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Changing Lifestyles, Changing Habits: Can Diet, Exercise Replace Medication?

separator Do you take medication for high cholesterol? Or have you just found out you need to start taking medication? If either of these is true, you may be wondering whether it’s possible for you to avoid taking these drugs by changing the kind and amount of food you eat and by exercising. 

The answer isn’t simple. Some people will always need to take medication to keep their cholesterol under control, no matter how much they change their food and exercise plans. They naturally produce more cholesterol than is healthy. Others may be able to reduce their medication dosage by eating differently and becoming more active. And there are some people who are able to stop taking medication after embarking on a serious program that eliminates unhealthy foods, strictly limits even the kinds of healthy foods you can eat and incorporates exercise and stress management. 

Study results after intensive lifestyle changes
The changes you would need to make depend on what your health status is now. If you already have high cholesterol and heart disease, chances are you’ll need to make bigger changes than if you’re simply trying to prevent the development of this condition. 

In the 1990’s, Dr. Dean Ornish, of the Preventive Medicine Research Institute in California, conducted a study called the Lifestyle Heart Trial. For one year, people with heart disease were separated into two groups—an experimental group and a control group. The experimental group changed their diets so that fat comprised only 10 percent of their food intake daily. (In comparison, the American Heart Association recommends a diet that has no more than 30 percent fat daily.) They also ate no meat. Participants exercised every day and took part in stress management training and smoking cessation. Nobody in the experimental group took cholesterol-lowering medication. 

The control group, on the other hand, followed general advice from their family physicians about healthy lifestyle changes, but they did not follow the specific regimen of the experimental group. Additionally, 60 percent of control group members took cholesterol-lowering medication. 

After 1 year, people in the experimental group had a 37.2 reduction in LDL (“bad”) cholesterol, fewer episodes of angina and a reduction in narrowing of the arteries. The control group patients, on the other hand, experienced a 6 percent reduction in LDL cholesterol, had more episodes of angina and they experienced increased narrowing of the arteries. Narrowing of the arteries creates a higher risk of heart attack. 

Participants were then invited to take part in a 5-year follow-up study. At the end of five years, changes were even more pronounced:

  • The experimental group had a 72 percent reduction in angina versus a 36 percent decrease for the control group.
  • In terms of narrowing of the arteries, the experimental group experienced a 7.9 percent improvement, while the control group experienced a 27.7 percent increase in narrowing.
  • The experimental group had twice as many cardiac events as the experimental group. These included heart attacks, angioplasty procedures, bypass surgery, other hospitalizations related to cardiac issues and cardiac-related death.
  • The experimental group experienced the same reduction in cholesterol levels as the control group patients who took cholesterol-lowering medication.

Supportive healthcare team can help you make intensive changes
Making changes similar to those made by the people in the Lifestyle Heart Trial takes a great deal of discipline and determination. For most people, it’s pretty much a 180 degree change in lifestyle. 

If you’re seriously interested in seeing what you can do to bring down your cholesterol levels, talk with your doctor. Explain that you want to make comprehensive changes. Talk with a dietitian or a nutritionist to figure out what kinds of meals you can plan. Remember, comprehensive changes incorporate not just diet and exercise, but quitting smoking and stress management as well. Your healthcare team can help you locate professionals who can guide you in all of these endeavors. 

Good habits help medication work better
If you do decide to see whether you can eliminate or reduce your need for medication, it’s important to work with your doctor on this. If you do actually bring your cholesterol down, your doctor’s involvement is necessary because you’ll probably need to adjust your medication dosage. 

Even if you’re not able to completely eliminate medication, having a healthy lifestyle helps your medication work better and typically leads to an improved quality of life overall.

S. Holt. Journal of the American Medical Association, 1998;280:2001-2007; The Natural Way to a Healthy Heart, M. Evans and Company, Inc., New York, New York, 1999. American Heart Association; National Heart, Lung and Blood Institute
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