| For medical practitioners and the general public - Cholesterol Journal Article Catalog. |
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| Logistical implementation of cholesterol screening at the worksite. Appointment versus walk-in approach Nielsen, M. M. (1991), Aaohn J 39(5): 235-40. Abstract: Worksite cholesterol screening programs providing initial cholesterol screening, dietary consultation, and follow up evaluation are an excellent way to assist individuals to know their cholesterol. Two methods for implementation of cholesterol screening at the worksite include walk-in and appointment. These methods can be tailored to accommodate any worksite population. Guidelines for planning, implementation, follow-up, and evaluation of cholesterol screening programs are discussed. |
| Long-chain polyunsaturated fatty acids in the sn-2 position of phosphatidylcholine decrease the stability of recombinant high density lipoprotein apolipoprotein A-I and the activation energy of the lecithin:cholesterol acyltransferase reaction Parks, J. S. and A. K. Gebre (1997), J Lipid Res 38(2): 266-75. Abstract: The lecithin:cholesterol acyltransferase (LCAT) kinetics and activation energy and the stability of apolipoprotein A-I (apoA-I) were investigated using recombinant HDL (rHDL) containing phosphatidylcholine (PC), 3Hcholesterol, and apo A-I. The PC component of the rHDL contained sn-1 16:0 and sn-2 18:1 (POPC), 20:4 (PAPC), 20:5 n-3 (PEPC), or 22:6 n-3 (PDPC) or 10% of the respective PC species and 90% sn-1 18:1, sn-2 16:0 PC ether (OPPC ether). The appVmax of the rHDL containing 100% PC varied 10-fold and was ordered POPC > PEPC > PAPC > PDPC, whereas the appKm values varied 19-43 microns PC. The ether-containing rHDL had appVmax values 17-40% of their respective 100% PC rHDL, but maintained the same rank order. The activation energy of LCAT was lower for rHDL containing long chain polyunsaturated fatty acids (PUFA) compared to rHDL containing 100% POPC or 10% PC/90% OPPC ether. The concentration of guanidine HCl (D1/2) required to denature one-half of the apoA-I on rHDL containing long chain PUFA was reduced (1.2-16 M) compared to those containing 100% POPC or 10% PC/90% OPPC (2.2-2.4 M) and there was a strong correlation (r = 0.71) between LCAT activation energy and the stability of apoA-I (i.e., D1/2). We conclude that long chain PUFA in the sn-2 position of PC decreases the catalytic efficiency of LCAT, the activation energy of the LCAT reaction and the stability of apoA-I on the rHDL particles. The strong association between rHDL apoA-I stability and LCAT activation energy suggests that the temperature-dependent step of the LCAT reaction may be sensitive to the strength of the interaction of apoA-I with rHDL PC. |
| Longer term effects of early dietary cholesterol level on synthesis and circulating cholesterol concentrations in human infants Bayley, T. M., M. Alasmi, et al. (2002), Metabolism 51(1): 25-33. Abstract: De novo endogenous cholesterol synthesis is an integral component of developing human infant adaptive mechanisms that regulate cholesterol homeostasis. Smaller central pools of cholesterol later in life may contribute to reduced low-density lipoprotein-cholesterol (LDL-C) concentrations in the plasma and thus reduce the risk of cardiovascular disease. Early infant adaptive mechanisms may theoretically result in altered central pools of cholesterol in later life. To examine the response of cholesterol homeostasis to long-term dietary cholesterol supplementation, endogenous cholesterol synthesis was studied in 81 full-term healthy neonates at 4 months or at 11 and 12 months of age. Thirty-two infants were breast-fed (BF) (6 males, 7 females), fed regular cows milk protein-based formula (RF) (6 males, 3 females) 0.85 mmol cholesterol/L (33 mg cholesterol/L), or fed regular cow milk protein-based formula with the addition of cholesterol (RF+cholesterol) (5 males, 5 females) 3.44 mmol cholesterol/L (133 mg cholesterol/L). Effects of cholesterol supplementation on cholesterol synthesis rates were evaluated at 4 months of age. Forty-nine other infants, BF (11 males, 6 females) fed