Ask Your Doctor if Foods are as Good as Statin Drugs
By Hunter Yost M.D.
Tucson Green Times – July 2010
Lipitor is the most profitable drug in history, achieving the highest sales in the world of any drug. Consistently ranking No. 1, Lipitor holds the title by a wide margin. Its annual sales of $16 billion were more than twice that of the next drug on the list in 2005, according to Consumer Reports. Combined statin sales were $25 billion in 2008 according to industry sources. Until last year, when surpassed by the antipsychotics, statins had been the highest selling class of drugs for the previous five years.
The tediously repeated commercial tagline, “When diet and exercise aren’t enough, ask your doctor about (the statin drug),” discourages people from even thinking about the question “Could food changes be as good as statin drugs?”
Yet this question was asked and studied by Canadian researchers several years ago. According to the 2003 issue of The Journal of the American Medical Association, adding soy protein, viscous fiber, and nuts can be as effective for lowering cholesterol as adding a statin to a low saturated fat diet.
In this four-week study, 46 relatively healthy adults with elevated cholesterol, including 25 men and 21 postmenopausal women (average age, 59 years; average body mass index, 27.6), were randomized to one of three diets. The control diet was very low in saturated fat, based on milled whole-wheat cereals and low-fat dairy foods, such as skim milk, fat-free cheese, and yogurt. The statin group received the same diet plus lovastatin (Mevacor), and the dietary portfolio group received a diet containing plant sterols (2g or .4 tsp), soy protein (42.8 g or 3 tbsp), viscous fibers (20 g or 4 tsp), and almonds (28 g or 2 tbsp) with 30% calories from fat. All of the groups followed a low-saturated fat vegetarian diet of approximately 2,000 calories with all food provided to the participants except fresh fruit and vegetables.
LDL-Cholesterol decreased by 8 percent in the control group, 30.9 percent in the statin group, and 28.6 percent in the dietary portfolio group. C-reactive protein (an inflammatory blood marker with just as much risk as cholesterol) decreased by 10 percent 33.3 percent, and 28.2 percent, respectively.
Most people lost weight. The significant reductions seen in the statin and dietary portfolio groups were significantly different from changes in the control group, and the efficacy of the dietary portfolio treatment was not significantly different from that of the statin treatment. Of the dietary components, it was the soy protein that had the strongest effect in lowering LDL cholesterol and raising HDL and preventing inflammation.
The authors concluded that the diet could “provide a potentially valuable dietary option for cardiovascular disease risk reduction in primary prevention,”… “For most patients, dietary intervention should be the first line of therapy … before introducing pharmacotherapy for hyperlipidemia.”
Although the research team reported that adherence to the diet exceeded 90 percent, about 40 percent of participants in the dietary portfolio group criticized the poor food variety and 27 percent thought the food volume was too great. This may be because they were not accustomed to eating a diet of high fiber foods and the increased amounts of vegetables and fruits.
Plant sterols had an additive effect with the fiber and soy in improving the cholesterol profile The FDA has approved the following claim for phytosterols (plant sterols): “Foods containing at least 0.4 gram per serving of plant sterols, eaten twice a day with meals for a daily total intake of at least 0.8 gram, as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease.”
Whole grains are rich in plant sterols, rice bran, oat bran, wheat germ, whole wheat and brown rice. Legumes are great sources of plant sterols, dried peas, dried beans, garbanzo beans and lentils. Nuts and seeds (unsalted) contain plant sterols such as almonds, walnuts, pecans, peanuts, sunflower seeds, pumpkin seeds and sesame seeds. Vegetables and fruits also contain plant sterols.
To get the improved cholesterol effects from diet one does not have to follow a vegetarian diet as in the study. The Mediterranean diet – with poultry, fish, lamb and wild game, and all of the foods mentioned above – can also provide the same beneficial effects.
There have been no commercials on TV about this Canadian study saying “Diet and exercise are enough for the vast majority of people.” In a future article I will go into more depth about the limitations of statin drugs.
Author: Hunter Yost M.D. is in private practice in northwest Tucson where he specializes in Functional and Nutritional Medicine.
