Changes in CVD risk factors after combined dietary counselling and supplementation with lipid-lowering milk product: The effect of compliance

Summary Background & aims Food intake has been associated with cardiovascular disease (CVD) risk and compliance is considered essential to elicit maximal responses to diet therapy. This study aimed to evaluate the changes in CVD risk factors after a 3-month counselling programme combined with supplementation with a lipid-lowering milk product, and to examine the effect of compliance on these factors. Methods Seventy-seven hypercholesterolaemic adults were randomized to receive a milk product enriched with phytosterols (EMG: n  = 40) or a placebo one (PMG: n  = 37). Both groups consumed 500 ml milk/d and attended seven counselling sessions. They were categorized as non-compliant, partially compliant or compliant based on attendance of sessions and milk consumption. Results Both groups significantly increased vegetable and decreased cheese consumption. Both EMG and PMG reduced their TC, LDL-C, apo-B and BMI. When analysed separately by compliance level, no changes were observed in non-compliant subjects in both EMG and PMG; partially compliant EMG and PMG reduced their TC and LDL-C levels; compliant EMG and PMG study participants further reduced their apo-B and BMI. Conclusion The results of this study highlight the importance of a high degree of compliance to a healthier lifestyle and diet to achieve desired changes in CVD risk factors, further to the use of a lipid lowering milk product.