Nuts (and Fiber) to High Cholesterol
	Who needs statin drugs when you've got the grocery store? By David Bjerklie

Aug. 4, 2003
Statins, the cholesterol-lowering wonder drugs, are getting a lot of press these days. And, to be sure, they can save lives by dramatically lowering blood levels of LDL, the "bad" cholesterol. But statin drugs are expensive and work only as long as you keep taking them. Also, they can have side effects and should not be taken by people with liver problems.

Which is why it is so heartening to learn that there are diets that can lower your cholesterol nearly as effectively as medication. Writing in the current issue of the Journal of the American Medical Association, researchers at the University of Toronto describe an experiment that compared three different regimens: a vegetarian diet low in saturated fats; the same diet supplemented with a statin drug (in this case, lovastatin); and a fiber-rich vegetarian diet consisting of foods chosen for their known cholesterol-lowering effects (such as oats, barley, soy protein and almonds) as well as a type of margarine enriched with plant sterols (cholesterol-lowering compounds found naturally in leafy green vegetables and vegetable oils).

The results? The low-fat diet reduced LDL cholesterol levels 8%. The same diet with lovastatin reduced cholesterol 31%. The fiber-and sterol-rich diet reduced cholesterol levels 29%--almost the same amount. The magnitude of the reduction is what is so encouraging, says lead author Dr. David Jenkins. "These are food components that research over 25 years has established as having cholesterol-lowering properties," he explains. "What we didn't know, but have now shown, is that their effect is actually additive."

The growing weight of such research has moved the American Heart Association to recommend that these foods be incorporated into heart-healthy diets. For similar reasons, the U.S. Food and Drug Administration now allows the labels on packages containing such nuts as walnuts, almonds, pecans, pistachios and peanuts to claim that they "may reduce the risk of heart disease." Statins will continue to be important, lifesaving drugs. But it's nice to know that you can get the same results without them.

For more information, see jama.ama-assn.org

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