Statins and food work well apart, but better together - The Cholesterol Report - Brief Article

The class of medications called statins has had remarkable success in lowering problem cholesterol levels, but don't think you can pop a Pravachol and head for Pizza Hut. The drugs work even better when combined with a healthy eating plan, concludes a new study from the Social Insurance Institution in Turku, Finland.

In a randomized, controlled crossover trial, switching hypercholesterolemic men to a Mediterranean diet reduced total cholesterol counts by 7.6 percent and low-density lipoproteins (the "bad" cholesterol) by 10.8 percent. Meanwhile, patients who started on simvastatin (brand name Zocor) dropped their total cholesterol by 20.8 percent and their LDL by 29.7 percent. (The drug also raised levels of HDL, the "good" cholesterol, by 7 percent.)

Rather than duplicating efforts, both therapies were found by the researchers to be "independent and additive." Making the nutritional changes "potentiated the cholesterol-lowering effect of simvastatin."

"The main goals of the dietary treatment were to reduce energy intake from saturated fats plus trans-unsaturated fats to no more than 10 percent," explains study leader Antii Jula, M.D. These heart-harming fats were partly replaced with monounsaturated and polyunsaturated fats rich in omega-3 fatty acids (such as those found in olive oil and fish oil) and an increased intake of fruits, vegetables and dietary fiber.

"A proper diet will give additional benefits to the statin treatment," says Jula. Along with its effect on cholesterol, he points out, the diet changes seemed to counteract a 13 percent rise in insulin levels caused by the simvastatin.

Other side effects of the medication included depressed levels of the antioxidants vitamin E, beta-carotene and ubiquinol, which should be evaluated in a long-term investigation, says Jula. Glucose levels remained unchanged in all groups. The results were published in the Journal of the American Medical Association.

Coincidentally, another Finnish study has shown the efficacy of a twofold approach to cholesterol. While plant sterols have been shown to lower cholesterol when incorporated into nutritional fats such as margarine, enriching low-fat foods had not been examined. Researchers at the Helsinki University Central Hospital compared two groups on low-fat diets, with one group eating breads, meats and jams enriched with plant sterols. While the first group demonstrated a 3 percent decline in total cholesterol and a 5 percent drop in LDL, those on the sterols reduced total cholesterol by 8 percent and LDL by 13 percent.

"The presence of mineral nutrients in doses recommended for blood pressure-lowering did not interfere with the cholesterol-lowering efficacy of the sterols, providing a promising approach to dietary prevention of cardiovascular diseases," concludes the report, published in the American Journal of Cardiology.