Life-style modification has been recommended by the National Cholesterol Education Program as the first approach to reduce serum lipid values and the risk for coronary heart disease. Presented are data from 4587 adults who attended a 3-week residential, life-style modification program consisting of a high-complex-carbohydrate, high-fiber, low-fat, and low-cholesterol diet combined with daily aerobic exercise, primarily walking. Total cholesterol values were reduced by 23%, from 6.06 to 4.66 mmol/L (234 to 180 mg/dL). Low-density cholesterol (LDL-C) values were also reduced by 23%, from 3.9 to 3.0 mmol/L (151 to 116 mg/dL), with most of the change occurring during the first 2 weeks. Male subjects showed a greater reduction in total cholesterol (24.4% vs 20.8%) and LDL-C (25% vs 19.4%) values compared with female subjects. Follow-up studies for 18 months on a small group showed that, in most cases, continued compliance with the program maintained total cholesterol values well below 5.18 mmol/L (200 mg/dL), the level recommended by the National Cholesterol Education Program. High-density cholesterol (HDL-C) was reduced by 16%, but the ratio of total cholesterol to HDL-C was reduced by 11%. Female subjects showed a greater drop in HDL-C values than did male subjects (19.4% vs 11.6%). Serum triglyceride values were reduced by 33%, from 2.29 to 1.54 mmol/L (200 to 135 mg/dL); again, male subjects showed a greater reduction than the did female subjects (37.9% vs 22.5%). Body weight was also significantly reduced, 5.5% for male subjects and 4.4% for female subjects. These results show that most adults can significantly reduce serum lipid values and the risk for atherosclerosis and its clinical sequelae through life-style modification consisting of diet and exercise.
(Arch Intern Med. 1991;151:1389-1394)
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Purchase Online Access to this article for 24 hours
Thank you for submitting a comment on this article. It will be reviewed by JAMA Internal Medicine editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 114
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
and access these and other features:
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.