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Articles: Christopher D. Gardner, Ann Coulston, Lorraine Chatterjee, Alison Rigby, Gene Spiller, and John W. Farquhar The Effect of a Plant-Based Diet on Plasma Lipids in Hypercholesterolemic Adults: A Randomized Trial Ann Intern Med 2005; 142: 725-733 [Abstract] [Full text] [PDF]

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Lowering LDL and HDL with the same intervention

Matthew Menken   (6 May 2005)

Lowering LDL and HDL with the same intervention 6 May 2005
Matthew Menken, M.D., F.A.C.P. World Federation of Neurology Research Group on Medical Education Send rapid response to journal: Re: Lowering LDL and HDL with the same intervention mmenken712{at}aol.com Matthew Menken	The authors have added to our growing knowledge of the interventions by means of which to lower LDL cholesterol. However, the plant-based diet in this study also lowers HDL cholesterol. This is worrisome. It is not unusual in practice to encounter patients with LDL cholesterol values that exceed guideline recommendations (<80 mg/dL), yet who have progressive vascular disease. Conversely, it is rare in practice to encounter patients with very high HDL cholesterol values (>80 mg/dL), and who have progressive vascular disease. At the present time, we have few effective and well tolerated interventions to raise HDL cholesterol. Thus virtually all of the clinical research to date has focused upon lowering LDL cholesterol levels in defined populations. Plainly, comparable clinical studies to raise HDL cholesterol cannot yet be carried out. Until and unless such HDL cholesterol studies are done, we should limit LDL-lowering interventions in practice to those strategies that are HDL-neutral, or which raise HDL cholesterol at the same time. Conflict of Interest: None declared