RF (7 males, 12 females), or RF+cholesterol (6 males, 7 females) until 6 months of age were studied to test the hypothesis of imprinting using a cross-over design study with a 1-month 250 mg cholesterol/day challenge at 11 months of age. The incorporation rate of deuterium in body water into erythrocyte-free cholesterol over 48 hours was used as an index of cholesterol fractional synthetic rate (FSR) at 4, 11, and 12 months of age. Both plasma total- and LDL-C were higher (P <.04) in BF compared with RF+cholesterol and RF formula-fed groups at 4 months of age. Plasma cholesterol concentrations for all 3 groups were similar at 11 and 12 months of age. FSR (pools/d) was 4-fold higher (P <.0001) in both RF and RF+cholesterol compared with BF groups, but not different between RF and RF+cholesterol formula-fed groups. No differences in FSR before and after cholesterol challenge were observed within the 3 feeding groups at 11 and 12 months of age. However, synthesis rates from 4 months to 12 months increased (P <.03) in BF infants and decreased in both RF+cholesterol (P <.0001) and RF (P <.0001) fed groups. These results demonstrate relative insensitivity of synthesis rates and serum cholesterol concentrations to cholesterol challenge, irrespective of early dietary cholesterol intake in formula-fed and BF infants. These findings support the notion that early dietary cholesterol causes minimal changes in cholesterol metabolism about 6 months after dietary exposure in young infants. |
| Longitudinal changes in plasma cholesterol and triglyceride levels in Japanese male workers, 1977-1992 Kuzuya, F. and H. Shimokata (1995), Ann N Y Acad Sci 748: 510-3. |
| Longitudinal study of cholesterol values in 68 children from birth to 11 years of age Sporik, R., J. H. Johnstone, et al. (1991), Arch Dis Child 66(1): 134-7. Abstract: Sixty eight children born in 1977 who were taking part in an unrelated study of childhood asthma were selected to have their serum cholesterol concentrations measured at birth, and at 4 months and 1, 2, 3, 4, 5, and 11 years of age. Concentrations of high density lipoprotein were measured at 5 and 11 years. Cholesterol values increased rapidly from birth and plateaued at 1 year. There was a further small rise just before puberty. Tracking of values was seen after the age of 1 year, but did not become established until 4 years of age. The cholesterol concentrations in girls were marginally higher than those in boys. The mean (SD) values of cholesterol (mmol/l) for boys were: at birth, 1.7 (0.4); at 1 year, 3.9 (0.9); at 5 years, 5.2 (1.9); and at 11 years, 5.0 (0.7). For girls the corresponding figures were; at birth, 1.9 (0.6); at 1 year, 4.7 (1.0); at 5 years, 4.6 (0.7); and at 11 years, 5.1 (0.7). The mean (SD) high density lipoprotein concentrations (mmol/l) for boys were: at 5, 1.16 (0.35) and at 11, 1.51 (0.23). For girls they were 1.28 (0.30) and 1.56 (0.27), respectively. The serum cholesterol concentrations in these children were high compared with published figures from north America. |
| Longitudinal study of effects of alcohol use and/or personal exercise on high density lipoprotein cholesterol in aging humans Flynn, M. A., A. S. Baker, et al. (2002), J Nutr Health Aging 6(3): 167-70. Abstract: Self-controlled alcohol use and/or personal physical exercise is generally believed to be advantageous in extending good health in aging humans. We investigated whether data collected over 31 years in the same subjects (369 men, 75 women) in our Longitudinal Aging Study of humans (1969-2000) showed strong relationship between alcohol and/or physical exercise with High Density Lipoprotein Cholesterol (HDLC). Women s HDLC interactions among age, diet, alcohol use and/or exercise were not found to be statistically significant in our study. Men, however, showed a strong positive statistical significance (p |
