Lower Your Cholesterol Without Taking Medications!

There once was a time when it was considered normal to have a total cholesterol of 300mg/dL.  However, like the dodo bird, that time has long since passed.  With the release of multiple studies, starting with the Framingham Heart Study, we've lowered and lowered our target goals.  Initially, our armamentarium was rather limited but gradually, we developed more powerful agents in the fight against cholesterol.  In recent years, statins have become the de facto standard 1st line agent of choice.  However, these statins are not without their limitations and side effects, such that many of my patients have asked about taking something natural, rather than synthetic, something with a better safety profile.

Let me first note that statins are actually a derivative of red yeast rice (RYR).  Given the lack of 3rd party oversight of manufacture & sales of nutritional supplements, I would venture that statins are in fact safer & more reliable than unmonitored RYR, as noted in a study published last October in the Archives of Internal Medicine.  Yet our faith in purportedly natural and organic products continues to overwhelm the evidence of safety and efficacy of our pharmaceutical products.

Lest this become a lovefest for Big Pharma, let me reassure you that I am using this as an introduction into ways to naturally lower your cholesterol as published in a small short randomized controlled trial in today's JAMA.  More specifically, the authors randomized 351 healthy patients w/o baseline heart disease, cancer or diabetes to a specific dietary portfolio of plant sterols, soy protein, viscous fiber, and nuts over 6 months in conjunction with either 2 clinic visits or 7 over this period for time or to a control diet consisting of high fiber & whole grains but without the portfolio components.

Those who increased consumption of plant sterols, soy protein, viscous fiber & nuts noted 13+% lower LDL, equivalent to switching from no statin to lowest dose and then to 2nd lowest (remember that the rule of 6's expects an approximate 6% lower LDL with each doubling of the statin's dose).  Unfortunately, time spent with a nutritionist did not appear to make a difference.  To be clear, the participants in the active arm of the trial had to consume 0.94g plant sterols, 9.8g of viscous fiber, 22.5g soy protein, and 22.5g nuts per 1,000kcal of energy daily. 

As noted yesterday, good nutrition plays a strong part of our health & mortality.  However, this study demonstrates that telling our patients to eat more fruits & veggies might not be enough to lower their cholesterol.  We have to be more specific in the details.  But if they can adhere to these 4 tenets of lipid lowering, they can expect some very impressive results without resorting to statins.