Impact of Diet on Plasma Lipids in Individuals with Heterozygous Familial Hypercholesterolemia: A Systematic Review of Randomized Controlled Nutritional Studies.
Study Goal
The researchers aimed to assess the impact of dietary counseling interventions on LDL-C levels in individuals with heterozygous familial hypercholesterolemia (HeFH) and evaluate potential biases in study designs.
Results Summary
The study found that the apparent lack of effectiveness of dietary interventions in modulating LDL-C levels in HeFH individuals may be due to biases in study designs rather than a true lack of effects. The likelihood of reporting significant LDL-C reductions was associated with the risk of bias in the studies.
Population
Individuals with heterozygous familial hypercholesterolemia (HeFH)
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
food-based interventions | neutral | LDL-C | individuals with HeFH | - | systematically assessed the impact | #1 |
dietary counseling interventions | neutral | LDL-C | individuals with HeFH | - | systematically assessed the impact | #2 |
dietary supplements | neutral | LDL-C | individuals with HeFH | - | systematically assessed the impact | #3 |
diet manipulation | no change | plasma levels of LDL-C | individuals with HeFH | - | apparent lack of effectiveness | #4 |
diet manipulation | decrease | LDL-C | individuals with HeFH | - | significant reductions | #5 |
BACKGROUND: Conclusive data on the effectiveness of dietary interventions in heterozygous familial hypercholesterolemia (HeFH) management are unavailable. Whether this is due to a true lack of effects or biases in intervention designs remains unsettled. We systematically assessed the impact on LDL-C of published dietary randomized controlled trials (RCTs) conducted among individuals with HeFH in relation to their design and risk of bias. METHODS: We systematically searched PubMed, Web of Science, and Embase in November 2020 to identify RCTs that assessed the impact of: (1) food-based interventions; (2) dietary counseling interventions; or (3) dietary supplements on LDL-C in individuals with HeFH. We evaluated the risk of bias of each study using the Cochrane Risk of Bias 2 method. RESULTS: A total of 19 RCTs comprising 837 individuals with HeFH were included. Of those, five were food-based interventions, three were dietary counseling interventions and 12 were dietary supplement-based interventions (omega-3, CONCLUSION: This systemic review shows that the apparent lack of effectiveness of diet manipulation in modulating plasma levels of LDL-C among individuals with HeFH is likely due to biases in study designs, rather than a true lack of effects. The likelihood of reporting significant reductions in LDL-C was associated with the concurrent risk of bias.