Dietary counselling effectively improves lipid levels in patients with endogenous hypertriglyceridemia: emphasis on weight reduction and alcohol limitation

Objective: To evaluate the short-term effect of dietary counselling in pati ents with endogenous hypertriglyceridemia and evaluate the effects of advis ed nutrient changes. Design: A prospective dietary intervention study in patients with endogenou s hypertriglyceridemia from January Ist 1988 to December 31 st 1996 accordi ng to the Dutch guidelines for a healthy diet. Before and after the dietary intervention period of 12 weeks, 24 h food recalls were used to assess die tary intake and macronutrient composition. Effectiveness was evaluated by a ssessment of body weight, serum lipids, lipoproteins and insulin resistance parameters. Setting: Leiden outpatient Lipid Clinic. Subjects: Forty-five newly diagnosed, untreated patients with endogenous hy pertriglyceridemia. Results: A significant reduction in energy intake and body weight as well a s changes in macronutrient composition were observed. Total serum triacylgl ycerol and cholesterol levels decreased by 31% and 15%, respectively. No ef fects were observed on serum glucose and insulin levels. Weight reduction w as significantly correlated with reduction of total plasma triacylglycerol levels and inversely correlated with changes in HDL cholesterol levels. Of all nutrients assessed, only reduction of alcohol intake correlated with im provement of total serum triacylglycerol. Conclusions: Short-term dietary counselling in patients with endogenous hyp ertriglyceridemia can effectively improve serum lipid and lipoprotein level s. With regard to the advised nutrient changes, weight loss and limitation of alcohol intake prove to be the best predictors of triacylglycerol reduct ion.