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Cholesterol-lowering foods, dietary counseling reduced LDL levels in older men and women

Jenkins DJ. JAMA. 2011;306:831-839.

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Combining a diet composed of cholesterol-lowering foods, such as soy protein, nuts and plant sterols, with dietary advice led to greater reductions in LDL than conventional dietary counseling alone, new data suggest.

Researchers at four centers in Canada analyzed 6-month outcomes of 351 participants with hyperlipidemia who were randomly assigned to one of three interventions between 2007 and 2009: routine dietary advice on a low-saturated-fat diet; routine advice on a dietary portfolio involving two clinic visits during 6 months; and intensive dietary advice on a dietary portfolio involving seven clinic visits during 6 months.

The modified intention-to-treat analysis included information from 345 participants, according to the researchers. By week 24, LDL levels decreased among participants in all three groups. A 3% (95% CI, –6.1 to 0.1), or 8 mg/dL, decrease was noted in the routine dietary advice group; a 13.1% (95% CI, –16.7 to –9.5), or 24 mg/dL, decrease was observed in the routine dietary portfolio group; and a 13.8% (95% CI, –17.2 to –10.3), or 26 mg/dL, decrease was reported in the intensive dietary portfolio group. The researchers also said overall attrition rates were comparable between study arms (18% for the intensive dietary portfolio group, 23% for the routine dietary portfolio group and 26% for the routine dietary advice group).

“This study indicated the potential value of using recognized cholesterol-lowering foods in combination,” the researchers wrote. “We believe this approach has clinical application. A meaningful 13% LDL reduction can be obtained after only two clinic visits of approximately 60- and 40-minute sessions. The limited 3% LDL reduction observed in the conventional diet is likely to reflect the adequacy of the baseline diet and therefore suggests that larger absolute reductions in LDL may be observed when the dietary portfolio is prescribed to patients with diets more reflective of the general population.”

Disclosure: Several researchers report involvement with various companies. The study was also partially funded by Loblaw Brands, Solae and Unilever.

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