![]() ![]() The purpose of the present study was to directly compare the effect of a statin treatment with that of a combination of cholesterol-lowering food from vegetable sources (dietary portfolio) on LDL size electrophoretic characteristics. However, few studies have examined the impact of these dietary components taken individually on the LDL particle size phenotype Reference Almario, Vonghavaravat, Wong and Kasim-Karakas 18 – Reference Behall, Scholfield and Hallfrisch 27and only one study has documented the combined effect of this portfolio of cholesterol-lowering foods on the LDL size phenotype Reference Lamarche, Desroches and Jenkins 28. There is now evidence that a combination of four dietary components, with relatively limited hypercholesterolaemic effects when taken individually, may be as effective as first-generation statins in lowering LDL-cholesterol Reference Jenkins, Kendall and Marchie 17. For that reason, the National Cholesterol Education Program Adult Treatment Panel III 15 and the American Heart Association Reference Krauss, Eckel and Howard 16 have recently recommended an increased use of functional foods with more potent effects on reducing cholesterol levels for optimal CHD risk reduction. While some studies have shown small but significant benefits of statins on LDL particle diameter Reference Zhao, Hollaar, ’t Hooft, Smelt, Gevers and van der Leuven 7, LDL subclass distribution Reference Yuan, Tsai, Hegland and Hunninghake 8 and on the reduction of cholesterol within the smallest LDL subfractions Reference Forster, Stewart, Bedford, Stewart, Rogers, Shepherd, Packard and Caslake 9 – Reference Marz, Scharnagl, Abletshauser, Hoffmann, Berg, Keul, Wieland and Baumstark 11, other studies have indicated that statins had only marginal or even no effect on LDL particle size Reference Superko, Krauss and DiRicco 12, Reference Tilly-Kiesi 13.Īlthough the traditional dietary approach currently recommended by the American Heart Association has been relatively efficacious in decreasing total cholesterol and LDL-cholesterol levels Reference Yu-Poth, Zhao, Etherton, Naglak, Jonnalagadda and Kris-Etherton 14, the magnitude of these benefits is generally modest. LDL particles are heterogeneous in terms of size, density and physical properties Reference Krauss and Burke 1 and it is now being increasingly recognized that small dense LDL particles are associated with an increased risk of CHD Reference Lamarche, Tchernof, Moorjani, Cantin, Dagenais, Lupien and Despres 2 even in the presence of a relatively normal LDL-cholesterol concentration Reference St Pierre, Ruel, Cantin, Dagenais, Bernard, Despres and Lamarche 3.ģ-Hydroxy-3-methyl-glutaryl-coA reductase inhibitors (statins) have been shown to be effective in reducing CHD risk and mortality 4, Reference Anon 5 and have been identified as the primary pharmacological tool in the treatment of elevated LDL-cholesterol concentration Reference Grundy 6. The dietary portfolio, like the statin treatment, had only minor effects on several features of the LDL size phenotype, but the pronounced reduction in cholesterol levels within the small LDL fraction may provide additional cardiovascular benefit over the traditional low-fat diet of National Cholesterol Education Program Step II. Finally, baseline C-reactive protein levels were a significant predictor of the LDL size responsiveness to the dietary portfolio but not to the other treatments. These were significantly greater ( P < 0♰1) than changes observed after the control diet ( − 0♱7 ( se 0♰8) mmol/l). The reductions in plasma LDL-cholesterol levels with the dietary portfolio and with statins were comparable and were largely attributable to reductions in the estimated concentration of cholesterol within the smallest subclass of LDL (portfolio − 0♶9 ( se 0♱0) mmol/l, statin − 0♹9 ( se 0♱0) mmol/l). LDL electrophoretic characteristics were measured by non-denaturing polyacrylamide gradient gel electrophoresis of fasting plasma at 0, 2 and 4 weeks of each treatment. Thirty-four hyperlipidaemic subjects completed three 1-month treatments as outpatients in random order: a very-low saturated fat diet (control) the same diet with 20 mg lovastatin a dietary portfolio high in plant sterols (1 g/4200 kJ), soya proteins (21♴ g/4200 kJ), soluble fibres (9♸ g/4200 kJ) and almonds (14 g/4200 kJ). We compared, in the same subjects, the impact of a dietary portfolio of cholesterol-lowering foods and a statin on LDL size electrophoretic characteristics. ![]() statins on LDL particle size as a risk factor for CVD has not been examined.
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