| Longitudinal study of serum cholesterol, apolipoproteins and sex hormones during puberty Stozicky, F., P. Slaby, et al. (1991), Acta Paediatr Scand 80(12): 1139-44. Abstract: In order to determine the age and sex dependency of some of the major risk factors for coronary heart disease during the period of sexual maturation a five-year longitudinal study was carried out on 105 boys and 133 girls living in Plzen, Czechoslovakia. Serum cholesterol was significantly elevated in 13-year-old girls (p less than 0.01), while no statistically significant sex-related differences in total and lipoprotein cholesterol and apolipoprotein A-I and apolipoprotein B levels were found in other age groups during the period of follow-up. In boys the total cholesterol showed a constant and statistically significant decrease (p less than 0.01) between the ages 11 to 13 years, but tended to rise during the last two years of study. In girls, serum cholesterol decreased significantly between the ages 11 to 15 years (p less than 0.05). A statistically significant decrease in pre-beta cholesterol was found in girls during puberty (p less than 0.05). The changes in beta lipoprotein cholesterol were similar to those for total cholesterol. The apolipoprotein A-I concentration decreased significantly between 11 and 15 years in boys (p less than 0.05), while it underwent no substantial change in girls. The apolipoprotein B level decreased permanently and significantly (p less than 0.05) during the 5-year period in girls. In boys, the concentration of this protein decreased between 11 and 14 years and increased during the 15th year when a value significantly higher than that for girls was attained (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) |
| Longitudinal study of the association between ABO phenotype and total serum cholesterol level in a Japanese cohort Wong, F. L., K. Kodama, et al. (1992), Genet Epidemiol 9(6): 405-18. Abstract: The relationship between ABO blood phenotype and total serum cholesterol (TC) level was examined in a Japanese population to determine whether an elevated TC level is associated with phenotype A, as has been demonstrated in many West European populations. Such studies in nonwhite populations are scarce, and findings generally failed to demonstrate the relationship. Inconsistent results from cross-sectional studies of various racial groups with widely varying ages raised an age effect as a possible explanatory factor. It was also suggested that the ABO-TC association may not be apparent in populations with low fat intake or low mean cholesterol level. These hypotheses are addressed by examining long-term TC data collected serially from the unexposed controls of the atomic bomb survivors in Hiroshima and Nagasaki who were participants of the Adult Health Study program at the Atomic Bomb Casualty Commission-Radiation Effects Research Foundation between 1958 and 1986. The statistical method of growth curve analysis, through the mixed effect model of Laird and Ware 1982, was used to model age-dependent changes in cholesterol levels within individuals. The effects of the ABO polymorphism in modifying the resultant growth curve are examined. We demonstrate that TC levels are elevated on average by about 4 mg/dl in phenotype A compared to non-A in the Japanese (P < 0.00001), and that this relationship is maintained from early to late adulthood, independent of sex, body mass index, cohort status, or city of residence. Thus, phenotype A individuals may be more predisposed to cardiovascular disease through one of its major risk factors. This is the first study of the ABO-cholesterol association in the Japanese, and the first based on a cohort with longitudinally collected TC data. |
| Longitudinal trends in total serum cholesterol levels in a Japanese cohort, 1958-1986 Yamada, M., F. L. Wong, et al. (1997), J Clin Epidemiol 50(4): 425-34. Abstract: The 28-year follow-up of a Japanese cohort, having collected vast amounts of data collected on total serum cholesterol (TC), provided an exceptional opportunity to examine TC temporal trends. The longitudinal statistical method of growth-curve analysis was used to elucidate the age-related changes in TC levels and to characterize these trends in relation to sex, birth cohort, time period, place of residence, and body mass index (BMI). Japanese TC levels at initial examination were remarkably lower than those in