PLEASE RESPOND TO THE FOLLOWING POST OF A CLASSMATE IN 150 WORDS, Remember that your posts must be substantive and contribute to the dialogue that is taking place and offer suggestions to improve their PICO(TT). Think tightening the focus, clearer terminology, and obstacles to successful application. Each of these should be a minimum of 150 words.

Classmate Post:

PICO question:  

In patients with Hypercholesterolemia, can converting to a 100% Mediterranean diet alone reduce cholesterol levels similarly to taking the standard treatment with a statin in six months?  

Population (P): Patients with Hypercholesterolemia.  

Rationale: The population in question is patients with Hypercholesterolemia. Hypercholesterolemia is characterized by an excess of low-density lipoprotein (LDL, or “bad cholesterol”) in the blood. When LDL blood levels become too high, that cholesterol can make your arteries narrow (atherosclerosis), making it hard for your blood to circulate, which puts you at risk of having a heart attack or stroke.  Hypercholesterolemia also affects about 1 out of every 20 adults, typically who are older than 40 years old, of Asian, Filipino, or Vietnamese descent, and post-menopausal women (Hypercholesterolemia, 2024).  

Intervention (I): Converting to a 100% Mediterranean diet.  

Rationale: The intervention, or changing the patients’ diet, is in question. The Mediterranean diet is based on the traditional cuisine of countries bordering the Mediterranean Sea. Its emphasis on unsaturated fats, which are consumed in place of saturated and trans fats, is a key factor in its potential to combat heart disease (Mediterranean diet for heart health, 2023).  

The Mediterranean diet’s reliance on plant-based unsaturated fats, primarily from olive oil and nuts, appears to be effective in reducing total cholesterol and LDL, or ‘bad’ cholesterol levels (Mediterranean diet for heart health, 2023). The diet’s potential to significantly impact cholesterol levels inspires future dietary interventions.    

Comparison (C): Standard statin treatment.  

Rationale: We are comparing the standard Statin treatment to a 100% Mediterranean diet to lower LDL levels in patients with Hypercholesterolemia. Statins decrease the body’s cholesterol production, particularly by interfering with the liver’s role in this process. They inhibit the liver from making an enzyme (HMG CoA reductase) needed to produce cholesterol (Professional, 2024). Understanding the liver’s crucial role in cholesterol production is key to managing Hypercholesterolemia. Your body makes seventy-five percent of your cholesterol, so helping it make less can make a big difference. The rest of your body’s cholesterol comes from what you eat. Statins also increase the removal of cholesterol by the liver, reducing LDL cholesterol levels by as much as 25 to 55 percent (Professional, 2024).  

Outcome (O): Reduce cholesterol levels.  

Rationale: Lowering LDL cholesterol reduces cardiovascular risk. Studies have consistently shown that it reduces the risk of cardiovascular death, heart attacks, strokes, and the need for cardiac catheterizations or bypass surgeries (Kimaiyo, 2021).  

Time (T): 6 months  

Rationale: This longitudinal study’s time frame is six months. Statins normally take about two to four weeks to start lowering cholesterol levels in patients with Hypercholesterolemia. Conversely, it can take three to six months to lower cholesterol through diet and exercise (Gurung, 2022). 

References 

Gurung, A., & Gurung, A. (2022, July 9). How long does it take to reduce cholesterol levels? –. Nix Health Care Hospital. https://www.nixhealthcare.org/how-long-does-it-take-to-reduce-cholesterol-levels/#:~:text=It%20can%20take%20approximately%20three,lifestyle%20changes%20to%20maintain%20cholesterolLinks to an external site.. 

Hypercholesterolemia. (2024, May 7). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/23921-hypercholesterolemiaLinks to an external site. 

Kimaiyo, D., MD. (2021, February 24). Lowering cholesterol protects your heart and brain, regardless of your age. Harvard Health. https://www.health.harvard.edu/blog/lowering-cholesterol-protects-your-heart-and-brain-regardless-of-your-age-2021022421978Links to an external site. 

Mediterranean diet for heart health. (2023, July 15). Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801#:~:text=Olive%20oil%20and%20nuts%20are,LDL%20or%20%22bad%22%20cholesterolLinks to an external site.. 

Professional, C. C. M. (2024, May 1). Statins. Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/22282-statinsLinks to an external site.