The investigation reported in this issue of the Archives by Henkin et al1 points out that long-term adherence to dietary therapy for high serum cholesterol levels remains a problem and presents a challenge to the health care team. This study revealed that many patients who initially responded to cholesterollowering diets later reverted to higher cholesterol levels. The authors express the view that lack of response to a cholesterol-lowering diet may be due to a physiological nonresponsiveness, inadequate knowledge, and inability to change dietary habits. Certainly, all of these factors are known to hamper successful long-term therapy for high serum cholesterol levels. Finally, the authors raise the question of whether continuing supervision and better nutritional labeling will improve dietary compliance in patients with elevated serum cholesterol levels.
Although it is well to point out that long-term success with any dietary program presents a challenge, it can be questioned whether the
Grundy SM. Adherence to Cholesterol-Lowering Diets. Arch Intern Med. 1992;152(6):1139. doi:10.1001/archinte.1992.00400180011001
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