Diet and nutritionHeart and cholesterol — can a plate of vegetables work better than statins?
- Ewa Dąbrowska — Dynamika zmian stężenia lipoprotein w surowicy w chorobie niedokrwiennej serca pod wpływem diety jarzynowo – owocowej
- Ewa Dąbrowska — Leczenie zespołu X metabolicznego dietą warzywno – owocową
- Effect of fat-modified and fruit- and vegetable-enriched diets on blood lipids in the Indian Diet Heart Study. · Am J Cardiol 1992
- Effect of diet and moderate exercise on central obesity and associated disturbances, myocardial infarction and mortality in patients with and without coronary artery disease. · J Am Coll Nutr 1996
- Fruit and vegetable consumption and LDL cholesterol: the National Heart, Lung, and Blood Institute Family Heart Study. · Am J Clin Nutr 2004
- Interpreting Lower HDL Cholesterol in Plant-Based Diets: Mechanisms and Clinical Implications. · Adv Nutr 2026
Ewa Dąbrowska describes how, after six weeks on a fruit-and-vegetable diet, the lipoprotein profile improved in participants with coronary artery disease.
- During this period, total cholesterol and LDL tended to decrease, while HDL increased; the LDL-to-HDL ratio also fell.
- In the first week, the changes temporarily went in the opposite direction: total cholesterol, LDL, and the LDL-to-HDL ratio increased, while HDL fell.
- After 12 weeks, including six weeks on a vegetarian diet, lipoprotein levels remained similar.
- Lipid disorders persisted in the group eating a mixed diet, and the results fluctuated.
What the authors write
After six weeks on the diet, total cholesterol, LDL, and triglycerides tended to decrease, while HDL increased by 32%.
The LDL-to-HDL ratio fell from 6.7 to 3.4, a decrease of 44.8%.
In the first week, total cholesterol, LDL, and the LDL-to-HDL ratio temporarily increased, while HDL fell.
After 12 weeks, lipoprotein levels remained similar to those recorded after the earlier period on the diet.
The six-week fruit-and-vegetable diet restored normal lipoprotein proportions, and continuing with a vegetarian diet helped maintain them.
Lipid disorders persisted in the control group eating a mixed diet, and the values for individual measures fluctuated.
The fruit-and-vegetable diet is presented as a strategy that may lead to the resolution of lipid disorders and coronary heart disease.
Research from PubMed · Europe PMC
We selected 4 studies with the best, positive results. This is a selection, not a full review of all research.
Total number of studies on this topic in PubMed: 27.
In patients with risk factors for coronary artery disease, adding fruit and vegetables to the diet lowered total cholesterol and LDL and raised HDL.
Aim of the study: This study was designed to test the efficacy of the administration of fruits and vegetables for 12 weeks as an adjunct to a prudent diet in decreasing blood lipids in 310 (intervention; group A) and 311 (control; group B) patients with risk factors of coronary artery disease (CAD) in a parallel, single-blind fashion.
Results: Serum triglycerides also decreased (7%) more in group A than B. Fasting blood glucose decreased by 6.9% in group A and by 2.6% in group B. The combined effect of a fat-modified diet plus fruits and vegetables was greater than these changes. Because tasty fruits were taken by the patients before meals (when they are hungry) and are easily available at reasonable cost in our marketing and buying capacity, the compliance was excellent.(ABSTRACT TRUNCATED AT 250 WORDS)
“Not stated” does not mean nobody paid — the database does not always record it.
In people with coronary artery disease or its risk factors, a diet enriched with fruit and vegetables was associated with a greater decrease in total cholesterol and LDL, a decrease in triglycerides, and an increase in HDL.
Aim of the study: To test whether a fat modified and fruit and vegetable enriched diet in conjunction with moderate physical activity reduces the cardiac event rate in patients with coronary artery disease (CAD) and its risk factors in an urban setting in India.
Results: Waist-hip ratios, fasting and post-prandial blood glucose, plasma insulin levels, blood pressure and weight fell significantly in patients in group A compared with those in group B. While triglycerides in group A showed a significant decrease, high density lipoprotein cholesterol showed a significant increase. Both groups showed a significant reduction in total and low density lipoprotein cholesterol, although the decrease was greater in group A than group B. Central obesity decreased by 6.2% in group A vs. 1.2% in group B, 95% confidence interval of difference 2.3 to 7.8. The incidence of cardiac events was significantly lower in group A than group B (29 vs. 43 patients, p < 0.01). All-cause mortality also significantly declined in group A compared with group B (16 vs. 24 died, p < 0.05). The group A patients with better adherence to exercise and diet showed greater reduction in central obesity and greater decline in cardiac event rates and total mortality compared to control group B.
“Not stated” does not mean nobody paid — the database does not always record it.
In a large observational study, higher fruit and vegetable consumption was associated with lower LDL levels.
Aim of the study: An elevated LDL-cholesterol concentration is associated with an increased risk of cardiovascular disease. The association between fruit and vegetable consumption and LDL has been inconsistent. The objective was to determine whether a high intake of fruit and vegetables is inversely associated with LDL concentrations.
Results: The mean (+/-SD) age of the men (n = 2047) was 51.5 +/- 14.0 y and that of the women (n = 2419) was 52.2 +/- 13.7 y. The average daily serving of fruit and vegetables was 3.2 +/- 1.7 for men and was 3.5 +/- 1.8 for women. Fruit and vegetable consumption was inversely related to LDL: in the categories 0-1.9, 2.0-2.9, 3.0-3.9, and > or = 4 servings/d, multivariate-adjusted mean (95% CI) LDL concentrations were 3.36 (3.28, 3.44), 3.35 (3.27, 3.43), 3.26 (3.17, 3.35), and 3.17 (3.09, 3.25) mmol/L, respectively, for men (P for trend < 0.0001) and 3.35 (3.26, 3.44), 3.22 (3.14, 3.30), 3.21 (3.13, 3.29), and 3.11 (3.04, 3.18), respectively, for women (P for trend < 0.0001). This association was observed across categories of age, education, smoking status, physical activity, and tertiles of Keys score. Exclusion of subjects with prevalent diabetes mellitus or coronary artery disease did not alter these results significantly.
“Not stated” does not mean nobody paid — the database does not always record it.
The review indicates that plant-based diets are associated with lower LDL and a lower risk of cardiovascular disease, although HDL may be slightly lower.
Aim of the study: Plant-based dietary patterns are associated with improved cardiometabolic health, including lower concentrations of serum low-density lipoprotein cholesterol, blood pressure, adiposity, inflammation, and lower risk of cardiovascular disease.
Results: We describe plausible mechanistic pathways, including lower saturated fat and cholesterol intake, reduced apolipoprotein A-I secretion and HDL production, and formation of smaller HDL particles that are cleared more rapidly. We suggest that modest HDL cholesterol reductions observed with healthy and appropriately planned plant-based diets should be interpreted within the broader context of net cardiometabolic benefit rather than as an isolated reason for clinical concern. However, substantial heterogeneity across studies-in both results and methodology, including variation in the definitions of plant-based diets-limits causal directionality and interpretation of reported diet-disease associations. Future analyses should improve diet classification and comparator selection, while controlling for weight change and macronutrient composition to isolate any potential effects of plant-based diets on HDL-related outcomes.
“Not stated” does not mean nobody paid — the database does not always record it.
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