Dietary intervention with emphasis on folate intake reduces serum lipids but not plasma homocysteine levels in hyperlipidemic patients

Hyperlipidemia and hyperhomocysteinemia are regarded as major risk factors for cardiovascular disease. Medical nutrition therapy (MNT), which involves a combination of nutritional diagnosis, therapy, and counseling for at-risk patients, has been proposed as a protocol to control these risk factors. The purpose of this study was to investigate the effect of an intensive MNT, specifically tailored to Korean hyperlipidemic patients, on levels of serum lipids and plasma homocysteine. Forty hyperlipidemic patients with blood levels of total cholesterol ≥200 mg/dL or triacylglycerol ≥150 mg/dL were recruited from the Kyung Hee University Medical Center (Seoul, Korea). They were randomly divided into control (no treatment) or experimental (MNT treatment) groups. A registered dietitian performed MNT, emphasizing dietary folate intake based on the guidelines for Korean hyperlipidemic patients; this was performed 5 times during the 12 weeks of the experiment. After the MNT period, we observed that body mass index (P < .001) and fat percentage (P < .05) was significantly decreased in the experimental group but not in the control group. Daily energy consumption, as well as carbohydrate, fat, and cholesterol intakes, all decreased significantly (P < .05) in the MNT group, whereas folate intake increased (P < .05). Blood levels of triacylglycerol (−30.8%), total cholesterol (−20.9%), low-density lipoprotein cholesterol (−14.5%), and ratio of low-density lipoprotein/high-density lipoprotein (−17.1%) were significantly lower in the experimental group after MNT (P < .001) compared with the control group. Plasma homocysteine levels were unchanged (P = .98); however, the levels of folate (P < .01), vitamin B₆ (P < .01), and vitamin B₁₂ (P < .05) increased significantly in the experimental group. These results indicate that MNT, with an emphasis on folate intake, can be effective at reducing blood levels of lipids and improving the blood levels of folate, vitamin B₆, and vitamin B₁₂ in Korean hyperlipidemic patients.