Personal and mediated health counseling for sustained dietary reduction of hypercholesterolemia.

Methods of effective cardiovascular risk reduction that are suitable for use in clinical settings are needed. Several behavioral interventions were designed to be compatible with office-based medical practice, to be delivered by paraprofessional counselors, and to be of low intensity and low cost. Eighty-three hypercholesterolemic volunteers were assigned to one of three experimental conditions (face-to-face counseling, mail and telephone counseling, initial session only). Twenty-six nonrandomized subjects served as a no-contact group and were followed for 1 year. Participants in the first three groups received risk factor education, behavioral recommendations, and a packet of materials, while those in the face-to-face and mail/telephone counseling groups were contacted for five brief follow-up sessions over a 4-month period. At the 1-year follow-up evaluation, subjects in the face-to-face and mail/telephone counseling conditions showed decreases in plasma cholesterol of 6.2 and 4.6%, respectively (P less than 0.01), while the other two groups evidenced small increases. There were no differences by condition for plasma triglycerides, systolic or diastolic blood pressure, or weight. Low-intensity, low-cost behavioral interventions delivered by paraprofessionals can produce long-term decreases in a major cardiovascular risk factor. Physicians are encouraged to incorporate similar interventions into their practices.

Nutrient Intake of Elite Male and Female Nordic Skiers.

In brief: This study of 13 male and 14 female members of the US Nordic Ski Team was conducted to analyze the nutrient content of their diet. The skiers recorded four sets of three-day dietary data during a year of training and competition. The results showed high calorie intake, as expected. However, fat intake was higher and carbohydrate intake lower than recommended amounts for optimal health and athletic performance. Iron intake by female skiers consistently failed to meet recommended levels, while cholesterol intake exceeded levels considered optimal. Intake of other nutrients reviewed in this report easily met recommended levels.

Comparison of nutrient intake in middle-aged men and women runners and controls.

Runners and other active individuals typically have plasma lipoprotein patterns different than their more sedentary peers. In an attempt to determine if these patterns could be explained by dietary differences, we studied nutrient intake in middle-aged (35-59 yr) men and women runners averaging 55-65 km/wk, and inactive controls. The runners were leaner (P less than or equal to 0.0001) and had higher caloric intakes (40-60% higher on a weight-adjusted basis); they also ate more fat and carbohydrate (P less than or equal to 0.01), and were more likely to consume alcoholic beverages. When nutrient intake was expressed as a percent of total calories, the runners ate less protein (P less than or equal to 0.001). The runners obtained a smaller percentage of calories from starch and a greater percentage from other carbohydrates. Differences in nutrient intake seemed unlikely to account for observed differences in plasma lipids and lipoproteins between the runners and controls.