Diet Affects Cholesterol, C-Reactive Protein, Same as Medication
A diet that is low in saturated fat and high in fiber, plant sterols (components found in the fats of certain foods including soy), vegetable protein, and nuts reduces cholesterol similarly to medication therapy, according to a new study published in JAMA (2003;290:502–10).
Cholesterol is a body chemical used to make steroid hormones and to provide structure for cell membranes. It is produced in the liver, obtained from dietary sources such as eggs, meats, and dairy foods, and excreted through the bowels. Cholesterol circulates in the blood and is distributed in many tissues throughout the body. Elevations in levels of total and low-density-lipoprotein (LDL, "bad") cholesterol in the blood increase the risk of heart disease. A family of medications known as statins is commonly used in the treatment of high cholesterol. Dietary recommendations historically have focused on the importance of reducing fat and in particular saturated fat. These changes have been shown to reduce cholesterol levels by 4 to 13%. Several other dietary changes have consistently demonstrated independent cholesterol-lowering effects, including increasing intake of soluble fiber, soy protein, nuts, and plant sterols. No previous studies have examined the effect on cholesterol levels of combining these dietary changes.
C-reactive protein (CRP) is a body chemical found in the blood when inflammation is present anywhere in the body. Levels of CRP rise in proportion with the degree of inflammation present. Recent studies have linked elevated CRP levels with cardiovascular disease and the use of statin medications to lower cholesterol levels has been shown to effectively reduce CRP. The beneficial effect of statin medications on risk of death from heart disease is thought to be due to their ability to reduce both cholesterol and CRP levels.
In the current study, 46 healthy people with high cholesterol were randomly assigned to one of three groups. All participants ate a vegetarian diet low in saturated fat during the four-week study. One group was treated with a statin medication (20 mg of lovastatin per day) and another received placebo. A third group ate a modified daily diet that included an additional 2 grams of plant sterols provided in a margarine, 20 grams of soluble fiber from psyllium, oats, and barley, 43 grams of soy protein from soy milk and soy meat-substitutes, and 1 ounce of whole almonds. At the end of the study, total cholesterol levels had decreased 6% in the placebo group, 23% in the statin group, and 22% in the modified-diet group. Levels of LDL-cholesterol dropped 8% in the placebo group, 31% in the statin group, and 29% in the modified-diet group. CRP levels decreased 10% in the placebo group, 33% in the statin group, and 28% in the modified-diet group. These reductions in total cholesterol, LDL cholesterol, and CRP were significantly greater in the statin and modified-diet groups than in the placebo group, but there was no significant difference between the statin and modified-diet groups.
The results of this study show that adherence to a diet that combines a number of beneficial changes can reduce cholesterol and CRP levels as effectively as medication, and more effectively than simply reducing saturated-fat intake. Such a diet is likely to have broad health benefits and might reduce the risks of many chronic diseases.
Maureen Williams, ND, received her bachelor’s degree from the University of Pennsylvania and her Doctorate of Naturopathic Medicine from Bastyr University in Seattle, WA. She has a private practice in Quechee, Vermont, and does extensive work with traditional herbal medicine in Guatemala and Honduras. Dr. Williams is a regular contributor to Healthnotes Newswire.
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