Nonpharmacological approaches for reducing serum low-density lipoprotein cholesterol.
OBJECTIVE
To reinforce the key role of diet and lifestyle modification as the first-line treatment for the reduction of raised serum low-density lipoprotein cholesterol (LDL-C) and prevention of cardiovascular disease. Also, to counter recent claims that the current dietary guidelines for the treatment of cardiovascular disease have misplaced emphasis on the importance of removing dietary saturated fat instead of sugar.


RESULTS
This review provides new insight into the effects of diet and lifestyle factors with established efficacy in lowering serum LDL-C. This includes energy-restricted weight loss and new findings on the effects of alternative day fasting; novel metabolic and molecular effects of replacing palmitic acid with oleic acid; evidence for a dose-response relationship between the intake of dietary stanols and LDL-C; and identification of a unique metabolic pathway for the excretion of cholesterol.


CONCLUSIONS
The review reports new evidence for the efficacy of alternate day fasting, reassurance that the current dietary guidelines are not misguided by recommending removal of saturated fat, that a high intake of dietary stanols can achieve a reduction in LDL-C of up to 18%, and describes a pathway of cholesterol excretion that may help to explain variation in the response of serum LDL-C to dietary fat and cholesterol.
Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Surrey, UK.
Bruce A
BA
Griffin
D031204:Caloric Restriction; D002791:Cholesterol, Dietary / Q000008:administration & dosage; D008078:Cholesterol, LDL / Q000097:blood*; D004038:Diet, Reducing; D005215:Fasting; D005227:Fatty Acids / Q000008:administration & dosage; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000178:diet therapy*; D008019:Life Style; D019301:Oleic Acid / Q000627:therapeutic use; D064167:Recommended Dietary Allowances
D002791:Cholesterol, Dietary; D008078:Cholesterol, LDL; D005227:Fatty Acids; D019301:Oleic Acid