Cholesterol lowering by diet: what can be achieved?

摘要

The cholesterol concentration in the plasma is poorly regulated by the human organism and is therefore easily influenced by lifestyle. Indeed cholesterol levels differ between populations. An important question is how much diet can be held responsible for differences in cholesterol level between e.g. Finland and Japan at the beginning of the Seven Countries Study around 1960. This difference can partly be explained by a difference in saturated fat intake but there was probably an accumulation of both genetic cholesterol elevating factors present in the Finnish society and of cholesterol-lowering factors in the Japanese society. However, controlled trials do show a major effect of diet on cholesterol. With iso-caloric diets low in saturated fat and high in fibre a reduction in total cholesterol of 20-30% can be realized. The reduction can be larger if weight loss also occurs. Further reductions may occur when novel foods are introduced on the market e.g. margarines enriched with plant sterols that give an additional reduction in total cholesterol of about 10%. It can be concluded that diet can reduce total cholesterol levels substantially. The value of novel foods in this context has to be evaluated.