With heart disease being the leading cause of death in the U.S, accounting for one in every sixth death, over 885,000 deaths and over $634.2 billion in medical costs per year. LDL cholesterol, which is a large contributor to the development of heart disease, is over healthy limits in about 48% of the U.S. adult population. When LDL cholesterol levels are lowered by 1mmol/l, heart disease risks are reduced by 22%. As a result, statins, an LDL-cholesterol lowering drug that is the most widely used drug world-wide, is the go to treatment for heart disease but come with some serious and widely under recognized health risks. Furthermore they are often prescribed by doctors before lifestyle interventions have been fully addressed. I know too many people who have been given heart medication without hearing even a word about what they could be doing differently with respect to diet and exercise. With that said, how do lifestyle interventions, namely ones using plant-based diets, stand up against the current common heart disease treatments?

Statins, while effective without question, come with some health risks and should be avoided unless absolutely necessary. A few of these risks include reduced glucose tolerance, higher risk for diabetes, and a reduced amount of coenzyme Q10, which is a vital fat soluble antioxidant. As a result, statins are frequently prescribed with suggestions to take coenzyme Q10 supplements. Reduced coenzyme Q10 is a major factor for a number of brain and muscle related syndromes. With these risks in mind, the FDA has now required statin label adjustments to display risks including reduced liver function, diabetes and memory loss. While statins are extremely effective at reducing the risk of heart disease and lowering LDL cholesterol, I strongly believe that they are currently overprescribed without enough education given to patients. But what can you expect when many doctors currently have a complete lack of education with respect to nutrition, and furthermore, pharmaceuticals are a much easier fix than a full blown lifestyle intervention. Current practices are more about getting more and more patients through the door, quickly, instead of taking the time to fully address the needs of each individual.

Lifestyle interventions that include plant based diets and exercise will not only reduce risks for heart disease but also just about any chronic disease out there. Vegetarian and vegan diets are consistently demonstrated to lower LDL cholesterol, with ovo-lacto vegetarians having reductions of 10% and vegans up to 25%! With the addition of extra fiber, soy and nuts, reductions on vegan diets where demonstrated to improve all the way to up to 35%! These numbers are comparable to just about any pharmaceutical treatment for heart disease. Moreover, plant-based diets are associated with a lower body weight, blood pressure, inflammatory markers as well as improved insulin sensitivity and glucose control. There is also growing evidence for the effectiveness of dark chocolate, green tea, flax, garlic, DHA-omega 3 (can be derived from algal supplements) and exercise for reducing LDL cholesterol. The combination of these ingredients with a vegan diet would be a smart option for patients to try before opting for pharmaceutical treatment.

Heart disease and high LDL cholesterol results in significant financial costs and health risks. As a result, I think that dietary changes should be the first-line therapy because they are both safe and cost effective. Clearly I’m a firm supporter of the need for more holistic approaches in the treatment of disease instead of a pinpointed option, especially when other areas of good health are so negatively affected. While heart disease medication definitely has its place in serious cases, I think that we can benefit more from lifestyle interventions that Support health across the board. So if you or someone you know has been prescribed heart medication, before you jump on board, discuss an intervention with exercise and a plant-based diet if your serious about taking the (hard) leap for better all-around health, including heart health.

References:

• Deichmann R, Lavie C, Andrews S. (2010) Coenzyme q10 and statin-induced mitochondrial dysfunction. Ochsner J.;10(1):16-21.
• Ferdowsian H, Barnard N. (2009) Effects of Plant-Based Diets on Plasma Lipids. doi:10.1016/j.amjcard.2009.05.032.
• Goff LM, Cowland DE, Hooper L, Frost GS. (2012) Low glycaemic index diets and blood lipids: A systematic review and meta-analysis of randomised controlled trials. doi:10.1016/j.numecd.2012.06.002.
• Harland J. (2012) Food combinations for cholesterol lowering. doi:10.1017/S0954422412000170.
• Khardori R, Nguyen D. (2012) Glucose control and cardiovascular outcomes: reorienting approach. doi:10.3389/fendo.2012.00110.
• Lewis S. (2011) Lipid-lowering therapy: who can benefit? doi:10.2147/VHRM.S23113.
• McEvoy C, Temple N, Woodside J. (2012) Vegetarian diets, low-meat diets and health: a review. doi:10.1017/S1368980012000936.

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