地域における食事指導の血清総コレステロールに対する効果に関する介入研究

Abstract

To determine the effect of cholesterol-lowering dietary counseling on levels of serum lipids, a 48-week randomized intervention study was conducted between June 1996 and May 1997 in Nara. A total of 70 Japanese women aged 40-64 years, who had 181-294 mg/dl serum total cholesterol levels but did not receive cholesterol-lowering drug treat- ment, were randomly assigned to two groups (first intervention group, 35 subjects and second intervention group, 35 subjects) to receive a 24-week intervention in rotation. The intervention program included three 40-minute cholesterol-lowering dietary counseling sessions, and three 2 and a half-hour lectures related to diet and cholesterol. Changes in dietary intakes and serum lipid levels by the intervention were examined by the paired t- test, and factors that relate to changes in serum lipid levels were analyzed using the stepwise multiple regression. After the interventions, significant reductions in intakes of dietary cholesterol, energy and fat were observed in the two intervention groups. During the same periods, serum total cholesterol levels decreased significantly by 4% for both groups, from 238.3 mg/dl to 227.9 mg/dl in the first intervention group, and from 237.9 mg /dl to 228.4 mg/dl in the second intervention group, and these changes were found to be related with reductions of dietary cholesterol intakes. Serum HDL cholesterol levels increased significantly in the two groups during the first 24-week period (June 1996- December 1996), but no significant relationship between changes in dietary intakes and serum HDL cholesterol change was observed. Significant reduction of serum triglyceride level was observed only in the first intervention group after the dietary counseling, and this change was shown to be associated with reduction of energy percentages of fat intake. The results indicated that the 24-week cholesterol-lowering dietary intervention program was effective for reducing serum total cholesterol, but its influence on levels of serum HDL cholesterol and triglyceride should be further investigated.