Nutritional intake of women and men on the NCEP Step I and Step II diets

Restriction of dietary fat and cholesterol are recommended for treating hyperlipidemia, but may alter vitamin or mineral intakes. We evaluated changes in nutrients of individuals taught the National Cholesterol Education Program (NCEP) Step II diet.

Subjects participated in a randomized controlled trial of the cholesterol-lowering effect of the NCEP Step II diet. Eligibility criteria included elevated fasting plasma LDL-cholesterol, no lipid-altering medications, and diet not already fat-modified. Subjects attended eight weekly dietitian-led classes. Four-day food records collected 6 months post-intervention were compared to baseline records.

Of 409 subjects with complete data, 123 met Step I and 166 met Step II diet criteria. Intakes of micronutrients associated with fruits and vegetables (beta-carotene and vitamin A, vitamin C, folic acid, magnesium, and potassium) increased on both diets. Patterns of decreased mean intake and/or fewer subjects consuming 2/3 Recommended Dietary Allowance were seen for calcium, vitamin E, and zinc.

NCEP Step I and II diets generally match or exceed unmodified diet for vitamin and mineral content. Premenopausal women do not appear to be at increased risk of low iron intake. Vitamin E intake decreases, although the significance is unknown in the context of lower fat intake and increased intake of other antioxidants. Diet counseling and materials should encourage sources of calcium for women, and zinc for both women and men.