When is it OK to Try Food Instead of Statins to Lower Cholesterol?

Cholesterol-lowering medications like Lipitor and Crestor, also known as statins, are frequently prescribed by physicians to people with high cholesterol levels. But lots of people are resistant to taking statins, and we know, because at Step One Foods we talk to them every day. 

Food can make a measurable improvement in as little as 30 to 90 days. So how do you know when it’s safe to for you to postpone medications for a few months while you try a food-first approach? 

According to the American Heart Association and the American College of Cardiology, there are four main categories of patients who are candidates for statin treatment for cholesterol management: 

1. People with established coronary/vascular disease; this is someone who has had a stent, bypass surgery, a heart attack, a stroke, and/or problems with arteries in other parts of their body.
2. People with diabetes.
3. People with LDL cholesterol levels over 190.
4. People who, with the use of a risk calculator, have been identified as having an elevated risk of future heart events. 

Add those four up and you get 70 million adults who should be on statins. Doesn’t sound like they left much wiggle room for a food-first approach.

Here’s our view:

1. If you have established coronary or vascular disease, you should be on a statin. You are at very high risk of developing more heart and vascular problems so using every possible tool to lower your risk is essential. The data is vast and consistent that statins lower risk under these circumstances. But this doesn’t mean that food doesn’t matter. Remember, you want to be doing EVERYTHING to lower your risk and what you eat has a major impact. So here, it’s not one or the other, it’s BOTH. We call this a food-too approach. And if you can’t tolerate statin medications, the food part becomes absolutely critical.
2. If you have diabetes, you should be on a statin. Diabetics have the same high risk of developing future heart and vascular issues as those people who already have heart problems. But food here is critical as well – not just for lowering heart risk–but for reversing your diabetes. If you can reverse your diabetes, you probably won’t need the statin anymore.
3. If you have very high LDL without heart disease or diabetes, you can try diet first. Very high LDL, especially over 200, tends to be genetically driven. But even then, people can experience dramatic cholesterol changes with food. We have seen individuals with very high cholesterol drop their LDL by 100 points with Step One Foods. Depending on your own result, a food-first strategy may not drop your cholesterol enough to eliminate the need for a statin, but it could mean you require a lower dose.
4. If you have a high risk score, you should try diet first. The risk calculator used by physicians is heavily weighted by age so nearly every man over age 60 and every woman over age 70 will be identified as a candidate for statins. But simply turning 60 should not mean that you need to start taking a medication. Use the calculator as a motivator to make lifestyle and dietary changes and work with your doctor to come up with a prevention plan tailored to your individual needs. 

One very important final note. If you are using food to lower your cholesterol, you should approach your efforts just as if you were using a medication. Follow-up with blood tests to measure how your efforts are working. Effects of dietary change can be seen in as little as 30 days.