Cholesterol Journal Articles

Record 4061 to 4080

Diagnostic importance of HDL cholesterol determination
Reissner, J. and W. Herrmann (1990), Z Med Lab Diagn 31(8): 426-31.
Abstract: The present paper describes the sensitivity to quantification of changes of HDL-cholesterol in serum by two different precipitation and analytical techniques during the treatment of patients. After the precipitation of VLDL and LDL by phosphotungstic acid/magnesium chloride the chemical determination of HDL-cholesterol in serum with the Liebermann-Burchard reaction yields different results in comparison to enzymatic HDL-cholesterol determined in serum supernatant after the precipitation by polyethylene glycol 20.000. Correlation analyses of apolipoprotein A-I with enzymatic HDL-, HDL2-, HDL3-cholesterol or electrophoretic alpha-cholesterol demonstrate that the therapeutically induced changes (by training and diet) of lipid composition are more correctly reflected by the enzymatic determination of HDL-cholesterol after serum precipitation by polyethylene glycol.

Diagnostic potential of serum vitamin E tocopherol and cholesterol levels in children with protein energy malnutrition in western Kenya
Kwena, A. M. and H. S. Nyandieka (2003), East Afr Med J 80(8): 419-23.
Abstract: OBJECTIVE: To determine the levels and diagnostic potential of vitamin E (alpha-tocopherol) in protein energy malnutrition (PEM) in western Kenya. DESIGN: Passive Hospital based study conducted on inpatients and outpatients. SETTING: Webuye sub-District and Moi Teaching and referral Hospitals, Western Kenya. SUBJECTS AND METHODS: Serum levels for vitamin E and cholesterol concentrations in children < 5 years of age (n=56) admitted to Webuye District Hospital, Bungoma, Western Kenya and some (n=3) admitted to Moi teaching and referral Hospital, Eldoret Kenya suffering from Kwashiorkor, Marasmus or PEM and malaria plus there controls, for a period of one year (January-December, 2001) were examined. High Performance Liquid Chromatography (HPLC) and Spectrophotometry were used for the analysis. RESULTS: The serum vitamin E levels were higher in Kwashiorkor (0.078 mg/ml, SD 0.034) than marasmus (0.075 mg/ml; SD 0.069) and controls (0.057 mg/ml; SD 0.022). The mean serum cholesterol levels were higher in marasmus (204.6 mg/dl; SD 104.8) than Kwashiorkor (186.0 mg/dl; SD 119.3) and controls (154.3; SD 33.3). There was a significant correlation in vitamin E concentrations between Kwashiorkor and controls only at P<0.01 as compared to Marasmus and Marasmic/Kwashiorkor. Vitamin E levels did not show significant correlation to cholesterol in malnourished children from Webuye, Bungoma in western Kenya at P<0.01. CONCLUSION: Vitamin E could be a useful diagnostic tool for PEM in this area.

Diagnostic value of cholesterol in pleural effusions
Ram, K. N. and R. S. Sing (1995), J Assoc Physicians India 43(11): 748-50.
Abstract: The separation of pleural effusions into transudates and exudates is the first task the physician must solve in evaluating a pleural effusion for management. Many criteria have been established, but without a definite efficacy of any of them. Cholesterol is an easy, effective, relatively cheap determination to differentiate transudates from exudates. In our prospective study of 40 patients, cholesterol best separated transudates from exudates. A pleural fluid cholesterol value of 60 mg/dl or above has sensitivity, specificity, PPV, NPV and efficacy of 100%, 93%, 96%, 92%, and 95.5% respectively. Pleural fluid to serum cholesterol ratio of 0.3 or higher has sensitivity, specificity, PPV, NPV and efficacy of 96%, 93%, 96%, 92%, and 95% respectively. P. CHOL and P/S CHOL ratio has a misclassification rate of 2.5% each. When both were combined all cases are clearly separated into transudates and exudates.

