Individual Responses to a Cholesterol-Lowering Diet in 50 Men With Moderate Hypercholesterolemia

doi:10.1001/archinte.1994.00420030127013

You are seeing this message because your Web browser does not support basic Web standards. Find out more about why this message is appearing and what you can do to make your experience on this site better.

Vol. 154 No. 3, 14 February 1994

Online Only
	•	Online First Table of Contents

Original Investigations

•	Online Features

This Article
•	References
•	Full text PDF
•	Reply to article
•	Send to a friend
•	Save in My Folder
•	Save to citation manager
•	Permissions

Citing Articles
•	Citation map
•	Citing articles on HighWire
•	Citing articles on Web of Science (59)
•	Contact me when this article is cited

Related Content
•	Similar articles in this journal

Social Bookmarking
	What's this?

Individual Responses to a Cholesterol-Lowering Diet in 50 Men With Moderate Hypercholesterolemia

Margo A. Denke, MD; Scott M. Grundy, MD, PhD

Arch Intern Med. 1994;154(3):317-325.

Abstract

Background
Dietary modification is the recommended first step in the treatmentof hypercholesterolemia. However, the efficacy of the NationalCholesterol Education Program Step 1 Diet in outpatients withhypercholesterolemia has been debated.

Methods
Fifty normotriglyceridemic men whose ad libitum low-densitylipoprotein (LDL) cholesterol levels were 4.14 to 5.69 mmol/L(160 to 220 mg/dL) participated in a two-period outpatient dietcounseling study that used a 1-month high-fat, high—saturatedfatty acid period (Hi-Sat) and a 4-month low-fat, low—saturatedfatty acid period (Step 1 Diet). Lipid, lipoprotein levels,and plasma triglyceride fatty acids were measured five timesduring the last 2 weeks of each dietary period and averagedfor each patient. Dietary intake was assessed by 7-day foodrecords. During the Hi-Sat period, an LDL turnover study wasdone to determine the fractional catabolic rate of LDL.

Results
The mean reduction in total and LDL cholesterol levels achievedby diet was 0.54 mmol/L (21 mg/ dL) and 0.39 mmol/L (15 mg/dL),respectively. These responses equaled those predicted from metabolicward investigations. While dietary responsiveness was normallydistributed, there was marked individual variation in response.The mean (±SD) for quartiles of LDL responsiveness were+0.41±0.21 mmol/L (+16±8 mg/dL), —0.16±0.13mmol/L (—6±5 mg/dL), —0.57±0.16 mmol/L(—22±6 mg/dL), and —1.16±0.26 mmol/L(—45±10 mg/ dL). These differences in responsewere partially explained by dietary adherence, baseline fractionalcatabolic rates of LDL, and the change in plasma triglyceridepalmitate level.

Conclusions
The Step 1 Diet is effective in lowering LDL cholesterol levelsfor many hypercholesterolemic men, and with appropriate counseling,outpatients can achieve results predicted by inpatient metabolicdiet studies. Nonetheless, the responsiveness for individualsis highly variable, and this variability is influenced by bothcompliance and biologic factors. Since many men achieved LDLcholesterol levels low enough to remove the need for drug therapyin primary prevention for coronary heart disease, dietary therapyshould remain the initial approach to the treatment of hypercholesterolemia.

(Arch Intern Med. 1994;154:317-325)

Author Affiliations

From the Center for Human Nutrition (Drs Denke and Grundy) and Departments of Internal Medicine (Drs Denke and Grundy), Biochemistry (Dr Grundy), and Clinical Nutrition (Dr Grundy), University of Texas Southwestern Medical Center at Dallas and Veterans Affairs Medical Center, Dallas.

Add to CiteULike CiteULike Add to Connotea Connotea Add to Delicious Delicious Add to Digg Digg Facebook Add to Reddit Reddit Add to Technorati Technorati Twitter What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Comparison of monounsaturated fat with carbohydrates as a replacement for saturated fat in subjects with a high metabolic risk profile: studies in the fasting and postprandial states
Berglund et al.
Am J Clin Nutr 2007;86:1611-1620.
ABSTRACT | FULL TEXT

Genetic analysis of diet-induced hypercholesterolemia in exogenously hypercholesterolemic rats
Asahina et al.
J. Lipid Res. 2005;46:2289-2294.
ABSTRACT | FULL TEXT

