A Heart Doctor’s New, More Affordable Alternative for Statins
Nearly 50% of all Americans have high cholesterol, yet some can become intolerant to statins—a type of medication used to lower it. Here's what one cardiologist who guides patients in making lifestyle changes hopes non-genetic high cholesterol patients might consider.
If you’re one of the two in five American adults with high cholesterol, chances are you’ve heard of statins—the class of medications specifically designed to lower LDL (“bad”) cholesterol. Due to the number of people with high cholesterol—defined as having a total cholesterol of 200 or higher—statins are some of the most frequently prescribed drugs on the planet. While statins are generally considered very safe—and while some patients do in fact need them—in some cases, statins can cause more harm than good.
“What people need to understand is that high cholesterol isn’t caused by a deficiency in statins; it’s caused in part or in whole by a deficiency of the right foods,” says Elizabeth Klodas, MD, FACC, a preventative cardiologist and expert in treating high cholesterol who trained at Mayo Clinic and Johns Hopkins. Dr. Klodas says that even though high cholesterol is in some cases a lifestyle disease, addressing lifestyle habits is “not how we’ve been taught to approach treatment. Instead,” Dr. Klodas says, “the thought is: High cholesterol? Here’s a pill. But that’s just covering up the downstream effects of poor diet, leaving patients with perfect numbers instead of perfect health.”
It’s important to note that there are some patients who require medication (in particular, people who have high cholesterol due to genetics). In cases where high cholesterol is caused by lifestyle patterns, Dr. Klodas says some statin prescriptions could potentially be avoided with some key changes. Also, even if statins have worked for you, that efficacy can wear off over time through a process called “statin intolerance.”
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What is statin intolerance?
Statin intolerance happens when you develop one or more side effects from statin medications that become worrisome enough that your doctor finds it necessary to reduce your statin dose or take you off the medications altogether.
The most common side effects of statins include muscle aches, liver function abnormalities, brain fog, and an increased risk of developing diabetes—and the higher your dose, the more likely you are to experience these, Dr. Klodas says. Generally, these symptoms are reversible upon stopping the drug.
“Estimates in the medical literature say 5% to 15% of patients on statins will become intolerant—but in clinical practice, most doctors will tell you that as many as 25% of patients fall into this category,” she tells The Healthy @Reader’s Digest.
What to do if you can’t (or don’t want to) take statins
Priority number one? Cleaning up your diet—which goes beyond just looking for foods with a checkmark or heart symbol on the box, she suggests.
Through Dr. Klodas’s research, she’s found that there are four key nutrients with documented health-promoting properties that, when they’re combined, can lower LDL cholesterol naturally:
- whole food fiber
- omega-3 fatty acids
- plant sterols
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Dr. Klodas explains: “These four nutrients are key because they affect various biochemical pathways involved in cholesterol metabolism. Fiber and plant sterols promote LDL cholesterol loss through bile-based pathways in the digestive system. Omega-3 fatty acids up-regulate LDL receptor function helping to clear LDL from the bloodstream. And antioxidants make any circulating LDL less toxic.”
But the solution, she cautions, isn’t just to take fistfuls of supplements with these nutrients—it’s ideal to get them from whole, real foods.
To help people figure out exactly how to eat this way, Dr. Klodas has created a line of customized foods and recipes based around these key nutrients. “We use proven heart-healthy ingredients like almonds and walnuts, oat bran and chia, 72% cacao chocolate, blueberries, apples, and cinnamon and because they’re just normal foods, there are no side effects,” she says.
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What the science says
Dr. Klodas and her team of researchers ran randomized clinical trials that compared their dietary intervention with a “normal” diet. The researchers found that the people using her “Step One Foods” twice per day had “highly significant LDL cholesterol reductions, with some people achieving medication level results within 30 days.”
Their findings were published in the peer-reviewed medical journal Current Cardiology Reports in 2020.
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Should you try the “food as medicine” approach?
Always speak with your doctor before you make major changes to your diet—especially if you have a history of heart disease or are currently on medications. But, Dr. Klodas says, using food as medicine is becoming more popular and widely recognized as an intervention for heart disease. “If a condition being treated is caused in part or in whole by food, step one should be to change the food—especially if the alternative is lifetime of medications,” she says. “And if you’re someone who can’t tolerate statin drugs, the goal shouldn’t be to get you to tolerate higher doses, but to minimize your dependence on them.”
Using “food as medicine” can be a game changer. Eating a heart-healthy diet, centered around these four nutrients, can not only help you lower your cholesterol but can also reduce blood pressure, improve blood sugar control, and help with weight loss, she says. Plus, eating whole foods is generally more affordable than taking prescription meds (not to mention tastier).
Don’t forget to add daily exercise for maximum heart benefits.
“There are no side effects to this diet,” this cardiologist says, “only ‘side benefits’—and it’s well worth your time to try it.”
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Elizabeth Klodas, MD, FACC, a preventative cardiologist and founder of Step One Foods
Current Cardiology Reports: "Healthcare Cost Implications of Utilizing a Dietary Intervention to Lower LDL Cholesterol: Proof of Concept Actuarial Analysis and Recommendation"
CDC: "High Cholesterol Facts"