Dietary supplementation contributes to lifestyle improvement in hypercholesterolemic patients in real-life contexts

Abstract

Aims:

Assess the evolution of cardiovascular lifestyle behaviors in hypercholesterolemic patients concomitantly with changes in their daily intake of phytosterol-supplemented yoghurt (Phyto-SY).

Methods:

Nationwide prospective observational study conducted in general practices across France and Spain. Each practitioner suggested lifestyle changes to five consecutive patients with hypercholesterolemia (whether or not they were taking hypocholesterolemic drugs) and recommended daily consumption of Phyto-SY. The study design involved an inclusion visit, a patient’s self-monitoring assessment after 1 month, and a final visit after 4 months. Primary evaluation criterion: changes in dietary habits assessed by a standardized Nutritional Lifestyle score. Secondary criteria: changes in lipid profile, anthropometry (waist circumference) and lifestyle behavior.

Results:

A total of 2376 hypercholesterolemic patients (of whom 54.8% were women) were included. The average age was 56.2 years old. The Nutritional Lifestyle score improved from 15.4 ± 5.4 to 8.7 ± 4.0 (p < 0.0001). Total cholesterol decreased by 10.6% (<0.0001), HDL-C increased by 8.0% (<0.0001), and LDL-C fell by 12.7% (<0.0001). Similar results were observed in patients treated with statins and those who were not. Frequency of walking (>30 min) increased from 59.3% to 78.3% (p < 0.0001). The overweight rate decreased from 22.8% to 17.5% (p < 0.0001) and waist circumference from 94.6 ± 13.3 cm to 93.0 ± 12.8 cm (p < 0.0001). Nutritional Lifestyles and other lifestyle markers’ improvement were parallel to adherence to Phyto-SY adherence.

Conclusion:

Improvements in Nutritional Lifestyle scores, which included regular consumption of Phyto-SY over 4 months, was significantly linked to healthier lifestyles and to beneficial modifications in atherogenic lipid profiles, which reflected patient empowerment in a ‘real life’ context.

Keywords::

• Cholesterol
• Food supplement
• Lifestyle behaviors
• Phytosterol

Transparency

Declaration of funding

This study was funded by Danone.

Declaration of financial/other relationships

F.A.A. has disclosed that he is the owner of Cen Nutriment, a company that received funding from Danone to conduct this study. E.Br. has disclosed that he has received sponsorship from Danone through Cen Nutriment. He is also on the Speakers’ Bureau of Danone, AstraZeneca and Amgen. M.J.C. has disclosed that he has received sponsorship from Danone through Cen Nutriment. He has also been a consultant to Danone and has received grants from the European Union, regional council of Burgundy. O.D. has disclosed that he is on the advisory boards of Danone, AstraZeneca, MSD, and Abbot, and has received honoraria for conference attendance from AstraZeneca, MSD, and Abbot. L.M. and E.Bo. have received sponsorship from Danone for their role in developing the manuscript.

CMRO peer reviewers on this manuscript have received an honorarium for their review work, but have no other relevant financial relationships to disclose.