Efficacy of a Therapeutic Lifestyle Change/Step 2 diet in moderately hypercholesterolemic middle-aged and elderly female and male subjects.
Lifestyle modification to decrease cardiovascular disease (CVD) risk has recently been reaffirmed by both the National Cholesterol Education Program and American Heart Association (AHA). Using a randomized crossover design, the Therapeutic Lifestyle Change (TLC)/Step 2 diet relative to a typical Western diet was assessed in 36 moderately hypercholesterolemic subjects in a clinical setting under isoweight conditions. Mean lipoprotein and apolipoprotein levels (fasting and non-fasting), fatty acid profiles, parameters of HDL metabolism, and glucose homeostasis were determined. Relative to the Western diet, the TLC/Step 2 diet resulted in 11% and 7% lower LDL cholesterol (LDL-C) and HDL cholesterol (HDL-C), respectively, with no significant change in TG levels or total cholesterol-HDL-C ratio. Similar responses were observed in the non-fasting state. Linoleic (18:2n-6c) and alpha-linolenic (18:3n-3) acids increased at the expense of oleic acid (18:1n-9c) in the cholesteryl ester, TG, and phospholipid subfractions. The dietary changes had no significant effect on fractional esterification rate of HDL, phospholipid transfer protein (PLTP), or cholesterol ester transfer protein activities, or glucose and insulin levels. Female and male subjects responded similarly. The TLC/Step 2 diet resulted in a decrease in some CVD risk factors and no apparent adverse effects in others.
Lichtenstein
Alice H
AH
Cardiovascular Nutrition Research Program and Lipid Metabolism Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111, USA. lichtenstein@hnrc.tufts.edu
Ausman
Lynne M
LM
Jalbert
Susan M
SM
Vilella-Bach
Montserrat
M
Jauhiainen
Matti
M
McGladdery
Sandra
S
Erkkilä
Arja T
AT
Ehnholm
Christian
C
Frohlich
Jiri
J
Schaefer
Ernst J
EJ
D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D004041:Dietary Fats / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000178:diet therapy*; D019787:Linoleic Acid / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D014280:Triglycerides / Q000097:blood*; D017962:alpha-Linolenic Acid / Q000627:therapeutic use
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004041:Dietary Fats; D014280:Triglycerides; D017962:alpha-Linolenic Acid; D019787:Linoleic Acid