In an experiment involving 46 people with high cholesterol, volunteers who followed the vegetarian diet lowered their cholesterol levels by 29 percent in just four weeks.
The improvement was comparable to that seen in the group which combined a diet low in saturated fats with a daily 20 mg dose of the cholesterol-lowering drug, lovastatin.
If the findings hold up in a larger, longer study, they could have broad implications for the millions of people with high cholesterol.
Alternative to drugs
"This study shows that people now have a dietary alternative to drugs to control their cholesterol," said report David Jenkins, a professor in the University of Toronto's department of nutritional sciences.
He said the fact that humans are adapted to the so-called "ape diet," - nuts, plant sterols, vegetable proteins etc - may explain why the benefits seen are so substantial.
And a professor of medicine at the University of Kentucky in Lexington went one step further, suggesting the diet should be the first stop for people at risk for heart disease.
"For most patients, dietary intervention should be the first line of therapy (perhaps for six to 12 weeks) before introducing pharmacotherapy for hyperlipidemia," said James Anderson.
"People now have a dietary alternative to drugs..."
- Professor David Jenkins
High cholesterol levels tend to increase with age, increasing an individual's risk of heart disease and obesity.
Bad cholesterol is known to clog the coronary arteries, choking off some of the oxygen supply to the body's main muscle.
Statins are some of the most commonly prescribed drugs to combat high cholesterol.
The drugs are effective but costlier than adopting a strict vegetarian diet. Some patients cannot tolerate them, while others may prefer a non-drug approach.
In recent years, the Food and Drug Administration and the American Heart Association have recognised the health benefits of nuts and soy proteins.
The AHA has recommended that people at risk of heart disease should include both foods in their diet alongside foods low in saturated fats.