Equine Nutrition Education Articles & Resources

A recent study was designed to compare the effects of dietary intervention and hormone replacement therapy (HRT), alone or in combination, on blood lipid profiles and body weight in postmenopausal women with hypercholesterolemia in Korea. Thirty-six postmenopausal women, aged 50 to 61 years, were recruited from a medical center for women in Seoul, Korea. All had hypercholesterolemia, defined as LDL cholesterol levels of greater than 160 mg/dL. Subjects were required to fill out a semi-quantitative food frequency questionnaire (semi FFQ). Subjects collected for the trial were those who ate more than 20% in fat intake and more than 100 mg/1000 kcal in cholesterol intake. Subjects were otherwise healthy and none were taking supplements and/ or medication that included estrogen.

The women were randomly assigned to one of three different treatments: hormone replacement therapy (HRT group, n=8), dietary intervention (DIET group, n=8), or the hormone replacement therapy combined with dietary intervention (HRT+DIET group, n=8). The HRT group and the HRT+DIET group both took a combined therapy of estrogen and progesterone, in which mg of conjugated equine estrogen (CEE, Premarin) was prescribed for 30 days and 5 mg of medroxy progesterone acetate (MPA, Provera) was combined for the first 12 days on a monthly cyclic schedule. The diet was designed to provide approximately 70 gm/1000 kcal of dietary cholesterol and the ratio of ingested saturated fat and cholesterol to calories (RISCC) of less than or equal to 8, and to meet the recommended dietary allowances (RDA) for known nutrients. The RISCC is the cholesterol-saturated fat index (CSI) adjusted for energy intake. Energy intake was individually tailored to maintain ideal body weight. The diet consisted of a 10-day rotating menu. Extensive dietary counseling was given at the beginning of dietary intervention, and was repeated at each subsequent visit. The study period was a total of 12 weeks. All subjects visited the clinic at weeks 0, 4 and 12 for treatment, blood sampling, and measurement of body weight.

Serum total cholesterol and LDL-cholesterol levels decreased by 13 to 16% and 24 to 28% in the HRT group; by 17 to 19% and 21 to 23% in the DIET group; and by 19 to 26% and 32 to 39% in the HRT+DIET group, respectively (P<). Serum HDL-C levels decreased in the DIET group (%, P<) but not in the HRT and HRT+DIET groups. Serum triglycerides increased in the HRT group (18%, P<) but decreased in the DIET group (%, P<). In the HRT+DIET group, serum triglycerides did not change significantly. Body weight decreased only in the DIET group.

To conclude, this study demonstrates the effectiveness of dietary intervention in postmenopausal women with elevated cholesterol levels. The treatment to reduce risk of CVD should be individualized on the basis of the individuals' dietary intake, and HRT should not be substituted for dietary intervention.

K. Jung, S. Kim, J. Woo, et al. The efficacy of dietary intervention alone or combined with hormone replacement therapy in postmenopausal women with hypercholesterolemia in Seoul, Korea. Eur J Nutr; 41:101-107 (August, 2002). [Correspondence: K. Jung, Korean Living Science Research Institute, Hanyang University, 17 Haengdang-dong Sungdong-ku, Seoul, 133-791 Korea. Tel: +82-2/2290-1207.