Cholesterol-lowering foods such as soy protein, almonds, plant sterol enriched margarines, oats and barley may reduce cholesterol levels more effectively when eaten in combination, says a new University of Toronto study by Professor David Jenkins.
The study, which appears in the current issue of the American Journal of Clinical Nutrition, also found that among the subjects who adhered to the diet (one third of test group), this combination of foods reduces low-density lipoprotein cholesterol ("bad" cholesterol) in similar ways as a first generation statin.
"The benefit of statins to individuals at high risk for cardiovascular disease is not in question here," says Jenkins, a professor in the Department of Nutritional Sciences and a Canada research chair in nutrition and metabolism. "Previous studies have demonstrated that statins can reduce heart disease risk between 25 and 50 per cent. We don't, however, know the long-term effects of these drugs when used on a large section of the broader population who are at low risk in primary prevention. Taking a pill may give people the false impression that they have nothing further to do to protect their health and prevent them from making serious lifestyle changes. Emphasizing diet changes in general can boost the success rate of statins while providing additional health benefits and a possible alternative for those for whom drugs are not a viable option."
Jenkins and his colleagues prescribed a seven-day menu high in viscous fibres, soy protein, almonds and plant sterol margarine to 66 people - 31 men and 35 women with an average age of 59.3 and within 30 percent of their recommended cholesterol targets. For the first time, 55 participants followed the menu under real-world conditions for a year. They maintained diet records and met every two months with the research team to discuss their progress and have their cholesterol levels measured.
"The participants found it easiest to incorporate single items such as the almonds and margarine into their daily lives," says Jenkins, who is also staff physician of endocrinology at St. Michael's Hospital. "The fibres and vegetable protein were more challenging since they require more planning and preparation, and because these types of niche products are less available. It's just easier, for example, to buy a beef burger instead of one made from soy, although the range of options is improving. We considered it ideal if the participants were able to follow the diet three quarters of the time."