Effectiveness of a low saturated fat, low cholesterol, weight-reducing diet for the control of hypertriglycer-idemia

In 114 men, 98 of them obese and 50 hypertriglyceridemic (control value ≥ 1.80 mmole/1), an assessment was made of the long-term effect on serum lipids of the Coronary Prevention Evaluation Program diet - a diet low in saturated fat and cholesterol, moderate (not high) in polyunsaturated fat, moderate (not low) in total fat and carbohydrate, and calorie-controlled to lower weight. After one year on diet, serum triglycerides were reduced 17.3 %, serum cholesterol 12.1 %, weight 5.3 %. Serum triglycerides fell significantly only in the 50 men with hypertriglyceridemia (with or without hypercholesterolemia). Fall from hyper triglyceridemic levels was significantly greater in men who reduced and stayed reduced than in those who at one year had regained weight. However, both subgroups with elevated triglyceride levels exhibited significant falls, suggesting that diet quality as well as calorie deficit played a part in the decline. These decreases were effectively maintained during the second year on the Program diet. Mean daily nutrient intake on the CPEP diet reported as per cent of calories was: total fat: 30.7, saturated fat: 9.5, polyunsaturated fat: 6.7, carbohydrate: 47.3. Cholesterol intake was 289 mg/day and alcohol intake was 9 g/day (2.6 % of calories). Carbohydrate intake averaged 217 g/day, chiefly from grains, fruits and starchy vegetables; consumption of refined sugars was a small part of total carbohydrate. These data - together with other reported findings - indicate that a low carbohydrate diet (defined as less than 150 g per day, or less than 30-35 per cent of calories) is seldom required to achieve significant lowering of serum triglycerides in middle-aged, obese, hypertriglyceridemic men, with or without hypercholesterolemia, providing that weight loss is accomplished and sustained, and intake of saturated fat and cholesterol is low. Scientific and practical reasons recommend this unitary diet plan for control of the common hyperlipidemias, with individualized modifications of approach based on serum lipid response. It is concluded that a significant proportion of adults with hyperlipidemia, including hypertriglyceridemia, can be successfully managed with a single nutritional regimen, as recommended by the American Heart Association and the Inter-Society Commission for Heart Disease Resources.