We appreciate Dr Barnard's interest in our article1 that was recently published in the ARCHIVES, but we disagree with his assertion that our results indicate that the National Cholesterol Education Program (NCEP) Step I diet is ineffective for reducing total and low-density lipoprotein (LDL) cholesterol levels. Our trial was designed to compare the influence of lean red meat and lean white meat on blood lipid levels, not to assess the efficacy of the NCEP Step I diet.1 In accordance with the original intent of the trial, we did not exclude subjects who were following an NCEP Step I diet before entering the study. Because many subjects were following a diet that was consistent with the NCEP Step I guidelines during the baseline period, relatively small changes in dietary fat, cholesterol, and serum lipid levels were observed. The changes in LDL cholesterol observed in both groups were consistent with those predicted based on data from diet records.
Davidson MH, Maki KC. The Lipid-Lowering Effect of Lean Meat Diets Falls Far Short of That of Vegetarian Diets—Reply. Arch Intern Med. 2000;160(3):393–394. doi: