Re: LDL cholesterol and diet question
- From: Matti Narkia <narkia@xxxxxxxxx>
- Date: Sun, 18 Dec 2005 19:06:52 +0200
Sat, 17 Dec 2005 19:49:17 +0200 in article
<gpi8q1l9sg1a2ct5mnc10cirvb7ucj4kq9@xxxxxxx> Matti Narkia <narkia@xxxxxxxxx>
wrote:
>Sat, 17 Dec 2005 05:00:01 +0200 in article
><17r6q1dr710p2ln9vefh2ofs8baju97l5g@xxxxxxx> Matti Narkia <narkia@xxxxxxxxx>
>wrote:
>
>>However, cholesterol is only part of the picture, only one risk factor,
>>which somehow has got a disproportionally dominating role in the prevention
>>and treatment of cardiovascular diseases. In the Seven Countries
>>Study started in 60s, Cretans had by far the lowest coronary mortality of
>>all the countries included, although their cholesterol was higher than in
>>the countries with higher coronary mortality. See
>>
>>Bruno Simini.
>>Serge Renaud: from French paradox to Cretan miracle
>>Lancet, Volume 355, Number 9197, 01 January 2000
>><http://www.thelancet.com/journals/lancet/article/PIIS0140673605719905/fulltext>
>>
>> "Then, ?when I saw the results of the Seven Countries
>> Study in 1980?, he recalls, ?I thought, Cretans must be
>> doing?or eating?something right?. Crete had by far the
>> lowest coronary mortality of the countries studied. Yet,
>> serum cholesterol concentrations were higher in Crete
>> than in other countries with higher coronary mortalities.
>> ?Something protects Cretans which does not reduce their
>> cholesterol?, proposed Renaud.
>>
>> Renaud guessed that the difference was a-linolenic acid
>> and set up the Lyon Diet Heart Study in 1985, a secondary
>> prevention trial. Overall, deaths and cardiovascular
>> events were reduced by at least 70%, with the protective
>> effect occurring within 2 months. This study, which was
>> published in The Lancet in 1994, was initially rejected
>> by the New England Journal of Medicine because the
>> ?intervention induced no changes in serum lipids?, a fact
>> that left the referees ?wondering how such a large
>> mortality reduction could have possibly been achieved?.
>>
>If I remember right, reducing LDL with statins prevents approximately one
>third of the cardiovascular events. In the Lyon Diet Heart Study Cretan
>style Mediterranean diet prevented 70% of the cardiovascular events, more
>that twice the amount which can be achieved with statins. Because Cretan
>style Mediterranean diet does not lower LDL, perhaps further improvement
>could be achieved by including into it LDL lowering food items such as
>eggplant, okra, cinnamon, soy protein, almonds, plant sterols, barley,
>psyllium, pomegranate juice and some probiotics, for example Enterococcus
>faecium , Lactobacillus plantarum 299v and Bifidobacterium longum.
>
This (Mediterranaean diet modified to include LDL reducing food items) is
probably a good enough approach for primary prevention of CHD, IMHO. For
secondary prevention, most people will probably be prescribed lipid lowering
medication as well, and most of them will take it - as did most patients in
the Lyon Diet Heart Study. But adherence to Cretan style traditional
Mediterranenan diet prevented about 70% of the major coronary events in a
population consisting mainly of lipid lowering drug users. Can statin users
afford to pass the opportunity to improve their chances to avoid major
coronary event by 70%?
--
Matti Narkia
.
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