Bran: Preventive Medicine
Given a choice between a medical therapy that costs about $248 a year or one costing nearly six times that much most patients would have no hesitation in opting for the cheaper alternative, assuming that equal results could be expected. Most of the time, unfortunately, such stark choices in health care aren’t available. An important exception, as a cost-effectiveness analysis in the current Journal of the American Medical Assn. points out, can be found in ways to reduce cholesterol levels.
Medical researchers have discovered an impressive correlation between cholesterol levels and heart disease, with each 1% drop in serum cholesterol associated with a 2% decline in heart-attack risk. The most common way to lower your cholesterol is to change what you eat. Some people, though, also require drug therapy, and that can be expensive. The analysis published in the AMA Journal by Dr. Bruce Kinosian says that the two most commonly prescribed cholesterol-lowering drugs range in price from $879 to $1,442 a year. By contrast, enriching the diet with more soluble fiber seems to provide the same benefits as drug therapy for many patients, but at only a fraction of the cost, even when the expense of supervision by a physician or nutritionist is included.
For demonstration purposes Kinosian and his associates talk about incorporating 1 1/2 cups of oat bran into the daily diet--about $40 a year worth of bran. The bran, like the commonly prescribed drugs, binds to bile acids and reduces their availability in the production of cholesterol. But oat bran isn’t the only good source of soluble fiber. Beans and other legumes, along with apples, oranges and grapefruits are among the foods rich in soluble fiber. The important thing for cholesterol reduction, Kinosian emphasizes, is to have a diet high in overall soluble fiber and to have its effectiveness monitored.
Steadily mounting health-care costs add significance and even urgency to efforts to find more cost-effective ways to treat and prevent major illnesses. Remarkable and life-prolonging advances continue to be made in pharmacology. But, as Kinosian asks, “If you can do it with diet, why use drugs?” That’s not only sound advice for individual patients but, given the economics of medical care, sound social policy as well.
