The contemporary researchers in the risk reduction research have consdiered dietary modification and weight control as the essential step to begin the treatment of high blood cholesterol and the prevention of coronary heart disease (CHD). This report describes the first intervention study in Taiwan on the effect of dietary therapy for patients with hyperlipidemia. In a biennial follow-up survey for Chin-Shan Community Cardiovascular (CCC) study in 1992-1993, the study team identified 902 patients who were eligible for this study based on the criteria of U.S. National Cholesterol Education Program-Adult Treament Panel II (NCEP-ATP II). From March to May 1994, 526 patients were invited to the first phase dietary educational program conducted by a physician and a dietitian. Each participant received a dietary manual and a 30-minute education on dietary treatment and the usage of the manual. Dietary patterns, blood lipid levels, body mass index (BMI), and waist to hip ratio (WHR) were evaluated for each participant at baseline and 3 months after the education.
Overall, 347 patients returned intervention clinic to complete the postintervention evaluations. Paired-t test revealed significant reduction in lipid profiles. The mean reduction and st andard deviation were 10.9 ± 1.7 mg/dl for total blood cholesterol (T-CHO), 13.9 ± 1.8 mg/dl for low density lipoprotein cholesterol (LDL-C), 2.24 ± 0.49 mg/dl for high density lipoprotein cholesterol (HDL-C) and 0.23 ± 0.03 mg/dl for apoprotein B. All these changes were significant at p<0.0001 level. BMI was also significantly reduced by 0.30 ± 0.05 (p<0.05). The changes in lipids and lipoproteins were much greater for patients with high levels of baseine T-CHO and LDL-C than that with low levels of baseline T-CHO and LDL-C. Patients with a baseline LDL-C ≧ 190mg/dl have had a mean reduction of 35.8mg/dl in T-CHO and 41.3mg/dl in LDL-C. The corresponding reductions for patients with baseline LDL-C below 160mg/dl were 2.1mg/dl in T-CHO and 4.8mg/dl in LDL-C. In conclusion, the simple dietary education program appeared to be effective in changing eating behavior among hypercholesterolemic patients and could significantly reuced their serum cholesterol levels. This benefit was even greater for patients with higher cholesterol levels.
