For patients with high levels of bad cholesterol, doctors routinely reach for two remedies: cholesterol-lowering statin drugs and a diet that cuts out foods high in saturated fat, such as ice cream, red meat and butter. But new research has found that when it comes to lowering artery-clogging cholesterol, what you eat may be more important than what you don't eat.
The study in the Journal of the American Medical Association found that incorporating several cholesterol-lowering foods — such as soy protein, plant sterols and nuts — into a diet can reduce bad cholesterol far more effectively than a diet low in saturated fat.
In fact, the authors assert, levels of LDL, the "bad" cholesterol, can drop to half that seen by many patients who take statins. That could drive down a person's risk of fatal heart attack or stroke by 20 percent, the authors wrote.
But this doesn't mean that people on statins should dump their drugs for tofu, said Cleveland Clinic cardiologist Dr. Steve Nissen, who was not involved in the study. Dietary changes do not have nearly the research track record that statins have racked up for heart attack prevention, he said.
"Patients don't want to take the medications, and I'm afraid that if you tell them there's a diet that works just as well, then they'll do that instead," he said.
The Canadian study subjects were told to eat a handful of nuts such as almonds or walnuts every day, and to substitute milk and meats with soy and tofu products as much as possible.
Also key: plant sterols, found in many grains, nuts, vegetables, legumes and fruits. These substances mimic LDL cholesterol particles in the gut, preventing their absorption, and allowing the LDL to be eliminated from the body.
The 345 subjects in the study all had high cholesterol levels and were considered at elevated risk of coronary heart disease. Subjects who incorporated cholesterol-busting foods saw their LDL cholesterol levels decline between 13.1 percent and 13.8 percent after six months.
Those on a low-saturated-fat diet averaged a 3 percent drop in their LDL cholesterol in the same period.