A COMBINED COMMUNITY STRATEGY TO REDUCE CHOLESTEROL AND OTHER RISK-FACTORS

Our primary objective was to conduct an integrated program to reduce c oronary risk factors in the population of an Israeli kibbutz. The popu lation-based objective was to reduce the mean community total choleste rol level. The individual-based objective was to provide counseling an d treatment for individuals at high risk and to reduce individual tota l and low-density lipoprotein cholesterol levels. The intervention inc luded food policy changes in the central kibbutz kitchen, health educa tion programs aimed at all age groups, and health counseling for indiv iduals at risk. Evaluation was by questionnaire at baseline and at the end of two years, blood lipoproteins, and monitoring of all food purc hased by the kibbutz. Fifty-three percent of the adult population (100 of 187) had borderline to high baseline total cholesterol levels. At one year, 27% of these were in the normal category. Egg consumption dr opped by 6%, liquid oil by 7%, and red meat by close to 19%, Consumpti on of fish, chicken meat, and vegetarian patties increased. Consumptio n of 1% milk increased by almost 300%. We conclude that an integrated health education program targeting individuals and the community toget her can be effective in reducing risk factors for coronary artery dise ase.