Skip to main content
Canadian Family Physician logoLink to Canadian Family Physician
. 1998 Jun;44:1289–1297.

Hypercholesterolemia screening. Does knowledge of blood cholesterol level affect dietary fat intake?

M Aubin 1, G Godin 1, L Vézina 1, J Maziade 1, R Desharnais 1
PMCID: PMC2278249  PMID: 9640523

Abstract

OBJECTIVE: To assess whether knowing blood cholesterol test results influences people's intention to lower their dietary fat intake and to assess changes in diet after 3 months. DESIGN: Randomized clinical study. SETTING: Two hospital-based family medicine centres. PARTICIPANTS: A total of 526 patients aged 18 to 65, without prior knowledge of their blood cholesterol levels, were recruited. Seventy did not appear for their appointments, and 37 did not meet study criteria, leaving 419 participants. From that group, 391 completed the study. INTERVENTIONS: Patients submitted to cholesterol screening were randomly assigned to one of two groups, completing the study questionnaires either before (control group) or after (experimental group) being informed of their screening test results. All participants were called 3 months after transmission of test results to assess their dietary fat intake at that time. MAIN OUTCOME MEASURES: Differences in intention to adopt a low-fat diet reported between the experimental and control groups and differences in dietary fat intake modification after 3 months between patients with normal and abnormal blood cholesterol test results. RESULTS: Knowledge of test results influenced patients' intentions to adopt low-fat diets (F1,417 = 5.4, P = .02). Patients reported lower mean dietary fat intake after 3 months than at baseline (P < .0001). The reduction was greater in patients with abnormal screening results (F2,388 = 3.6, P = .03). CONCLUSIONS: Being informed of personal blood cholesterol levels effects an immediate change in eating habits that translates into reduced dietary fat intake.