western countries. During the study period from 1958 to 1986, TC levels increased dramatically with age in both sexes. The slope of the cholesterol growth curve was steeper for women than for men, with the difference growing larger after age 40 years. Drastic changes in Japanese behavior and lifestyle, especially westernization of the diet, are thought to have affected the TC values as time-period effects. As a result of this temporal change, which affected different cohorts at different ages, TC values were higher in members of the younger cohort. The increase of the TC values as time-period effects were larger in earlier period than in later period. These time-period effects appeared to be almost similar in men and women. The TC growth curves also varied by city of residence. Subjects in urban areas had higher TC values than subjects in rural areas. Changes associated with BMI from 1958 to 1986 were only partially responsible for the increased steepness of the TC growth curve. |
| Longitudinal trends of total and HDL cholesterol in a representative population sample in the Czech Republic Cifkova, R., Z. Skodova, et al. (2000), Vnitr Lek 46(9): 501-5. Abstract: Cardiovascular diseases are the main cause of death in the Czech Republic. Since 1984 there is a decline of the total and cardiovascular mortality in the CR which is due to a decline of the mortality from IHD and cerebrovascular disease. Within the framework of the MONICA project in 1985, 1988 and 1992 in six districts of the CR screening examinations of cardiovascular disease risk factors were made. For examination always 1% of the population aged 25-64 years (random sampling) was invited. In 1997 and 1998 a similar cross-sectional surmy was made in nine districts of the CR. A total of 3,209 subjects were examined. In 1985-1997/98 in the representative population samples of six districts of the CR there was a significant decline of total cholesterol (men from 6.21 +/- 1.29 to 5.65 +/- 1.15 mmol/l, p < 0.001, women from 6.18 +/- 1.26 to 5.53 +/- 1.21 mmol/l, p < 0.001 and the total cholesterol/HDL ratio (men from 4.94 +/- 1.83 mmol/l to 4.66 +/- 1.46, p < 0.001, women from 4.14 +/- 1.32 to 3.89 +/- 1.30 mmol/l p < 0.001). |
| Long-term (5-year) changes in HDL cholesterol in cardiac rehabilitation patients. Do sex differences exist? Warner, J. G., Jr., P. H. Brubaker, et al. (1995), Circulation 92(4): 773-7. Abstract: BACKGROUND: It is unknown whether the benefits of a cardiac rehabilitation program on HDL cholesterol (HDL-C) are equally achieved in men and women. To study this, we compared changes in HDL-C and other lipids in a large group of men and women participating in a cardiac rehabilitation program for up to 5 years. METHODS AND RESULTS: We compared changes in HDL-C and other fasting lipids in 553 men and 166 women participating in a cardiac rehabilitation program at baseline and then annually for up to 5 years. Patients exercised 3 days a week at 70% to 85% of their maximum heart rate predetermined by a symptom-limited treadmill test. Aerobic capacity was estimated in metabolic equivalents (METs), and percent body fat was determined by skin-fold measurements. Baseline HDL-C, LDL cholesterol (LDL-C), and total cholesterol were significantly higher in women, whereas the ratio of total cholesterol to HDL-C was lower. Although both men and women showed an increase in HDL-C after 1 year (10% and 7%, respectively), only the women's level continued to increase over 5 years (20% versus 5% for men, P =.03). The sex difference in change in HDL-C remained after adjustment for age and smoking. A nonsignificant trend toward a greater change in HDL-C in women existed after adjustment for baseline percent body fat and estimated METs. The change in the ratio of total cholesterol to HDL-C was also more favorable in women, with a 38% decrease over 5 years compared with a 14% decrease in men (P =.01). Total cholesterol decreased by 20% in women and 8% in men (P =.001), whereas LDL-C dropped by 34% in women and 15% in men (P =.0001). There was no sex difference in change in triglycerides. CONCLUSIONS: Women with heart disease who participate in a cardiac rehabilitation program may achieve greater lipid benefits over longer periods of time than previously demonstrated in men. |
