Background Dietary intervention to lower serum LDL-cholesterol (LDL-C) is
effective, yet underutilised in general practice.
Objective This report summarises the findings of an expert roundtable
convened to review the evidence relating to dietary interventions to
lower serum LDL-C.
Discussion Interventions that lower LDL-C lower the risk of cardiovascular
disease. Comprehensive dietary intervention is indicated in all
patients with an absolute 5 year risk for coronary disease of 10% or
greater. Short term trials indicate that these interventions have the
potential to lower LDL-C by approximately 20%. A year long trial has
shown mean LDL-C lowering of 13%, with about one-third of subjects
achieving a reduction greater than 20%, highlighting the importance
of adherence to dietary advice. The most effective dietary strategies
are replacing saturated and trans fatty acids with poly- and monounsaturated
fats and increasing intake of plant sterols. Losing weight
and increasing soluble fibre and soy protein intake can also lower
serum cholesterol and may be considered when recommending
a nutritionally balanced, cholesterol lowering diet. Motivational
interviewing by general practitioners can improve the effectiveness
of brief, behaviour orientated advice and dietary counselling to lower
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