With 61% of the U.S. adult population considered overweight or obese, the National Heart, Lung, and Blood Institute has released a new practical guide to help doctors treat their overweight patients. It consists of a 10-step plan to help the nation's 97 million obese or overweight adults to lose weight and thereby reduce their risk of illness or death from hypertension, diabetes, heart disease and other conditions that have been associated with overweight.

Of particular interest to those with high cholesterol is this specific recommendation:

Weight loss is recommended to lower elevated levels of total cholesterol, LDL-cholesterol, and triglycerides, and to raise low levels of HDL-cholesterol in overweight and obese persons with abnormal lipid levels.

In making this recommendation, the experts evaluated dozens of controlled clinical trials to determine the effect of weight loss on various lipid components. They found:

• There is strong evidence that weight loss produced by lifestyle modifications in overweight individuals is accompanied by reductions in serum triglycerides and by increases in the "good" HDL-cholesterol.
• Weight loss generally produces some reduction in serum total cholesterol and the "bad" LDL-cholesterol.
• There is limited evidence that a decrease in abdominal fat correlates with improvements in lipids.
• There is strong evidence that increased aerobic activity to increase cardiorespiratory fitness favorably affects blood lipids, particularly if accompanied by weight loss.
• There is suggestive evidence from trials of weight loss medications that weight loss achieved by these medications with accompanying lifestyle modifications does not result in consistent effects on blood lipids.

Next week we'll look at the panel's recommended methods for losing weight.

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