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Should a Low-Fat Diet Be Plant-Based?

In the short term, a low-fat diet that emphasized plant-based foods lowered cholesterol more than a typical low-fat diet did.

Is a low-fat diet that emphasizes plant-based foods (fruits, vegetables, whole grains, and legumes) better at lowering cholesterol than a typical low-fat diet is? Researchers randomly assigned 120 generally healthy adults (age 30–65; 50% men; LDL levels, 130–190 mg/dL; BMI, 19–31) to eat one of these types of diets for 4 weeks.

The two diets were designed to be identical in total fat, saturated fat, protein, carbohydrate, and cholesterol content; to be consistent with AHA Step I guidelines; and to allow for calorie-intake adjustments to keep body weight constant. Meals either were eaten at the study center or were distributed in coolers to be eaten off site. Fasting blood samples were taken on 4 separate days: 2 at baseline and 2 at study completion.

As expected, body-weight changes were negligible in both groups during the 4-week study. However, compared with the typical low-fat diet, the plant-based low-fat diet yielded significantly greater declines in mean levels of total cholesterol (–17.6 mg/dL vs. –9.2 mg/dL) and of LDL cholesterol (–13.8 mg/dL vs. –7.0 mg/dL). Changes in levels of HDL cholesterol and triglycerides did not differ significantly between the two groups. LDL changes varied widely among individuals.

Comment: In the short term, a low-fat diet that emphasized plant-based foods had a greater total- and LDL-cholesterol–lowering effect than a typical low-fat diet did, even though both diets were consistent with AHA guidelines. A diet low in saturated fat and cholesterol that also includes lots of plant-based foods might increase the lipid-lowering potential of the diet.

— Joel M. Gore, MD

Published in Journal Watch Cardiology June 3, 2005

Citation(s):

Gardner CD et al. The effect of a plant-based diet on plasma lipids in hypercholesterolemic adults: A randomized trial. Ann Intern Med 2005 May 3; 142:725-33.

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• Medline abstract (Free)

Jenkins DJA et al. Diet and cholesterol reduction. Ann Intern Med 2005 May 3; 142:793-5.

• Original article (Subscription may be required)
• Medline abstract (Free)