BMJ 1994;308:227-231 (22 January)

Papers

Long term metabolic effects of two dietary methods of treating hyperlipidaemia

A A Rivellese, P Auletta, G Marotta, G Saldalamacchia, A Giacoo, V Mastrilli, O Vaccaro, G Riccardi 

Institute of Internal Medicine and Metabolic Diseases, Federico II University - Medical School, 80131 Naples, Italy Correspondence to:Dr Rivellese.

Abstract

Objectives : To compare the long term metabolic effects of two diets for treating hyperlipidaemia.
Design : Randomised controlled study: after three weeks of normal (control) diet, subjects were randomly allocated to one of two test diets and followed up for six months.
Setting : Lipid clinic of tertiary referral centre in Naples.
Subjects : 63 subjects with primary type IIa and IIb hyperlipoproteinaemia entered the study, and 44 completed it. Exclusion criteria were taking drugs known to influence lipid metabolism, evidence of cardiovascular disease, homozygous familial hypercholesterolaemia, and body mass index over 30.
Interventions : Two test diets with reduced saturated fat (8%) and cholesterol (-200 mg/day): one was also low in total fat and rich in carbohydrate and fibre, and the other was low in carbohydrate and fibre and rich in polyunsaturated and monounsaturated fats.
Main outcome measures : Fasting plasma lipid and lipoprotein concentrations; blood glucose, insulin, and triglyceride concentrations before and after a test meal.
Results : In comparison with the control diet, both test diets induced significant and similar decreases in low density lipoprotein cholesterol concentrations (by a mean of 0.72 (SE 0.15) mmol/1, P<0.001, for low total fat diet; by 0.49 (0.18) mmol/l, P<0.05, for high unsaturated fat diet) and plasma triglyceride concentrations (by 0.21 (0.09) mmol/l, P<0.05, for low total fat diet; by 0.39 (0.15) mmol/l, P<0.05, for high unsaturated fat diet), while high density lipoprotein cholesterol concentrations after fasting and plasma glucose and insulin concentrations during test meals were not modified by either diet.
Conclusions : Both test diets are suitable (alone or in combination) for treatment of hypercholesterolaemia.

Clinical implications

  • Clinical implications

  • The optimal diet for treating hyperlipidaemia is still not known, largely because of the lack of long term studies

  • We studied the long term (six month) clinical effects of two diets on subjects with type IIa and IIb primary hyperlipoproteinaemia

  • In one diet reduced saturated and total fat was compensated by increased carbohydrate and fibre (especially soluble fibre), while in the other reduced saturated fat was compensated by increased unsaturated fat (especially monounsaturated)

  • Both diets significantly reduced plasma concentrations of low density lipoprotein cholesterol and triglycerides without any reduction in high density lipoprotein cholesterol concentrations or impairment of blood glucose metabolism

  • Both diets are suitable for treatment of hyperlipidaemia, but a combination of the two might be more palatable.


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to StumbleUpon StumbleUpon   Add to Technorati Technorati    What's this?

This article has been cited by other articles:

  • McAuley, K., Mann, J. (2006). Thematic review series: Patient-Oriented Research. Nutritional determinants of insulin resistance. J. Lipid Res. 47: 1668-1676 [Abstract] [Full text]  
  • Oliver, S.D. (2000). The long-term safety and tolerability of ispaghula husk. The Journal of the Royal Society for the Promotion of Health 120: 107-111 [Abstract]  
  • Tang, J L, Armitage, J M, Lancaster, T, Silagy, C A, Fowler, G H, Neil, H A W, Smith, G. D., Ebrahim, S. (1998). Systematic review of dietary intervention trials to lower blood total cholesterol in free-living subjects • Commentary: Dietary change, cholesterol reduction, and the public health---what does meta-analysis add?. BMJ 316: 1213-1220 [Abstract] [Full text]  
  • Ramsay, L E, Yeo, W W, Jackson, P R, Riccardi, G, Rivellese, A A, Vaccaro, O (1994). Dietary treatment of hyperlipidaemia Diets were poorly evaluated. BMJ 308: 916-917 [Full text]  
  • (1994). WHICH DIET FOR HYPERLIPIDEMIA?. JWatch General 1994: 7-7 [Full text]  
Access jobs at BMJ Careers
Whats new online at Student BMJ