Effectiveness of Altering Serum Cholesterol Levels Without Drugs

Abstract

Drug therapy with statins and other agents can result in dramatic lipid-lowering effects. Despite the wealth of data supporting the beneficial effects of pharmacologic therapy on cardiovascular risk, patients often express a desire to accomplish similar goals with diet alone. And, except for patients with extreme cholesterol elevations, consensus panels all promote dietary therapy as an initial step in the treatment of hyperlipidemia. This review examines a variety of dietary strategies designed to lower lipid levels, including the American Heart Association diet, the Ornish diet, the Mediterranean diet, exercise, phytosterols, fiber, soy products, and fish oil. Though the declines in low-density lipoprotein cholesterol levels with these methods range from 0% to 37%, cardiovascular risk may be more significantly impacted than would be predicted from these changes alone. Significant benefits can be reaped from nonpharmacologic measures.

Changes in Lipid Profile of Wistar Rats after Sustained Consumption of Different Types of Commercial Vegetable Oil: A Preliminary Study

“…Based on our results, however, we can say that the addition of vegetable oils to the diet improved HDL values. These results are consistent with other studies showing that diets low in fat and high in carbohydrates succeed in lowering LDL values; however, these diets also lower the levels of HDL [43]. The fact that partially hydrogenated oil generates significantly higher HDL values compared with high MUFA oils is strange.…”

Evaluation of a PDA-based Dietary Assessment and Intervention Program: A Randomized Controlled Trial

“…A research assistant next contacted the potential participant's physician to obtain approval to follow the Ornish Prevention Diet, a verylow fat, vegetarian diet. The Ornish diet was selected because it is diet with considerable research support [17] but is also a restrictive diet that is difficult for most to follow [18].…”

Statins and primary prevention: Is all the evidence in?

“…Biochemically significant decreases in LDL-C, together with statistically and clinically significant decreases in coronary artery disease (CAD) and all-cause mortality, were not observed until the advent of 3-hydroxy-3-methylglutaryl coenzyme A (HMGCoA) inhibitors, or statins, more than two decades ago (6). More recently, intensive lifestyle modifications, either with diet alone (ie, incorporating the low-fat Ornish diet) or with diet and moderate exercise, have been found to produce large reductions in LDL-C (up to 37%) and significant reductions in the extent of atherosclerosis development (7). These studies, however, have generally been carried out in relatively small numbers of individuals, in contrast to the landmark statin trials, and should be repeated with larger study populations to make more conclusive and specific recommendations about lifestyle interventions.…”