text_1: Certain foods may be the best medicine for lowering ‘bad’ cholesterol
text_2: This story was about a study comparing a special vegetarian diet containing a “portfolio” of cholesterol-lowering foods (e.g. nuts, soy, margarines fortified with plant sterols) with standard dietary advice for preventing heart disease (e.g. cut out saturated fat). There was plenty to like about this story, including comments from two excellent independent sources which added valuable context to the piece. The story also makes the very important point that this study looked only at a surrogate marker of heart disease risk, LDL cholesterol, and not actual heart disease outcomes. But the story didn’t provide crucial information about costs or availability of the diet components and it didn’t fairly describe how difficult it would be for most people to maintain this kind of diet. These mistakes are compounded by a glaring misinterpretation of the study which is trumpeted in the headline — i.e. that the diet tested in the study lowered LDL cholesterol “more than statin drugs.”  Many people at risk of heart disease don’t want to take cholesterol-lowering drugs, can’t take them because of troubling side effects, or don’t achieve their targets on drug therapy alone. Others may have cholesterol levels above target but below the range where statin therapy is indicated. Diet-based interventions such as this “portfolio diet” represent an important potential alternative for these patients.