(03-07-07) Which lifestyle interventions effectively lower LDL cholesterol?

Powers E, Saultz J, Hamilton A, Lo V.

Oregon Health and Sciences University, Portland, OR USA.

Counseling, weight loss, exercise, and drinking alcohol all effectively lower low-density lipoprotein cholesterol (LDL-C). Specifically, one to 2 daily drinks of alcohol lowers LDL-C, if consumed regularly for more than 4 weeks (strength of recommendation [SOR]: A, based on consistent results of multiple randomized controlled trials [RCTs]). Counseling by physicians, dieticians, or pharmacists is effective at increasing patient compliance with medications, thereby lowering LDL-C (SOR: C, good evidence that intervention lowers LDL-C, insufficient to prove that it reduces mortality/morbidity). Weight loss has been associated with reductions in LDL-C. However, other factors---including degree of caloric restriction, drug intervention, and diet composition--may play a more significant role than weight loss alone (SOR: A, based on a meta-analysis and consistent results of RCTs). Exercise significantly lowers LDL-C (SOR: A, based on meta-analyses and consistent results of RCTs). Smoking cessation may have a beneficial effect (SOR: B, based on inconsistent results from RCTs that it lowers LDL-C). Exercise-based alternative practices (yoga and tai chi) lower LDL, and meditation may have a beneficial effect (SOR: C, moderate evidence that intervention lowers LDL, insufficient evidence to prove that it reduces mortality/morbidity).

Source: J Fam Pract. 2007 Jun;56(6):483-5.

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