Intense dietary counseling lowers LDL cholesterol in the recruitment phase of a clinical trial of men who had coronary artery bypass grafts

Abstract

Intense dietary counseling lowered low-density-lipoprotein (LDL) cholesterol levels during the recruitment phase of a 5-year clinical trial of men who had undergone coronary artery bypass grafts. At visit 1, a 24-hour dietary recall was obtained and analyzed for intakes of total energy; total, saturated, monounsaturated, and polyunsaturated fat; and dietary cholesterol. Participants were then instructed to follow the National Cholesterol Education Program (NCEP) Step I diet. Additional dietary counseling was provided at 1-month intervals during visits 2 and 3. At visit 3, another 24-hour dietary recall was obtained and analyzed similarly. Of 59 men with an LDL cholesterol level greater than 4.5 mmol/L at visit 1, 52 decreased their level to 4.5 mmol/L or less to qualify for the 5-year study. Between visits 1 and 3, mean LDL cholesterol levels decreased significantly from 4.86 +/- 0.04 mmol/L to 4.27 +/- 0.05 mmol/L, which coincided with significant mean decreases in dietary intake of total fat from 33.4 +/- 1.3% to 25.2 +/- 1.4%, saturated fat from 11.1 +/- 0.6% to 7.0 +/- 0.4%, and dietary cholesterol from 122 +/- 6.1 to 90 +/- 6.3 mg/1,000 kcal. Overall, the dietary intake improved to more closely follow the NCEP Step II diet and resulted in a 10.7% decrease in total cholesterol level and a 12.4% decrease in LDL cholesterol level.