title: Lowering LDL-cholesterol through diet: potential role in the statin era.
abstract: OBJECTIVE
  A healthy diet should be rich in vegetables and fruits, whole-grain, high-fiber foods, and fish and should contain a small amount of saturated and trans fats. In addition to these recommendations, some food ingredients such as plant sterol/stanol soy protein and isoflavones may help reduce cholesterol levels. Increased dietary fiber intakes are associated with significantly lower prevalence of cardiovascular disease and lower LDL-cholesterol concentration of about 5-10%. Beyond LDL-cholesterol lowering effects, other benefits have been observed on hypertension, diabetes mellitus. In this review, we summarize the different dietary approaches proven to be associated with LDL-cholesterol decrease. Nutritional interventions that do not exert significant LDL-cholesterol decrease have not been included in this review.
  
  
  RESULTS
  On top of a 'classical' step 1 and step 2 diet, the cornerstone of dietary recommendations, recent findings confirm the deleterious effects of trans fatty acid or the beneficial effects of sterols/stanols and nuts.
  
  
  CONCLUSIONS
  Dietary recommendations may have an impressive impact on cardiovascular events because they can be implemented early in life and because the sum of the effect on LDL-cholesterol is far from being negligible: step 1 diet (-10%), dietary fibers (-5 to -10%), plant sterols/stanols (-10%), nut consumption (-8%), and soy protein (-3 to -10%).
authors.affiliation: Department of Endocrinology and Metabolism, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France. eric.bruckert@psl.aphp.fr
authors.forename: Eric
authors.initials: E
authors.lastname: Bruckert
authors.forename: David
authors.initials: D
authors.lastname: Rosenbaum
mesh_terms: D008078:Cholesterol, LDL / Q000187:drug effects / Q000378:metabolism*; D004032:Diet; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology; D009754:Nuts; D010840:Phytosterols / Q000378:metabolism
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010840:Phytosterols