Reduction of Low-Density Lipoprotein Cholesterol through Plant-Based Diets: A Scoping Review

Background: Cardiovascular disease (CVD) is the leading cause of death in the world. High levels of low-density lipoprotein cholesterol (LDL-C) are recognized as a key modifiable factor of CVD and currently managed by pharmacological therapies such as statins. There is an increasing interest in applying dietary interventions as a non-drug approach for lowering LDL-C. Recent research demonstrated that a plant-based diet characterized by high intake of vegetables and fruits, legumes, nuts, whole grains and limited amount of meat products can substantially reduce LDL-C levels. Objective: This review aims to summarize the available evidence on the association between various plant-based diets and LDL-C, highlight current knowledge gaps in this developing field, and suggest areas for future research. Methods: A comprehensive search was conducted to identify relevant studies describing plant-based diets and LDL-C using PubMed, Scopus and Web of Science databases over the last 10 years. An independent reviewer screened studies for eligibility and then charted data. Extracted data included study characteristics, dietary intervention, and outcome measures. Results: Out of 900 studies, 18 eligible studies were identified including 11 RCTs, 3 cohorts, and 4 systematic reviews with meta-analysis. The collective evidence demonstrated that plant-based diets are associated with decreased levels of LDL-C levels, where vegan diets had the most consistent results while others had an effect depending on adherence and duration. Conclusion: This scoping review highlighted the potential of plant-based diets in management of cardiovascular health.