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Direct comparison of dietary portfolio vs statin on C-reactive protein

European Journal of Clinical Nutrition volume 59, pages 851–860 (2005)Cite this article

Abstract

Background:

3-Hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) markedly reduce serum cholesterol and have anti-inflammatory effects. The effect of cholesterol-lowering diets on inflammatory biomarkers is less well known.

Objective:

To compare the efficacy of a dietary combination (portfolio) of cholesterol-lowering foods vs a statin in reducing C-reactive protein (CRP) as a biomarker of inflammation linked to increased cardiovascular disease risk.

Methods:

In all, 34 hyperlipidemic 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 (statin); and a diet high in plant sterols (1.0 g/1000 kcal), soy protein (21.4 g/1000 kcal), viscous fibers (9.8 g/1000 kcal), and almonds (14 g/1000 kcal) (portfolio). Fasting blood samples were obtained at weeks 0, 2, and 4.

Results:

Using the complete data, no treatment reduced serum CRP. However, when subjects with CRP levels above the 75th percentile for previously reported studies (>3.5 mg/l) were excluded, CRP was reduced similarly on both statin, −16.3±6.7% (n=23, P=0.013) and dietary portfolio, −23.8±6.9% (n=25, P=0.001) but not the control, 15.3±13.6% (n=28, P=0.907). The percentage CRP change from baseline on the portfolio treatment (n=25) was greater than the control (n=28, P=0.004) but similar to statin treatment (n=23, P=0.349). Both statin and portfolio treatments were similar in reducing CRP and numerically more effective than control but only the change in portfolio was significant after the Bonferroni adjustment.

Conclusions:

A combination of cholesterol-lowering foods reduced C-reactive protein to a similar extent as the starting dose of a first-generation statin.

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Acknowledgements

This work was supported by the Canada Research Chair Endowment of the Federal Government of Canada; the Canadian Natural Sciences and Engineering Research Council of Canada; Loblaw Brands Limited (Toronto, ON); Unilever Canada (Toronto, ON); and the Almond Board of California (Modesto, CA).

We sincerely thank President's Choice, Loblaw Brands Limited, Unilever Research & Development (Vlaardingen, the Netherlands), the Almond Board of California, The Hain-Celestial Group (Melville, NY), Kraft Foods (Glenview, IL), Procter & Gamble Inc. (Toronto, ON), Pepsico Foods Canada-Quaker Peterborough Plant (Peterborough, ON), Nestlé Canada Inc. (Pickering, ON), Bartlett Farms, Barwell Food Sales Inc. (London, ON), and Burnbrae Farms (Upton, PQ) for the generous donation of foods used in this study.

We thank Mr Edward Vidgen, Toronto, Canada for statistical support on this project; Mr Larry C Griffin, Ms Sherry Casey, and Mr. Pietro Satriano of President's Choice, Loblaw Brands Ltd; Dr Karen G Lapsley of the Almond Board of California; Dr Elke Trautwein of Unilever (Research and Development); Dr Paul Schur of Unilever Canada; Dr Gerry Amantea of The Hain-Celestial Group; Dr Margaret C Martini of Kraft Foods; Mr Grant Morrison of Pepsico Foods Canada; Ms Kathy Galbraith of Natural Temptations Bakery (Burlington, ON); Mr Don Bartlett of Bartlett Farms, Barwell Foods Sales Inc; Ms Michele Brown of Lean Cuisine Marketing Team of Nestlé Canada; Ms Margaret Hudson of Burnbrae Farms Ltd, for their assistance on this project; and to the study participants for their attention to detail and enthusiasm.

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Authors and Affiliations

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

    D J A Jenkins, C W C Kendall, A Marchie, D A Faulkner, A R Josse, J M W Wong, R de Souza, A Emam, T L Parker, R G Josse, L A Leiter & W Singer

  2. Department of Medicine, Division of Endocrinology and Metabolism, St Michael's Hospital, Toronto, Ontario, Canada

    D J A Jenkins, R G Josse, L A Leiter, W Singer & P W Connelly

  3. Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada

    D J A Jenkins, C W C Kendall, A Marchie, D A Faulkner, J M W Wong, R de Souza, A Emam, T L Parker, T J Li, R G Josse & L A Leiter

  4. Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada

    D J A Jenkins, R G Josse, L A Leiter, W Singer & P W Connelly

  5. Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada

    P W Connelly

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  1. D J A Jenkins
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  2. C W C Kendall
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  3. A Marchie
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Correspondence to D J A Jenkins.

Additional information

Guarantor: DJA Jenkins.

Contributors: Study concept and design: DJAJ, CWCK, DAF. acquisition of data: DJAJ, CWCK, AM, DAF, JMWW, R de S, AE, TLP, TJL, PWC; analysis and interpretation of data: DJAJ, CWCK, DAF, ARJ, TJL, RGJ, LAL, PWC; drafting of the manuscript: DJAJ, CWCK, AM; critical revision of the manuscript for important intellectual content: DJAJ, CWCK, AM, DAF, ARJ, JMWW, R de S, AE, TLP, TJL, RGJ, LAL, WS, PWC; statistical expertise: TJL; obtained funding: DJAJ, CWCK; administrative, technical or material support: CWCK, AM, DAF, JMWW, R de S, AE, TLP, RGJ, LAL, WS, PWC; study supervision: DJAJ, CWCK, DAF.

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Jenkins, D., Kendall, C., Marchie, A. et al. Direct comparison of dietary portfolio vs statin on C-reactive protein. Eur J Clin Nutr 59, 851–860 (2005). https://doi.org/10.1038/sj.ejcn.1602152

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