title: Efficacy of a Therapeutic Lifestyle Change/Step 2 diet in moderately hypercholesterolemic middle-aged and elderly female and male subjects.
abstract: 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.
authors.affiliation: 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
authors.forename: Alice H
authors.initials: AH
authors.lastname: Lichtenstein
authors.forename: Lynne M
authors.initials: LM
authors.lastname: Ausman
authors.forename: Susan M
authors.initials: SM
authors.lastname: Jalbert
authors.forename: Montserrat
authors.initials: M
authors.lastname: Vilella-Bach
authors.forename: Matti
authors.initials: M
authors.lastname: Jauhiainen
authors.forename: Sandra
authors.initials: S
authors.lastname: McGladdery
authors.forename: Arja T
authors.initials: AT
authors.lastname: Erkkilä
authors.forename: Christian
authors.initials: C
authors.lastname: Ehnholm
authors.forename: Jiri
authors.initials: J
authors.lastname: Frohlich
authors.forename: Ernst J
authors.initials: EJ
authors.lastname: Schaefer
mesh_terms: 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
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004041:Dietary Fats; D014280:Triglycerides; D017962:alpha-Linolenic Acid; D019787:Linoleic Acid