Diagnostic value of immune cholesterol as a marker for atherosclerosis
Orekhov, A. N., O. S. Kalenich, et al. (1995), J Cardiovasc Risk 2(5): 459-66.
Abstract: BACKGROUND: The serum of patients with coronary atherosclerosis contains circulating immune complexes including low-density lipoproteins (LDLs). We have developed a technique for the evaluation of LDL content in circulating immune complexes by measuring total cholesterol levels in polyethylene glycol precipitates (immune cholesterol). In the present study, the value of immune cholesterol in the diagnosis of atherosclerosis was compared with that of other laboratory parameters, such as total cholesterol levels, triglycerides, LDL cholesterol, high-density lipoprotein cholesterol, lipoprotein(a), and apolipoproteins B and A-1. METHODS: Immune cholesterol and the other parameters were determined in blood samples from 200 patients with documented coronary and extracoronary atherosclerosis. Coronary atherosclerosis was assessed by coronary angiography; stenoses in the aortic arch and branches and in lower-limb arteries were evaluated by angiography and ultrasonography. RESULTS: Only immune cholesterol and the ratio of apolipoprotein B to apolipoprotein A-1 correlated significantly with the severity of coronary atherosclerosis. The accuracy of the diagnosis of coronary atherosclerosis by immune cholesterol was 78%, considerably higher than that of other laboratory parameters. Use of a combined parameter consisting of immune cholesterol, LDL cholesterol, and the patient's age increased the diagnostic accuracy to 81%. A high level of immune cholesterol is characteristic not only of coronary atherosclerosis but also of extracoronary atherosclerosis. The sensitivity, specificity and accuracy of the diagnosis of extracoronary atherosclerosis were even higher than those for coronary atherosclerosis. CONCLUSION: Immune cholesterol may be employed as a novel marker in the diagnosis of advanced atherosclerosis.

Diastolic blood pressure changes during exercise positively correlate with serum cholesterol and insulin resistance
Brett, S. E., J. M. Ritter, et al. (2000), Circulation 101(6): 611-5.
Abstract: BACKGROUND: Metabolic factors, including plasma concentrations of cholesterol and insulin resistance, may influence blood pressure through effects on vascular reactivity. Such effects might influence blood pressure during exercise more strongly than at rest. METHODS AND RESULTS: We examined whether there is an association between serum cholesterol or insulin resistance and change in blood pressure during mild exercise. Blood pressure was measured at rest and during fixed low-workload bicycle ergometry (50, 75, and 100 W, each for 3 minutes) in 75 healthy active men (age, 18 to 66 years). Blood pressure at rest was not significantly correlated with serum cholesterol or insulin resistance (estimated from the fasting glucose-insulin product). The change from resting values in diastolic but not systolic blood pressure during exercise was correlated with serum cholesterol (R>0.47, P<0.0001 for each workload) and insulin resistance (R>0.38, P<0.01 for each workload). Serum cholesterol and insulin resistance were the only independent predictors of the change in diastolic blood pressure during exercise in a stepwise regression model incorporating age, body mass index, serum cholesterol, triglycerides, HDL cholesterol, insulin resistance, and heart rate during exercise. In a further study, the change in diastolic blood pressure during exercise was greater in men with uncomplicated type 2 diabetes (13.6 mm Hg 95% CI, 8.5 to 18.8; n=10) than in nondiabetic control men (2.7 mm Hg 95% CI, -2. 0 to 7.3; n=10; P=0.002). CONCLUSIONS: Changes in diastolic blood pressure during gentle exercise are strongly associated with serum concentrations of total cholesterol and insulin resistance. This may contribute to development of hypertensive complications in dyslipidemic and/or insulin-resistant patients.

Diatomaceous earth lowers blood cholesterol concentrations
Wachter, H., M. Lechleitner, et al. (1998), Eur J Med Res 3(4): 211-5.
Abstract: In this study a potential influence of diatomaceus earth to lower blood cholesterol was investigated. During 12 weeks we monitored serum lipid concentrations in 19 healthy individuals with a history of moderate hypercholesterinemia (9 females, 10 males, aged 35 - 67 years). Individuals administered orally 250 mg diatomaceous earth three-times daily during an 8 weeks observation period. Serum concentrations of cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and triglycerides levels were measured before study entry, every second week during the period of diatomaceous earth intake and 4 weeks after stop of intake. Compared to baseline (285.8 +/- 37.5 mg/dl = 7.40 +/- 0.97 mM) diatomaceous earth intake was associated with a significant reduction of serum cholesterol at any time point, reaching a minimum on week 6 (248.1 mg/dl = 6.43 mM, -13.2% from baseline; p<0.001). Also low-density lipoprotein cholesterol (week 4: p<0.05) and triglycerides levels decreased (week 2: p<0.05, week 4: p<0.01). Four weeks after intake of diatomaceous earth was stopped, serum cholesterol, low-density lipoprotein cholesterol and triglycerides still remained low and also the increase of high-density lipoprotein cholesterol became significant (p<0.05). Diatomaceous earth, a bioproduct, is capable of reducing blood cholesterol and positively influencing lipid metabolism in humans. Placebo-controlled studies will be necessary to confirm our findings.

