Effects of the National Cholesterol Education Program's Step I and Step II dietary intervention programs on cardiovascular disease risk factors: a meta-analysis

Yu-Poth, Shaomei; Zhao, Guixiang; Etherton, Terry D.; Naglak, Mary; Jonnalagadda, Satya S.; Kris‐Etherton, Penny M.

doi:10.1093/ajcn/69.4.632

Cited by 503 publications

(311 citation statements)

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“…The fact that both interventions were effective in improving the serum lipid profiles compared to the baseline levels was not surprising, given these diets more closely matched the macronutrient profiles of established lipid-modifying diets such as the NCEP Step 1 (Yu Poth et al, 1999) than did the subjects' pre-experimental diets.…”

Section: Discussionmentioning

confidence: 96%

Lupin kernel fibre-enriched foods beneficially modify serum lipids in men

et al. 2004

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Objective: To examine the effect of a diet containing a novel legume food ingredient, Australian sweet lupin (Lupinus angustifolius) kernel fibre (LKFibre), compared to a control diet without the addition of LKFibre, on serum lipids in men. Design: Randomized crossover dietary intervention study. Setting: Melbourne, Australia -Free-living men. Subjects: A total of 38 healthy males between the ages of 24 and 64 y completed the intervention. Intervention: Subjects consumed an LKFibre and a control diet for 1 month each. Both diets had the same background menus with seven additional experimental foods that either contained LKFibre or did not. Depending on energy intake, the LKFibre diet was designed to contain an additional 17 to 30 g/day fibre beyond that of the control diet. Results: Compared to the control diet, the LKFibre diet reduced total cholesterol (TC) (mean7s.e.m.; 4.571.7%; P ¼ 0.001), low-density lipoprotein cholesterol (LDL-C) (5.472.2%; P ¼ 0.001), TC: high-density lipoprotein cholesterol (HDL-C) (3.072.0%; P ¼ 0.006) and LDL-C:HDL-C (3.872.6%; P ¼ 0.003). No effects on HDL-C, triacylglycerols, glucose or insulin were observed. Conclusions: Addition of LKFibre to the diet provided favourable changes to some serum lipid measures in men, which, combined with its high palatability, suggest this novel ingredient may be useful in the dietary reduction of coronary heart disease risk.

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Section: Discussionmentioning

confidence: 96%

Lupin kernel fibre-enriched foods beneficially modify serum lipids in men

et al. 2004

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“…However, most expert bodies and major review articles now apply meta analysis to produce large data sets (e.g. [117]). These advances have enabled a clearer consensus to be reached with respect to the LDL cholesterol raising properties of lauric, myristic and palmitic acids.…”

Section: Saturated Fatty Acidsmentioning

confidence: 99%

Dietary fatty acids and human health

Williams¹

2000

Ann. Zootech.

535

374

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-A considerable amount of evidence has accumulated to support the view that the very long chain omega 3 fatty acids (eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)) have beneficial cardiovascular and anti-inflammatory properties and that levels of their consumption are insufficient in most Western diets. More recently, attention has been given to the possibility that the precursor omega-3 PUFA, alpha linolenic acid (ALNA), may share some of the beneficial actions of EPA/DHA on human health. Further research into the metabolism and physiological actions of ALNA, and comparisons with EPA/DHA, is needed before conclusions regarding the optimal amounts and types of omega-3 PUFA for human health can be defined. Conjugated linoleic acid (CLA), which arises as a metabolic by-product of rumen hydrogenation and which is found in foods of animal origin, has been proposed to possess potent health promoting properties, but much of this research has been conducted in experimental animals. There is an urgent need for complementary studies in human volunteers, to confirm the putative anti-carcinogenic, anti-atherogenic, anti-lipogenic and immuno-suppressive properties of CLA.human health / fatty acids / omega-3 PUFA / conjugated linoleic acid Résumé -Acides gras alimentaires et santé humaine. Il a été amplement démontré que les acides gras à très longue chaîne en oméga 3, les acides eicoapentaenoïque (EPA) et decosahexaenoïque (DHA) ont des effets positifs relatifs à l'apparition des maladies cardio-vasculaires, et des propriété anti-inflammatoires. Leur consommation par l'Homme est insuffisante dans la plupart des pays occidentaux. Récemment il est apparu que l'acide alpha linolénique, précurseur des acides gras en oméga 3, pouvait partager avec l'EPA et le DHA certains effets positifs sur la santé humaine. Des recherches complémentaires sur le métabolisme et le rôle physiologique de l'acide alpha linolénique, ainsi que des comparaisons avec l'EPA et le DHA sont nécessaires avant de pouvoir définir les apports recommandés optimaux de chacun de ces acides gras. L'acide linoléique conjugué (CLA) qui provient du métabolisme ruminal des acides gras et qui est présent dans les aliments d'origine animale, a été décrit comme potentiellement favorable à la santé humaine, mais la plupart des expérimentations ont été conduites sur animaux de laboratoire. Il y a une urgence à réaliser des études complémentaires sur des volontaires humains, afin de confirmer les propriétés annoncées du CLA, à savoir des effets anti-carcinogène, anti-athérogène, anti-lipogénique et une modulation de l'immunité. santé humaine / acides gras / oméga-3 PUFA / acide linoléique conjugué

