EFFICACY OF THE NATIONAL CHOLESTEROL EDUCATION-PROGRAM STEP-I DIET - A RANDOMIZED TRIAL INCORPORATING QUICK-SERVICE FOODS

Objective: To determine the effect of incorporating quick-service meal s into a Step I diet on the achievement of the National Cholesterol Ed ucation Program (NCEP) guidelines and on the blood lipid response of h yperlipidemic subjects (as possibly, the achievement of, and adherence to, dietary goals may be assisted by the inclusion of familiar foods, instead of their exclusion). Methods: This was a randomized, parallel design study in free-living subjects. Hypercholesterolemic men and wo men (low-density lipoprotein cholesterol [LDL-C] level, 3.36 to 5.69 m mol/L [130 to 220 mg/dL]) who were consuming a high-fat diet (>33% of total calories from fat) were randomly assigned to either a traditiona l NCEP Step I diet (n=44) or an NCEP Step I diet with the incorporatio n of frequent quick-service meals (NCEP-QS, n=45). Results: After 8 we eks of treatment, both groups similarly reduced their reported dietary intakes of energy (approximately 30%), total percent fat (approximate ly 8%), percent saturated fat (approximately 3%), and cholesterol (app roximately 38% to 28%). Both groups also experienced a decrease in the levels of total serum cholesterol (NCEP Step I diet, 8%; NCEP-QS Step I diet, 3%) and LDL-C (NCEP Step I diet, 10%; NCEP-QS Step I diet, 4% ). However, compared with the group receiving the NCEP-QS Step I diet, the subjects who were consuming the NCEP Step I diet showed a signifi cantly greater reduction in their total serum cholesterol and LDL-C le vels over time (P<.05). Weight loss was significantly correlated (P<.0 01) with the decrease in the total serum cholesterol and LDL-C levels for all subjects combined. Conclusions: Hyperlipidemic subjects who we re consuming an NCEP Step I diet, with or without the incorporation of quick-service meals, experienced a significant decrease in their tota l serum cholesterol and LDL-C levels, body weight, and reported fat in take. The beneficial responses in lipid levels were modestly mitigated in the quick-service diet group.