Using Processed Food to Treat High Cholesterol?

Should we have better signposts in dietary guidelines to help people avoid ultra-processed foods? Or should we lean into processed foods with bio-active ingredients to treat high cholesterol in people who don’t want to take statins? Admittedly, this dichotomy is a bit extreme. But it does illustrate the confusing mix of information coming at us on the subject of processed food, health, and nutrition.

On one hand, researchers from Australia are lamenting the lack of advice about food processing in dietary guidelines around the world. But at the same time, other researchers are suggesting that specially processed snacks, pancakes, and oatmeal can “meaningfully reduce LDL cholesterol” in adults who won’t or can’t take statins.

An RCT of Functional Foods for High Cholesterol

A press release boldly claims that an RCT of processed functional foods is the “first of its kind” and it “proves” food can be as effective as medications for lowering cholesterol. However, Stephen Kopecky and colleagues are a bit more careful with words in the publication of their study, in the Journal of Nutrition.

It is a small, well-controlled study of just 54 adults in a randomized, double-blind, crossover design. It was only eight weeks long. The outcomes focused only on serum lipids. So the claim that these snacks are as good as lipid lowering medications is a bit of puffery.

Nonetheless, it does point to the potential value of these processed functional foods for people who don’t want to take statins. These were all products formulated to contain plenty of fiber, omega-3 fatty acids, phytosterols, and antioxidants.

What would the long-term compliance and outcomes with these medicalized foods be? This trial cannot answer that question.

Seeking Guidance on Ultra-Processed Foods

On the other side of the ledger, Daniela Koios, Priscila Machado, and Jennifer Lacy-Nichols seem to have a pretty clear view of the problems with processed foods. They published a global analysis of guidance on this subject in 106 sets of dietary guidelines from all over the world.

What did they find? In a word, deficiency. “Nutrient-based messages were more common than messages about processing levels,” they wrote. In a commentary for The Conversation, Machado and Lacy-Nichols were more explicit:

“The absence of clear and actionable guidance is a risk for public health and the environment.”

So are industrially formulated foods a threat to health? Or beneficial? The answer, of course, is that this is a subject that defies simple answers. We have our doubts about the merits of pretending food is medicine.

But we don’t doubt that some dietary patterns are healthier than others. Some of the best patterns minimize the consumption of highly processed foods. Translating that into dietary guidelines to improve public health is an imprecise science.

Click here for the study by Kopecky et al and here for the press release. For the analysis by Koios et al, click here. The commentary by Machado and Lacy-Nichols is here.

Porridge Eaters, painting by Georges de la Tour / WikiArt

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February 16, 2022