In the accompanying article, Barnard1 reports data from 4587 adults who attended the residential program at the Pritikin Longevity Center, Santa Monica, Calif, for a period of 3 weeks. During this period, participants consumed a high-complex-carbohydrate, high-fiber, low-fat, and low-cholesterol diet combined with daily aerobic exercise. Total serum cholesterol and low-density cholesterol (LDL-C) values fell substantially, both by 23%; in addition, values of total triglycerides and high-density cholesterol (HDL-C) declined. Barnard suggests that a dietary change such as that employed by the Pritikin Center can markedly improve the lipoprotein pattern.
It is interesting to speculate on the various factors responsible for the striking reduction in cholesterol levels noted in this report. These factors probably include: (1) regression to the mean, (2) effects of institutionalization, (3) reduction in dietary saturated fatty acids, (4) reduction in dietary cholesterol, (4) weight loss, and (5) exercise. Each of these factors can be considered briefly.