Diazepam binding inhibitor and total cholesterol plasma levels in cirrhosis and hepatocellular carcinoma
Venturini, I., M. L. Zeneroli, et al. (1998), Regul Pept 74(1): 31-4.
Abstract: Cholesterol is used by cells for biosynthetic processes and for steroid synthesis. Although the role of cholesterol in tumorigenesis is not clear it is known that steroids are important factors in human carcinogenesis. A polypeptide, diazepam binding inhibitor (DBI), which is an endogenous ligand for peripheral benzodiazepine receptors enhances steroidigenesis by promoting cholesterol delivery to the inner mitochondrial membrane which represents the rate-limiting step of steroid biosynthesis. We have assayed the total cholesterol (TC) and the DBI plasma concentrations in patients with liver cirrhosis complicated by hepatocellular carcinoma (HCC) in comparison with those of uncomplicated liver cirrhosis. TC and DBI levels have been studied in 73 cirrhotic patients and in 23 patients with HCC. Both TC and DBI levels were higher in HCC patients when compared with age, sex and Child-Pugh class matched cirrhotic controls. The values (mean+/-S.D.) in patients in Child-Pugh class B and C with and without HCC were respectively 128+/-30 mg/dl vs. 106+/-27 mg/dl (P < 0.01) and 2.05+/-0.78 pmol/ml vs. 0.78+/-0.84 pmol/ml (P < 0.0001). The data may be the result of the metabolic influence of tumors that enhances steroid biosynthesis during tumor proliferation.

Diet and cholesterol reduction
Jenkins, D. J., C. W. Kendall, et al. (2005), Ann Intern Med 142(9): 793-5.

Diet and coronary heart disease: beyond dietary fats and low-density-lipoprotein cholesterol
Fraser, G. E. (1994), Am J Clin Nutr 59(5 Suppl): 1117S-1123S.
Abstract: Traditionally, the effects of diet on coronary heart disease have been attributed to the effects of medium-chain fatty acids, soluble fiber, and dietary cholesterol on serum low-density-lipoprotein (LDL) cholesterol concentrations. We review evidence here that many other dietary substances may affect risk, often via mechanisms not involving LDL-cholesterol concentrations directly. Such substances include phytosterols, tocotrienols, arginine, and antioxidant vitamins. The effects of diet on high-density-lipoprotein-cholesterol concentrations, triglycerides (fasting and postprandial), oxidized LDL particles, prostaglandins, and endothelium-derived relaxing factor are described. Finally, an illustration of some epidemiologic associations between diet and coronary disease events is made from the Adventist Health Study data.

Diet and disease: the "phyte" over intestinal cholesterol
Carter, B. A. and S. J. Karpen (2001), Gastroenterology 121(5): 1255-6.

Diet and plasma lipids in women. I. Macronutrients and plasma total and low-density lipoprotein cholesterol in women: the Framingham nutrition studies
Millen, B. E., M. M. Franz, et al. (1996), J Clin Epidemiol 49(6): 657-63.
Abstract: This study examined relationships between diet and plasma total and LDL cholesterol levels in a population-based sample of 695 premenopausal and 727 postmenopausal women participating in the Framingham Offspring/Spouse Study. Regression analyses controlled for age, caloric intake, apolipoprotein E isoform type, estrogen use, and important CVD risk factors indicated that plasma total and LDL-cholesterol levels were directly associated with consumption of saturated fat and inversely associated with total calorie intake. In contrast, dietary cholesterol was not a predictor of plasma total or LDL cholesterol levels. Total cholesterol levels were also directly associated with total fat, oleic acid, and animal fat, and inversely associated with carbohydrate intake. Stepwise regressions with key nutrients indicated that saturated fat was consistently associated with total and LDL cholesterol levels in Framingham women. These analyses suggest that diet explains 2% of the variability in these lipid levels in a cross-sectional sample of women; the full model explains 22-27%.

