J Korean Diabetes Assoc.  2007 Sep;31(5):377-382.

Non-drug Intervention in Lipid Management: Dietary Portfolio

• Kim IJ

Abstract

Non-Pharmaceutical interventions are essential in lipid management. The NCEP recommends the following three tiered approach to lipid management: 1. Institution of therapeutic lifestyle changes (TLC); 2. Use of non-drug adjuncts, including viscous fibers and plant sterol/stanol products; and 3. Drug therapy when required to reach treatment goals. Even though non-drug approaches often receive minimal attention in clinical practice, the efficacy of non-drug therapies is not so small. Non-drug adjuncts are known to reduce LDL cholesterol as follows: 12.5% for 45 g of soy protein/d; 6% to 7% for 9 to 10 g of psyllium/d, with smaller reductions for other viscous fibers; 10% for 1 to 2 g of plant sterols/d and 1% for 10 g almonds/d. Recently, combining these foods in a single dietary portfolio decreased LDL cholesterol and CRP similarly to the extent which achieved by a usual dose of a statin. This dietary portfolio can be regarded as an effective non-drug approach to reduce the risk of cardiovascular disease.

Keyword

Dietary portfolio; Lipid management; Therapeutic lifestyle changes (TLC)

MeSH Terms

Cardiovascular Diseases
Cholesterol, LDL
Drug Therapy
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Life Style
Plants
Cholesterol, LDL

Figure

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  Fig. 1 Low-density-lipoprotein cholesterol (LDL-C) goal achievement according to risk category. The LDL-C goals were < 160, < 130, and < 100 mg/dL, respectively, for subjects with 0 -1 risk factor, 2+ risk factors and coronary heart disease (CHD), and risk equivalents (RE)4).

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  Fig. 2 A Model of steps in therapeutic lifestyle changes (TLC).

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