| Long-term amiodarone therapy raises serum cholesterol Lakhdar, A. A., E. Farish, et al. (1991), Eur J Clin Pharmacol 40(5): 477-80. Abstract: Serum total cholesterol and triglyceride levels were measured in 12 patients before and 3.6 and 9 months after treatment with amiodarone. In addition, we monitored serum T4, T3, reverse T3 and TSH levels. Amiodarone and its desethyl metabolite levels were measured on each occasion. Serum total cholesterol and T4 levels rose from 5.95 mmol/l, and 102.7 mmol/l respectively at baseline to 6.95 and 115.8 at 6 months and reverse T3 increased at 3, 6 and 9 months from baseline. Serum triglycerides did not change. No relationship existed between cholesterol, T4 and T3 and amiodarone (or its metabolite) levels nor between cholesterol and thyroid hormone levels. These data demonstrate that amiodarone therapy is associated with an elevation in serum cholesterol. This may have clinical implications in view of the current widespread use of the drug. |
| Long-term assessment of psychological well-being in a randomized placebo-controlled trial of cholesterol reduction with pravastatin. The LIPID Study Investigators Stewart, R. A., K. J. Sharples, et al. (2000), Arch Intern Med 160(20): 3144-52. Abstract: BACKGROUND: There is controversial evidence that a low serum cholesterol level is associated with an increased risk of depression, suicide, and violence. The aim of this study was to identify or exclude any small or infrequent adverse effect of long-term reduction of serum cholesterol with pravastatin sodium on psychological well-being. METHODS: The study population consisted of 1130 respondents from a representative sample of 1222 patients with stable coronary artery disease participating in the Long-term Intervention with Pravastatin in Ischaemic Disease (LIPID) study. Subjects were randomized in a double-blind manner to treatment with pravastatin sodium, 40 mg/d (n = 559), or placebo (n = 571) for at least 4 years. Psychological well-being was assessed with a standard self-administered questionnaire at baseline and after 6 months, 1 year, 2 years, and 4 years. The questionnaire assessed anxiety and depression, anger, impulsiveness, alcohol consumption, and adverse life events. RESULTS: Serum cholesterol levels decreased by an average of 1.3 mmol/L (50 mg/dL) with pravastatin therapy and did not change with placebo. During follow-up there was no significant difference by treatment group in measures of anxiety and depression, anger expression, or impulsiveness (95% confidence interval excluded differences of >0.2 SD) and no difference in the proportion of subjects with excessive alcohol consumption or adverse life events (odds ratio, 1.0; 95% confidence interval, 0.8-1.2). There was no evidence of a treatment effect for persons whose baseline serum cholesterol level was in the lowest 10% (<4.6 mmol/L 178 mg/dL) or whose scores for anxiety and depression, anger, or impulsiveness were in the highest 10% at baseline. There was no association between change in the serum cholesterol level and measures of anxiety and depression, anger, or impulsiveness during follow-up. CONCLUSION: Long-term reduction of serum cholesterol with pravastatin has no adverse effect on psychological well-being. |
| Long-term blood cholesterol-lowering effects of a dietary fiber supplement Knopp, R. H., H. R. Superko, et al. (1999), Am J Prev Med 17(1): 18-23. Abstract: BACKGROUND: The study evaluated the blood cholesterol-lowering effects of a dietary supplement of water-soluble fibers (guar gum, pectin) and mostly non-water-soluble fibers (soy fiber, pea fiber, corn bran) in subjects with mild to moderate hypercholesterolemia (LDL cholesterol, 3.37-4.92 mmol/L). METHODS: After stabilization for 9 weeks on a National Cholesterol Education Program Step 1 Diet, subjects were randomly assigned to receive 20 g/d of the fiber supplement (n = 87) or matching placebo (n = 82) for 15 weeks and then receive the fiber supplement for 36 weeks. The efficacy