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  • Intervention
    Will consuming high fiber foods as part of a diet low in saturated fat and cholesterol reduce total cholesterol and LDL even more than a diet low in saturated fat and cholesterol alone?
    • Conclusion

      Consuming diets high in total fiber (17-30g/day) and soluble fiber (7-13g/day) as part of a diet low in saturated fat and cholesterol can further reduced TC by 2-3% and LDL up to 7%.

    • Grade: I
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What risk factors for CHD may be modified by a diet low in saturated fat and cholesterol and high in total and soluble fiber?
    • Conclusion

      Limited research indicates that other risk factors for CHD may be modified by a diet low in saturated fat and cholesterol and high in total and soluble fiber. These risk factors include BP, lipoprotein subclasses and particle sizes, and fasting and post-prandial insulin.

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    Does medical nutrition therapy (MNT) given by a Registered Dietitian (RD) result in changes in adult patients' levels of dietary fat, saturated fat, serum cholesterol and cardiac risk factors?
    • Conclusion

      Medical Nutrition Therapy (MNT) provided by Registered Dietitians (RDs) promotes changes in dietary intake of fat and saturated fat and positively impacts changes in serum lipid levels. When patients attended two to four MNT sessions over six to twelve weeks, they reduced daily dietary fat (5% to 8% saturated fat (2% to 4%) and energy intake (232-710kcal per day). Serum total cholesterol (TC) was lowered by 7% to 21% and low-density lipoprotein cholesterol (LDL-C) was lowered by 7% to 22%. Triglycerides (TG)were lowered from 11% to 31%.
       

    • Grade: I
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
  • Monitoring and Evaluation
    In patients with disorders of lipid metabolism, does medical nutrition therapy (MNT) given by a registered dietitian result in changes in levels of dietary fat, saturated fat, serum cholesterol, and cardiac risk factors?
    • Conclusion

      Available data from studies on Medical Nutrition Therapy provided by a registered dietitian indicate that with 2 to 6 planned visits patients reported 15-22% reduction in total dietary fat (from 32-33% of calories to 25-28% of calories), and 22-36% reduction in saturated fat (from 11-12% of calories to 7-9% of calories). This was accompanied by 6-13% reduction in total plasma cholesterol and 7-14% reduction in LDL-C. Findings further suggest decreases in triglycerides and possibly HDL but results are inconsistent. MNT involved an initial planned visit ranging from 45-90 minutes and a follow-up planned visits ranging from 30-60 minutes over a 6 week to 6 month time period. Data on long-term adherence and sustained lipid response are unavailable.

    • Grade: I
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.