Despite the well-documented benefits of cholesterol-lowering drugs called statins, a new study from Finland shows that diet still makes 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 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.
The research team compared the two cholesterol-lowering approaches in 120 men with untreated high cholesterol. During the first 4 to 6 weeks of the study, the men were randomly assigned to adopt a Mediterranean diet or to continue their normal diet. Then half of the men in each group were randomly assigned to take a statin drug each day. The remaining men in each group took a placebo, which did not contain any medication. After 12 weeks, the men taking the drug switched to the placebo and vice versa.
Both diet and drug therapy provided benefits on their own, and these effects added to each other when used in combination, the researchers report. Both approaches lowered total cholesterol and LDL. But the cholesterol-lowering drug reduced levels of three important antioxidants - vitamin E, beta-carotene and ubiquinol--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.
The Mediterranean diet may also counteract statins' potentially harmful effects on the sugar-regulating hormone insulin. Unlike the drug, which boosted levels of insulin in the blood, the healthier diet lowered insulin levels.
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