Implications of recent lipid-lowering clinical trials and the specific changes to the NCEP guidelines will be the focus of discussion by Neil J. Stone, M.D., professor of clinical medicine of the Feinberg School of Medicine at Northwestern University.

"The evidence provided in recent clinical trials has shown us that there is a need to substantially reduce LDL-cholesterol levels to less than 70 mg/dL in very high risk patients to help reduce the risk of heart disease," said Dr. Stone. "However, it is not going to be easy to get these patients to this goal."

Achieving these new LDL cholesterol goals in high risk patients will be the focus of a presentation given by Peter H. Jones, M.D., Associate Professor of Medicine, Section of Atherosclerosis and Lipid Research at the Baylor College of Medicine.

"In light of these new recommendations, healthcare professionals need to develop appropriate therapeutic strategies to help our patients achieve goal," said Dr. Peter Jones. "Since single drug use, primarily with statins, may not be adequate, we need to individually tailor therapy with bile acid sequestrants, cholesterol absorption inhibitors and nicotinic acid to determine the most safe and effective combination therapy for our patients with high cholesterol."

Other presentations will focus on advanced lipid testing, pathogenesis of atherosclerosis, regulation of glucose and lipid metabolism, the role of HDL (good) cholesterol and triglycerides in cardiovascular disease, the impact of diet on cholesterol management, genetic and environmental interactions in metabolic syndrome, and emerging therapies in the management of high cholesterol.

lipid/

The prevalence of type 2 diabetes, often associated with obesity, reflects an underlying insulin resistance in the Mexican population generally. Among urban Mexicans, nearly one-third of women between the ages of 12 and 49 are overweight. Yet when the research team took into account body mass index and other such potentially confounding factors as socioeconomic status, age at first birth, number of children, and family history of breast cancer, the relationship between carbohydrate intake and breast cancer remained the same.

Dietary fat “ certainly a contributor to obesity “ fared well in the research, showing no significant association with breast cancer risk overall. Willett noted, however, that the intake of polyunsaturated fat by the women in the study group was only about half that of the United States population.

Insoluble fiber intake was associated with lower risk of breast cancer, possibly because fiber may modulate the absorption of carbohydrates and thus affect the glycemic response.

This study raises important questions about high carbohydrate diets, particularly among populations or individuals prone to insulin resistance. However, one study is not enough to make major changes in diet, and more work on this topic is urgently needed, Willett said.

aacr

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