Letters

Lipid lowering dietary advice

BMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6995.1669f (Published 24 June 1995) Cite this as: BMJ 1995;310:1669
  1. Francesco Angelico,
  2. Roberto Volpe

    EDITOR,—Scientists and practitioners agree that dietary modification should be the first step of any cholesterol lowering regimen, but H A W Neil and colleagues report that the reduction in concentrations of total cholesterol and low density lipoprotein cholesterol after dietary advice given in general practice to hypercholesterolaemic patients by a dietitian, practice nurses, or in a diet leaflet alone was small.1 The poor response seems to be related mainly to the low dietary compliance in poorly motivated patients. This agrees with our objective evaluations of the compliance to hypocholesterolaemic dietary prescriptions: on the basis of changes in the plasma fatty acid pattern, after two months on the diet only 40% of patients could be defined asgood adherers, while 22% had a poor compliance and the remaining a variable adherence over time.2 Neil and colleagues conclude that a more intensive intervention than is normally available in primary care is probably necessary and a mass approach to dietary changes is needed.

    Instead, better results have been obtained in 65 …

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