Microsoft word - 7f - anti-cholesterol diet abstract.doc

HYPOCHOLESTEROLEMIC FOODS AND THEIR MEANS OF ACTION Functional foods providing plant sterols (called phytosterols) or plant stanols (called phytostanols) have literally invaded our
supermarkets. Multiple studies have demonstrated their capacity to lower LDL cholesterol levels by 10 to 15% within 2 months [1-3]. To be efficient, daily intake must reach 2 g/day, but higher dosages don’t give further cholesterol reductions [4]. A dietary portfolio combining the benefits of plant sterols, soy proteins and viscous fibers may be as effective as taking 20
mg per day of a statin such as lovastatin, enabling a 29% drop of LDL cholesterol level [5]. However, the beneficial impact of this portfolio seems to result mainly from the synergic action of phytosterols (see above) and of fibers (e.g. provided by
psyllium) [6] rather than profitable effects of soy proteins, which have recently become more and more controversial [7, 8].
Further randomized controlled trials have confirmed the huge hypocholesterolemic effect of sensible dietary portfolios that were including almonds [9], leading to the concept of Miocene-like diet high in leafy vegetables, fruits and nuts [10, 11].
“We conclude that reintroduction of plant food components, which would have been present in large quantities in the plant based diets eaten throughout most of human evolution into modern diets can correct the lipid abnormalities associated with contemporary eating patterns and reduce the need for pharmacological interventions”, i.e. the Garden of Eden diet [10].
Different studies and publications have emphasized the hypocholesterolemic action of specific fruits or nuts. The dietary supplementation of lycopene from tomato may reduce plasma LDL cholesterol concentration by 14% [12]. Eating apple
polyphenols exerts hypocholesterolemic effects through promoting cholesterol catabolism and through inhibiting cholesterol intestinal absorption [13]. Consuming two or three kiwi fruits per day for 4 weeks lowers triglycerides levels by 15% [14].
A diet rich in walnut significantly reduces levels of both total cholesterol and LDL cholesterol by approximately 5% [15]. In
rats, flaxseed meal provides significant decreases of plasma total cholesterol (20%) and triglycerides (35%) compared to a
casein-based diet [16]. Finally, consuming green tea or catechins inhibits the absorption of dietary lipids and “may be used as
safe and effective lipid-lowering therapeutic agents” tackling cholesterol levels as well as triglycerides levels [17]. Our views on animal fats-based diets have thoroughly changed since the publication of an article about Greenland Eskimos in 1976: “The essentially lower serum cholesterol level found in Greenland Eskimos was not explained by our findings. It is suggested instead to be a special metabolic effect of the long chain polyunsaturated fatty acids from marine mammals” [18]. Very interestingly, coronary heart disease appears extremely limited in those populations despite the lack of vegetable foods, therefore providing an additional means to improve cardiovascular health through abundant consumption of oily fish [18].
According the medical literature [19], fish species containing the higher amounts of long chain omega 3s (EPA & DHA) are the following: salmon, sardine, herring, mackerel, tuna, rainbow trout, and halibut, to which we can add anchovy and eel. To
finish with, we cannot omit the impressive results obtained by a Cretan diet high in alpha-linolenic acid essentially from rape
seed oil and other typical Mediterranean diet foods, far superior to the classic low fat diet for patients having suffered from a
first myocardial infarction [20, 21]. Moderate fat consumption (25-35% of energy) appears far better than extremes [22]… 1. Blair, S.N., et al., Incremental reduction of serum total cholesterol and low-density lipoprotein cholesterol with the addition of plant stanol ester-containing spread to statin therapy. Am J Cardiol,
2000. 86(1): p. 46-52.
2. Mensink, R.P., et al., Effects of plant stanol esters supplied in low-fat yoghurt on serum lipids and lipoproteins, non-cholesterol sterols and fat soluble antioxidant concentrations. Atherosclerosis, 2002.
