Dietary Advice to Reduce Fat Intake is More Successful When it Does Not Restrict Habitual Eating Patterns

Abstract

Objective To determine the relative and combined effects of dietary advice to lower fat intake and alter eating frequency on nutrient intake and plasma lipid levels in men with recently diagnosed hyperlipidemia. Design In this 4-week dietary intervention trial, a 7-day food diary was used in the week preceding the intervention and on the third week of the intervention to determine eating frequency. A 7-day dietary history and lipid profile (after subjects had fasted) were taken at baseline and at the end of the 4 weeks of dietary intervention. Subjects Eighty nonobese, free-living men with newly diagnosed primary hypercholesterolemia. Intervention Group 1: fat intake was reduced and eating frequency decreased. Group 2: Fat intake was reduced and eating frequency maintained. Group 3: Fat intake was maintained and eating frequency decreased. Group 4: Fat intake was maintained and eating frequency increased. Main outcome measures Changes in lipid profiles of the subjects and evaluation of subjects's perception of the dietary advice they received. Statistical analyses performed Baseline and intervention values were compared using a paired t test; 2-way analysis of variance was used across treatment groups. Results Dietary advice to lower fat intake significantly lowered total and low-density lipoprotein cholesterol levels; this advice also decreased intake of total fat and saturated fatty acids significantly, but less so in the group asked to restrict eating occasions to 3 per day. Advice to alter eating frequency was found to be difficult to follow. Applications Lipid-lowering dietary advice should be incorporated into the existing eating frequency pattern of each person. J Am Diet Assoc. 1999;99:685–689.