Lowering Cholesterol: Statins Or Diet?

A near-vegetarian diet rich in fiber-filled foods like fruits, vegetables, whole grains, and beans, similar to the Pritikin Eating Plan, was as effective as statin drugs in reducing LDL “bad” cholesterol levels, according to research.

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The investigation, led by Dr. David Jenkins of the University of Toronto, enrolled 66 men and women with elevated cholesterol levels, average age 59, in a study that lasted one year.

“Real World” Living

After receiving intensive instruction about their new cholesterol-lowering diet, the participants went home and followed the diet all on their own, buying their own groceries, cooking at home, etc.

Portfolio Diet

The eating plan, called the “portfolio” diet, was a combination of cholesterol-lowering foods. In addition to multiple daily servings of fruits, vegetables, fiber-rich beans, and whole grains like oat bran and barley, the diet recommended soy products like tofu soymilk and veggie burgers, as well as plant sterol margarine (about one tablespoon daily), two ounces daily of nuts, and psyllium-containing cereals.

The diet allowed limited servings of fat-free or low-fat dairy foods, egg whites, and low-saturated-fat meat options, like fish, white skinless poultry meat, and lean or extra lean red meat. Off limits were all foods high in saturated and trans fats.

The diet, in short, closely resembled the Pritikin Eating Plan.

LDL Reductions

After one year, LDL cholesterol had dropped, on average, 13%. The more closely the participants followed the diet, the lower their cholesterol levels dropped. The nearly one-third of participants who stuck most closely to the diet reduced their LDL levels more than 20%.

“Such reductions,” noted the authors, “approach the levels seen with the first generation statins.”

Dr. Jenkins’ findings echo those of UCLA scientists studying the results of men and women attending the Pritikin Longevity Center. In the largest investigation, tracking more than 4,500 Pritikin guests, LDL levels plummeted an average of 23% in just three weeks.(2) Several studies involving smaller numbers of Pritikin grads documented similar reductions.

Statins Or Diet

Data on the cholesterol-lowering power of diet is important, stressed Dr. Jenkins and colleagues, because among the millions now taking prescription statin drugs, many “may wish to use diet rather than medications as the primary prevention to control serum cholesterol concentration.”

Statins’ Side Effects

Sometimes, it’s just personal preference. Many people simply don’t like taking medications – the fewer, the better, and the lower the dosage, the better. Others experience negative side effects from statins, including muscle pain, memory loss, and elevated liver enzymes,(3) and are therefore looking for drug-free options.

And as guidelines for LDL levels drop lower and lower (recent trials recommend LDL levels of 80), dietary options “will become increasingly important,” states Dr. Jenkins. To drive LDL levels way down, many patients may prefer a combination statin/diet therapy rather than mega-doses of statins (a doubling and tripling of regular doses) because data indicate that the negative side effects of statins increase as dosages increase.(4)

The good news, as the studies from the University of Toronto and the Pritikin Research Foundation have confirmed, is that diet works. The right diet – full of fiber-rich fruits, vegetables, whole grains, and beans and very low in saturated fat – can reduce, and maybe even eliminate, the need for statins.

1. American Journal of Clinical Nutrition, 2006; 83: 582.

2. Archives of Internal Medicine, 1991; 151: 1389.

3. Geriatric Times, 2004; 5(3): 18.

4. Archives of Internal Medicine, 2005; 165: 2671.

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