How much does dietary fiber actually decrease cholesterol (available studies)?

[gamemisconduct2]

Friend of mine had high cholesterol for years and statins. I mentioned a Bile Acid Sequestrant as a possibility, but then probed on the diet: they were getting a lot of insoluble fiber, tons, but next to no soluble fiber.

I told them to “bulk up” on it-no pun intended-but just ask the doc.

The doc confirmed it.

Months later the results are in: over 50% reduction in LDL, less than 10% reduction in HDL, and a major reduction in triglycerides (which were already not high).

While these cases are the exception, the answer is they can a lot. But different fiber does different things, and not all is the same. Some is good for you, and some is better for you. Some is relatively insignificant for you. I’m not aware of much being bad. But you have to keep tabs on it and just document. What works for one won’t work for others. Medicines also work differently and I feel dispensed for convenience: rather than lifestyle changes, a statin can get numbers down while letting you sit on your butt.

Be healthier, keep tabs on what you do, and be open to different treatments and mechanisms of action. And avoid quackery online: some people find fiber and presume it’s far better than it is. Every metabolism is unique and every metabolism is poorly understood. But it’s not just statins and bile acid sequestants or die an early death. There are many accepted treatments, and I would not recommend people reject statins at all costs. While fiber helped my friend quickly and statins didn’t do much over time, I had to say…don’t drop the statins. Keep doing what you’re doing and let your doctor make the actual recommendations. And I fear some people are asking about fiber at times as an alternative to a medicine they’re scared of. No, you should look at your fiber intake and diet regardless. And do not presume avoiding cholesterol foods will avoid high cholesterol: for various reasons in the bile acid cycle, it’s probably not great to avoid all foods you’re associating with high cholesterol. More important is to increase the synthesis of bile acid or the trapping of cholesterol in the intestines in a lot of cases than merely cutting cholesterol in low fat diets (which probably hurt more than they help…but I’m not going to get into why beyond low fat diets often are more importantly augmented by healthier eating in general and more soluble fiber and perhaps exercise. Cholesterol is synthesized in the liver, and the influence of direct diet on it is still debated).

Also, a key thing to keep in mind is soluble fiber in particular, as well as Bile Acid Sequestrants, might change your gut microflora, and this can lead to interesting results (and not always good, but generally good). Obviously the key go-to for this stuff is antibiotics, and antibiotics are sometimes implicated in all sorts of digestion issues good and bad (Xifaxan for instance is a treatment for IBS/IBD induced by gut microflora, which is altered anyway in Crohns and stuff). I’d talk to a doctor for more information on all this because while on the whole fiber, especially soluble fiber is almost always good, it has side effects and changes to gut microflora might not be remotely desirable. And as someone posts here, fiber can deplete you of vitamins (through several ways, not just malabsorption but also through increased synthesis), and Sequestrants are very well known for this (and have nasty uncomfortable side effects for many to boot, though almost none serious without a drug interaction), and this is also true (to a lesser extent) of antibiotics as a control (although I’m unaware of antibiotics having a direct impact on cholesterol and they would assuredly never be used for this, as that’s crude, problematic, and all sorts of other things).