Efficacy of Dietary Modification Following the National Cholesterol Education Program (NCEP) Recommendation on Lipid Profiles among Hyperlipidemia Subjects
Suruchsawadee Thiengwiboonwong DrPH*, Rewadee Chongsuwat PhD*, Paradee Temcharoen DrPH*, Wongdyan Pandii DrPH**, Patcharanee Pavadhgul PhD*
Affiliation : * Department of Nutrition, Faculty of Public Health, Mahidol University, Bangkok, Thailand ** Department of Parasitology and Entomology, Faculty of Public Health, Mahidol University, Bangkok, Thailand
Background : Hyperlipidemia has adverse effects on atherosclerosis, causing it to develop into cardiovascular disease. The
prevalence of hyperlipidemia has been increasing among those in the working-age group and may be caused by inappropriate
dietary patterns. Dietary modification should form the basis of lipid management.
Objective : Evaluate the effects of a dietary modification following the NCEP-ATP III recommendation on lipid profiles
among hyperlipidemia subjects.
Material and Method: The design was a quasi-experimental study, with a pre-test/post-test two-group design. Each group
consisted of 31 hyperlipidemia subjects aged 30 to 59 years old with total cholesterol (TC) greater than or equal to
240 mg/dl or low-density lipoprotein cholesterol (LDL-C) greater than or equal to 130 mg/dl. The present study was
conducted between January and June 2009. The research procedure included 6-week nutrition counseling and a 2-week
follow-up for 12 weeks. Data were collected by self-reported questionnaire and a 3-day food record. Dietary and biological
assessments were compared before and after the experiment. Statistical analysis was performed using means, standard
deviations, independent and paired t-tests, Friedman test, Mann-Whitney U test, and Wilcoxon signed-rank test.
Results : The intervention group had a significant reduction of TC and LDL-C at the end of the experiment (p<0.05).
Moreover, this group had a significantly higher percentage reduction of TC and LDL-C than the control group (8.5%
vs. 3.0%, and 10.8% vs. 2.4%, respectively) (p<0.05). Distributions of monounsaturated fatty acids (MUFAs) in the
intervention group were significantly higher than in the control group (p<0.05). Distribution of saturated fatty acids
(SFAs):MUFAs:polyunsaturated fatty acids (PUFAs) were 12.0:13.4:6.3% in the intervention group and 12.3:9.2:5.6% in
the control group. Neither group was able to reduce SFAs intake to <7% as recommended. Neither the recommended
one-third of vegetable protein nor two-thirds of complex carbohydrate was achieved. Dietary fiber was less than 10 g/1,000 kcal.
The cholesterol intake in the intervention group was less than in the control group (155.9 vs. 206.3 mg/d).
Conclusion : The dietary modification in the present study significantly lowered TC and LDL-C. However, compliance with
the recommendation of high MUFAs intake was difficult to achieve. The dietary modification might be focused instead on
lowering intake of SFAs, replacing animal protein with vegetable protein, and increasing complex carbohydrates, fruits,
and vegetables to raise dietary fiber.
Keywords : Dietary modification, Lipid profiles, Hyperlipidemia subjects
