title: Double-blind, randomized feedback control fails to improve the hypocholesterolemic effect of a plant-based low-fat diet in patients with moderately elevated total cholesterol levels.
abstract: OBJECTIVE
  To determine whether the cholesterol-lowering effect of a plant-based low-fat diet can be improved by a flexible control design that controls the extent of fat reduction based on the individual response of blood cholesterol.
  
  
  METHODS
  Randomized, double-blind intervention study.
  
  
  METHODS
  A hotel in Prerow, Germany.
  
  
  METHODS
  A total of 32 participants (21 female and 11 male participants) with total cholesterol level > 5.7 mmol/l.
  
  
  METHODS
  The control group consumed a plant-based low-fat diet with constantly 20% of energy as fat; the intervention group received a diet with either 20 or 15% of energy as fat, depending on the serum cholesterol response of the preceding week. A flexible control design based on the individual cholesterol response during a run-in period of 1 week was used within a low-fat intervention.
  
  
  RESULTS
  During the run-in period, the consumption of a plant-based low-fat diet led to a reduction in total cholesterol by 18+/-6 mmol/l (P < 0.001), in LDL cholesterol by 19+/-9 mmol/l (P < 0.001) and triglycerides by 13+/-3 mmol/l (P < 0.001). During the feedback control period, an additional reduction in total cholesterol by 13+/-8 (P < 0.001) and in LDL cholesterol by 17+/-11 (P < 0.001) was observed compared to 15+/-15 and 7+/-18 in the control group. The effect of an additional feedback control was only marginal and not statistically significant compared to the effect of the low-fat diet alone.
  
  
  CONCLUSIONS
  On a level of fat intake already reduced to 20% of energy, the use of a feedback control to adapt the fat content of the diet depending on the individual serum cholesterol response was not more effective in reducing blood cholesterol levels than a plant-based low-fat diet alone.
authors.affiliation: German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal. koebnick@mail.dife.de
authors.forename: C
authors.initials: C
authors.lastname: Koebnick
authors.forename: S
authors.initials: S
authors.lastname: Plank-Habibi
authors.forename: B
authors.initials: B
authors.lastname: Wirsam
authors.forename: S
authors.initials: S
authors.lastname: Gruendel
authors.forename: A
authors.initials: A
authors.lastname: Hahn
authors.forename: C
authors.initials: C
authors.lastname: Meyer-Kleine
authors.forename: C
authors.initials: C
authors.lastname: Leitzmann
authors.forename: H J F
authors.initials: HJ
authors.lastname: Zunft
mesh_terms: D000368:Aged; D002784:Cholesterol / Q000097:blood / Q000378:metabolism*; D008078:Cholesterol, LDL / Q000097:blood; D018752:Diet, Fat-Restricted; D004041:Dietary Fats / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000178:diet therapy*; D008297:Male; D008875:Middle Aged; D010945:Plants, Edible; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
chemical_list: D008078:Cholesterol, LDL; D004041:Dietary Fats; D014280:Triglycerides; D002784:Cholesterol