ôô

Can These Snack Bars Replace Your Cholesterol Meds?

Some new "functional food" products offer an alternative for those who can't or won't take medication to control cholesterol. What's in these products and what's the evidence to support the claims?

By
Monica Reinagel, MS, LD/N, CNS
4-minute read
Episode #657

What if you could replace your daily cholesterol medication with a couple of tasty snack bars?

A company called Step One Foods has created "clinically formulated" foods that it claims can replace cholesterol medication for people who are "unable or unwilling to take statin drugs." The product line includes a variety of snack bars, along with flavored oatmeal, pancake, and smoothie mixes.

In a study conducted at the Mayo Clinic, 54 people with high cholesterol were instructed to consume two of these products per day. This resulted in a 10% reduction in their LDL (or "bad") cholesterol levels after four weeks.

I think it's too soon to say that these snack foods can replace cholesterol medications on a long-term basis. But it's certainly an interesting development.

More than a third of adults over the age of 45 have high cholesterol, and statin drugs are among the most commonly prescribed medications. Statins are quite effective in lowering cholesterol—and, by the way, also pretty good at reducing systemic inflammation. They are also inexpensive and covered by most insurance companies.

Although they are generally safe, statins do have the potential to cause side effects, such as muscle pain or weakness. Only a small minority of people experience side effects, and for many, they are little more than an annoyance. But side effects (or even just a fear of side effects) could be one reason that people are unwilling or unable to take statins.

How'd Step One make these products?

The Step One products are rich in nutrients that are known to have a positive effect on cholesterol: soluble fiber, omega-3 fatty acids, antioxidants, and phytosterols.

Phytosterols are naturally-occurring compounds that block the absorption of cholesterol in the intestine. According to the National Lipid Association, consuming 2,000 mg of phytosterols every day can lower your cholesterol and reduce your risk of heart disease. Not coincidentally, two of these bars or mixes a day provide exactly 2,000 mg of phytosterols, along with about 10 g of fiber and 2000 mg of plant-based omega-3 fats.

These products are made primarily from whole foods: dried fruits, nuts, seeds, bran, and flavorings like peanut butter, chocolate, and cinnamon. No sweeteners, gums, or preservatives.

I can imagine that these products might have a lot of appeal for people who are determined to control their cholesterol without medication, through a healthy diet, exercise, and other lifestyle strategies. 

Of course, high cholesterol is not always about a poor diet or unhealthy lifestyle; sometimes it's simply a genetic predisposition. When doing all of the "right things" doesn't lower cholesterol, these folks often feel like they have failed. For them, a food-based alternative to medication might be very attractive. 

Unlike statins, however, medical insurance isn't going to cover Step One products and they aren't inexpensive: a month's supply will run you $130 a month, or $4 a day. Even without insurance, a generic statin typically costs less than $20 a month.

Can you do control cholesterol with diet?

But if it's just about including more cholesterol-lowering foods, is an expensive functional food necessary? Couldn't you just eat more oat bran, nuts, chia seeds, and dried fruit and call it good? Not quite. 

With a little effort, you could easily match the amount of fiber, omega-3, and antioxidants found in these bars. But you wouldn't come close to the amount of phytosterols.

Nuts and seeds are among the most potent whole food sources of phytosterols, but they provide less than 100 mg of phytosterols per serving. In fact, Step One products are heavily fortified with phytosterols derived from pine sap. So, in addition to eating more nuts, seeds, and oat bran, you'd also need to add a phytosterol supplement in order to replicate the same effect. A month's supply of phytosterol supplements will cost you around $30.

What role do Step One products play in a heart-healthy diet?

The cholesterol-lowering effects of these functional foods have only been tested in one small study that lasted only 30 days. Their long-term effectiveness has yet to be established. So, I definitely don't recommend going off your cholesterol medication without consulting your doctor.

Keep in mind that if these bars were to replace your meds, you'd need to be as diligent about eating your bars and shakes as you are about taking your medication every day.  And, unlike statins, these foods will contribute 300-400 calories to your diet every day. In order to avoid adding unneeded calories, you'd need to consume these foods instead of other foods that you normally eat, not in addition to them.

Would there be any harm in including these in your diet as a way of keeping your heart healthy? The ingredients are wholesome and nutritious. As snack foods go, you could definitely do worse! But you could probably find whole-food bars that are less expensive. More to the point, these are more than just fruit and nut bars. 

Phytosterols are generally thought to be beneficial. But whether it's a nutritional supplement or a heavily fortified food product,  you always want to be thoughtful about adding a nutrient to your diet in amounts that you would not get from food. For example, high levels of phytosterols could reduce the effectiveness of a cholesterol-lowering medication called cholestyramine (or Questran).  While eating foods that are high in phytosterols would not be a concern, combining this medication with a phytosterol supplement would not be a good idea. Cholesterol also plays a much different role in growing bodies than it does in adult ones. So these foods, which contain the equivalent of a high-dose phytosterol supplement, would not be appropriate for children. 

Citations +
The Quick And Dirty
  • A new line of snack bars and smoothie mixes promises to lower your cholesterol without medication.
  • These whole food-based products are fortified with phytosterols, plant-based compounds that help lower cholesterol.
  • More research is needed to establish whether these functional foods can replace cholesterol-lowering medications.
  • The amount of phytosterols in this product may not be appropriate for everyone.

About the Author

Monica Reinagel, MS, LD/N, CNS

Monica Reinagel is a board-certified licensed nutritionist, author, and the creator of one of iTunes' most highly ranked health and fitness podcasts. Her advice is regularly featured on the TODAY show, Dr. Oz, NPR, and in the nation's leading newspapers, magazines, and websites. Do you have a nutrition question? Call the Nutrition Diva listener line at 443-961-6206. Your question could be featured on the show.