Millions of Americans pop statins to keep their cholesterol levels down. But new research suggests that cholesterol-friendly foods, such as soy products and tree nuts, may also contribute to lowering LDL, or "bad," cholesterol levels.
The study, published in the Journal of the American Medical Association, found that people who ate a healthy diet filled with cholesterol-lowering foods experienced a 13 percent decrease in their LDL cholesterol levels. Those who followed a diet low in saturated fats experienced a 3 percent decrease.
"The main takeaway here is that people can lower their cholesterol with diet if they put their minds to it," said Dr. David Jenkins, a professor of nutrition and metabolism at University of Toronto and lead author of the study. "These can be small changes. We're not asking people to live behind bars."
Jenkins created the "portfolio diet," which combines foods that allow maximum benefit in lowering cholesterol and preventing heart disease. The regimen includes regular consumption of tree nuts and high amounts of fiber from oats, barley and vegetables. The diet says to replace butter with plant sterol-enriched margarine and substitute soy-based products for meat.
"The study highlighted the power of food to lower risk for cardiovascular disease: What you do eat and what you don't eat are both important," said Dr. Jane Klauer, a New York internist specializing in metabolism and nutrition.
While Jenkins said most study participants followed a moderately healthy diet to begin with, it's possible for people to see positive changes in their cholesterol levels even after making small changes to eating regimens.
"Replacing sources of saturated fat, such as red meat and dairy products, with sources of healthy fats, such as nuts and soy products will definitely have greater benefits than replacing red meat and dairy products with carbohydrates," said Dr. Walter Willett, professor of epidemiology and nutrition at the Harvard School of Public Health.
Before suggesting medication, doctors generally encourage high cholesterol patients to change their diet and lifestyle. If noninvasive measures do not sufficiently lower the levels, they will often prescribe statin drugs, which reduce the production of cholesterol in the liver.
"Diet should be used with drugs to reach LDL and non-HDL cholesterol goals," Dr. Robert Eckel, director of the General Clinic Research Center at Colorado Health Science University, wrote in an email to ABCNews.com. "The bulk of evidence indicates the importance of fruits and vegetables, whole grains (fiber), lean poultry and fish to reduce cardiovascular disease risk."
"If goals are not reached with lifestyle changes (including appropriate amounts of physical activity), statins are the drug of choice to reduce cardiovascular disease risk," continued Eckel.
The study had only a six-month follow-up, and many experts suggested a longer follow-up period was necessary to understand the long-term effects of the portfolio diet.
Many experts also noted that an herbivorous, or plant-based, diet would be difficult for meat eaters to maintain.
"The diet was vegetarian and, not surprisingly, had dropouts, even with the counseling," said Dr. Merle Myerson, director of the Cardiovascular Disease Prevention Program at St. Luke's and Roosevelt Hospitals. "I don't think that really long-term adherence would be good.
"The authors state that this is 'long-term.' I don't feel that six months is long term."
"Convincing people to change dietary patterns is difficult, much less convincing them to become vegetarians," said Klauer. "Change is difficult for people. But as they are rewarded with looking and feeling more vital, they are motivated to persevere."