For years, people with high blood cholesterol have been advised to lower their intake of saturated fat (the kind found mainly in red meat, whole milk, butter, and cheese). And while this advice still holds true, new research suggests that other foods may influence cholesterol levels. The results are published in the Journal of the American Medical Association.

Studying a "portfolio" of foods

Researchers in Canada studied 46 healthy men and women with high blood cholesterol (average age: 59) to determine whether a diet containing a variety of cholesterol-lowering food components would be comparable with the medication lovastatin in lowering cholesterol levels.

The study lasted a month, in which the participants were randomly assigned to undergo one of three "interventions":

1. a typical low-saturated fat diet ("control" group)
2. the same diet as for group #1 but with the addition of lovastatin ("medication" group)
3. a low-saturated fat diet that was also high in plant sterols (found in some margarines), soy protein (such as in soy milk, tofu, and soy deli slices), soluble fiber (such as in oats or barley), and almonds. This last combination of plant foods was described as the "portfolio" diet.

Although the study was conducted on an outpatient basis, most of the food was provided for the participants and the diets were designed so that the participants would neither gain nor lose weight during the 1-month period.

'Portfolio' diet nearly as effective as medication

Both the medication group and the portfolio diet group experienced significant reductions in cholesterol levels, compared with the control group. The medication group and the portfolio diet group had a decrease in LDL cholesterol of about 30%, while the control group had a decrease of only 8%.

How it works and what it means for you

The researchers suggest that the portfolio diet is effective because of the "additive" effects of the different dietary components. That is, they all work in different ways to lower blood cholesterol but their different effects may result in significant reductions in cholesterol levels.

For people who would prefer to control their cholesterol levels without the use of medication, these results are certainly encouraging news. It's important to note, however, that the portfolio diet was vegetarian and not everyone may find it palatable. Also, this was a fairly small study, and fat remains, by far, the biggest food factor that influences cholesterol. Further research is needed to determine which foods, in what amounts, offer health benefits. But for those who enjoy a snack of soy beverage, almonds, and psyllium fiber, it may well be a worthy endeavor.