The cholesterol-lowering effect of statins is potentiated by whole grains intake. The Polish Norwegian Study (PONS)

Published:November 11, 2017DOI:


      • Only one in four statin users has an adequate whole grains intake.
      • Statin users have lower blood lipids when they have an adequate whole grains intake.
      • Pharmacological and dietary approaches have additive hypocholesterolemic effects.
      • Statin use may not replace the benefits of adequate whole grain intake.
      • Practitioners need to emphasize both pharmacological and lifestyle approaches.



      Hypercholesterolemia treatment guidelines emphasize an adequate whole grains (WG) intake, alone or complementary to pharmacological treatment. We conducted this study to compare the prevalence of adequate WG intake and levels of blood lipids according to the statin/WG intake status.


      This cross-sectional analysis of a community-based study included 12,754 men and women, age 45–64. Statin use over past 30 days was recorded by trained nurses. Food intake over past 12 months was assessed by a validated food-frequency questionnaire. Adequate WG intake was defined as ≥3 oz-equivalents/day, representing ≥3 WG servings/day.


      The prevalence of an adequate WG intake was marginally superior in statin users (26.79%) than non-users (21.51%). This superiority was attenuated after multiple covariates adjustment (PR 1.12, 95%CI 1.02–1.22). Statin users with an adequate WG intake had lower multivariable-adjusted mean blood total cholesterol (185.14 mg/dL vs. 190.14 mg/dL) and LDL cholesterol (103.30 mg/dL vs. 108.19 mg/dL) than those with an inadequate WG intake. Statin users with an adequate WG intake had lower odds (OR, 95% CI) of having TC ≥ 240 mg/dL (OR 0.67, 95% CI 0.46–0.98) and lower odds of having LDL ≥ 100 mg/dL (OR 0.72, 95% CI 0.58–0.89), compared to statin users with inadequate WG intake. A subgroup analysis restricted to those with prevalent CVD yielded similar results.


      In this community based sample of middle-aged adults, only one in four statin users had adequate whole grain intake. Statin users with adequate WG intake had statistically and clinically significant lower levels of blood total- and LDL-cholesterol.


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