With a high cholesterol and heart disease in the family, Phil's doctor had urged him to adhere to American Heart Association's low-fat, low-cholesterol diet.

"Your LDL cholesterol is 181-it's down only 7%. That's still too high, Phil," the doctor said, sighing. "At your age (46 years old), you can't afford to walk around with an LDL that high. You'll end up with a heart attack. Here's a prescription for -----, a statin drug. This'll drop your cholesterol like a stone."

Phil took the doctor's prescription but never filled it. He'd read somewhere about the muscle and liver side-effects of the so-called "statin" cholesterol drugs. Despite his doctor's reassurances, he was more scared of the drug than of the prospect of a heart attack in his life. Instead, he embarked on a program that included several readily-obtainable foods and included them in his daily routine for several months.

On his return to the doctor, Phil's LDL was down to 112-a 38% drop. "Wow! That's a great result on your medicine," the doctor declared. But Phil informed him of his reluctance to take the medication and how he used foods instead.

Mention fiber and nearly everyone thinks of the dry, cardboard-like breakfast cereals found in the grocery store. It's as if healthy ingredients come at the cost of taste. But the majority of fibers these products contain really provide limited benefits. Wheat-fiber based products like these have essentially no effect whatsoever on cholesterol in your body (though it's good for your bowels.)

Fiber comes in a broad variety of shapes and sizes that you can incorporate into your nutritional program in interesting, delicious ways that can deliver powerful health benefits. With knowledge of superior sources of fiber in food and supplements, you can create a smorgasbord of fiber to substantially lower cholesterol.

But I already eat whole wheat bread!

Most Americans take in a meager 14 grams of fiber a day. Processed foods created for convenience and temptation (and profit) are generally stripped of fiber content. Sugary, dried, instant, microwavable, just-add-water foods in glitzy packaging are therefore miserably deficient in fiber.

The benefits of fiber begin when you take in at least 25 grams every day. This is the level of fiber intake recommended by most national organizations like the American Heart Association. But something unexpected happens when your fiber intake is 50 grams or more a day: cholesterol plummets, blood sugar is lowered, diabetes can be prevented-and you can lose weight, too.

The diet advocated by the American Heart Association lowers cholesterol around 7%. (Yawn.) Compare this to a diet with more stratospheric quantities of fiber (>50 grams per day): cholesterol is lowered 30% or more- that's as good as the statin cholesterol medicines. (Imagine what would happen if you combined a cholesterol-lowering medicine and super-high fiber intake.)

Oat bran

Beta-glucan is a soluble fiber that avidly absorbs water and transforms into a gooey gel. This gel, as it traverses the twenty-some feet of intestines, is an efficient absorber of cholesterol. Beta-glucan is responsible for the cholesterol-lowering properties of oatmeal that you've likely heard about. You know what's even better than oatmeal? Oat bran. Ounce for ounce, oat bran has twice the soluble fiber of oatmeal. You can buy oat bran in bags and boxes in most grocery stores. Oat bran is also more versatile. You can use it as a hot cereal microwaved in skim milk or soy milk (add raw sunflower or pumpkin seeds, fresh berries, or sliced fruit), or you can add it to yogurt, fruit smoothies, or protein drinks. Like oatmeal, you can also use it in your baking.

One ounce of oat bran (1/4 cup) contains 4 grams of fiber, of which 3 grams are soluble. Including ? cup of oat bran a day in your diet can powerfully lower cholesterol.

Pectins

Pectin is the soluble fiber found in abundance in apples and citrus fruits, especially grapefruit. In citrus, the pectin is most concentrated in the white rinds, not the pulp, so don't do such a good job when you peel. The quantity of pectin in a single piece of fruit is relatively modest (around 1.5 grams), but when reaching for a piece of fruit, an apple or citrus fruit can be one way to add modestly to your net daily soluble fiber intake.

Flaxseed

Flaxseed is an ancient food, described in Egyptian writings dating back thousands of years. When the seeds are ground, the lignans, a structural fiber, are exposed and available as soluble fiber. (In addition to powerful cholesterol-lowering properties, the lignans are being intensively investigated for their cancer-preventing properties.) Flaxseed is available both as whole seeds and already-ground. Whole seeds need to be ground (e.g., in your coffee-grinder) to release the fibers. Don't confuse flaxseed oil with the seed itself. When the oil is extracted from flaxseed to produce flaxseed oil, it can be a source of linolenic acid, which in turn is converted by your body to a small quantity of omega-3 fatty acids (as in fish). But the bulk of benefit from flaxseed is found in the lignan, or fiber, content, and the ground seeds are therefore required, not just the oil.

Use flaxseed just as you would oat bran: Mix with skim or soy milk, raw seeds, and berries to make a warm cereal; mix with yogurt, fruit smoothies, protein drinks. Two tablespoons a day provides 17 grams of fiber, of which 6 grams are soluble.

Beans

Beans are an excellent and easy addition to most dinner menus. A ? cup serving of starchy beans-pinto, Spanish, black, red, white-provides around 2 grams of soluble fiber and 4 grams total fiber. (Green beans are great for many reasons but are not a significant source of soluble fiber.) Vegetarian chilis and bean soups are among the many ways you can use these tremendous sources of fiber. Although beans are a carbohydrate source, the glycemic index (sugar-raising effect) is relatively low.

