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To the Editor: Dr Jenkins and colleagues¹ reported that hyperlipidemic adults who received a diet high in plant sterols, soy protein, viscous fibers, and almonds (called the "dietary portfolio") had statistically significant reductions in low-density lipoprotein cholesterol and C-reactive protein levels compared with a control group receiving only the diet very low in saturated fat. Participants who received lovastatin plus a diet low in saturated fats also had significant improvements in their lipid profiles.

In his accompanying Editorial, Dr Anderson² concluded that "For most patients, dietary intervention should be the first line of therapy . . . before introducing pharmacotherapy for hyperlipidemia." The results reported by Jenkins et al, however, do not support that conclusion. In fact, no data could conceivably support that recommendation. No statistically significant differences were found in the results of statin vs dietary portfolio interventions, but even if there were such differences, Anderson's recommendation would not . . . [Full Text of this Article]

Robert M. Veatch, PhD
Kennedy Institute of Ethics
Georgetown University
Washington, DC

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