At present,
dyslipidemia is most commonly treated with
drug therapy. However, because safety concerns regarding the use of
pharmaceutical agents have arisen, a need for alternative nonpharmacological
therapies has become increasingly apparent. The National
Cholesterol Education Program (NCEP) Adult Treatment Panel III (
ATP III) recommends lifestyle
therapies, which include a combination of diet and exercise modifications, in place of
drug treatment for patients who fall into an intermediate range of
coronary heart disease (CHD) risk. This review examined the
cholesterol lowering efficacy of the following 2 NCEP-recommended combination
therapies: 1) low saturated fat diets combined with exercise, and 2) nutritional supplementation, i.e.,
fish oil, oat bran, or
plant sterol supplementation, combined with exercise, in the treatment of
dyslipidemia. Combination
therapies are particularly advantageous because diet and exercise elicit complementary effects on
lipid profiles. More specifically,
diet therapies, with some exceptions, lower total (TC) and
LDL cholesterol (
LDL-C) concentrations, whereas exercise interventions increase
HDL cholesterol (HDL-C) while decreasing
triglyceride (TG) levels. With respect to specific interventions, low saturated fat diets combined with exercise lowered TC,
LDL-C, and TG concentrations by 7-18, 7-15, and 4-18%, respectively, while increasing HDL-C levels by 5-14%. Alternatively, nutritional supplements combined with exercise, decreased TC,
LDL-C, and TG concentrations by 8-26, 8-30, and 12-39%, respectively, while increasing HDL-C levels by 2-8%. These findings suggest that combination lifestyle
therapies are an efficacious, preliminary means of improving
cholesterol levels in those diagnosed with
dyslipidemia, and should be implemented in place of
drug therapy when
cholesterol levels fall just above the normal range.