Cardiovascular Diseases Clinical Trial
To determine the effect in men and postmenopausal women with elevated LDL-cholesterol and low HDL-cholesterol of an exercise regimen with or without the National Cholesterol Education Program (NCEP) Step Two diet compared to usual care control group on HDL- and LDL-cholesterol.
BACKGROUND:
The NCEP is a major public education program providing advice to physicians and the public
on management and prevention of coronary heart disease. However, data supporting the advice
are derived primarily from middle-aged men, with less data available for women and older
individuals. Furthermore, there have been recent reports that when low saturated fat diets
such as the NCEP Step One and NCEP Step Two diets, are followed, HDL-cholesterol is lowered
as well as LDL-cholesterol.
DESIGN NARRATIVE:
Randomized, controlled, factorial design powered for men and women separately. One hundred
eighty postmenopausal women, 45 through 64 years of age, and 197 men, 30 through 64 years of
age, who had low high-density lipoprotein (HDL) cholesterol levels (< or =59 mg per
deciliter in women and < or =44 mg per deciliter in men) and moderately elevated levels of
low-density lipoprotein (LDL) cholesterol (>125 mg per deciliter but <210 mg per deciliter
in women and >125 mg per deciliter but <190 mg per deciliter in men) were enrolled. The
subjects were randomly assigned to aerobic exercise, the NCEP Step 2 diet, or diet plus
exercise, or to a control group, which received no intervention. The four interventions were
delivered for one year: usual care (written dietary materials only with delayed intervention
optional), exercise only (supervised, progressive aerobic exercise program at least three
times per week), diet only (group and individual dietary instruction on the NCEP Step
One/Step Two diet delivered by registered dietitians), and diet plus exercise. At baseline
and at the end of one year, measurements were made of blood lipids and lipoproteins, plasma
glucose and insulin, glucose tolerance, blood pressure, body composition through hydrostatic
weighing and waist and hip circumterences, aerobic fitness (VO2 max), and five unannounced
24-hr. recalls. The primary outcomes measured was HDL-cholesterol, major secondary endpoints
included LDL-C, LDL-C/HDL-C ratio, and triglycerides.
;
Allocation: Randomized, Intervention Model: Factorial Assignment, Primary Purpose: Prevention
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