I am not surprised. I tell patients, interns and students that the only dietary intervention that I see work for hyperlipidemia is significant weight loss. Standard Lifestyle Recommendations Have Little Effect on Cholesterol Levels. I like this article (registration required), because it reports on data. At follow-up, the researchers observed no significant changes in any of the measures among patients randomized to the standard lifestyle recommendations.

However, patients in the other groups experienced weight loss (from 1.7 kg to 3.7 kg), reductions in total cholesterol (by 4% to 6%), reduction in LDL cholesterol (6%) and a lowering of mean systolic blood pressure (from 7.3 mm Hg to 8.8 mm Hg), the researchers found.

Patients in the supervised exercise program also significantly improved their exercise capacity, they add. These patients also reported a significantly greater improvement in health-related quality of life compared with other patients, according to the report in the July issue of Preventive Medicine.

"These improvements in cardiovascular disease risk factors in the more intense groups translates into a 3% to 6% absolute reduction of the estimated 10-year cardiovascular disease risk, whereas this risk remained stable in the step 1 group," the researchers note. "This represents a relative risk reduction varying from 15% to 27% over baseline for the more intensive interventions, compared with only 6% for the step 1 diet group."

Dr. Lalonde and colleagues conclude that "more intensive lifestyle interventions may be associated with improvement in cardiovascular health and quality of life. Further studies should be done to identify interventions that are both effective and attractive for the majority."