Many people choose diet over medication to lower their cholesterol levels. After all, medications come with the possibility of unpleasant and worrisome side effects, plus they can have potentially dangerous interactions with other medications you are taking.

But how much can diet alone do? Quite a bit, as it turns out.

In particular, a chemically-modified wheat fiber known as resistant starch significantly lowered the cholesterol levels and reduced the risk of metabolic syndrome in a recent study by researchers at South Dakota State University.

Participants who had preexisting metabolic syndrome experienced a decrease in all types of cholesterol.

Moul Dey, associate professor of health and nutritional sciences, focuses her research on the use of wheat fiber to lower cholesterol and prevent heart disease. She and Bonnie Specker, director of the E. A. Martin Endowed Program in Human Nutrition, studied the effect of resistant starch on two Hutterite colonies in eastern South Dakota.

Instead of a lab study with controlled experimental conditions, Dey and Specker incorporated the starch into the participants’ flour in what Dey referred to as “a free-living community style environment.” Minimal modifications were made to the Hutterite’s normal diet which consists of foods made from scratch. Every meal contains one or two flour-based items.

After 26 weeks, participants who had preexisting metabolic syndrome experienced a decrease in all types of cholesterol. High blood pressure, high levels of blood triglycerides and cholesterol, low levels of good cholesterol, high fasting glucose, and obesity are the hallmarks of metabolic syndrome.

“The non-HDL types of cholesterols went down significantly, but we also saw a lowering of good HDL cholesterol,” said Dey. Recently published research has suggested that lowering bad cholesterol is more beneficial to heart health than increasing good cholesterol.

Everyone in the study had decreases in body fat and increased lean body mass — both those with metabolic syndrome and those who were healthy. No one really lost weight, and there was no change in body mass index (BMI) observed during the study.

Fewer than three percent of Americans meet the recommended intake of fiber. Since most Western-style diets include wheat-based foods, the authors suggest that using resistant starch enriched wheat flour for regular flour could be an effective way to increase fiber intake among Americans, thereby promoting a healthier lifestyle.

While dietary factors can regulate expression of genes that play a role in the development of chronic disease, working within the Hutterite colonies lessened the genetic variability in this study. The researchers plan to study changes in gut microbes after consuming this same type of fiber, and hope to continue their research with a more diverse population.

The study is published in Molecular Food and Nutrition Research.