The effects of low fat diet and intensive physical exercise were examined in a randomized prospective study in patients with angiographically documented coronary heart disease. In addition to supervised regular physical exercise, patients of the intervention group (n = 18) were subjected to intensive dietary councelling with the aim of a low fat, low cholesterol diet to be maintained for at least 12 months. The control group (n = 27) received relevant advise only and usual care by private physicians. In the intervention group there was significant lowering of plasma triglycerides (202 ± 82/141 ± 74mg/dl) and body weight (78.2 ± 9.5/73.7 ± 10.4 kg) while total and LDL cholesterol did not change significantly. There was a tendency for a rise of HDL-cholesterol (35.6 ± 9.0/40.4 ± 14.8 mg/dl, p = 0.07). According to 24-hour diet protocols there was a significant lowering of energy intake (2,298 ± 697/1,602 ± 758 kcal/day), of fat intake (111.7 ± 44.4/52.0 ± 23.9 g/day) and of intake of dietary cholesterol (402.8 ± 186/161.3 ± 100.3 mg/day) as well as of saturated fatty acids (42.5 ± 20.4/14.3 ± 8.1 g/day). Fatty acid composition of adipose tissue was not correlated with the patients’ 24-hour dietary protocols. In the control group there were no changes of plasma lipids, body weight or diet composition according to 24-hour protocols after 1 year compared to data at the beginning of the study. There was, however, a marked correlation of adipose tissue composition and dietary information given by the patients. The results suggest that dietary protocols in the intervention group reflect information regarding a healthy diet rather than behavior while in the control group true dietary information is yielded by the protocols.
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