Incorporation of Lean Red Meat into a National Cholesterol Education Program Step I Diet: A Long-Term, Randomized Clinical Trial in Free-Living Persons with Hypercholesterolemia
Donald B. Hunninghake, MD, Kevin C. Maki, PhD, Peter O. Kwiterovich, Jr., MD, Michael H. Davidson, MD, Mary R. Dicklin, PhD, and Stephanie D. Kafonek, MD
The University of Minnesota Hospital and Clinics, Minneapolis, Minnesota (D.B.H.), Chicago Center for Clinical Research, Chicago, Illinois (K.C.M., M.H.D., M.R.D.), TheJohns Hopkins University Lipid Clinic, Baltimore, Maryland (P.O.K., S.D.K.), Parke-Davis, Morris Plains, New Jersey (S.D.K.) [firstname.lastname@example.org]
Objective: Clinicians often recommend that intake of all meat, particularly red meat, be reduced in conjunction with a low-fat, low-cholesterol diet to reduce low-density lipoprotein (LDL) cholesterol. This study was designed to determine the long-term effects of lean red meat (beef, veal and pork) compared to lean white meat (poultry and fish) consumption on lipoprotein concentrations in free-living hypercholesterolemic subjects consuming a National Cholesterol Education Program (NCEP) Step I diet.
Methods: A randomized, crossover design was utilized. Hypercholesterolemic men and women (LDL cholesterol between 3.37 and 4.92 mmol/L) (triglycerides <3.96 mmol/L) (n=145) were counseled to consume 80% of their 170 g/d meat intake as either lean red meat or lean white meat for two 36-week phases, separated by a four-week washout period of free meat selection. Subjects were instructed to follow an NCEP Step I diet throughout the study.
Results: There were no significant differences in lipid concentrations between the lean red meat and lean white meat phases. LDL cholesterol was 4.02 ± 0.04 (SEM) and 4.01 ± 0.04 mmol/L in the white and red phases, respectively; this represented a decrease of ~2% from baseline concentrations (p<0.01). Total cholesterol also declined by 1% from baseline (p<0.05), and high-density lipoprotein (HDL) cholesterol rose over the study period by ~2% to ~3% from baseline to reach concentrations of 1.37 ± 0.03 mmol/L and 1.38 ± 0.03 mmol/L in the white and red phases, respectively (p<0.001). Triglycerides were not altered by treatment.
Conclusions: Consumption of lean red meat or lean white meat, as part of an NCEP Step I diet, is similarly effective for reducing LDL cholesterol and elevating HDL cholesterol concentrations in free-living persons with hypercholesterolemia.