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“…These small numbers may not contain sufficient power to draw a definitive conclusion; however, it is of value to mention two key studies that examined this relationship using a meta-analytic approach (Dattilo & Kris-Etherton, 1992;Yu-Poth et al, 1999). In (Dattilo & Kris-Etherton, 1992) a strong and consistent pattern was found, ie 'the greater the initial TC the greater decrease occurred with weight loss'.…”

Section: Lipoprotein Response To Weight Loss Hh Ditschuneit Et Almentioning

confidence: 99%

Lipoprotein responses to weight loss and weight maintenance in high-risk obese subjects

Ditschuneit

Frier²,

Flechtner-Mors

2002

Eur J Clin Nutr

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and 2 Slim-Fast Foods Company, West Palm Beach, Florida, USA Objective: To examine changes in plasma lipids and lipoproteins after 51 months of reduced energy intake and sustained weight loss. Methods: One-hundred patients were randomized to one of two dietary interventions for 3 months (weight loss period). Groups A and B received an energy-restricted diet plan of 5.2 -6.3 MJ=day but group B was further instructed to replace two of three meals with a nutrient-fortified liquid meal replacement (MR). Upon completion of the weight loss period, all patients were given the same instructions regarding energy intake and were advised to use one MR daily. Body weight and 7 day food diaries were measured monthly or bimonthly and blood lipids at baseline, 3, 9 and 51 months. Results: Of the original 100 patients 75 had completed 4 y. Of those 75, 73 had complete lipid records. Baseline body weights of Groups A and B were 90.7 AE 14.0 and 91.6 AE 9.8 kg, respectively. The percentage change in total cholesterol (%DTC) decreased in a linear fashion with increasing weight loss, when all data was combined, but did not approach statistical significance (P 0.26, r ¼ 0.02). Further regression analysis found a significant negative linear relationship (P 0.0001, r ¼ 0.69) between initial total cholesterol (TC) concentrations and %DTC. Hence, data from 27 of the 73 completers who exhibited an elevated serum total cholesterol ( ! 6.2 mmol=l) were isolated and analyzed further. Baseline TC was 6.75 AE 0.64, 5.85 AE 0.63 at 9 months (P < 0.05) and 5.76 AE 0.52 mmol=l at 51 months (P < 0.05). Similar values for VLDL-cholesterol were 1.33 AE 0.80, 0.74 AE 0.24 and 0.66 AE 0.21 mmol=l by 51 months (P < 0.05). Weight decreased by 5.2 AE 5.1, 7.6 AE 4.9 and 6.7 AE 4.6% at 3, 9 and 51 months, respectively. Conclusion: Continuous energy restriction associated with a clinically meaningful weight loss significantly improved the lipid profile of high-risk patients. Similar weight and diet changes occurring in patients with normal plasma cholesterol were either increased or without affect.

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Effects of the National Cholesterol Education Program's Step I and Step II dietary intervention programs on cardiovascular disease risk factors: a meta-analysis

Abstract: Step I and Step II dietary interventions have multiple beneficial effects on important cardiovascular disease risk factors.

Cited by 503 publications

References 48 publications

Lupin kernel fibre-enriched foods beneficially modify serum lipids in men

Lupin kernel fibre-enriched foods beneficially modify serum lipids in men

Dietary fatty acids and human health

Lipoprotein responses to weight loss and weight maintenance in high-risk obese subjects

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