Blood cholesterol reduction following community-based screening and dietary counseling

Abstract

Screening for total blood cholesterol levels using Boehringer Mannheim Reflotrons was conducted at 52 sites over three and a half months on the North Coast of New South Wales, Australia, in 1987. Mixed teams of health staff and community volunteers screened 9,046 participants between the ages of 25 and 64. The mean age was 47, 60% were female, and the average blood cholesterol level was 5.36 mmol/L (207 mg/dL). While only 16% were smokers, nearly half of the sample was over 25 BMI. A total of 2,354 (26%) were found to be at moderate risk and 1,345 (15%) were at high risk. A brief dietary consultation was offered to the 41% who were over the recommended 5.5 mmol/L (213 mg/dL) level.At a four month follow-up of 2,183 of these same individuals, the blood cholesterol level was lower in 76% of participants and BMI was lower in 65%. Mean blood cholesterol reduction was 8% after correction for regression towards the mean, and mean BMI reduction was 2%. A telephone survey of 100 participants who attended the retest revealed that 84% had changed their diet to reduce fat intake, with 68% switching to low-fat dairy products, 50% reducing meat intake, and 34% eating more fruit and vegetables. Our experience shows that community-based screening with dietary counseling can have a significant impact on the public's dietary behavior, and can therefore reduce the risk of cardiovascular disease.