analyses included the 125 subjects (58 fiber; 67 placebo) who were treatment and diet compliant. One hundred two (52 fiber; 50 placebo) completed the 15-week comparative phase. Of these subjects 85 (45 fiber; 40 placebo) elected to continue in the 36-week noncomparative extension phase. RESULTS: The mean decreases during the 15-week period for LDL cholesterol (LDL-C), total cholesterol (TC), and LDL-C/HDL-C ratio were greater (P < 0.001) in the fiber group. The mean changes from pre-treatment values in LDL-C, TC, and LDL-C/HDL-C ratio for subjects in the fiber group were -0.51 mmol/L (-12.1%), -0.53 mmol/L (-8.5%), and -0.30 (-9.4%), respectively. The corresponding changes in the placebo group were -0.05 mmol/L (-1.3%), -0.05 mmol/L (-0.8%), and 0.05 (1.5%), respectively. The fiber supplement had no significant effects (P > 0.05) on HDL cholesterol (HDL-C), triglyceride, iron, ferritin, or vitamin A or E levels. Similar effects were seen over the subsequent 36-week noncomparative part of the study. CONCLUSIONS: The fiber supplement provided significant and sustained reductions in LDL-C without reducing HDL-C or increasing triglycerides over the 51-week treatment period. |
| Long-term cholesterol feeding alters the reactivity of primate coronary microvessels to platelet products Quillen, J. E., F. W. Sellke, et al. (1991), Arterioscler Thromb 11(3): 639-44. Abstract: Hypercholesterolemia impairs endothelium-dependent relaxations to several platelet-derived substances in large vessels. The effect of hypercholesterolemia on the response of coronary microvessels to platelet products and thrombin is less well defined. Three groups of cynomolgus monkeys were studied: normal (n = 6), short-term hypercholesterolemic (8-11 weeks, n = 5), and long-term hypercholesterolemic (18-80 months, n = 6). Responses of coronary microvessels, 100-200 microns in diameter, to thrombin (0.1-10 units/ml) and the platelet products ADP (1 nM-100 microM), serotonin (1 nM-100 microM), and the thromboxane A2 analogue U46619 were studied using an in vitro microvessel imaging apparatus. Vessels were studied after preconstriction with thromboxane A2 analogue U46619 to evaluate both relaxations and constrictions to each agent. Concentrations of U46619 to attain preconstriction were much lower for the long-term group (16 +/- 19 nM) as compared with the control and short-term hypercholesterolemic groups (689 +/- 48 and 664 +/- 63 nM, respectively, p less than 0.01). Relaxations of long-term hypercholesterolemic vessels to ADP tended to be less than those of either control or short-term hypercholesterolemic vessels. Thrombin, when added to normal or short-term hypercholesterolemic vessels, caused identical relaxations but paradoxically caused constrictions in microvessels of long-term hypercholesterolemic monkeys (55 +/- 17% of KCl contraction, p less than 0.001 vs. other groups). Peak constrictions to serotonin were markedly enhanced in the long-term hypercholesterolemic group (59 +/- 7% of maximal KCl responses) compared with control and short-term hypercholesterolemic responses (28 +/- 8% and 32 +/- 5%, respectively, both p less than 0.05 vs. long-term hypercholesterolemia.(ABSTRACT TRUNCATED AT 250 WORDS) |
| Long-term cholesterol feeding stimulates increased bile phospholipids and gallbladder prostanoid synthesis Myers, S. I., D. Haley-Russell, et al. (1991), Surgery 109(5): 656-62. Abstract: The effect of long-term cholesterol feeding on male rabbit gallbladder prostanoid synthesis and bile phospholipid and bile acid levels was examined. In rabbits fed a 2% cholesterol diet for 2, 5, 7, 9, 12, 15, 18, and 21 weeks, serum cholesterol levels increased 12-fold or higher (68-fold at 21 weeks) when compared to the control levels. Total prostanoid synthesis was significantly increased at 7 weeks or more of cholesterol feeding with 6-keto PGF1 alpha (PGI2 metabolite) and PGE2 as the major products. By 21 weeks of cholesterol feeding, 6-keto PGF1 alpha and PGE2 levels were increased 15-fold and 11-fold higher, respectively, compared to the control. Total bile phospholipid levels were significantly increased at 12 weeks or more