Full text

PDF
1289

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allen S. S., Bache-Wiig M. L., Hunninghake D. B. Patient perceptions about the influence of cholesterol on heart disease. Am J Prev Med. 1992 Jan-Feb;8(1):30–36. [PubMed] [Google Scholar]
  2. Blankenhorn D. H., Johnson R. L., Nessim S. A., Azen S. P., Sanmarco M. E., Selzer R. H. The Cholesterol Lowering Atherosclerosis Study (CLAS): design, methods, and baseline results. Control Clin Trials. 1987 Dec;8(4):356–387. doi: 10.1016/0197-2456(87)90156-5. [DOI] [PubMed] [Google Scholar]
  3. Brown G., Albers J. J., Fisher L. D., Schaefer S. M., Lin J. T., Kaplan C., Zhao X. Q., Bisson B. D., Fitzpatrick V. F., Dodge H. T. Regression of coronary artery disease as a result of intensive lipid-lowering therapy in men with high levels of apolipoprotein B. N Engl J Med. 1990 Nov 8;323(19):1289–1298. doi: 10.1056/NEJM199011083231901. [DOI] [PubMed] [Google Scholar]
  4. Burke G. L., Sprafka J. M., Folsom A. R., Hahn L. P., Luepker R. V., Blackburn H. Trends in serum cholesterol levels from 1980 to 1987. The Minnesota Heart Survey. N Engl J Med. 1991 Apr 4;324(14):941–946. doi: 10.1056/NEJM199104043241402. [DOI] [PubMed] [Google Scholar]
  5. Canner P. L., Berge K. G., Wenger N. K., Stamler J., Friedman L., Prineas R. J., Friedewald W. Fifteen year mortality in Coronary Drug Project patients: long-term benefit with niacin. J Am Coll Cardiol. 1986 Dec;8(6):1245–1255. doi: 10.1016/s0735-1097(86)80293-5. [DOI] [PubMed] [Google Scholar]
  6. Carmody T. P., Fey S. G., Pierce D. K., Connor W. E., Matarazzo J. D. Behavioral treatment of hyperlipidemia: techniques, results, and future directions. J Behav Med. 1982 Mar;5(1):91–116. doi: 10.1007/BF00845259. [DOI] [PubMed] [Google Scholar]
  7. Connelly P. W., MacLean D. R., Horlick L., O'Connor B., Petrasovits A., Little J. A. Plasma lipids and lipoproteins and the prevalence of risk for coronary heart disease in Canadian adults. Canadian Heart Health Surveys Research Group. CMAJ. 1992 Jun 1;146(11):1977–1987. [PMC free article] [PubMed] [Google Scholar]
  8. Crouch M., Sallis J. F., Farquhar J. W., Haskell W. L., Ellsworth N. M., King A. B., Rogers T. Personal and mediated health counseling for sustained dietary reduction of hypercholesterolemia. Prev Med. 1986 May;15(3):282–291. doi: 10.1016/0091-7435(86)90047-2. [DOI] [PubMed] [Google Scholar]
  9. Denke M. A., Frantz I. D., Jr Response to a cholesterol-lowering diet: efficacy is greater in hypercholesterolemic subjects even after adjustment for regression to the mean. Am J Med. 1993 Jun;94(6):626–631. doi: 10.1016/0002-9343(93)90215-b. [DOI] [PubMed] [Google Scholar]
  10. Desharnais R., Godin G., Jobin J. Motivational characteristics of Evalu*Life and the Canadian Home Fitness Test. Can J Public Health. 1987 May-Jun;78(3):161–164. [PubMed] [Google Scholar]
  11. Foreyt J. P., Scott L. W., Mitchell R. E., Gotto A. M. Plasma lipid changes in the normal population following behavioral treatment. J Consult Clin Psychol. 1979 Jun;47(3):440–452. doi: 10.1037//0022-006x.47.3.440. [DOI] [PubMed] [Google Scholar]
  12. Godin G., Desharnais R., Jobin J., Cook J. The impact of physical fitness and health-age appraisal upon exercise intentions and behavior. J Behav Med. 1987 Jun;10(3):241–250. doi: 10.1007/BF00846538. [DOI] [PubMed] [Google Scholar]
  13. Gordon R. L., Klag M. J., Whelton P. K. Community cholesterol screening. Impact of labeling on participant behavior. Arch Intern Med. 1990 Sep;150(9):1957–1960. doi: 10.1001/archinte.150.9.1957. [DOI] [PubMed] [Google Scholar]
  14. Grundy S. M. Cholesterol and coronary heart disease. A new era. JAMA. 1986 Nov 28;256(20):2849–2858. [PubMed] [Google Scholar]
  15. Hahn D. L. Systematic cholesterol screening during acute care visits. J Am Board Fam Pract. 1993 Nov-Dec;6(6):529–536. [PubMed] [Google Scholar]
  16. Holme I. An analysis of randomized trials evaluating the effect of cholesterol reduction on total mortality and coronary heart disease incidence. Circulation. 1990 Dec;82(6):1916–1924. doi: 10.1161/01.cir.82.6.1916. [DOI] [PubMed] [Google Scholar]
  17. Huebsch J. A. Educational and behavioral strategies for successful cholesterol management. J Cardiovasc Nurs. 1991 Jan;5(2):44–54. doi: 10.1097/00005082-199101000-00007. [DOI] [PubMed] [Google Scholar]
  18. Kannel W. B., Castelli W. P., Gordon T., McNamara P. M. Serum cholesterol, lipoproteins, and the risk of coronary heart disease. The Framingham study. Ann Intern Med. 1971 Jan;74(1):1–12. doi: 10.7326/0003-4819-74-1-1. [DOI] [PubMed] [Google Scholar]
  19. Pekkanen J., Linn S., Heiss G., Suchindran C. M., Leon A., Rifkind B. M., Tyroler H. A. Ten-year mortality from cardiovascular disease in relation to cholesterol level among men with and without preexisting cardiovascular disease. N Engl J Med. 1990 Jun 14;322(24):1700–1707. doi: 10.1056/NEJM199006143222403. [DOI] [PubMed] [Google Scholar]
  20. Robertson I., Phillips A., Mant D., Thorogood M., Fowler G., Fuller A., Yudkin P., Woods M. Motivational effect of cholesterol measurement in general practice health checks. Br J Gen Pract. 1992 Nov;42(364):469–472. [PMC free article] [PubMed] [Google Scholar]
  21. Råstam L., Luepker R. V., Pirie P. L. Effect of screening and referral on follow-up and treatment of high blood cholesterol levels. Am J Prev Med. 1988 Sep-Oct;4(5):244–248. [PubMed] [Google Scholar]
  22. Sacks F. M., Pfeffer M. A., Moye L. A., Rouleau J. L., Rutherford J. D., Cole T. G., Brown L., Warnica J. W., Arnold J. M., Wun C. C. The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. Cholesterol and Recurrent Events Trial investigators. N Engl J Med. 1996 Oct 3;335(14):1001–1009. doi: 10.1056/NEJM199610033351401. [DOI] [PubMed] [Google Scholar]
  23. Shepherd J., Cobbe S. M., Ford I., Isles C. G., Lorimer A. R., MacFarlane P. W., McKillop J. H., Packard C. J. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. West of Scotland Coronary Prevention Study Group. N Engl J Med. 1995 Nov 16;333(20):1301–1307. doi: 10.1056/NEJM199511163332001. [DOI] [PubMed] [Google Scholar]
  24. Stamler J., Wentworth D., Neaton J. D. Is relationship between serum cholesterol and risk of premature death from coronary heart disease continuous and graded? Findings in 356,222 primary screenees of the Multiple Risk Factor Intervention Trial (MRFIT). JAMA. 1986 Nov 28;256(20):2823–2828. [PubMed] [Google Scholar]
  25. Strychar I. M., Potvin L., Pineault R., Pineau R., Prévost D. Changes in knowledge and food behaviour following a screening program held in a supermarket. Can J Public Health. 1993 Nov-Dec;84(6):382–388. [PubMed] [Google Scholar]
  26. Sytkowski P. A., Kannel W. B., D'Agostino R. B. Changes in risk factors and the decline in mortality from cardiovascular disease. The Framingham Heart Study. N Engl J Med. 1990 Jun 7;322(23):1635–1641. doi: 10.1056/NEJM199006073222304. [DOI] [PubMed] [Google Scholar]

Articles from Canadian Family Physician are provided here courtesy of College of Family Physicians of Canada

RESOURCES