The Impact of the Guidelines for a Healthy Diet of the Netherlands Nutrition Council on Total and High Density Lipoprotein Cholesterol in Hypercholesterolemic Free-living Men

Abstract

To study the impact of dietary intervention on the plasma total and high density lipoprotein cholesterol (HDL cholesterol) levels in hypercholesterolemic men, the authors selected 80 male participants in a monitoring risk factor project carried out in Amsterdam, The Netherlands. These men had plasma total cholesterol levels of between 6.5 and 10.0 mmol/liter (between 251 and 387 mg/dl) and were randomly assigned to either the intervention (n = 39) or the control (n = 41) group. At the start of the intervention period, after 5 weeks, and after 26 weeks, both the intervention and the control groups were examined. This examination consisted of a measurement of height, weight, plasma total and HDL cholesterol, and a dietary interview. The intervention program consisted of a personalized dietary advice to the respondent, based on the report of the Netherlands Nutrition Council. The study took place between September 1987 and November 1988. Because of this intervention program, the plasma total and HDL cholesterol levels decreased. The difference in change in plasma total cholesterol between the intervention and control groups was 0.47 mmol/liter (18 mg/dl) after 5 weeks and 0.30 mmol/liter (12 mg/dl) after 26 weeks. For HDL cholesterol, a significant difference in change after 5 weeks disappeared after 26 weeks. The public health implications of the decrease in plasma total cholesterol are discussed.

Dietary counselling effectively improves lipid levels in patients with endogenous hypertriglyceridemia: emphasis on weight reduction and alcohol limitation

“…We speculate that the observed changes in body weight are too modest to detect an improvement of insulin resistance. The observed effectiveness of the current dietary advice in hypertriglyceridemic patients was more pronounced compared with patients with hypercholesterolemia or combined hyperlipidemia that has been described previously (Bloemberg et al, 1991;Wijsman et al 1996). This con®rms the concept that hypertriglyceridemia is the lipoprotein disorder most susceptible to dietary intervention.…”

“…Subjects who already followed a healthy diet and did not need dietary advice were not included in this study. Thereafter an individual dietary advice according to`Guidelines for a Healthy Diet' from the Netherlands Nutrition Council was given (Netherlands Nutrition Council, 1986), as described before (Bloemberg et al, 1991). These dietary guidelines are similar to the American Heart Association Step 1 diet (National Cholesterol Education Program, 1994), with the exception that not less than 30% but 30±35% of total energy intake should be derived from fat.…”

Dietary fat intake does affect obesity!

“…After consuming a low-fat diet (15% of energy from fat) for 10-12 wk ad libitum, moderately hypercholesterolemic men and women lost 3.6 kg (65). After consuming a low-fat diet (Ϸ30% of energy from fat) for 5 wk, 39 hypercholesterolemic patients lost significantly more weight than 41 hypercholesterolemic patients consuming a control (usual) diet; this loss was maintained at 26 wk (60). In another study, the reduced-fat group lost 1.3 kg, even though their energy intake increased (68).…”

The role of dietary fat in body fatness: evidence from a preliminary meta-analysis of ad libitum low-fat dietary intervention studies

“…If results from the same study were reported in more than one publication, the data were included only once (n = 15). A total of 15 publications reporting 16 studies met the inclusion criteria (Lee-Han et al 1988;Boyd et al 1990;Buzzard et al 1990;Ornish et al 1990;Bloemberg et al 1991;Sheppard et al 1991;Baer, 1993;Hunninghake et al 1993;Kasim et al 1993;Raben et al 1995;Pritchard et al 1996;Siggaard et al 1996;Simon et al 1997;Stefanick et al 1998;Weststrate et al 1998). These studies included a total of 1728 individuals, 1074 women and 654 men.…”