Diet and plasma lipids in women. II. Macronutrients and plasma triglycerides, high-density lipoprotein, and the ratio of total to high-density lipoprotein cholesterol in women: the Framingham nutrition studies
Sonnenberg, L. M., P. A. Quatromoni, et al. (1996), J Clin Epidemiol 49(6): 665-72.
Abstract: This study examined relationships between macronutrients and plasma triglycerides, HDL, and the total-to-HDL cholesterol ratio (T/H ratio) in a population-based sample of 695 premenopausal and 727 postmenopausal women participating in the Framingham Offspring/Spouse Study. Multivariate regression analyses revealed that plasma triglycerides were inversely related to protein, fiber, and polyunsaturated fat and directly related to saturated fat and oleic acid. Alcohol intake was directly related to HDL cholesterol and inversely related to the T/H ratio in all subgroups of women, except for postmenopausal women with the 3/2 or 2/2 apolipoprotein E phenotype. Similarly, a direct relationship between dietary fat and HDL cholesterol was limited to this single subgroup of postmenopausal women. Since dietary fat and alcohol do not appear to have consistent effects on plasma lipids in all groups of women, it is important to consider the genetic contribution to diet/lipid relationships in epidemiological studies and when evaluating lipid-lowering interventions.

Diet and risk of colorectal adenomas: macronutrients, cholesterol, and fiber
Sandler, R. S., C. M. Lyles, et al. (1993), J Natl Cancer Inst 85(11): 884-91.
Abstract: BACKGROUND: Diet is thought to be important in the etiology of colorectal cancer. Studies suggest that a diet high in red meat and saturated fat and low in dietary fiber and vegetables may increase cancer risk. Diet may also be important in the development of colorectal adenomas that are precursors of most colorectal cancers, but this hypothesis has not been well studied. PURPOSE: This case-control study was designed to examine the effects of dietary consumption of cholesterol, fiber (vegetables, fruits, beans, and grains), and macronutrients (protein, carbohydrate, and fat) on risk for colorectal adenomas. METHODS: Analyses were based on data from 236 subjects (105 men and 131 women) with histologically confirmed adenomas (cases) and 409 adenoma-free control subjects (165 men and 244 women), all of whom had had colonoscopy. Case and control subjects were similar with respect to gender, body mass, race, marital status, education, and indications for colonoscopy. Using a validated quantitative food-frequency questionnaire, an experienced graduate nutritionist interviewed each subject by telephone. Sex-specific analyses were conducted because the ranges of nutrient intake were substantially different for men and women. Odds ratios (ORs) were calculated according to quintiles of nutrient intake. RESULTS: Carbohydrate intake was inversely related to adenoma risk in women (P for trend =.002). Compared with women in the lowest quintile of carbohydrate consumption, those in the highest quintile were 60% less likely to develop adenomas (OR = 0.39; 95% confidence interval CI = 0.19-0.80). Intake of fruit (P for trend =.028) and intake of fiber derived from vegetables and fruits (P for trend =.012) were also inversely related to adenomas in women. Total fat showed a positive association in women (P for trend =.004), with an OR of 2.69 for the highest versus the lowest quintile (95% CI = 1.31-5.50). Results were comparable for saturated fat (P for trend =.027). The risks in men were generally similar in direction and magnitude but were not statistically significant. CONCLUSIONS: These data support the hypothesis that a diet high in fat and low in carbohydrates, fruits, and fruit and vegetable fiber increases risk not only for colorectal cancer but also for precursor colorectal adenomas. IMPLICATIONS: These results, which are consistent with findings of other investigators, suggest that environmental factors, influencing risk for colorectal cancer, such as a high-risk diet, may lead to development of the precursor adenomas.

Diet as a risk factor for cholesterol gallstone disease
Cuevas, A., J. F. Miquel, et al. (2004), J Am Coll Nutr 23(3): 187-96.
Abstract: Cholesterol gallstone disease is a common condition in western populations. The etiology is multifactorial with interaction of genetic and environmental factors. Obesity, aging, estrogen treatment, pregnancy and diabetes are consistently associated to a higher risk. A number of dietary factors have been involved in the pathogenesis of cholelithiasis. In this article we summarize several studies that have evaluated the role of diet as a potential risk factor for gallstone formation, including energy intake, cholesterol, fatty acids, fiber, carbohydrates, vitamins and minerals, and alcohol intake. Consumption of simple sugars and saturated fat has been mostly associated to a higher risk, while fiber intake and moderate consumption of alcohol, consistently reduce the risk. The association between cholesterol intake and gallstone disease has been variable in different studies. The effects of other dietary factors are less conclusive; additional studies are therefore necessary to clarify their relevance in the pathogenesis of gallstone disease. Recent discoveries of the role of orphan nuclear receptors in the regulation of fatty acid and hepatic cholesterol metabolism and excretion open new perspectives for a better understanding of the role of dietary constituents on cholesterol gallstone formation. KEY TEACHING POINTS: The etiology of cholesterol gallstone disease is multifactorial with interaction between genome and environment. It has been postulated that dietary constituents are important determinants for the formation of lithogenic bile. Intake of high energy, simple sugar and saturated fat favors gallstone formation. Fiber and moderate consumption of alcohol reduce the risk. The role of orphan nuclear receptors in the regulation of hepatic cholesterol metabolism and excretion open new leads for understanding the role of dietary constituents on cholesterol gallstone formation.

