This article puts several disparate pieces about dietary interventions that can be made to improve cholesterol profile together in one place in a helpful manner. The article covered the results of a recent study that showed that the addition of what was terms a ‘portfolio of heart friendly foods’ to the diet can result in a significant reduction in the level of ‘bad’ cholesterol. This ‘porfolio’ included viscous fiber, soy protein, plant sterols and nuts. What the article failed to mention that this cholesterol reducing portfolio was added to a heart healthy diet, not a standard American diet which is higher in saturated and trans fats. Thus it may be necessary to first be consuming a diet low in these fats before adding the portfolio components to the diet will results in a decrease in LDL or ‘bad’ cholesterol. The article did include examples of the types of foods to be added with an explanation for the mechanism by which it appears that each lowers cholesterol.
The article began with material on an updated approach to heart healthy eating which includes the notion that is possible to work any food into diet by considering portion size and comensating with other foods; and secondly that the consumption of foods (such as eggs or shellfish) that are high in cholesterol does not have a large affect on circulating levels of cholesterol. The article could have done a better job of setting the stage for readers to evaluate the impact of the dietary changes described by more clearly detailing the benefits and providing information on the potential harms and costs.
There was no discussion about how the addition of these foods affected the total food budget for the study participants.
While the article does provide some comparison between the group of individuals who were most compliant with including all the diet additions (a 20% reduction) and those who “fell off the wagon” (a 10% reduction), the article should have included absolute to better enable the reader to understand whether these changes were meaningful to them.
There was no discussion of any potential downsides to the dietary changes recommended, though the article to start off with a section that touched on the idea that dietary changes can be ‘negotiated’. The addition of foods to a diet without reduction in intake of other food will lead to an increase in total calories consumed which could lead to weight gain.
The evidence provided comes from a study published in the American Journal of Clinical Medicine which was cited in the article. The article did not clearly represent that the foods added to the diet were added to a heart healthy diet. However, the article did include the extent to which ‘bad’ cholesterol was lowered in those adhereing rigidly and less strictly to the diet.
Although the article did cast heart disease as’ the country’s No. 1 Killer’, the overall tone was not one of disease mongering.
There were several experts interviewed for this story and the study published in the American Journal of Clinical Nutrition was mentioned as the source of the dietary information provided.
The article reported on a study in the American Journal of clinical Nutrition that found these food additions lowered cholesterol levels as much as “first-generation statin drugs”. There was no information on effectiveness of other drugs to lower cholesterol or interventions such as weight loss or exercise.
The article provides a very clear list of the heart friendly foods that contain each of the categories of cholesterol lowering foods. However, it neglected to mention that the research only demonstrated that these foods lower cholesterol when added to an already heart-healthy diet (i.e. < 7% of calories from saturated fat and < 200mg dietary cholesterol/day)
The three recommendations about diet to lower cholesterol are not new and are not presented as novel. However, putting these concepts together in one place is handy.
This article does not appear to rely on a press release.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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