McGowan M P, Joffe A, Duggan A K, McCay P S
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.
J Adolesc Health. 1994 Mar;15(2):155-62. doi: 10.1016/1054-139x(94)90543-6.
Since atherosclerosis begins in childhood and cholesterol levels can track from adolescence to adulthood, early intervention to lower elevated levels may be important. Our objective was to test the effectiveness of a health education intervention in hypercholesterolemic college students.
Thirty-nine university students with plasma low-density lipoprotein cholesterol (LDL-C) levels > or = 75th percentile (2.84 mmol/L, 110 mg/dL) were randomized into two study groups. The control group (n = 19) attended a lecture and viewed a brief video on diet and cholesterol. The intervention group (n = 20) participated in 7 weekly sessions on nutrition and behavior modification. At baseline and 8 weeks later, all subjects completed standardized tests assessing knowledge and attitudes regarding cholesterol, saturated fat, fiber, and heart-healthy lifestyles. Lipid profiles were analyzed at baseline, 8 weeks, and 8 months after study initiation.
The groups did not differ at baseline in terms of knowledge, attitudes or lipid profiles. At the 8-week post-test, the intervention group's knowledge was superior to that of the control group (p = < 0.001). Both groups showed improvement in their attitude toward a heart-healthy diet. At the 8-week follow-up, the intervention group lowered their mean plasma LDL-C by 0.21 mmol/L (8 mg/dL) whereas the control group's level fell by an average of 0.05 mmol/L (3 mg/dL) (p = 0.40). At the 8-month follow-up, LDL-C levels increased from baseline in both groups, but the control group levels rose significantly more than the intervention group (0.34 mmol/L vs. 0.05 mmol/L, p = 0.045). Students whose baseline LDL-C was > or = 95% (3.36 mmol/L, 130 mg/dL) benefitted more from the intervention than those with levels > or = 75% but < 95%.
We conclude that a 7-week intervention results in significant improvement in nutritional knowledge and protects hyperlipidemic college students with levels > or = 95% from significant increases in LDL-C.