Diet enrichment with calcium and magnesium enhances the cholesterol-lowering effect of plant sterols in obese Zucker rats
Vaskonen, T., E. Mervaala, et al. (2001), Nutr Metab Cardiovasc Dis 11(3): 158-67.
Abstract: BACKGROUND AND AIM: Recent clinical studies have demonstrated that plant sterols moderately lower serum cholesterol levels in patients with mild hypercholesterolemia. Furthermore, there is evidence suggesting that mineral nutrients, such as calcium and magnesium, may also decrease serum cholesterol concentrations. In this study, we tested the hypothesis that supplementation with mineral nutrients may enhance the cholesterol-lowering effect of plant sterols in obese Zucker rats. Furthermore, we compared the lipid-lowering effects of monovalent sodium and potassium cations with those of divalent calcium and magnesium cations. METHODS AND RESULTS: A Western-type high-fat/high-cholesterol diet increased serum cholesterol by 175% and liver cholesterol by 65% in comparison with a low-fat/low-cholesterol control diet. On the contrary, the high-fat/high-cholesterol diet decreased intestinal cholesterol absorption, as assessed by means of serum campesterol-, sitosterol-, and sitostanol-to-cholesterol ratios, thus indicating that it was under negative feedback regulation. Supplementation of the high-fat/high-cholesterol diet with plant sterols or mineral nutrients partially prevented the diet-induced increased in serum cholesterol and, when given concurrently, their cholesterol-lowering effect was enhanced. Their combination also effectively prevented the diet-induced increase in liver cholesterol concentration, and had beneficial effects on liver and myocardial hypertrophy, and the development of obesity. These beneficial effects were at least partially mediated by an enhanced blockade of intestinal cholesterol absorption. Interestingly, only divalent cations enhanced the cholesterol-lowering effect of plant sterols, thus supporting the idea that the lipid-lowering effect of divalent cations is related to the formation of insoluble and inabsorbable calcium and magnesium chelates with fatty acids. CONCLUSIONS: Our findings indicate that the cholesterol-lowering effect of plant sterols is enhanced by the co-administration of divalent calcium and magnesium cations but not by monovalent sodium and potassium cations.

Diet fat saturation and feeding state modulate rates of cholesterol synthesis in normolipidemic men
Mazier, M. J. and P. J. Jones (1997), J Nutr 127(2): 332-40.
Abstract: To determine whether diets differing in fats affect cholesterol synthesis in normal individuals, nine men were randomly assigned to three groups that received three diets in a crossover design for 2 wk. Diets were either monounsaturated (MONO), polyunsaturated (POLY), or saturated (SAT). Subjects then drank a dose of deuterium oxide, and unesterified cholesterol fractional synthesis rates (FSR) were calculated during consecutive fed and unfed periods. Absolute synthesis was calculated as the product of FSR and pool size, the latter obtained from a decay curve following a 4-(14)Ccholesterol injection. Serum cholesterol concentrations varied with each diet consumed (P = 0.001); the SAT diet produced the highest and the POLY diet the lowest. Triglyceride concentrations were highest when subjects consumed the SAT diet and lowest with the POLY diet (P = 0.03); values obtained with the MONO diet did not differ significantly from those seen otherwise. HDL cholesterol concentrations were lowest when the SAT diet was consumed, highest when subjects were fed the MONO diet (P = 0.05), and midway but not significantly different with the POLY diet. Cholesterol FSR were greater when subjects consumed (P = 0.001) rather than not, and FSR during 12-h periods were greater (P = 0.045) when subjects ate the POLY diet rather than the SAT diet. Absolute synthesis was also greater (P = 0.04) when subjects were fed, but did not differ with fat type (P = 0.789). Results suggest that cholesterol synthesis is greater when men are fed than when they are not fed, and reduced synthesis is not responsible for the effect of different fats on cholesterol concentrations.

