Original Communication
European Journal of Clinical Nutrition (2005) 59, 851–860. doi:10.1038/sj.ejcn.1602152 Published online 18 May 2005
Direct comparison of dietary portfolio vs statin on C-reactive protein
Guarantor: DJA Jenkins.
Contributors: Study concept and design: DJAJ, CWCK, DAF. acquisition of data: DJAJ, CWCK, AM, DAF, JMWW, R de S, AE, TLP, TJL, PWC; analysis and interpretation of data: DJAJ, CWCK, DAF, ARJ, TJL, RGJ, LAL, PWC; drafting of the manuscript: DJAJ, CWCK, AM; critical revision of the manuscript for important intellectual content: DJAJ, CWCK, AM, DAF, ARJ, JMWW, R de S, AE, TLP, TJL, RGJ, LAL, WS, PWC; statistical expertise: TJL; obtained funding: DJAJ, CWCK; administrative, technical or material support: CWCK, AM, DAF, JMWW, R de S, AE, TLP, RGJ, LAL, WS, PWC; study supervision: DJAJ, CWCK, DAF.
D J A Jenkins1,2,3,4, C W C Kendall1,3, A Marchie1,3, D A Faulkner1,3, A R Josse1, J M W Wong1,3, R de Souza1,3, A Emam1,3, T L Parker1,3, T J Li3, R G Josse1,2,3,4, L A Leiter1,2,3,4, W Singer1,2,4 and P W Connelly2,4,5
- 1Clinical Nutrition and Risk Factor Modification Center, St Michael's Hospital, Toronto, Ontario, Canada
- 2Department of Medicine, Division of Endocrinology and Metabolism, St Michael's Hospital, Toronto, Ontario, Canada
- 3Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- 4Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- 5Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Correspondence: DJA Jenkins, Clinical Nutrition and Risk Factor Modification Center, St Michael's Hospital, 61 Queen St East, Toronto, Ontario, Canada M5C 2T2. E-mail: cyril.kendall@utoronto.ca
Received 28 June 2004; Revised 4 March 2005; Accepted 18 March 2005; Published online 18 May 2005.
Abstract
Background:
3-Hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) markedly reduce serum cholesterol and have anti-inflammatory effects. The effect of cholesterol-lowering diets on inflammatory biomarkers is less well known.
Objective:
To compare the efficacy of a dietary combination (portfolio) of cholesterol-lowering foods vs a statin in reducing C-reactive protein (CRP) as a biomarker of inflammation linked to increased cardiovascular disease risk.
Methods:
In all, 34 hyperlipidemic 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 (statin); and a diet high in plant sterols (1.0 g/1000 kcal), soy protein (21.4 g/1000 kcal), viscous fibers (9.8 g/1000 kcal), and almonds (14 g/1000 kcal) (portfolio). Fasting blood samples were obtained at weeks 0, 2, and 4.
Results:
Using the complete data, no treatment reduced serum CRP. However, when subjects with CRP levels above the 75th percentile for previously reported studies (>3.5 mg/l) were excluded, CRP was reduced similarly on both statin, -16.3
6.7% (n=23, P=0.013) and dietary portfolio, -23.86.9% (n=25, P=0.001) but not the control, 15.313.6% (n=28, P=0.907). The percentage CRP change from baseline on the portfolio treatment (n=25) was greater than the control (n=28, P=0.004) but similar to statin treatment (n=23, P=0.349). Both statin and portfolio treatments were similar in reducing CRP and numerically more effective than control but only the change in portfolio was significant after the Bonferroni adjustment.
Conclusions:
A combination of cholesterol-lowering foods reduced C-reactive protein to a similar extent as the starting dose of a first-generation statin.
Keywords:
almonds, soy protein, viscous dietary fiber, plant sterols, national cholesterol education program diet, low saturated fat
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