Christopher D. Gardner, PhD; Ann Coulston, MS, RD; Lorraine Chatterjee, MS; Alison Rigby, PhD, MPH, RD; Gene Spiller, PhD; John W. Farquhar, MD
Acknowledgments: The authors gratefully acknowledge the work of Karla J. Oliveira, MS, RD, for menu design and prestudy diet assessment; Pat Kolar for her work as study coordinator; and David Ahn, RD, PhD, for data programming and statistical analyses.
Grant Support: By NIH grant R01 HL57386 and by Human Health Service grant M01-RR00070, General Clinical Research Centers, National Center for Research Resources, National Institutes of Health.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Christopher D. Gardner, PhD, Hoover Pavilion, N229, 211 Quarry Road, Stanford, CA 94305-5705; e-mail, mailto:email@example.com.
Current Author Addresses: Drs. Gardner, Rigby, and Farquhar and Ms. Chatterjee: Hoover Pavilion, N229, 211 Quarry Road, Stanford, CA 94305-5705.
Ms. Coulston: 1386 Cuernavaca Circulo, Mountain View, CA 94040-3571.
Dr. Spiller: Health Research and Studies Center, 340 Second Street, Suite 7, Box 338, Los Altos, CA 94023-0338.
Author Contributions: Conception and design: C.D. Gardner, A. Coulston, G. Spiller, J.W. Farquhar.
Analysis and interpretation of the data: C.D. Gardner, A. Coulston, A. Rigby, G. Spiller, J.W. Farquhar.
Drafting of the article: C.D. Gardner, A. Coulston, A. Rigby, G. Spiller, J.W. Farquhar.
Critical revision of the article for important intellectual content: C.D. Gardner, A. Coulston, A. Rigby, G. Spiller, J.W. Farquhar.
Final approval of the article: C.D. Gardner, A. Coulston, A. Rigby, G. Spiller, J.W. Farquhar.
Provision of study materials or patients: C.D. Gardner, L. Chatterjee.
Statistical expertise: C.D. Gardner.
Obtaining of funding: C.D. Gardner, J.W. Farquhar.
Administrative, technical, or logistic support: A. Coulston, L. Chatterjee.
Collection and assembly of data: C.D. Gardner, L. Chatterjee, A. Rigby.
A variety of food combinations can be used to meet national U.S. guidelines for obtaining 30% of energy or less from total fat and 10% of energy or less from saturated fat.
To contrast plasma lipid responses to 2 low-fat diet patterns.
Randomized clinical trial.
4-week outpatient feeding study with weight held constant.
120 adults 30 to 65 years of age with prestudy low-density lipoprotein (LDL) cholesterol concentrations of 3.3 to 4.8 mmol/L (130 to 190 mg/dL), body mass index less than 31 kg/m2, estimated dietary saturated fat at least 10% of calories, and otherwise general good health.
Plasma lipid levels.
Two diets, the Low-Fat diet and the Low-Fat Plus diet, designed to be identical in total fat, saturated fat, protein, carbohydrate, and cholesterol content, consistent with former American Heart Association Step I guidelines. The Low-Fat diet was relatively typical of a low-fat U.S. diet. The Low-Fat Plus diet incorporated considerably more vegetables, legumes, and whole grains, consistent with the 2000 American Heart Association revised guidelines.
Four-week changes in the Low-Fat and Low-Fat Plus groups were −0.24 mmol/L (−9.2 mg/dL) versus −0.46 mmol/L (−17.6 mg/dL) for total cholesterol (P = 0.01) and −0.18 mmol/L (−7.0 mg/dL) versus −0.36 mmol/L (−13.8 mg/dL) for LDL cholesterol (P = 0.02); between-group differences were −0.22 mmol/L (−9 mg/dL) (95% CI, −0.05 to −0.39 mmol/L [−2 to −15 mg/dL]) and −0.18 mmol/L (−7 mg/dL) (CI, −0.04 to −0.32 mmol/L [−2 to −12 mg/dL]) for total and LDL cholesterol, respectively. The 2 diet groups did not differ significantly in high-density lipoprotein cholesterol and triglyceride levels.
Previous national dietary guidelines primarily emphasized avoiding saturated fat and cholesterol; as a result, the guidelines probably underestimated the potential LDL cholesterol-lowering effect of diet. In this study, emphasis on including nutrient-dense plant-based foods, consistent with recently revised national guidelines, increased the total and LDL cholesterol-lowering effect of a low-fat diet.
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Gardner CD, Coulston A, Chatterjee L, Rigby A, Spiller G, Farquhar JW. The Effect of a Plant-Based Diet on Plasma Lipids in Hypercholesterolemic Adults: A Randomized Trial. Ann Intern Med. 2005;142:725–733. doi: 10.7326/0003-4819-142-9-200505030-00007
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Published: Ann Intern Med. 2005;142(9):725-733.
Cardiology, Coronary Risk Factors, Dyslipidemia.
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