Cut Cholesterol Without Leaving the Kitchen

Adding grains, nuts lowers levels as sharply as a statin

(HealthDay is the new name for HealthScoutNews.)

TUESDAY, July 22, 2003 (HealthDayNews) -- Adding fiber-rich plants such as oats, barley and nuts to a standard low-fat diet can reduce cholesterol levels by nearly 30 percent, just about as much as a statin drug, Canadian researchers report.

It was a short-term trial lasting just four weeks, with only 46 participants, but it shows that diet alone can produce impressive cholesterol-lowering results, says study leader Dr. David J.A. Jenkins, a professor in the University of Toronto's nutritional sciences department.

"The main message of the experiment is that where before, most reductions of cholesterol by diet alone have been modest, we can put a number of components together that we feel have a much broader appeal and for many people can be an alternative to doses of the older statins," Jenkins says.

He says "older statins" because just one drug was used in the trial, lovastatin (Mevacor), which has been around for years. With scientific caution, Jenkins says a trial of the diet against newer statins is still needed.

Nevertheless, he says, the results of the trial, reported in the July 23/30 issue of the Journal of the American Medical Association, speak for themselves.

Jenkins and his colleagues assigned 16 people with dangerously high blood cholesterol levels to follow a standard cholesterol-lowering diet -- low in saturated fat and rich in whole-wheat cereals. Another 14 people ate the same diet and also took lovastatin, while a third group of 16 followed the experimental diet, which included ample amounts of oats, barley, psyllium, soy foods and almonds.

Those added components are rich in plant sterols, viscous fiber and soy protein. The U.S. Food and Drug Administration now allows claims that sterols, viscous fiber, some nuts (including almonds), and soy protein can reduce the risk of heart disease. But "this dietary combination has never been directly compared to a statin," the researchers note.

After four weeks, the people following the standard diet had an average reduction of 8 percent in blood levels of LDL cholesterol, the "bad kind" that clogs arteries. The reduction was 30.9 percent for those taking the statin and 28.6 percent for those eating the experimental diet.

It was the same for readings of C-reactive protein, a marker of inflammation that is a suspected risk factor for heart disease. The drop was 10 percent for the standard diet, 33.3 percent for the statin, and 28.2 percent for the new diet.

That diet "is consistent with the new guidelines of the American Heart Association," says Dr. Nieca Goldberg, director of women's cardiac care at Lenox Hill Hospital in New York City and a spokeswoman for the association.

Those guidelines "recognize the importance of adding fiber and soy protein and nuts to the diet," Goldberg says. "This diet is not exactly the American Heart Association diet, but the association does include elements of it."

Some caution is needed because the study was a small one, Goldberg says, and "the diet is pretty restricted." But it does provide guidance for doctor and people worried about their cholesterol levels, she adds.

"A lot of people go to the doctor for advice, and the doctor will say don't eat this or that,'" she says. "Here we are looking at specific nutrients that might have cholesterol-lowering benefits."

The issue of compliance -- can people follow this diet for a long time? -- is important to both Jenkins and Goldberg. Jenkins is optimistic because the added foods are familiar to most people. "Many people eat bran on a regular basis," he says. "We're not talking about foods that have never been introduced before."

A change in language would be helpful, Goldberg says. People tend to think of a diet as a short-term measure, she says, so "what we really need is a healthy eating plan for life, rather than calling it a diet."

More information

You can pick up the current guidelines on healthy eating from the American Heart Association or the National Heart, Lung, and Blood Institute.

SOURCES: David J.A. Jenkins, M.D., professor, department of nutritional sciences, University of Toronto; Nieca Goldberg, M.D., director, women's cardiac care, Lenox Hill Hospital, New York City; July 23/30, 2003, Journal of the American Medical Association
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