Diet Can Lower Bad Cholesterol by the Same Amount as a Statin Can

Current medical professionals would like you to think that only taking statin medicines will lower your LDL cholesterol by an appreciable amount.

What about the effect of the Mediterranean diet on LDL cholesterol level and Creactive protein blood levels?

A study was published in the Journal of the American Medical Association (JAMA) in 2003

Forty-six healthy adult Canadians with high cholesterol (25 men and 21 postmenopausal women) and an average age of fifty-nine years were randomly assigned to undergo one of three dietary interventions in an outpatient setting for one month. The three interventions were a diet very low in saturated fat (the control diet), the same diet plus 20 milligrams of lovastatin per day, or a diet high in plant sterols, soy protein, soluble fiber, and almonds (the Portfolio diet). Both plant sterols and soluble fiber decrease cholesterol levels: plant sterols by inhibiting the absorption of cholesterol and soluble fiber by increasing the excretion of cholesterol in the bowel. Soy protein reduces the synthesis of cholesterol in the liver and may increase the organ’s uptake of cholesterol, thereby lowering the amount of cholesterol in the blood by yet another mechanism.

The main outcomes measured were lipid and CRP levels, blood pressure, and body weight. At the end of four weeks, the control diet group had an 8 percent drop in LDL cholesterol; the statin diet group, a 30.9 percent drop in LDL cholesterol; and the Portfolio diet group, a 28.6 percent drop in LDL cholesterol.

There was no significant difference in the statin and Portfolio diet groups with respect to lowering LDL cholesterol. In other words, you can drop your bad cholesterol the same amount with diet as you can with a statin.

If you look at the ratio of LDL cholesterol to HDL cholesterol (you want that to drop; in other words, you want LDL cholesterol lower and HDL cholesterol higher), the diet that was very low in saturated fat actually caused a 3 percent increase in this ratio, although this was not statistically significant, while the
ratio dropped 28.4 percent in the statin diet group and 23.5 percent in the Portfolio diet group.

CRP dropped 10 percent in the control diet group, 33.3 percent in the statin diet group, and 28.2 percent in the Portfolio diet group. Remember, the reductions in blood cholesterol levels in both the statin diet group and the Portfolio diet group were statistically greater than the changes in the control diet group, but there was no significant difference between the reduction achieved in the statin group compared to the Portfolio diet group. The same thing held true for the CRP reductions. Both the statin and Portfolio diet groups achieved statistically significant greater reductions than the control diet group, but there
was no significant difference between the statin group and the Portfolio diet group in CRP reduction. Women achieved the same benefit as men.

The authors calculated the coronary heart disease risk and found it to be similarly reduced in the statin and Portfolio diet groups (25.8 percent and 24.9 percent, respectively) and significantly greater than the 3 percent reduction in the control group. The bottom line is that the Portfolio diet was every bit as 79
good as statin therapy plus a low saturated fat diet in lowering LDL cholesterol and CRP.

Unlike the JUPITER trial, this study did not receive reams of publicity in the medical and lay presses.

A much larger study of the effects of the Mediterranean diet on risk factors for heart disease was reported in the Annals of Internal Medicine in 2006.9 In this trial, 772 healthy people between the ages of fifty-five and eighty—without symptoms of heart disease but considered at risk—were randomized to either a low-fat diet recommended by the American Heart Association or one of two Mediterranean diets. The study took place in ten medical centers in Spain.

Participants had to meet at least one of two criteria: (1) a diagnosis of adultonset diabetes or (2) three or more risk factors for ASCVD such as current smoking, high blood pressure, high LDL cholesterol, low HDL cholesterol, being overweight, or a family history of premature coronary heart disease (CHD). Those assigned to the Mediterranean diets were given nutritional education and either 1 liter of extra-virgin olive oil a week or 30 grams per day of walnuts, hazelnuts, and almonds. The outcomes were measured at three months, and included body weight, body mass index (BMI), waist measurement, blood pressure, blood lipids, blood sugar, and inflammatory markers.

However, the entire study, which involves about nine thousand people and which goes by the acronym PREDIMED, standing for the Prevención con Dieta Mediterránea study, was projected to last until 2011. The primary end point was to be the composite of cardiovascular death, nonfatal heart attack, and nonfatal stroke. This article just reported data obtained after three months on the diets, in a subset of the entire study population.

Body weight, BMI, and waist measurements declined slightly in all three groups but were not significantly different among the groups. Compared to the people assigned to the low-fat diet, those on either of the two Mediterranean diets exhibited significantly reduced systolic and diastolic blood pressures and blood sugar levels. They also decreased their ratio of total cholesterol to HDL cholesterol and increased their HDL cholesterol level. Total cholesterol and triglyceride levels decreased only in the Mediterranean diet with nuts group.

The Mediterranean diet groups also demonstrated improved sensitivity to insulin, the hormone that regulates blood sugar levels, a beneficial finding in that resistance to the action of insulin is associated with many adverse cardiovascular effects.

The researchers also found interesting changes in various inflammatory markers. CRP levels decreased only in people who were on the Mediterranean diet supplemented with olive oil. There were no significant changes in CRP in people on the low-fat diet or the nut-supplemented Mediterranean diet. The average decrease in CRP in the olive oil–supplemented group was an impressive 0.54. Interestingly, the study also looked at some other inflammatory markers and found that all decreased significantly in people on either
Mediterranean diet, and increased significantly in the low-fat diet group. In other words, the low-fat diet preached by the AHA for years actually increased the amount of inflammation in the body, thereby increasing the likelihood of atherosclerosis!

And despite the fact that the Mediterranean diets were high-fat diets, and many of the people in the study were diabetic or obese, there was no weight gain on average when these diets were supplemented with sizable amounts of unsaturated fats in the form of nuts and olive oil. In fact, there was slight weight




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