets, the results were tabulated:

— Portfolio diet and statin drugs had nearly the same results: The portfolio diet reduced LDL cholesterol by 30 percent, the statin drugs by 33 percent and the control diet by 9 percent.

— Nine people (26 percent) achieved their lowest "bad" LDL cholesterol on the portfolio diet.

Dietary changes seem to equal the effect of statin drugs in reducing LDL cholesterol. A diet that combines a number of cholesterol-lowering foods may provide an option for reducing mild-to-moderate LDL cholesterol in people without pre-existing heart disease, writes Jenkins.

By Jeanie Lerche Davis, reviewed by Brunilda Nazario, MD

SOURCE: Jenkins, D. American Journal of Clinical Nutrition, vol. 81, pp. 380-387.