TY - JOUR
T1 - Effects of the National Cholesterol Education Program's Step I and Step II dietary intervention programs on cardiovascular disease risk factors
T2 - A meta-analysis
AU - Yu-Poth, Shaomei
AU - Zhao, Guixiang
AU - Etherton, Terry
AU - Naglak, Mary
AU - Jonnalagadda, Satya
AU - Kris-Etherton, Penny M.
PY - 1999/4
Y1 - 1999/4
N2 - Background: Plasma lipid and lipoprotein responses have been variable in dietary intervention studies. Objective: The objective of this study was to evaluate the effects of the National Cholesterol Education Program's Step I and Step II dietary interventions on major cardiovascular disease risk factors using meta-analysis. Design: MEDLINE was used to select 37 dietary intervention studies in free-living subjects published from 1981 to 1997. Results: Step I and Step II dietary interventions significantly decreased plasma lipids and lipoproteins. Plasma total cholesterol (TC), LDL cholesterol, triacylglycerol, and TC:HDL cholesterol decreased by 0.63 mmol/L (10%), 0.49 mmol/L (12%), 0.17 mmol/L (8%), and 0.50 (10%), respectively, in Step I intervention studies, and by 0.81 mmol/L (13%), 0.65 mmol/L (16%), 0.19 mmol/L (8%), and 0.34 (7%), respectively, in Step II intervention studies (P < 0.01 for all). HDL cholesterol decreased by 7% (P = 0.05) in response to Step II but not to Step I dietary interventions. Positive correlations between changes in dietary total and saturated fatty acids and changes in TC and LDL and HDL cholesterol were observed (r = 0.59, 0.61, and 0.46, respectively; P < 0.001). Multiple regression analyses showed that for every 1% decrease in energy consumed as dietary saturated fatty acid, TC decreased by 0.056 mmol/L and LDL cholesterol by 0.05 mmol/L. Moreover, for every 1-kg decrease in body weight, triacylglycerol decreased by 0.011 mmol/L and HDL cholesterol increased by 0.011 mmol/L. Exercise resulted in greater decreases in TC, LDL cholesterol, and triacylglycerol and prevented the decrease in HDL cholesterol associated with low-fat diets. Conclusion: Step I and Step II dietary interventions have multiple beneficial effects on important cardiovascular disease risk factors.
AB - Background: Plasma lipid and lipoprotein responses have been variable in dietary intervention studies. Objective: The objective of this study was to evaluate the effects of the National Cholesterol Education Program's Step I and Step II dietary interventions on major cardiovascular disease risk factors using meta-analysis. Design: MEDLINE was used to select 37 dietary intervention studies in free-living subjects published from 1981 to 1997. Results: Step I and Step II dietary interventions significantly decreased plasma lipids and lipoproteins. Plasma total cholesterol (TC), LDL cholesterol, triacylglycerol, and TC:HDL cholesterol decreased by 0.63 mmol/L (10%), 0.49 mmol/L (12%), 0.17 mmol/L (8%), and 0.50 (10%), respectively, in Step I intervention studies, and by 0.81 mmol/L (13%), 0.65 mmol/L (16%), 0.19 mmol/L (8%), and 0.34 (7%), respectively, in Step II intervention studies (P < 0.01 for all). HDL cholesterol decreased by 7% (P = 0.05) in response to Step II but not to Step I dietary interventions. Positive correlations between changes in dietary total and saturated fatty acids and changes in TC and LDL and HDL cholesterol were observed (r = 0.59, 0.61, and 0.46, respectively; P < 0.001). Multiple regression analyses showed that for every 1% decrease in energy consumed as dietary saturated fatty acid, TC decreased by 0.056 mmol/L and LDL cholesterol by 0.05 mmol/L. Moreover, for every 1-kg decrease in body weight, triacylglycerol decreased by 0.011 mmol/L and HDL cholesterol increased by 0.011 mmol/L. Exercise resulted in greater decreases in TC, LDL cholesterol, and triacylglycerol and prevented the decrease in HDL cholesterol associated with low-fat diets. Conclusion: Step I and Step II dietary interventions have multiple beneficial effects on important cardiovascular disease risk factors.
UR - http://www.scopus.com/inward/record.url?scp=0032933426&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0032933426&partnerID=8YFLogxK
U2 - 10.1093/ajcn/69.4.632
DO - 10.1093/ajcn/69.4.632
M3 - Article
C2 - 10197564
AN - SCOPUS:0032933426
SN - 0002-9165
VL - 69
SP - 632
EP - 646
JO - American Journal of Clinical Nutrition
JF - American Journal of Clinical Nutrition
IS - 4
ER -