Jan. 28, 2022 — What if you could lower your cholesterol by eating foods that you like?
A new study shows that when people were asked to eat “hedonically acceptable” snacks that contained ingredients known to lower cholesterol, nearly all of them did.
In contrast, only about half of people asked to change their diets substantially to lower cholesterol followed the diet in a previous study.
Neither type of dieting reduces “bad” cholesterol as much as statin drugs do, but the special ingredients in the tasty snacks “can rapidly and meaningfully reduce LDL cholesterol in adult patients unable or unwilling to take statin drugs,” according to the study.
Published in TheJournal of Nutrition, the trial was done by researchers at the Mayo Clinic, the University of Manitoba, and the Richardson Centre for Functional Foods and Nutraceuticals in Canada.
The researchers recruited 59 people to take part in the study, though five of them dropped out. That left 18 men and 36 women, with an average age of 49, who were put into treatment and control groups.
There were two treatment periods of 4 weeks each, separated by a “washout” period of the same length. During the treatment phases, the participants were told to eat a variety of ready-made snacks twice daily as a substitute for something they were already eating. Other behavior changes were discouraged.
The people in both groups could choose snacks from six products that were identically packaged and coded by Step One Foods of Minneapolis, which took part in the study. These foods included oatmeal, pancakes, cranberry bars, chocolate bars, smoothies, and a granola-type offering.
The treatment group received modified versions of these snacks that included ingredients that have been shown to improve heart health. The control products were similar items from grocery stores and supermarkets. For example, standard store-bought granola was the control for the study granola, with serving size adjusted to have the same calorie count.
Lower Cholesterol, Higher Compliance
LDL cholesterol was reduced by about 8.8% on average in those who got the modified snacks, and some participants had reductions of 20% or more. Total cholesterol was reduced by an average of 5.1% with treatment foods, compared with control snacks. But HDL cholesterol, triglycerides, serum glucose, insulin, and high-sensitivity C-reactive protein concentrations were not significantly different between the control groups.
The vegan portfolio diet, which also delivers high concentrations of fiber and plants, has been shown to help cut LDL cholesterol by 17% when combined with a nationally approved cholesterol education program. That said, “because such a large part of the diet must be controlled, user compliance has been poor,” according to the new study.
Specifically, the rate of people sticking to the diet trial was less than 50%, snack study co-author Stephen L. Kopecky, MD, a professor of medicine at the Mayo Clinic, says. In contrast, the compliance of people in the new study was 95% with the treatment food and 96.5% with the control food.
Statins have a much greater effect than any diet on cholesterol reduction. For example, in the snack study treatment group, LDL cholesterol dropped by about a third of the decrease that can be achieved by taking statin drugs.
Kopecky believes people who consume these snacks regularly could reduce their LDL cholesterol further. But he sees this kind of dieting as a complement to statins, not as a substitute.
The biggest immediate value of this approach, he says, would be to help people who are unwilling or unable to take statins. He estimates this includes 15%-20% of patients whose cholesterol is high enough to merit a statin prescription. With close to 40% of Americans at risk for heart disease because of high cholesterol, that’s a lot of people.
In the long term, Kopecky hopes that the food industry will supply more foods that genuinely lower cholesterol, rather than just claiming to do that. But food companies follow what the market wants, he says. Americans are unlikely to eat more healthy foods than they do now; in fact, they get 57% of their calories from ultra-processed foods like frozen dinners and chips. So maybe changing the content but not the taste of some of those foods would have a positive effect, he suggests.
“If the food industry follows this lead and people start eating these foods, and you could lower cholesterol by 10% across the country, that would have huge health implications,” he said.