Implementing new dietary guidelines of the National Cholesterol Education Program

The aggregate cost of coronary heart disease in the United States is between $50 billion and $100 billion per year. The most cost-effective method of reducing this is by health education. In 1993, the National Cholesterol Education Program released its second report containing the updated recommendations for the evaluation and treatment of people with high levels of total cholesterol and low-density lipoprotein cholesterol. The new guidelines emphasize the importance of maximizing the benefits of nondrug therapies (e.g., diet, weight loss, and exercise) before adding pharmacologic therapy. The nutrition counselor teaches clients the National Cholesterol Education Program dietary guidelines through assessing, motivating, implementing, and monitoring adherence and therapeutic response. It is important to stress which foods to use or decrease and to give specific examples that apply in everyday life. The addition of drug therapy should be considered carefully and reserved for high-risk patients, only after sufficient application of dietary therapy, weight control, and physical exercise have been attempted.