[Intensive dietary advice for patients with severe hypercholesterolemia]

Screening in general practice revealed a total of 124 patients (71 men and 53 women) with severe hypercholesterolaemia, defined as serum cholesterol levels over the 95th percentile for sex and age. The average serum cholesterol was 9.3 mmol/l with a maximal value of 15.5 mmol/l. On the basis of a dietary history for 48 hours and a dietetic interview, a dietician undertook a dietary analysis with the help of a computer programme (DANKOST) before and after dietary alterations for one and three months. The aims were normal body weight, cholesterol intake of under 200 mg/day, ratio between saturated and unsaturated fat between 1.0 and 1.8 and a roughage content of 26-30 g/day. A total of 61 patients completed the recommended dietary alterations. Alcohol intake was significantly higher in men and constituted more than 8% of the energy intake in 43 patients. Serum cholesterol was reduced by a total of 15.3%, triglyceride by nearly 20% while high density lipoprotein remained unchanged. The maximal decrease in serum cholesterol was 43%. In patients who adhered to the dietary changes, the average decrease was over 20%. Patients with hypertension and patients with serum cholesterol levels greater than or equal to 9 mmol/l showed greater decreases than the group as a whole. On the basis of the dietary interview, it did not prove possible to predict which patients would stick to the dietary restrictions.