EFFECTS OF AN AMERICAN-HEART-ASSOCIATION DIET AND WEIGHT-LOSS ON LIPOPROTEIN LIPIDS IN OBESE, POSTMENOPAUSAL WOMEN

The sequential effects of an American Heart Association (AHA) Step 1 d iet and subsequent weight loss on lipoprotein lipids in obese [body ma ss index (in kg/m(2)) > 27], postmenopausal women (n = 48) were determ ined. Subjects followed a euenergetic AHA Step 1 diet for 2 mo, follow ed by a weight-loss diet (deficit of 1.0-1.5 MJ/d) for 6 mo. The AHA d iet lowered concentrations of total (7%), low-density-lipoprotein (LDL ) (6%), and high-density-lipoprotein (HDL) (14%) cholesterol (P < 0.01 ). Weight loss (-5.6 +/- 0.7 kg; P < 0.01) decreased plasma triacylgly cerol concentrations (9%; P < 0.01) and increased HDL-cholesterol conc entrations (8%; P < 0.01) compared with changes after the AHA diet, bu t there were no changes in total or LDL cholesterol. The combined AHA diet and weight-loss interventions lowered triacylglycerol (10%) and t otal (6%), LDL (6%), and HDL (7%) cholesterol. These changes correlate d indirectly with the baseline concentration for each lipid. When the women were divided on the basis of initial LDL-cholesterol concentrati on, the AHA diet and weight-loss interventions reduced (P < 0.01) tria cylglycerol (19%), total cholesterol (13%), and LDL cholesterol (14%) in the women with hypercholesterolemia but not in normocholesterolemic or mildly hypercholesterolemic women. Thus, an AHA Step 1 diet and su bsequent weight loss improve lipoprotein lipid profiles of obese, post menopausal women with hypercholesterolemia. However, because it lowers HDL cholesterol, a low-fat diet without substantial weight loss may n ot be beneficial for improving lipoprotein lipid risk factors for coro nary artery disease in obese, postmenopausal women with normal lipid p rofiles.