Men and Women Differ in Lipoprotein Response to Dietary Saturated Fat and Cholesterol Restriction
Li et al.
J. Nutr. 2003;133:3428-3433.
ABSTRACT | FULL TEXT

Genetic variation and the lipid response to dietary intervention: a systematic review
Masson et al.
Am J Clin Nutr 2003;77:1098-1111.
ABSTRACT | FULL TEXT

References
Circulation 2002;106:3373-3421.
FULL TEXT

Individual Cholesterol Variation in Response to a Margarine- or Butter-Based Diet: A Study in Families
Denke et al.
JAMA 2000;284:2740-2747.
ABSTRACT | FULL TEXT

Differential Effect of National Cholesterol Education Program (NCEP) Step II Diet on HDL Cholesterol, Its Subfractions, and Apoprotein A-I Levels in Hypercholesterolemic Women and Men After 1 Year : The beFIT Study
Walden et al.
Arterioscler. Thromb. Vasc. Bio. 2000;20:1580-1587.
ABSTRACT | FULL TEXT

Incorporation of Lean Red Meat into a National Cholesterol Education Program Step I Diet: A Long-Term, Randomized Clinical Trial in Free-Living Persons with Hypercholesterolemia
Hunninghake et al.
J. Am. Coll. Nutr. 2000;19:351-360.
ABSTRACT | FULL TEXT

A locus conferring resistance to diet-induced hypercholesterolemia and atherosclerosis on mouse chromosome 2
Mouzeyan et al.
J. Lipid Res. 2000;41:573-582.
ABSTRACT | FULL TEXT

Comparison of the Effects of Lean Red Meat vs Lean White Meat on Serum Lipid Levels Among Free-living Persons With Hypercholesterolemia: A Long-term, Randomized Clinical Trial
Davidson et al.
Arch Intern Med 1999;159:1331-1338.
ABSTRACT | FULL TEXT

U-shape relationship between change in dietary cholesterol absorption and plasma lipoprotein responsiveness and evidence for extreme interindividual variation in dietary cholesterol absorption in humans
Sehayek et al.
J. Lipid Res. 1998;39:2415-2422.
ABSTRACT | FULL TEXT

Effects of Reducing Dietary Saturated Fatty Acids on Plasma Lipids and Lipoproteins in Healthy Subjects : The Delta Study, Protocol 1
Ginsberg et al.
Arterioscler. Thromb. Vasc. Bio. 1998;18:441-449.
ABSTRACT | FULL TEXT

ApoE Genotype Does Not Predict Lipid Response to Changes in Dietary Saturated Fatty Acids in a Heterogeneous Normolipidemic Population
Lefevre et al.
Arterioscler. Thromb. Vasc. Bio. 1997;17:2914-2923.
ABSTRACT | FULL TEXT

Interaction of Diet and Genes in Atherogenesis Report of an NHLBI Working Group
Tall et al.
Arterioscler. Thromb. Vasc. Bio. 1997;17:3326-3331.
ABSTRACT | FULL TEXT

Lipoprotein Lipid Response to the National Cholesterol Education Program Step II Diet by Hypercholesterolemic and Combined Hyperlipidemic Women and Men
Walden et al.
Arterioscler. Thromb. Vasc. Bio. 1997;17:375-382.
ABSTRACT | FULL TEXT

Screening for Mild Thyroid Failure at the Periodic Health Examination: A Decision and Cost-effectiveness Analysis
Danese et al.
JAMA 1996;276:285-292.
ABSTRACT

Hypercholesterolemia With Cholesterol-Enriched LDL and Normal Levels of LDL Apolipoprotein B : Effects of the Step I Diet and Bile Acid Sequestrants on the Cholesterol Content of LDL
Vega and Grundy
Arterioscler. Thromb. Vasc. Bio. 1996;16:517-522.
ABSTRACT | FULL TEXT

Efficacy of Low-Dose Cholesterol-Lowering Drug Therapy in Men With Moderate Hypercholesterolemia
Denke and Grundy
Arch Intern Med 1995;155:393-399.
ABSTRACT

Cholesterol-Lowering Diets: A Review of the Evidence
Denke
Arch Intern Med 1995;155:17-26.
ABSTRACT

Individual Responsiveness to a Cholesterol-Lowering Diet in Postmenopausal Women With Moderate Hypercholesterolemia
Denke
Arch Intern Med 1994;154:1977-1982.
ABSTRACT

| | |