British Journal of Nutrition

Full Papers

Comparison of a dietary portfolio diet of cholesterol-lowering foods and a statin on LDL particle size phenotype in hypercholesterolaemic participants

Iris Gigleuxa1, David J. A. Jenkinsa2, Cyril W. C. Kendalla2, Augustine Marchiea2, Dorothea A. Faulknera2, Julia M. W. Wonga2, Russell de Souzaa2, Azadeh Emama2, Tina L. Parkera2, Elke A. Trautweina3, Karen G. Lapsleya4, Philip W. Connellya5 and Benoît Lamarchea1 c1

a1 Institute of Nutraceuticals and Functional Foods, Laval University, Quebec, Canada

a2 Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada

a3 The Unilever Food and Health Research Institute, Unilever R&D, Vlaardingen, The Netherlands

a4 Almond Board of California, Modesto, CA, USA

a5 Departments of Medicine and Laboratory Medicine and Pathobiology, University of Toronto; Keenan Research Center in the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada

Abstract

The effect of diet v. statins on LDL particle size as a risk factor for CVD has not been examined. We compared, in the same subjects, the impact of a dietary portfolio of cholesterol-lowering foods and a statin on LDL size electrophoretic characteristics. Thirty-four hyperlipidaemic 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; a dietary portfolio high in plant sterols (1 g/4200 kJ), soya proteins (21·4 g/4200 kJ), soluble fibres (9·8 g/4200 kJ) and almonds (14 g/4200 kJ). LDL electrophoretic characteristics were measured by non-denaturing polyacrylamide gradient gel electrophoresis of fasting plasma at 0, 2 and 4 weeks of each treatment. The reductions in plasma LDL-cholesterol levels with the dietary portfolio and with statins were comparable and were largely attributable to reductions in the estimated concentration of cholesterol within the smallest subclass of LDL (portfolio − 0·69 (se 0·10) mmol/l, statin − 0·99 (se 0·10) mmol/l). These were significantly greater (P < 0·01) than changes observed after the control diet ( − 0·17 (se 0·08) mmol/l). Finally, baseline C-reactive protein levels were a significant predictor of the LDL size responsiveness to the dietary portfolio but not to the other treatments. The dietary portfolio, like the statin treatment, had only minor effects on several features of the LDL size phenotype, but the pronounced reduction in cholesterol levels within the small LDL fraction may provide additional cardiovascular benefit over the traditional low-fat diet of National Cholesterol Education Program Step II.

(Received November 06 2006)

(Revised April 20 2007)

(Accepted May 21 2007)

Correspondence:

c1 Corresponding author: Dr Benoît Lamarche, fax (418) 656 5877, email Benoit.Lamarche@inaf.ulaval.ca

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