Food vs. Medication

Several years ago I had a patient, a woman in her early forties. She wasn't overweight, but her triglycerides (one of the items we test when we check cholesterol levels) were over 12,000. No, that's not a typo. Twelve. Thousand. (Normal would be under 150.) This put her at a greatly enhanced risk for heart disease.

Most of the time a woman like her would be put on medication to improve her cholesterol scores. In clinical trials, medications known as statins (Mevacor and Lovastatin are two examples) have improved LDL cholesterol scores by about 30%.

On the other hand, studies have shown the possible benefits of adding soy protein to the diet - or nuts, or certain types of fiber, or plant sterols. A short-term study in 2003 was devised to test the combined effects of those three foods when compared with treatment with medication (JAMA 2003;290(4):502-510). The study was perfomed by scientists from the University of Toronto and partially funded by the Almond Board of California and the Unilever Health Institute (makers of Promise Buttery Spread and Take Control spread).

Forty-six otherwise healthy men and women of normal weight - but with elevated cholesterol levels - were recruited to participate in the study. They were randomly assigned to one of three different, but all vegetarian, dietary paths for one month:

1. Low in saturated fat, based on low-fat dairy and whole grain cereals (the control group);
2. The same diet, but supplemented with a statin, or
3. A diet containing soy foods, almonds, fiber, and plant sterols.

The diets were designed for each participant to maintain their current body weight. Their cholesterol levels were tested at the beginning and end of the study.

The results are striking. The control group improved their LDL cholesterol scores by about 8%. The statin-supplemented diet improved their score by almost 31%. But what's really impressive is that the group with the soy, nuts, and fiber diet improved their score by almost 29%!

What this means for you

Quite simply, you can get just as good results from improving your diet as you would by taking medication. Certainly that doesn't give you license to dump your cholesterol medications if you're already on them, but a better diet could help you get off them or avoid having to take them at all.

And my patient? I put her on an early version of eatTHISdiet. Six weeks later her triglycerides were in the normal range.

First posted: October 10, 2007