of cholesterol feeding, and total bile acids significantly increased only from 5 through 12 weeks of cholesterol feeding. These data show that long-term feeding male rabbits with a 2% cholesterol diet increased endogenous gallbladder prostanoid synthesis, which was associated with an increase in bile phospholipid levels. Increased rabbit gallbladder bile phospholipids may represent a compensation of the animal for toxic levels of tissue and bile cholesterol. Increased phospholipid levels in the bile or tissue could serve as a source of increased availability of arachidonic acid leading to a nonspecific increase in gallbladder prostanoid synthesis. |
| Long-term cholesterol-lowering effects of 4 fat-restricted diets in hypercholesterolemic and combined hyperlipidemic men. The Dietary Alternatives Study Knopp, R. H., C. E. Walden, et al. (1997), Jama 278(18): 1509-15. Abstract: CONTEXT: The long-term effect of aggressively vs moderately fat-restricted diets has not been studied extensively in free-living subjects with different types of hyperlipidemia. OBJECTIVE: To compare the cholesterol-lowering effects of 4 levels of dietary fat intake restriction after 1 year. DESIGN: Randomized, parallel, comparison trial. SETTING: Male employees of a large industry. PARTICIPANTS: A total of 444 men had low-density lipoprotein cholesterol (LDL-C) levels above the 75th age-specific percentile. Subjects with triglyceride (TG) levels less than the 75th age-specific percentile were defined as hypercholesterolemic (HC) and those with TG levels at or above the 75th age-specific percentile were defined as combined hyperlipidemic (CHL). INTERVENTIONS: Hypercholesterolemic subjects were randomized to diets 1, 2, 3, and 4 taught to contain 30%, 26%, 22%, and 18% fat, and the CHL subjects were randomized to diets 1, 2, and 3. All 4 diets were taught to subjects and spouses or partners in 8 weekly 2-hour classes. MAIN OUTCOME MEASURES: Plasma lipoprotein levels after 1 year. RESULTS: Fat intake after 1 year declined from a mean of 34% to 36% of energy to 27%, 26%, 25%, and 22% in the 4 HC diet groups and 28%, 26%, and 25% in the 3 CHL diet groups. Mean+/-SD percent LDL-C reductions were 5.3%+/-16.2%, 13.4%+/-12.6%, 8.4%+/-11.2%, and 13.0%+/-15.7% in the HC diet groups and 7.0%+/-16.2%, 2.8%+/-15.8%, and 4.6%+/-13.5% in the CHL diet groups (P<.01 in all but 1 instance). Apoprotein B levels decreased 8.6%, 10.7%, 4.3%, and 5.3% in the HC groups and 14.6%, 11.4%, and 9.9% in the CHL groups (P<.05-.01 in each instance). Triglyceride levels increased significantly in subjects following HC diets 3 and 4, 21.7% and 38.7% (P<.05 and.01), but not in any CHL subjects. High-density lipoprotein cholesterol decreased 2.8% and 3.2% in subjects on HC diets 3 and 4, respectively (P<.05 in both cases). CONCLUSIONS: After 1 year, moderate restriction of dietary fat intake attains meaningful and sustained LDL-C reductions in HC subjects and apoprotein B reductions in both HC and CHL subjects. More extreme restriction of fat intake offers little further advantage in HC or CHL subjects and potentially undesirable effects in HC subjects. |
| Long-term cholesterol-lowering effects of psyllium as an adjunct to diet therapy in the treatment of hypercholesterolemia Anderson, J. W., M. H. Davidson, et al. (2000), Am J Clin Nutr 71(6): 1433-8. Abstract: BACKGROUND: Hypercholesterolemia is a major risk factor for coronary heart disease and nutrition management is the initial therapeutic approach. OBJECTIVE: This multicenter study evaluated the long-term effectiveness of psyllium husk fiber as an adjunct to diet in the treatment of persons with primary hypercholesterolemia. DESIGN: Men and women with hypercholesterolemia were recruited. After following an American Heart Association Step I diet for 8 wk (dietary adaptation phase), eligible subjects with serum LDL-cholesterol concentrations between 3.36 and 4.91 mmol/L were randomly assigned to receive either 5.1 g psyllium or a cellulose placebo twice daily for 26 wk while continuing diet therapy. RESULTS: Serum total and LDL-cholesterol concentrations were 4.7% and 6.7% lower in the psyllium group than in the placebo group after 24-26 wk (P < 0.001). Other outcome measures did not differ significantly between groups. CONCLUSIONS: Treatment with 5.1 g psyllium twice daily produces significant net reductions in serum total and LDL-cholesterol concentrations in men and women with primary hypercholesterolemia. Psyllium therapy is an effective adjunct to diet therapy and may provide an alternative to drug therapy for some patients. |
