Plasma low density lipoprotein (LDL) cholesterol is associated with cardiovascular disease, although the cause and effect are continually misrepresented by the mainstream medical establishment. Based on the preconceived idea that raised plasma LDL cholesterol is a cause of cardiovascular disease, pharmaceutical companies have aggressively marketed cholesterol lowering drugs. The latest group of these drugs is the first and subsequent second generation statins, which are marketed as being superior to the early cholesterol lowering drugs such as clofibrate. In addition, dietary advice to control plasma cholesterol from mainstream healthcare is centred around restriction of dietary cholesterol and saturated fat, despite a lack of scientific evidence showing that dietary lipid intakes affect blood lipid levels. In contrast, the nutritional sciences have accumulated strong evidence that intakes of certain dietary factors can beneficially modify plasma lipoprotein levels, with magnitudes of deviation similar to the best results seen with statins.
For example, researchers1 have investigated the effect of four cholesterol lowering foods in comparison to the statin drug lovastatin, on the blood lipids of 66 hyperlipidaemic subjects. Subjects were instructed to alter their diet to include 1.0 g per 1000 kcal plant sterols from a margarine, 10 g per 1000 kcal viscous fibre from oats, barley, psyllium, okra and eggplant, 22.5 g per 1000 kcal soy protein from soy milk and soy meat, and 23 g per 1000 kcal whole almonds. Data from this 12 month trial was compared to data collected from the same subjects during a 1 month trail of first generation statin drugs, using 20 mg per day of lovastatin. After 1 year, 31.8 % of the subjects had LDL cholesterol reductions >20 % and the reductions were not significantly different from the reductions for these subjects seen when taking lovastatin.
Associations between LDL cholesterol reductions and adherence to the diet showed that the dietary changes were as effective as the drug regimen at lowering LDL cholesterol if patient compliance was considered. When those subjects that did not adhere fully to the diet were included, the diet was still able to lower LDL cholesterol by 14 and 12.8 % at 3 months and 1 year, respectively. Overall, compliance was satisfactory for the almonds and for the plant sterol margarine, but not for the fibre and soy protein. Interestingly, during the 1 year trial, there was a significant weight loss amongst the subject (-0.7kg). This is interesting because blood lipid improvements are associated with weight loss. It is therefore tempting to speculate that the weight loss experienced by the subjects was the cause of the beneficial changes to plasma LDL cholesterol concentrations, as has been reported elsewhere.
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