Abstract
Purpose
Dietary therapy remains the first line of treatment for patients with high blood cholesterol
levels. Among free-living persons, compliance with National Cholesterol Education
Program (NCEP) dietary recommendations is uncertain.
Subjects and methods
We performed a cross-sectional, baseline analysis of 91,627 postmenopausal women enrolled
in the Women’s Health Initiative Observational Study. Among women with self-reported
hypercholesterolemia, we ascertained factors associated with compliance with National
Cholesterol Education Program dietary recommendations, defined for the Step II diet
as ≤30% of total calories from fat, <7% of calories from saturated fat, and daily
dietary cholesterol <200 mg.
Results
Of the 13,777 participants who reported having high cholesterol levels requiring drug
therapy, only 20% reported total fat, saturated fat, and dietary cholesterol consumption
consistent with Step II dietary goals. Factors associated with Step II dietary compliance
included having a college degree (odds ratio [OR] = 1.26; 95% confidence interval
[CI]: 1.14 to 1.40), a prior cardiovascular event (OR = 1.48; 95% CI: 1.28 to 1.70),
and consumption of five or more daily servings of fruits or vegetables (OR = 3.0;
95% CI: 2.7 to 3.3). Being married, smoking, a sedentary lifestyle, and a higher body
mass index were all associated with reduced compliance (all P <0.0001). In the subsample in which plasma lipid levels were measured, dietary compliance
was associated with higher levels of low-density lipoprotein cholesterol (P = 0.02).
Conclusion
Since the inception of the NCEP in 1985, health care providers, public health programs,
and patients have not successfully implemented the dietary recommendations.
Keywords
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Article info
Publication history
Accepted:
May 7,
2002
Received in revised form:
April 29,
2002
Received:
August 29,
2001
Identification
Copyright
© 2002 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
