Despite the well-documented benefits of cholesterol-lowering drugs called statins, a new study from Finland shows that diet can still make a difference in patients taking these drugs when it comes to keeping cholesterol under control.
In a study of men with high cholesterol, a combination of a Mediterranean-style diet and the drug Zocor was more effective at lowering cholesterol than either approach alone. The diet also counteracted some of the detrimental effects of the drug.
Based on the findings, the study's authors say that the importance of a healthy diet needs to be emphasized to patients taking statins.
A Mediterranean-style diet is rich in fruits, vegetables, grains and nuts. It includes few saturated fats, but plenty of healthier fatty acids like the ones found in olive oil. This diet has also been shown to reduce the risk of heart disease.
Both approaches lowered total cholesterol and LDL, with simvastatin lowering levels about three times as much.
But the cholesterol-lowering drug reduced levels of three important antioxidants -- vitamin E, beta-carotene and coenzyme Q10 -- by 16% to 22%. The health consequences of the decline in these antioxidants is not known and needs to be evaluated in long-term studies.
In contrast to statin therapy, the Mediterranean diet only caused a slight decrease in vitamin E levels.
Another benefit of a Mediterranean diet, according to Jula, is that it may counteract statins' potentially harmful effects on the sugar-regulating hormone insulin. Unlike Zocor, which boosted levels of insulin in the blood, the healthier diet lowered insulin levels.
JAMA February 6, 2002;287:598-605
This is an important topic, because if you believe the new cholesterol guidelines published last year, 36 million Americans should be on these drugs.
However, there is very little reason to take any statin drugs like Zocor for high cholesterol. This study, published in the most widely circulated medical journal in the world, shows that there is a synergistic benefit of applying diet and the drug.
That is an interesting observation, since the diet they used had a considerable amount of grains that will clearly worsen cholesterol levels in most people.
Let us not forget that Baycol, another statin, was pulled from the market last year after it had killed a number of people.
It would have been interesting to see the results head-to-head following the eating plan I advocate versus the statin drugs. I suspect you will find the eating plan produces equivalent, or better, necessary reduction in cholesterol levels, but far superior results to health, which of course, is the main endpoint.
Please remember that your cholesterol level is not some big game to see how low you can get it. The only reason that physician's monitor it is that poor levels are associated with an increased risk for heart disease.
Also, remember that most people who have a heart attack have cholesterol levels around 180. The major problem with heart disease risk, but hardly ever emphasized in the literature, is the ratio of HDL to cholesterol.
The finding that statins lower antioxidant levels in people taking them has been posted in this newsletter before. That is why you will want to take vitamin E and coenzyme Q-10 if you do take statins for any reason.
However, my suggestion is to aggressively implement the eating plan, as when that is combined with an exercise program, it seems to work in normalizing cholesterol in over 95% of people, without the use of drugs or supplements.
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