Moderately Reducing Fat In Diet Can Help Lower Cholesterol Levels

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Title: Moderately Reducing Fat In Diet Can Help Lower Cholesterol Levels
URL: http://www.pslgroup.com/dg/44C06.htm
Doctor's Guide
November 11, 1997

CHICAGO, IL -- November 11, 1997 -- Moderately reducing the amount of fat intake in people with high cholesterol can help lower cholesterol levels. However, more extreme reductions in dietary fat do not provide further benefits and may be harmful to some people, according to an article in tomorrow's issue of The Journal of the American Medical Association (JAMA)

Robert Knopp, M.D., of the University of Washington in Seattle, WA., and colleagues studied 444 men with high cholesterol working in the same industry to study the long-term effect of aggressively versus moderately restricting fat intake on lowering cholesterol levels.

The researchers divided the men into two groups -- those that had only high cholesterol (HC) and those that had both high cholesterol and elevated triglycerides (CHL), which is associated with higher risk of cardiovascular disease than having only high cholesterol. The two groups were assigned to one of four diets containing 30 percent, 26 percent, 22 percent and 18 percent of energy from fat.

The researchers found total plasma cholesterol, low-density lipoprotein cholesterol (LDL-C), the so-called bad cholesterol associated with increased risk of coronary heart disease, and concentrations of apoprotein B (apo B) were reduced by all diets in both the HC and CHL groups. Additionally, a maximum and essentially equal amount of LDL-C reduction was observed with the target 26 percent and 18 percent fat-intake diets in the HC group and a maximum LDL-C reduction was observed with the 30 percent fat-intake diet in the CHL group.

"Further, fat restriction below targets of 26 percent in HC subjects and 30 percent in CHL subjects was without added benefit after 12 months of dietary effort," the researcher write. "Furthermore, no statistically significant added benefit of more aggressive fat restriction beyond the 30 percent diet was observed in body weight, glucose, insulin or blood pressure levels in HC or CHL subjects."

However, the researchers identified potential harmful effects of the more aggressive fat-restricted diets:

-- Plasma levels of the high-density lipoprotein cholesterol (HDL-C), the so-called good cholesterol believed to protect against arterial disease, decreased and triglyceride levels increased significantly in the HC group on the most fat-restricted diets (targets of 22 percent and 18 percent).

-- Levels of very low-density lipoprotein cholesterol (VLDL-V) increased in the HC group following the diet with the target 18 percent of its calories from fat.

-- Apo B reductions were less with the more fat-restricted diets.

"These observations indicate that the extra effort of aggressive fat restriction may be not only less beneficial but also counterproductive, since elevated [triglycerides] and apo B and low HDL-C levels are all cardiovascular risk predictors in their own right," the researchers write.

The authors suggest the findings of this study may pertain to the recommended dietary guidelines of the National Cholesterol Education Program (NCEP), which restrict total fat to less than 30 percent of energy and saturated fat to less than 10 percent and seven percent in two steps. In this study, the researchers claim dietary treatment was successful in shifting the subjects to lower cardiovascular risk categories as defined by the NCEP.

"These results support NCEP recommendations for the dietary management of both HC and CHL subjects, but additional treatment approaches are needed for the greater severity of cardiovascular disease risk factors in CHL subjects," the researchers added.

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