Effects of an American Heart Association step I diet and weight loss on lipoprotein lipid levels in obese men with silent myocardial ischemia and reduced high-density lipoprotein cholesterol.
Reduced plasma concentrations of high-density lipoprotein cholesterol (HDL-C) are a risk factor for coronary artery disease (CAD). In this study, we examined the sequential effects of an isocaloric American Heart Association (AHA) step I diet and a hypocaloric AHA step I diet (AHA step I diet + weight loss) on lipoprotein lipid levels in 14 middle-aged and older (60 +/- 6 years, mean +/- SD) obese (body mass index [BMI] > 27 kg/m2) nondiabetic men with exercise-induced silent myocardial ischemia (SI) and reduced HDL-C levels (0.85 +/- 0.14 mmol/L). Nine men of comparable age and obesity and with no evidence of exercise-induced ischemia that were evaluated longitudinally served as metabolic controls. In men with SI, after 3 months on the isocaloric AHA step I diet plasma triglyceride (TG) levels decreased by 26% (2.25 +/- 0.66 to 1.67 +/- 0.69 mmol/L, P < .005), cholesterol by 12% (5.24 +/- 0.84 to 4.62 +/- 0.78 mmol/L, P < .01), and low-density lipoprotein cholesterol (LDL-C) by 10% (3.40 +/- 0.69 to 3.05 +/- 0.70 mmol/L, P < .01). However, plasma HDL-C levels also decreased by 7% (0.85 +/- 0.14 to 0.79 +/- 0.13 mmol/L, P < .05). Subsequent weight loss (11 +/- 4 kg) in conjunction with the AHA step I diet resulted in an additional decrease of 24% in TG (P < .005), 10% in cholesterol (P < .05), and 10% in LDL-C (P < .05). Plasma HDL-C levels increased by 8% (P < .01), thereby correcting the decline seen on the AHA step I diet alone.(ABSTRACT TRUNCATED AT 250 WORDS)
Katzel
L I
LI
Department of Medicine, University of Maryland School of Medicine, Baltimore.
Coon
P J
PJ
Dengel
J
J
Goldberg
A P
AP
D000368:Aged; D002309:Cardiology; D008076:Cholesterol, HDL / Q000097:blood*; D004032:Diet; D006493:Heparin / Q000494:pharmacology; D006801:Humans; D008049:Lipase / Q000378:metabolism; D008071:Lipoprotein Lipase / Q000378:metabolism; D008074:Lipoproteins / Q000097:blood*; D008099:Liver / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood* / Q000150:complications; D009765:Obesity / Q000097:blood* / Q000150:complications; D012955:Societies, Medical; D014481:United States; D015431:Weight Loss
D008076:Cholesterol, HDL; D008074:Lipoproteins; D006493:Heparin; D008049:Lipase; D008071:Lipoprotein Lipase