New Study: Combination of Cholesterol-lowering Foods Works Better for Lowering LDL than Diet of Low Saturated Fats.
People trying to lower their low-density lipoprotein cholesterol levels (LDL-C) do better over a 6-month period when urged to eat a diet that combines cholesterol-lowering foods (nuts, soy protein, plant sterols, etc.) than they do when counseled to use a low-saturated fat diet, according to a new study in the most recent issue of the Journal of the American Medical Association (JAMA).
The background information section of the article explains that this Canadian study is the first systematic attempt to compare the effects of using known cholesterol-lowering foods in a therapeutic diet for high serum cholesterol patients with the effects of more conventional low-fat diets. Interest in including such foods, either singly or in combination, i.e. a dietary portfolio, has been part of ongoing attempts to improve diet therapy for such patients.
The project, conducted in multiple medical centers across Canada by a team headed by David J. A. Jenkins, M.D., of St. Michael’s Hospital and the University of Toronto, attempted to discover whether such a diet caused LDL-C levels to significantly decrease when compared with a control low-saturated fat diet, after a 6-month follow-up period. Although the control diet had ample amounts of whole grains and high fiber foods, it did not have the plant sterols, nuts, viscous fiber, and soy protein – all listed as cholesterol lowering by the U.S. Food & Drug Administration – of the experimental diet. The study followed 351 patients with hyperlipidemia at 4 academic medical centers in Toronto, Quebec City,Winnipeg, and Vancouver, in evaluations conducted between June 2007 and February 2009, using 1 of 3 possible treatment regimes.
The participating patients received diet counseling for 6 months for either (1) the conventional low-saturated fat control diet, or (2) a “routine” experimental dietary portfolio regime with including 2 clinic visits during the 6 months, or (3) an “intensive” experimental portfolio regime with 7 clinic visits.
The report gives a modified intention-to-treat analysis of 345 participants, which shows an overall attrition rate that did not differ significantly between the 3 treatments, at 18% for the intensive portfolio, 23% for the routine portfolio, and 26% for the control diet group.
The control diet group showed LDL-C levels that decreased, during the period from inception to week 24, by –3.0 % (-8 mg/dL). The groups counseled to eat the experimental cholesterol-lowering diet showed, for the routine portfolio group, decreased levels of -13.1% (-24 mg/dL) and for the intensive portfolio group, -13.8% (-26mg/dL).
The study authors write, “Percentage LDL-C reductions for each dietary portfolio were significantly more than the control diet. The 2 dietary portfolio interventions did not differ significantly. Among participants randomized to one of the dietary portfolio interventions, percentage reduction in LDL-C on the dietary portfolio was associated with dietary adherence.”
They sum up, “In conclusion, this study indicated the potential value of using recognized cholesterol-lowering foods in combination. We believe this approach has clinical application. A meaningful 13 percent LDL-C reduction can be obtained after only 2 clinic visits of approximately 60-and 40-minute sessions. The limited 3 percent LDL-C reduction observed in the conventional diet is likely to reflect the adequacy of the baseline diet and therefore suggests that larger absolute reductions in LDL-C may be observed when the dietary portfolio is prescribed to patients with diets more reflective of the general population.”
Source: August 23, 2011, Science Daily.
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