LIPOPROTEIN LIPID RESPONSE TO THE NATIONAL CHOLESTEROL EDUCATION-PROGRAM STEP-II DIET BY HYPERCHOLESTEROLEMIC AND COMBINED HYPERLIPIDEMIC WOMEN AND MEN

The beFIT study tested whether teaching the NCEP step II diet (<30% of calories from total fat and <7% from saturated fat) is an effective t herapy in hypercholesterolemic women and men with or without elevated triglycerides after 6 months. Hypercholesterolemic subjects had two LD L cholesterol measurements above the age- and sex-specific 75th percen tile, and combined hyperlipidemic subjects additionally had similarly elevated triglyceride. Subjects were randomized to receive dietary int ervention (eight weekly classes) immediately or 6 months later. Follow -up visits were quarterly, with lipid measurements and 4-day food reco rds. Subjects randomized to delayed intervention did not report diet c hanges or experience lipid changes; the immediate intervention group s ignificantly reduced fat and cholesterol intakes, resulting in signifi cant LDL cholesterol lowering. Six months after diet instruction, 178 women and 231 men reported total and saturated fat intakes of approxim ate to 25% and 7.5% kcal. LDL cholesterol was significantly reduced in women (7.6% and 8.1%) and men (8.8% and 8.1%) with hypercholesterolem ia and combined hyperlipidemia, respectively, but was not different by sex or lipid disorder. Candidates for drug therapy were reduced from between 27% and 37% to 20%. HDL cholesterol was significantly decrease d in women (-6.4% and -4.7%) but not in men (-1.3% and -2.7%). The 6.4 % reduction in hypercholesterolemic women was significantly different from that of men. The significance of the HDL cholesterol reduction in women is unknown. LDL cholesterol response was similar between women and men and between hypercholesterolemic and combined hyperlipidemic s ubjects. LDL cholesterol lowering by diet can significantly reduce the number of hyperlipidemic persons requiring drug therapy.