Retzlaff B M, Walden C E, McNeney W B, Buck B L, McCann B S, Knopp R H
Northwest Lipid Research Clinic, Seattle, WA 98104, USA.
J Am Coll Nutr. 1997 Feb;16(1):52-61. doi: 10.1080/07315724.1997.10718649.
Restriction of dietary fat and cholesterol are recommended for treating hyperlipidemia, but may alter vitamin or mineral intakes. We evaluated changes in nutrients of individuals taught the National Cholesterol Education Program (NCEP) Step II diet.
Subjects participated in a randomized controlled trial of the cholesterol-lowering effect of the NCEP Step II diet. Eligibility criteria included elevated fasting plasma LDL-cholesterol, no lipid-altering medications, and diet not already fat-modified. Subjects attended eight weekly dietitian-led classes. Four-day food records collected 6 months post-intervention were compared to baseline records.
Of 409 subjects with complete data, 123 met Step I and 166 met Step II diet criteria. Intakes of micronutrients associated with fruits and vegetables (beta-carotene and vitamin A, vitamin C, folic acid, magnesium, and potassium) increased on both diets. Patterns of decreased mean intake and/or fewer subjects consuming 2/3 Recommended Dietary Allowance were seen for calcium, vitamin E, and zinc.
NCEP Step I and II diets generally match or exceed unmodified diet for vitamin and mineral content. Premenopausal women do not appear to be at increased risk of low iron intake. Vitamin E intake decreases, although the significance is unknown in the context of lower fat intake and increased intake of other antioxidants. Diet counseling and materials should encourage sources of calcium for women, and zinc for both women and men.
推荐限制饮食中的脂肪和胆固醇来治疗高脂血症，但这可能会改变维生素或矿物质的摄入量。我们评估了接受美国国家胆固醇教育计划（NCEP）第二步饮食指导的个体的营养变化。
受试者参与了一项关于NCEP第二步饮食降胆固醇效果的随机对照试验。入选标准包括空腹血浆低密度脂蛋白胆固醇升高、未服用改变血脂的药物以及饮食未进行过脂肪调整。受试者参加了由营养师主导的为期八周的课程。将干预后6个月收集的4天食物记录与基线记录进行比较。
在409名有完整数据的受试者中，123人符合第一步饮食标准，166人符合第二步饮食标准。两种饮食中与水果和蔬菜相关的微量营养素（β-胡萝卜素、维生素A、维生素C、叶酸、镁和钾）的摄入量均增加。钙、维生素E和锌的平均摄入量下降，且摄入低于或等于2/3推荐膳食摄入量的受试者人数减少。
NCEP第一步和第二步饮食的维生素和矿物质含量通常与未调整的饮食相当或更高。绝经前女性铁摄入量低的风险似乎并未增加。维生素E摄入量减少，尽管在脂肪摄入量降低和其他抗氧化剂摄入量增加的情况下其意义尚不清楚。饮食咨询和材料应鼓励女性补充钙源，男性和女性都应补充锌源。
