Public agencies concerned with cardiovascular health always stress the importance of diet and lifestyle as the primary means of lowering fats in the blood and coronary heart disease (CHD) risk. But if your cholesterol goes over the danger line, it’s fairly likely that your doctor will prescribe statins (Lipitor, Crestor or Zocor) and a low saturated fat diet. The doctors probably do this, rather than encouraging other dietary changes, because it’s difficult to get people to eat in a manner that will move the cholesterol in the right direction. Also, they are taught a large arsenal of treatments for illness using strong medications and surgery. Life-style changes are hard to do and seldom profitable. So for many people statins will continue to be the most common treatment aimed at reducing risk of CHD.You may have noticed how many studies say something like, “This is initial information; we still need the gold standard, ‘A Randomized Control Trial.” Randomized Control Trials are expensive and challenging to conduct. But a new study in the August 24, 2011, Journal of the American Medical Association (JAMA) is an actual randomized controlled trial using diet to control cholesterol, instead of statins.

The Canadian researchers found and reported interesting results. They compared three different dietary regimens: a low-saturated fat diet, a diet that emphasized cholesterol-lowering foods and two counseling sessions, and a cholesterol-lowering foods and seven counseling sessions. Each group adhered to the plan for 6 months. The people who had the counseling on cholesterol-lowering foods had 13 to 14% percent cholesterol drop; those who were on the low-saturated fats had only a 3 percent drop.

So the knee jerk reaction is to give up on watching the saturated fat, but a 3% drop is moving in the right direction; so don’t start loading up on the cheese, butter, ice cream and red meat.

If you don’t have a great pharmacy plan, or are like me, averse to taking any drug if diet and exercise are as good or better, you may want to take a second look at the ‘portfolio’ eating plan of the JAMA article. It really is pretty exciting to see the 13 to 14% drop by eating the portfolio of foods. One of the hidden benefits is that the foods that were in the ‘portfolio’- eating plan are relatively inexpensive. Compare the price of refined, sugar laden, processed cereal with oatmeal. Lentils, beans, peas, and barley are frequently seen as the paradigmatic example of eating cheap – “If I lose my job, I’ll be eatin’ beans.”

David Jenkins M.D., the lead researcher said that it doesn’t really take much; some soy protein, a handful of nuts, some sterol-enriched margarine and two servings of oatmeal a day can really make a difference.

One of the big differences in this study is that they had to replace foods; not just avoid foods, like a traditional low saturated fat diet. The study shows that what you do eat is really important; not just what you don’t eat. It can be tough to make the changes, but I guess if you’re as motivated as I am to stay off the statin drugs, I’d certainly be glad to give it a try. In reality, we’re already ‘giving it a try’ at our home, as you know if you read this blog often. It seems to be working well for us.

The foods in the portfolio plan include foods with lots of soluble fiber; soy products, and margarine supplemented with stanols.

Soluble fiber is often ‘gummy’ – think of cooked okra and oatmeal. Fruits, barley, nuts, beans are the champions for soluble fiber. A fabulous chart showing both soluble fiber and insoluble fiber; published by the Harvard School of Public Health can help identify great foods loaded with fiber. What I like about the Harvard fiber chart is that it shows both the soluble fiber and the insoluble fiber; and that really helps illustrate how foods in nature often contain both types of fiber. Please notice that the foods are fruits, vegetables, nuts and legumes. We don’t get a significant amount of fiber from meat, eggs, cheese, milk, and sugar.

Not only are the soluble fiber foods especially good at lowering LDL-cholesterol (the bad kind), but it also slows the conversion of carbs to blood sugar and helps you feel full longer – helping you control your weight – perfect for diabetics, pre-diabetics and those working on weight management. The mechanism is not just the soluble fiber ‘soaking’ up the bad LDL-cholesterol, but also plant sterols (stanols) occur in many vegetables, grains, nuts, legumes and fruits. These compounds (stanols) mimic LDL cholesterol in the intestine, and compete with the LDL cholesterol; the result is that the body wastes some of the LDL cholesterol – and that’s good.

You may have read recently that President Clinton has turned his back on burgers and fries (the World’s killer diet); after learning about the power of whole plants, he has made a decision to become a vegan. We’re talking ‘no animal’ foods – that’s amazing. He’s trying to reverse his heart disease, guided by Dean Ornish and others. It’s apparent that President Clinton has been convinced that he could reverse his heart disease – good for him. I hope that we don’t all wait until we have heart attacks and bypasses, to decide to do something about our diet, exercise and ultimately our health.

Certainly, we at Dr. Grandma’s don’t want to sway you from following your doctor’s orders; but we would encourage you to eat the way the poor Mediterranean peoples of the 1950’s and before, ate. This was an era before they could afford much meat. They ate primarily plants (tomatoes, eggplants, okra, greens and more greens, nuts, fish, seeds, and plenty of fruit) and they used olive oil. They did not eat much meat (couldn’t afford it), cheese, processed grains, or sugar. Whole plants powered these people; but they did not know or probably even appreciate that they had the lowest CHD risk in the world at that time.

The real challenge may be in learning how to make it happen – the change from the World’s Killer Diet to a plant-based eating style. Learning how to cook with greens, whole grains, soy, legumes, and nuts; and how to replace most of the processed white flour products, the sugar, sugar, sugar (in all its forms); red meat; and the fatty/salty junk food and restaurant foods.

I realize that this new research is not exactly a news flash, if you’ve been reading this blog for a long time. But we strive to continue to provide a well-documented body of knowledge. It’s more than interesting – it is compelling – that such a huge preponderance of research keeps coming up with essentially the same story. If we start making changes now, there may be hope ahead to avoid the statin drugs and the high risk of CHD at the same time.