[Dietary treatment of mild to moderate hypercholesterolemia. Effectiveness of different interventions].
OBJECTIVE
To compare the efficacy of brief dietary intervention by family physicians in their daily practice and in group sessions to standard dietetic treatment in mild to moderate hypercholesterolemia.


METHODS
Randomised clinical trial.


METHODS
Family practice clinic in a remote community.


METHODS
Between September 1, 1991 and September 30, 1992, 135 men and women between 20 and 60 years old with mild to moderate hypercholesterolemia were recruited and randomly assigned to three treatment groups to be taught the American Heart Association low fat diet. Each participant had an LDL-C reading higher than the desirable level set by the Canadian Consensus Conference on Cholesterol.


METHODS
The three treatment groups received different interventions: individual consultations with a family physician in his office (phase I); group sessions with a physician and a dietician (phase II); and individual consultations with a dietician (phase II). Participants were followed for 6 months with visits and blood tests every 2 months.


METHODS
Reduction in serum levels of total cholesterol, LDL-C, HDL-C, and triglycerides was measured after 2, 4, and 6 months of dietary treatment. Changes in risk factors (smoking, weight, level of physical activity) and patients' cholesterol/saturated fat index were also measured.


RESULTS
Ninety-nine subjects completed the 6-month regimen. The mean reduction in serum LDL-C was 0.08 mmol/L (1.8%) in Group I, 0.07 mmol/L (1.6%) in Group II, and 0.28 mmol/L (6.3%) in Group III (P = 0.94). An LDL-C reduction of 10% or more relative to initial level was observed in 27% of participants in Group I and approximately 40% of subjects in the other two groups (P = 0.41). Counseling resulted in a decrease in body weight, smoking, and dietary fat consumption and an increase in physical activity.


CONCLUSIONS
Treatment by a dietician achieved better results and should remain the standard. Physicians should focus on the detection and control of other heart disease risk factors.
Gosselin
P
P
Département de Médecine sociale et préventive, Université Laval.
Verreault
R
R
Gaudreault
C
C
Guillemette
J
J
D000328:Adult; D008078:Cholesterol, LDL / Q000097:blood; D018752:Diet, Fat-Restricted; D004046:Dietetics / Q000592:standards*; D005194:Family Practice / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000188:drug therapy*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D052756:Nutritional Sciences / Q000193:education; D010353:Patient Education as Topic / Q000379:methods*; D012307:Risk Factors; D012657:Self-Help Groups
D008078:Cholesterol, LDL
Traitement diététique de l'hypercholestérolémie légère à modérée. Efficacité de différentes interventions.