Dietary treatment of hypercholesterolemia: can we predict long-term success?
OBJECTIVE
To look for associations between changes in LDL cholesterol and baseline characteristics of patients receiving dietary therapy for hypercholesterolemia.


METHODS
Ninety-six hypercholesterolemic individuals aged 30-65 from three primary care clinics and a worksite clinic received counseling by a physician and/or a dietitian for lifestyle and dietary modifications. Baseline nutritional intake was evaluated using three-day food diaries. Lipoprotein levels were evaluated at six weeks and thereafter every three months for one year. Partial (adjusted) correlations (beta) were calculated between baseline parameters (demographic, anthropometric, nutritional and laboratory) and changes of LDL cholesterol for the short and long term (three and 12 months).


RESULTS
The average LDL cholesterol level decreased by 6 +/- 10% (p < 0.001) at the end of 12 months. This reduction was positively correlated with baseline LDL cholesterol level (beta = +0.4, p = 0.001), and negatively correlated with the baseline BMI (beta = -0.2, p < 0.05) and saturated fat intake (beta = -0.3, p < 0.05). The differences between low and high subgroups of baseline LDL cholesterol, BMI and saturated fat intake became apparent only after six to twelve months of therapy and probably result from varying levels of adherence to the dietary regimen. A significant correlation was found between the change in LDL cholesterol after six weeks and the change in LDL cholesterol after 12 months (beta = 0.4, p < 0.001).


CONCLUSIONS
The probability of successfully reducing LDL cholesterol with dietary therapy can be predicted by baseline LDL cholesterol level, BMI and saturated fat intake, as well as by the response to dietary changes within six weeks of therapy.
Henkin
Yaakov
Y
Department of Cardiology, PO Box 151, Soroka University Medical Center, Beer-Sheva, Israel. yaakovh@bgumail.bgu.il
Shai
Iris
I
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015930:Diet Records; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D005069:Evaluation Studies as Topic; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000178:diet therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins; D014280:Triglycerides