| Long-term consumption of fermented dairy products over 6 months increases HDL cholesterol Kiessling, G., J. Schneider, et al. (2002), Eur J Clin Nutr 56(9): 843-9. Abstract: OBJECTIVE: Assessment of the hypocholesterolaemic effect of yoghurt supplemented with Lactobacillus acidophilus 145 and Bifidobacterium longum 913 in women. DESIGN: The cross-over study consisted of three periods (7 weeks each): first period, control yoghurt for all 29 women; second period, probiotic yoghurt for 18 women, control yoghurt for 11 women; third period, the reverse of that in the second period. SETTING: Department of Nutritional Physiology, Institute of Nutritional Science, Friedrich Schiller University, Jena. SUBJECTS: Twenty-nine healthy women, aged 19-56 y. Fifteen of these were normocholesterolaemic and 14 women were hypercholesterolaemic. INTERVENTION: Yoghurt (300 g) daily containing 3.5% fat and starter cultures of Streptococcus thermophilus and L. lactis. Probiotic yoghurt was the control yoghurt enriched with L. acidophilus 145, B. longum 913 and 1% oligofructose (synbiotic). RESULTS: The mean serum concentration of total cholesterol and the LDL cholesterol was not influenced by the synbiotic (P>0.05). The HDL concentration increased significantly by 0.3 mmol/l (P=0.002). The ratio of LDL/HDL cholesterol decreased from 3.24 to 2.48 (P=0.001). CONCLUSIONS: The long-term daily consumption of 300 g yoghurt over a period of 21 weeks (control and synbiotic) increased the serum concentration of HDL cholesterol and lead to the desired improvement of the LDL/HDL cholesterol ratio. |
| Long-term dosing of arzoxifene lowers cholesterol, reduces bone turnover, and preserves bone quality in ovariectomized rats Ma, Y. L., H. U. Bryant, et al. (2002), J Bone Miner Res 17(12): 2256-64. Abstract: Long-term effects of a new selective estrogen receptor modulator (SERM) arzoxifene were examined in ovariectomized (OVX) rats. Arzoxifene was administered postoperatively (po) at 0.1 mg/kg per day or 0.5 mg/kg per day to 4-month-old rats, starting 1 week after OVX for 12 months. At study termination, body weights for arzoxifene groups were 16-17% lower than OVX control, which was caused by mainly reduced gain of fat mass. Longitudinal analysis of the proximal tibial metaphysis (PTM) by computed tomography (CT) at 0, 2, 4, 6,9, and 12 months showed that OVX induced a 22% reduction in bone mineral density (BMD) at 2 months, which narrowed to a 12% difference between sham-operated (sham) and OVX rats by 12 months. Both doses of arzoxifene prevented the OVX-induced decline in BMD. Histomorphometry of the PTM showed that arzoxifene prevented bone loss by reducing osteoclast number in OVX rats. Arzoxifene maintained bone formation indices at sham levels and preserved trabecular number above OVX controls. Micro-CT analysis of lumbar vertebrae showed similar preservation of BMD compared with OVX, which were not different from sham. Compression testing of the vertebra and three-point bending testing of femoral shaft showed that strength and toughness were higher for arzoxifene-treated animals compared with OVX animals. Arzoxifene reduced serum cholesterol by 44-59% compared with OVX. Uteri wet weight from arzoxifene animals was 38-40% of sham compared with OVX rats, which were 29% of sham. Histology of the uterine endometrium showed that cell heights from both doses of arzoxifene were not significantly different from OVX controls. In summary, treatment of OVX rats with arzoxifene for nearly one-half of a lifetime maintained beneficial effects on cholesterol and the skeleton. These data suggest that arzoxifene may be a useful therapeutic agent for osteoporosis in postmenopausal women. |