Rx Nutrition Resource Center

Rx Nutrition Resource Center

Disclosures: Klodas is the founder of One Step Foods.
January 26, 2022
2 min read

Nutrient-dense foods may help reduce cholesterol among statin-intolerant patients

Disclosures: Klodas is the founder of One Step Foods.
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Substituting a small portion of food with nutrient-dense foods may effectively lower cholesterol among patients with hyperlipidemia without the use of drugs, according to findings published in the Journal of Nutrition.

The “food as medicine” approach resulted in an average 9% decrease in LDL cholesterol within 30 days among participants, Elizabeth Klodas, MD, the founder and chief medical officer of Step One Foods, a health food company based in Minnesota, and colleagues reported.

Mean cholesterol reductions with a food intervention among adults with hyperlipidemia not on statin.
Kopecky SL, et al. J Nutr. 2022;doi:10.1093/jn/nxab375.

A food-based intervention can help address the root cause of a patient’s health condition rather than treating their symptoms, Klodas told Healio.

“There’s no shortage of chronic health conditions that couldn’t benefit from studies on food to see whether they make a difference,” she said.

Elizabeth Klodas

In a multicenter, randomized, double-blind, free-living crossover study, Klodas and colleagues evaluated the effect of consuming snacks containing a compendium of functional bioactives on fasting LDL cholesterol among participants who were unwilling to use or intolerant to at least one statin drug. The study cohort included 18 men and 36 women with a mean age of 49 years and a mean small dense LDL cholesterol of 131 mg/dL. The researchers instructed the participants to consume a variety of ready-to-eat snacks (Step One Foods) two times per day as a substitute for food items they were usually consuming. The food replacements were made entirely from whole food-based ingredients and designed to deliver a nutrient-packed snack of 5 g of fiber or more, 1,000 mg omega-3 (n-3) fatty acids, 1,000 mg phytosterols and 1,800 µmol antioxidants per serving.

Participants were instructed to avoid any other behavioral changes during the study period. Klodas and colleagues matched control snacks with similar, calorie-equivalent items from grocery stores. The study involved two regimented phases of 4 weeks each separated by a 4-week washout period. Participants’ serum lipids were measured at baseline and the end of each phase.

Compliance to the study foods was 95%, according to Klodas and colleagues. Overall, when participants substituted foods for the Step One Foods snacks, they experienced an average reduction in LDL cholesterol of 8.8% (P < .0001), and an average reduction in total cholesterol of 5.08% (P < .0001) compared with the control foods. Some participants experienced reductions in LDL cholesterol of more than 20%, according to the researchers. However, HDL cholesterol, triglycerides, serum glucose, insulin and high-sensitivity C-reactive protein concentrations did not differ significantly between the treatment and control groups.

The food-based intervention is meant to be an adjunct or alternative treatment to expand the breadth of treatment options for individuals who are unwilling to use or intolerant to statins, Klodas said. A food-based adjunct intervention like Step One Foods may also reduce health care costs that fall on patients from medications, she noted.

This study is “the first time we present physicians with dose food,” which allows them to test how responsive their patients are to food and help them solve any underlying issues in a reliable way,” Klodas said.


Kopecky SL, et al. J Nutr. 2022;doi:10.1093/jn/nxab375.

First of its kind study proves food intervention can be as effective as medications for lowering cholesterol. https://www.eurekalert.org/news-releases/940695. Published Jan. 26, 2022. Accessed Jan. 26, 2022.