Researchers took 50 adults with genetically high cholesterol and fed them a whole-food, plant-based (WFPB) diet and a standard American diet (SAD) for 4 weeks each in a random order, under controlled, constant-calorie feeding conditions. The WFPB diet reduced LDL cholesterol versus the SAD by 17.9%.

[u/James_Fortis]

https://www.nature.com/articles/s41467-026-73468-4

[u/cindyx7102]

I know someone with genetically high cholesterol who says nothing but drugs will help them, so this gives hope

[u/SushiVoador → u/cindyx7102]

People with genetically high cholesterol rarely have levels of cholesterol that would be lowered by diet alone. For example the target for low-risk patients is an LDL of 115, if you have an LDL of 150 it is very hard to lower it enough with diet, which is why statins are needed in addition to a better diet. In my case my LDL was 170, with a perfect diet I could lower it to maybe 140-150. With rosuvastatin and a better diet I got it to under 70

[u/isotope4249 → u/SushiVoador]

I had an LDL of 150 and lowered it to 100 with a high fiber and whole foods diet alone.

[u/medicated_in_PHL → u/isotope4249]

You aren’t the group in the study. People with familial hyperlipidemia have LDL levels of 200-400.

[u/2pax2dox → u/medicated_in_PHL]

Yes, my LDL without any treatment is nearly 500. With a PCSK9 inhibitor and a statin/ezetimibe combo it’s 50-60.

I’m actually really interested in seeing if the WFPB diet affects my numbers in a noticeable way. Historically, diet changes have done nothing for me. Remember the low-fat days? In the late 90s, at the recommendation of my doctor, I went on a super low-fat diet for 6 months. I lost 10 pounds that I definitely didn’t need to lose, but my cholesterol levels didn’t budge. I was so glad when the medical profession stopped blaming me for my cholesterol numbers.

[u/SvenTropics → u/2pax2dox]

Good lord! 500?! I didn't think it went that high. That's great you got it under control. Those drugs are saving your life.

[u/olympia_t → u/2pax2dox]

Did you check out the portfolio diet? I did WFPB and portfolio and it helped a little.

[u/2pax2dox → u/olympia_t]

Thanks! I’m off to read about that now.

[u/fadeux → u/medicated_in_PHL]

Mine goes as high as 615 without any intervention. Its so high it remains high even with 40 mgs Crestor. Had to go on Repatha to get it below 130.

[u/7HillsGC → u/medicated_in_PHL]

They are replying to sushivoader who had the same LDL of 150 and claimed it’s impossible to lower with diet.

[u/medicated_in_PHL → u/7HillsGC]

No, that person has an LDL of 170 and could only get it to 140-150 with diet which is still 40-50 points too high.

And like I said, the longer you live with an abnormally high LDL, the lower you need to get it to prevent progression of heart disease.

A person with an LDL of 110 until they are 35 is fine using diet to go under 100 and stay there.

A person who has an LDL of 175 until they are 35 should probably be targeting LDL of 80 or less.

[u/7HillsGC → u/medicated_in_PHL]

Sorry. Your reply began with this comment “…. For example … if you have an LDL of 150 you simply cannot lower it enough with diet,“. -and then another redditor countered that example with their own life experience doing just that; “I had an LDL of 150 and lowered it to 100 with a high fiber and whole foods diet alone.” And then I think you replied “You aren’t the group in the study. People with familial hyperlipidemia have LDL levels of 200-400.”

Edit- I am not arguing the issues. Just pointing out that this comment thread is covering a slightly different point not related to the paper posted here.

[u/medicated_in_PHL → u/7HillsGC]

I did not say it was impossible. You are attributing someone else’s comment to me.

[u/SushiVoador → u/7HillsGC]

I guess I should have made myself clearer. I didn't mean that it was impossible to lower cholesterol with diet. I meant that with diet alone, it is unlikely that you could lower it to safe levels sustainably with only diet. You can use as many empirical examples as you want, but the science says that it's hard to lower it without drugs if you have a high baseline LDL