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A Mediterranean‐style low glycemic load diet decreases the risk for heart disease by decreasing atherogenic lipoproteins. Addition of a medical food containing plant sterols and soy protein has a more favorable effect on LDL metabolism

We assessed lipoprotein profiles of women classified with metabolic syndrome (MetS) and with elevated plasma LDL cholesterol (LDL‐C) adhering to a Mediterranean low glycemic diet alone (n = 40) or accompanied by intake of a medical food containing plant sterols, soy protein, rho iso‐alpha acids, and proanthocyanidins (PSS) (n = 44). Decreases in energy intake from baseline (p < 0.00001) paralleled with a decrease in carbohydrate and an increase in protein (p < 0.05). Both groups experienced favorable impacts on MetS parameters, with decreases in waist circumference, plasma triglycerides (TG), and blood pressure (p < 0.01). In addition, decreases in trunk fat were observed (p< 0.0001) for all subjects. While LDL‐C and apolipoprotein (apo) B decreased in all subjects (p < 0.01), there was a greater decrease in the PSS group (p < 0.01). All subjects had a decrease in atherogenic large VLDL (p < 0.0005) and small LDL particles (p < 0.0001). In agreement with decreases in medium HDL (p < 0.001), apo A‐II, associated with atherogenicity, decreased as well (p < 0.001). Lastly, decreases were noted in levels of apo C‐III and E (p < 0.01), which are implicated in hypertriglyceridemia. The data suggest that the dietary prescription improved TG metabolism by decreasing the formation of large VLDL and by reducing apolipoproteins interfering with lipoprotein lipase activity. Inclusion of PSS imparted further beneficial effects associated with LDL metabolism. [Supported by MetaProteomics, LLC, Gig Harbor, WA]