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Tell me more about the cholesterol diet you mentioned on TV

Asked by Diane Cronin, United States

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What is the name of the new diet to lower cholesterol that Dr. Sanjay Gupta talked about on "House Call" on CNN?

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Diet and Fitness Expert Dr. Melina Jampolis Physician Nutrition Specialist

Expert answer

Hi Diane,

The cholesterol-lowering diet that I referred to on "House Call with Dr. Sanjay Gupta" is not a specific diet but rather a dietary portfolio of cholesterol-lowering foods. The study that I referred to was published in the American Journal of Clinical Nutrition in 2005 by a group of researchers in Canada. In the study, they took 34 people with high cholesterol and put them on three separate "treatments" (in random order) for one month each. The "control" treatment (the standard diet with which the two others were compared) consisted of a very low saturated fat diet. The second treatment consisted of the same very low saturated fat diet plus a 20 mg dose of a popular statin medication. The third treatment was the portfolio diet, which consisted of the following cholesterol-lowering foods. (The amounts were based on total calories the subjects consumed, which varied):

1. Plant sterols (1.0 gram for every 1,000 calories consumed) -- these are found in nature but at smaller doses, so they are added to foods including butter spreads, yogurts, and even tortilla chips at higher concentrations

2. Soy-protein foods (including soy milk and soy burgers) -- 21.4 grams per 1,000 calories

3. Almonds (14 grams per 1,000 calories)

4. Viscous fiber (10 grams per 1,000 calories) from oats, barley, psyllium, and the vegetables okra and eggplant

After one month, the control group showed an 8.5 percent drop in LDL (bad cholesterol), the group taking medication showed an average 33.3 percent reduction in LDL, and the portfolio diet group showed a 29.6 percent reduction in LDL. Amazingly, 26 percent of the participants actually achieved their lowest LDL (remember all participants spent a month following each treatment arm) following the portfolio diet.

Since this was a very strict study and all the food for the portfolio diet was provided, the same researchers published a follow-up study in 2006 in which they prescribed the same portfolio diet to 66 people with high cholesterol for 12 months, without providing the food, to measure the effects of the portfolio diet under real world conditions. While the results were not quite as dramatic, after one year the average drop in LDL was about 13 percent, and 32 percent of the participants achieved a greater than 20 percent reduction in LDL after one year. Success directly related to how closely participants followed the diet, and those who followed the diet the most closely achieved the best results.

In the past decade, we have come to understand that heart disease is not only associated with elevated cholesterol levels, it also results from inflammation and oxidative damage. A more recent study by the same group published in the journal Metabolism (December 2008) looked at the effect of adding strawberries, as a source of antioxidants, to improve the portfolio diet even further. They found that adding strawberries (454 grams a day, 112 calories, or about 2 servings) compared with additional oat bran bread showed an even more significant reduction in oxidative damage to LDL cholesterol, which could reduce heart disease even further.

It is important to note that while these researchers chose very specific foods, heart healthy choices are not limited to these foods. I recommend that people looking to lower cholesterol and decrease their risk of heart disease increase their intake of brightly colored fruits and vegetables (for antioxidants), increase viscous fiber (with whole grains including but not limited to oats, barley, psyllium), replace a portion of the animal protein in their diet with plant based protein (including beans, soy protein, and nuts), and add nuts and seeds in moderation. Portion control is key since weight gain may offset the benefits of a heart healthy diet. In addition, it's a good idea to eat salmon or any fish high in omega 3 fatty acids (tuna, sardines, mackerel, halibut) at least twice a week (or take an omega 3 fatty acid capsule daily), consider having a glass of wine with dinner (no need to start drinking if you don't already but wine may help raise the good HDL cholesterol and also contains antioxidants), and try to get at least 30 minutes of exercise on most days.

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