Eat Right to Reduce Heart Disease Risk

Diets high in soy, plant sterols, and certain kinds of fiber may be as effective as the cholesterol-lowering drug lovastatin (Mevacor™) in reducing some people’s LDL (“bad”) cholesterol levels, reports the American Journal of Clinical Nutrition (2005;81:380–7).

Cardiovascular disease (CVD) can take many different forms: stroke, heart attack, congestive heart failure, and abnormal heart rhythms are among them. An elevated blood level of total cholesterol or LDL cholesterol is a risk factor for CVD development. Other risk factors include smoking, obesity, high blood pressure, and diabetes.

CVD is a leading cause of disability and death in the US, which has led the American Heart Association and the National Cholesterol Education Program to develop new strategies to help people control their cholesterol. Recently, these groups have identified certain “functional foods” that contain ingredients that have been shown to reduce cholesterol. Functional food components include soy protein, sterols (substances found in many plant foods and oils), nuts (other than peanuts), and fiber from oats, barley, psyllium, okra, and eggplant. These components reduce cholesterol concentrations by decreasing cholesterol absorption in the intestines and by limiting cholesterol synthesis in the liver.

Medical treatment for high cholesterol may include the use of drugs such as lovastatin. These drugs work by inhibiting a key enzyme for cholesterol formation in the liver. As a side effect, this class of drugs also inhibits the formation of coenzyme Q10, a compound necessary for proper cellular function, which, if depleted, can actually compromise heart health.

The new study compared the effects of a functional foods diet with lovastatin on cholesterol levels in 34 people with high cholesterol who did not have CVD. Participants were assigned to one of the following groups: a functional foods diet, a control diet plus 20 mg of lovastatin per day (lovastatin group), or a control diet plus placebo (control group).

The functional foods diet contained 10 grams of fiber per 1,000 calories from oats, barley, and psyllium; 100 grams of okra every other day; 200 grams of eggplant every other day; 20 grams of soy protein per 1,000 calories from soy milk and meat substitutes; 14 grams of almonds per 1,000 calories; and a margarine that provided 1 gram of plant sterols per 1,000 calories.

The control diet was high in fiber (primarily from whole-wheat cereals, breads, and muffins) and very low in saturated fat. The diet was supplemented with sunflower and safflower oils; egg substitutes and fat-free dairy products provided protein.

Participants followed each regimen for four weeks, with a no-treatment period of two to six weeks between diet periods. Blood pressure, weight, and blood measurements of total cholesterol, LDL cholesterol, HDL (“good”) cholesterol, and triglycerides were taken every two weeks during the study.

After four weeks of each treatment, LDL cholesterol levels decreased by 9% in the control group, 30% in the functional foods group, and 33% in the lovastatin group. LDL cholesterol levels were significantly lower in the functional foods and lovastatin groups than in the control group. Of interest, 26% of the participants achieved their lowest LDL cholesterol level while following the functional foods diet. Lovastatin and the functional foods diet were equally able to reduce LDL cholesterol concentrations to the desirable range for preventing CVD. Based on all the measured parameters, the overall risk of heart disease was significantly lower in the functional foods and lovastatin groups than in the control group. There was no difference in heart disease risk between the lovastatin and functional foods groups.

This is the first study to compare the effects of a cholesterol-lowering drug with dietary changes in the same people. The study’s results suggest that dietary therapy can be considered as a first-line treatment for people with elevated cholesterol who do not have CVD.

Kimberly Beauchamp, ND, received her bachelor’s degree from the University of Rhode Island and her Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. She is a co-founder and practicing physician at South County Naturopaths, Inc., in Wakefield, RI. Dr. Beauchamp teaches holistic medicine classes and provides consultations focusing on detoxification and whole-foods nutrition.

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