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Physician Says Diet Lowers Cholesterol

Contact: Amanda White

Photo of James W. Anderson, M.D., showing foods that help manage diet to lower cholesterol
James W. Anderson, M.D., shows foods that help manage diet to lower cholesterol.

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“Dietary management is an essential part of the treatment for lipid disorders, although adherence to strict and intensive dietary interventions requires motivation by patients, encouragement by physicians, and, perhaps, counseling by dietitians and nutrition experts. For most patients, dietary intervention should be the first line of therapy (perhaps for six to 12 weeks) before introducing pharmacotherapy for hyperlipidemia.”

-- James W. Anderson, M.D.,
UK endocrinologist

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July 22, 2003 (Lexington, Ky.) -- University of Kentucky endocrinologist James W. Anderson, M.D., says a recent study indicates that managing diet is the key to treating all common lipid disorders. His observations are published in an editorial in The Journal of the American Medical Association (JAMA) July 23/30 issue. Anderson is professor of medicine and clinical nutrition, UK College of Medicine, director of the UK Metabolic Research Group and director of the Health Management Resources (HMR) weight management program, in conjunction with UK.

The editorial accompanies the results of a short-term study by David J.A. Jenkins, M.D., from the University of Toronto, Canada, and colleagues. The study suggests that a specific type of low-saturated-fat diet may reduce cholesterol levels as much as cholesterol-lowering medications (statins).

Jenkins and his colleagues studied a group of adults with high cholesterol levels to determine whether a specific type of diet that includes soy protein, plant sterols (naturally occurring components of all plants mainly found in vegetable oils, vegetables and fruits) and soluble fibers (oats, barley, psyllium) would reduce cholesterol levels as much as a cholesterol-lowering drug (a statin). LDL-cholesterol levels decrease 30 percent on both the diet and statin therapy. Both interventions also decreased
C-reactive protein levels—a strong indicator of risk for heart disease.

“The findings of Jenkins and colleagues reported in JAMA indicate that intensive dietary therapy may be just as effective in reducing cholesterol levels as the starting dosage of a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin) drug,” Anderson said.

“Dietary management is an essential part of the treatment for lipid disorders, although adherence to strict and intensive dietary interventions requires motivation by patients, encouragement by physicians, and, perhaps, counseling by dietitians and nutrition experts. For most patients, dietary intervention should be the first line of therapy (perhaps for six to 12 weeks) before introducing pharmacotherapy for hyperlipidemia.”

Of all the cholesterol-lowering nutrients, Anderson said soy protein has the broadest range of effects on serum lipoproteins and cardiovascular risks. He said the
study’s findings suggest that intensive nutritional therapy that includes low intake of saturated fat, trans-fatty acid, and cholesterol, with emphasis on soy protein, soluble fiber, plant sterols, and almonds, may be a useful first-line intervention for select patients with blood lipid disorders.

According to Anderson, the results of the study could have far-reaching implications for a large number of patients with dyslipidemia.

“These results are potentially important, given the expense, safety concerns, and intolerance related to statin use,” Anderson said. “Those who are motivated to adopt prudent diets might achieve meaningful lipid reductions without pharmacotherapy.”

Anderson suggests that these dietary changes can be achieved with widely available cereals and soy products. Oat bran cereal and other whole oat cereals as well as dry beans provide soluble fiber. Psyllium fiber is available in capsules so that the necessary fiber can be achieved with 4 capsules daily. Soy protein is available in milk, cereals, soy nuts, bars and many other products; 20 grams of soy protein will lower LDL-cholesterol about 8 to 10 percent.

The authors of the Canadian study said “…current dietary recommendations focusing on diets low in saturated fat have been expanded to include soy protein and foods high in soluble fibers (e.g., oats and barley) and plant sterols. These guidelines, together with additional suggestions to include vegetable protein foods (soy) and nuts (almonds), appear to reduce LDL-C levels similarly to the initial therapeutic dose of a first generation statin. Using the experience gained, further development of this approach may provide a potentially valuable dietary option for cardiovascular disease risk reduction in primary prevention.”


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