Diet induced regulation of genes involved in cholesterol metabolism in rat liver parenchymal and Kupffer cells
Hoekstra, M., R. Out, et al. (2005), J Hepatol 42(3): 400-7.
Abstract: BACKGROUND/AIMS: Feeding rodents atherogenic diets enriched in cholesterol or cholic acid changes hepatic cholesterol metabolism. In the present study, the effect of an atherogenic diet enriched in cholesterol and cholic acid on cellular hepatic cholesterol metabolism was studied. METHODS: Gene and protein expression analysis was performed on parenchymal, endothelial, and Kupffer cells isolated from rats fed a chow or atherogenic diet using quantitative real-time PCR and immunoblotting, respectively. RESULTS: The atherogenic diet raised the serum cholesterol concentration 11-fold, mostly in the VLDL fraction, and led to heavy lipid loading of rat liver parenchymal and Kupffer cells. Only moderate changes in the expression of genes involved in cholesterol metabolism were observed in parenchymal cells on the diet, while PPAR delta expression was 6.8-fold decreased. Kupffer cells, however, showed a highly adaptive response with a 2- to 9-fold induction of SR-BI, ABCA1, and ABCG5/G8, and an 82-fold induction in CYP7A1 mRNA expression, respectively. CONCLUSIONS: Heavy lipid loading of parenchymal cells leads to moderate gene expression changes, while Kupffer cells respond in a highly adaptive fashion by stimulating the expression of genes involved in cholesterol metabolism and transport.

Diet modification alters plasma HDL cholesterol concentrations but not the transport of HDL cholesteryl esters to the liver in the hamster
Woollett, L. A., D. M. Kearney, et al. (1997), J Lipid Res 38(11): 2289-302.
Abstract: These studies were undertaken to investigate the mechanism whereby diet modification alters the plasma concentration of high density lipoprotein (HDL) cholesteryl ester and apoA-I and to determine whether diet-induced alterations in circulating HDL levels are associated with changes in the rate of reverse cholesterol transport. Rates of HDL cholesteryl ester and apoA-I transport were measured in hamsters fed a control low-cholesterol, low-fat diet or the same diet supplemented with soluble fiber (psyllium) or with cholesterol and triglyceride (Western-type diet). The Western-type diet increased the plasma concentration of HDL cholesteryl ester by 46% compared to the control diet and by 86% compared to the psyllium-supplemented diet; nevertheless, the absolute rates of HDL cholesteryl ester transport to the liver were identical in the three groups. Diet-induced alterations in circulating HDL cholesteryl ester levels were due to changes in the rate of HDL cholesteryl ester entry into HDL (whole body HDL cholesteryl ester transport) and not to regulation of HDL cholesteryl ester clearance mechanisms. The Western-type diet increased the plasma concentration of HDL apoA-I by 25% compared to the control diet and by 45% relative to the psyllium-supplemented diet. Diet-induced alterations in plasma HDL apoA-I concentrations were also due entirely to changes in the rate of apoA-I entry into HDL (whole body HDL apoA-I transport). These studies demonstrate that the absolute flux of HDL cholesteryl ester to the liver, which reflects the rate of reverse cholesterol transport, remains constant under conditions in which plasma HDL cholesteryl ester concentrations are altered over a nearly 2-fold range by diet modification.

Diet modification in lowering plasma cholesterol levels. A randomised trial of three types of intervention
Johnston, H. J., M. Jones, et al. (1995), Med J Aust 162(10): 524-6.
Abstract: OBJECTIVE: To compare the efficacy of three types of diet and lifestyle interventions for lowering plasma lipid levels. DESIGN: Randomised parallel-group trial. SUBJECTS AND SETTING: Adults with plasma cholesterol levels of 5.5-8.0 mmol/L attending two Sydney community health screening clinics were asked to participate: 179 agreed and 131 completed the study. INTERVENTIONS: A pamphlet with brief advice; group dietary counselling; or individual counselling. Counselling included three sessions with a dietitian/nutritionist over six months. MAIN OUTCOME MEASURES: Plasma total cholesterol levels measured by Reflotron analyser; fasting serum lipid levels measured by standard laboratory methods; and calculated low-density lipoprotein cholesterol levels. RESULTS: Significantly lower plasma total cholesterol levels (Reflotron) were observed at two months and at six months with each of the three interventions. Additionally, both types of dietitian-based counselling resulted in small but significant decreases in plasma low-density lipoprotein cholesterol levels at six months in a subset of subjects. CONCLUSION: Although there were no statistically significant differences in efficacy between the three types of intervention, dietitians have a role to play in setting up such counselling programs.

Diet to reduce cholesterol: heart recommendations agree with NCI, DHHS
Smigel, K. (1990), J Natl Cancer Inst 82(6): 450-1.

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