160(1): p. 205-13.
3. Vecka, M., A. Zak, and E. Tvrzicka, [Phytosterols as a functional food]. Cas Lek Cesk, 2007. 146(4):
4. Law, M., Plant sterol and stanol margarines and health. Bmj, 2000. 320(7238): p. 861-4.
5. Jenkins, D.J., et al., A dietary portfolio approach to cholesterol reduction: combined effects of plant
sterols, vegetable proteins, and viscous fibers in hypercholesterolemia. Metabolism, 2002. 51(12): p.
1596-604.
6. Shrestha, S., et al., A combination of psyllium and plant sterols alters lipoprotein metabolism in hypercholesterolemic subjects by modifying the intravascular processing of lipoproteins and increasing
LDL uptake. J Nutr, 2007. 137(5): p. 1165-70.
7. Meyer, B.J., et al., Limited lipid-lowering effects of regular consumption of whole soybean foods. Ann Nutr Metab, 2004. 48(2): p. 67-78.
8. Thorp, A.A., et al., Soy food consumption does not lower LDL cholesterol in either equol or nonequol producers. Am J Clin Nutr, 2008. 88(2): p. 298-304.
9. Jenkins, D.J., et al., Effects of a dietary portfolio of cholesterol-lowering foods vs lovastatin on serum lipids and C-reactive protein. Jama, 2003. 290(4): p. 502-10.
Jenkins, D.J., et al., The Garden of Eden--plant based diets, the genetic drive to conserve cholesterol and its implications for heart disease in the 21st century. Comp Biochem Physiol A Mol
Integr Physiol, 2003. 136(1): p. 141-51.
Kendall, C.W. and D.J. Jenkins, A dietary portfolio: maximal reduction of low-density lipoprotein cholesterol with diet. Curr Atheroscler Rep, 2004. 6(6): p. 492-8.
Fuhrman, B., A. Elis, and M. Aviram, Hypocholesterolemic effect of lycopene and beta-carotene is related to suppression of cholesterol synthesis and augmentation of LDL receptor activity in
macrophages. Biochem Biophys Res Commun, 1997. 233(3): p. 658-62.
Osada, K., et al., Dose-dependent hypocholesterolemic actions of dietary apple polyphenol in rats fed cholesterol. Lipids, 2006. 41(2): p. 133-9.
Duttaroy, A.K. and A. Jorgensen, Effects of kiwi fruit consumption on platelet aggregation and plasma lipids in healthy human volunteers. Platelets, 2004. 15(5): p. 287-92.
Ros, E., et al., A walnut diet improves endothelial function in hypercholesterolemic subjects: a randomized crossover trial. Circulation, 2004. 109(13): p. 1609-14.
Bhathena, S.J., et al., Dietary flaxseed meal is more protective than soy protein concentrate against hypertriglyceridemia and steatosis of the liver in an animal model of obesity. J Am Coll Nutr,
2003. 22(2): p. 157-64.
Koo, S.I. and S.K. Noh, Green tea as inhibitor of the intestinal absorption of lipids: potential mechanism for its lipid-lowering effect. J Nutr Biochem, 2007. 18(3): p. 179-83.
Bang, H.O., J. Dyerberg, and N. Hjoorne, The composition of food consumed by Greenland Eskimos. Acta Med Scand, 1976. 200(1-2): p. 69-73.
Kris-Etherton, P.M., W.S. Harris, and L.J. Appel, Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation, 2002. 106(21): p. 2747-57.
de Lorgeril, M., et al., Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet, 1994. 343(8911): p. 1454-9.
Renaud, S., et al., Cretan Mediterranean diet for prevention of coronary heart disease. Am J Clin Nutr, 1995. 61(6 Suppl): p. 1360S-1367S.
Wolfram, G., Dietary fatty acids and coronary heart disease. Eur J Med Res, 2003. 8(8): p. 321-4.

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