TORONTO — A vegetarian diet high in soluble fibre and low in saturated fats can lower bad cholesterol levels as effectively as some commonly prescribed drugs, a new study has shown, suggesting medication-free cholesterol control may be a viable option for some people.
Researchers from the University of Toronto showed that a diet heavy in foods such as okra, eggplant, soy proteins, oatmeal and almonds resulted in a 28.6 per cent reduction in LDL cholesterol levels after just one month.
Study participants who followed a low fat diet and took a common cholesterol-lowering drug, lovastatin, achieved a 30.9 per-cent reduction in LDL cholesterol over the same period. Statistically those two results are virtually the same.
It's part of a continuing effort by a team led by Dr. David Jenkins - the man who brought the world the Garden of Eden diet - to devise a regime that lowers cholesterol, appeals to modern taste buds and can be incorporated into a busy lifestyle.
"What we have to do is we have to marry effectiveness with tolerability," said Jenkins, director of the clinical nutrition and risk modification centre at St. Michael's Hospital.
"And this diet's got the right sort of mix of tolerability and effectiveness to suit a number of people. Not everyone, but a number. This is the first time we've been able to combine those two aspects."
The findings, published Wednesday in the Journal of the American Medical Association, were greeted with enthusiasm by people familiar with Jenkins's work and those interested in finding ways to improve overall heart health.
"This reduction in LDL cholesterol should reduce risk of heart attack by about 60 per cent. Six-zero, yeah. So it's a big-time reduction," said Dr. James Anderson, an endocrinologist and nutritionist at the University of Kentucky, who wrote a commentary on the study for JAMA.
The rule of thumb is that for every one per cent reduction in LDL cholesterol, one gains a two per cent reduction in risk of having a cardiac event, explained Dr. Andreas Wielgosz, a spokesman for the Heart and Stroke Foundation.
Low density lipoprotein or LDL cholesterol is responsible for the fat layers that build up inside the walls of blood vessels, which can lead to hardening of the arteries and heart disease.
"It shows what can be achieved in a very short time - within a month they were able to get these levels down," said Wielgosz, head of cardiology at Ottawa Hospital.
"I think it's very exciting. I think this is the way to go. . . . The work that Dr. Jenkins and others are doing in refining these food choices is going to help people lower those cholesterol levels without necessarily going to drugs."
Jenkins and his colleagues earned worldwide attention a few years ago when they published a paper on their Garden of Eden diet, based on the roots, shoots and berries consumed by our cave-dwelling ancestors. Within two weeks on that diet, study participants saw their bad cholesterol levels plummet by 30 per cent.
The problem was, consuming enough calories to maintain ones starting weight was an all-day affair. (Because weight loss can trigger a drop in cholesterol, it is important that participants in these studies don't lose weight and muddy the results of the studies.)
People on the Garden of Eden diet had to eat 5.2 kilograms of food a day on average. And many complained about the lack of variety - and taste - among the foods.
So the team has been at work ever since trying to devise a more varied and easy to follow food plan, one they've dubbed the Portfolio diet.
For this study, they tested it out against a low fat diet (which reduced LDL cholesterol by eight per cent) and the low fat diet plus the statin. A total of 46 people completed the study, with 16 in the Portfolio diet arm.
The diet is rich in Jenkins calls viscous fibre - sticky fibres proven to help clear cholesterol from the blood. They are found in foods like barley, oatmeal, okra and eggplant.
The daily volume of food was about a third of that of the Garden of Eden diet, Jenkins said, adding the people who followed it didn't complain about how much they had to eat but said they couldn't eat any more.
Those who lost weight were asked to, however.
"Some of them did ... but we just force-fed them until the weight came back up to where they started," he said. "They complained bitterly about that - (but) not the other aspects of the diet."
In fact, about 40 per cent of those who followed the diet said it was one they could live with. (An equal percentage said they would need more variety of foods to be happy and 13 per cent said they couldn't do without meat.)
Jenkins took those comments as a sign they are getting closer to a diet that could work outside of a clinical trial setting.
"We're not just long-faced puritans ... eating raw carrots and all bran and wear hair shirts. Not quite like that," he said with a chuckle.
However, Anderson's commentary noted that - as in Jenkins's earlier studies - participants all had their food provided for them and the study period was merely a month. The commentary questioned whether people would follow the diet if they had to secure the foods - some of which aren't always stocked in neighbourhood grocery stores - themselves or whether they could follow it for sustained periods of time.
Jenkins anticipated those questions, noting next week a new study begins in which participants will be told what to eat but will be asked to buy their own food. They are to follow the diet for six months, he said.
Funding for the study came from the Canadian Natural Sciences and Engineering Research Council of Canada, Loblaw Brands Ltd., the Almond Board of California and Unilever Canada
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Study: Diet works well to lower bad cholesterol
I'll have to look into that. I'm not a fan of oatmeal, okra or eggplant. 
I'd only eat barley if...
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