Psyllium Seed

Psyllium seed is the main ingredient in the familiar Metamucil, as this seed has the capacity to absorb many times its weight in water, making intestinal contents bulkier and softer. But it also lowers cholesterol 7?10%, just like oat bran and flaxseed. Psyllium is useful for its convenience: Just dissolve a teaspoon in 8?12 oz of water and drink. However, it is much less versatile than oat bran and flaxseed in that you really can't conceal it in yogurt or fruit smoothies or protein drinks. A teaspoon of psyllium (containing 2.4 grams of soluble fiber, 3 grams total fiber) is most useful when you are unable for one reason or another to use another soluble fiber source (e.g., when you're traveling). Taken 30 minutes prior to meals, you can also use it to produce satiety, or the feeling of fullness that discourages you from overeating. Many people use this as a helpful weight-loss strategy.

Nuts

Nuts are little powerhouses of beneficial nutrients. Unfortunately, manufacturers will roast them in oils (often hydrogenated), add salt, or coat them in sugar and other less healthy additives ("honey-roasted"). Stick with the raw variety for greatest benefit. In particular, raw almonds and walnuts pack the greatest punch when it comes to lowering cholesterol. A ? cup serving of either each day lowers cholesterol 8%. The route by which nuts accomplish this is not entirely clear, but the content of fiber, phytosterols (in almonds and similar to that found in butter-substitutes Take Control and Benecol), and other phytonutrients likely all contribute to the effect. Nuts are also rich in monounsaturated oils (similar to that in olive oil) and this may contribute to cholesterol-lowering. What's more, the generous fiber content of nuts has been shown to lower blood sugar and can even lower the effective glycemic index of carbohydrate foods (slows sugar release into the blood). This effect can help prevent diabetes. The wonderful satiety effect (feeling full) of raw nuts will permit you to eat a handful of nuts and feel satisfied. Up to a ? cup a day is advised for full benefits.

Phytosterols

Phytosterols (also known as stanol and sterol esters) are found in abundance in many plants and closely resemble human cholesterol in structure. But when 2 level tablespoons are taken orally each day, they lower cholesterol around 15%. Curiously, phytosterols need to be "esterified", or bound, to a chemical side-group that gives them an oily consistency in order to exert their full cholesterol-lowering effect in the intestine. This is the reason that phytosterols come in oil-based forms as butter substitutes (Take Control, Benecol) and more recently as a mayonnaise-substitute. You can find the butter substitute products in the dairy aisle of the grocery store. Beware of their calorie content, as excessive quantities can still cause you to gain weight despite the cholesterol-lowering effect.

Soy protein powder

Soy beans have many beneficial nutrients. Among them are isoflavones, which are believed by many to help relieve menopausal symptoms in women, as isoflavones resemble estrogen. However, it is the protein we're interested in for cholesterol-lowering properties. The protein has been shown to lower cholesterol 15?20% by shutting off the liver's production of cholesterol. Soy protein, in fact, is one of the foods endorsed by the FDA to lower cholesterol.

The easiest way to get the 25 grams (3 tablespoons) of soy protein required for full cholesterol-lowering benefit is through powders that you can purchase in canisters at grocery and health food stores. Use the powder as part of health shakes (with yogurt or kefir, fresh fruit, oat bran, skim milk, soy milk, etc.) Other sources of soy protein include soy milk, textured-vegetable protein used as a meat substitute, soy nuts, soy cheese, low-carb pasta, and soy butter.

Create a smorgasbord of fiber

Including just a little of one or two of these strategies will help lower your cholesterol. But if you're looking for a super-charged benefit, combine several of these foods and nutrients. It is entirely possible to lower LDL cholesterol a full 30% or more when you put several together each and every day. A sample approach might be:

? Raw almonds-? cup per day (total fiber 5.8 g; soluble 0.6 g)

? Oat bran-? cup per day (total fiber 4 g, 3 g soluble)

? Psyllium seed-2 tsp per day (6 g total fiber; 4.8 g soluble)

? Citrus fruit-e.g., 1 orange (around 1 g soluble fiber)

? Beans-1/2 cup per day, cooked (4 g total fiber; 1 g soluble)

? Soy protein powder-3 tbsp in protein shake (25 grams protein)

The fiber content of this regimen alone-over 20 grams added-packs a powerful effect on cholesterol. Most people lose a modest quantity of weight, as well, because of the feeling of fullness that fiber-rich foods provide. If you are diabetic or have "borderline" or "pre-" diabetes, blood sugars are often lower on this regimen. (Discuss this with your doctor to avoid excessively low blood sugars if you take oral diabetic medications or insulin.)

But beware. . .

Start with too much fiber all at once and you may-paradoxically-end up with constipation. The safest way to proceed if you begin with an average low-fiber American diet is to add one or two fiber sources at a time, and add another form only after two weeks. This permits your intestines to accommodate to the increased bulk. Also be sure to take in plenty of water, as these fibers will draw water into the intestine and can actually cause you to be dehydrated if you do not drink enough. If the fiber cannot draw enough water into the intestine, you can end up with a very nasty case of constipation. Not pretty! (Consult your doctor if you have a history of congestive heart failure, kidney or liver disease, edema, or have been advised to follow a fluid restriction before you embark on a program that requires greater fluid intake.)

William Davis, MD is a practicing cardiologist and author of the book Track Your Plaque: The only prevention program that shows how to use the new heart scans to detect, track, and control coronary plaque. His new book, What Does my Heart Scan Show? will be available for free through http://www.trackyourplaque.com.