LIPOPROTEIN LIPID RESPONSE TO THE NATIONAL CHOLESTEROL EDUCATION-PROGRAM STEP-II DIET BY HYPERCHOLESTEROLEMIC AND COMBINED HYPERLIPIDEMIC WOMEN AND MEN
Ce. Walden et al., LIPOPROTEIN LIPID RESPONSE TO THE NATIONAL CHOLESTEROL EDUCATION-PROGRAM STEP-II DIET BY HYPERCHOLESTEROLEMIC AND COMBINED HYPERLIPIDEMIC WOMEN AND MEN, Arteriosclerosis, thrombosis, and vascular biology, 17(2), 1997, pp. 375-382
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.