Good news on cholesterol

Our columns are designed to share with you actionable, evidence-based nutrition information, and most of the time that's exactly what we do. But focusing on helping you improve your health, while a positive goal, can sometimes be a little bit of a downer: "reduce your risk of death with X," "prevent [some serious disease] with Y," "manage your [chronic condition] by eating more Z".... You'd think we were all living in terror of eating the wrong thing.

It's particularly nice, then, to be able to share some good news: people do seem to be improving their diets.

A team of researchers in the United Kingdom made use of anonymized information gathered through the Health Survey for England, a yearly survey of a nationally representative sample on health, demographic, and other information that started in 1991 (PLOS ONE DOI: 10.1371/journal.pone.0123112). Trained nurses measure participants' height, weight, and blood pressure and take blood samples for testing cholesterol levels, among other health details.

The authors focused on the measures of total cholesterol, comparing the results from the 1991-92 and 2011-12 survey years, noting that the average total cholesterol score had fallen in the intervening years. In those same years, however, more people were using cholesterol-lowering drugs, specifically statins (brand names you know might be Lipitor or Zocor).

We know how much each specific statin and its various strengths can be expected, on average, to affect people's cholesterol scores. With that information, the researchers were able to estimate how much the two-decade drop in cholesterol scores was due to people taking statins.

The good news I mentioned? Only about one-third of the reduction in people's cholesterol scores was due to taking cholesterol-lowering medications. Better still, the authors note that the Health Survey for England also captures how much people exercised - an amount that has "not increased substantially during this period," as they put it. That means that two-thirds of that cholesterol drop is likely to be because people changed their diets - presumably for the better. That's huge!

What this means for you

At this point we would tell our patients, "You're doing great! Don't stop!" Small, incremental changes that you can live with for the long term are your best strategy for improving your diet - and thereby, your health. Following a Mediterranean-style diet is an easy, tasty way to do just that. Find out your Mediterranean Diet score (with tips to improve your score).

First posted: December 9, 2015