ObjectiveTo compare the efficacy of three types of diet and lifestyle interventions for lowering plasma lipid levels.DesignRandomised parallelgroup trial.Subjects and settingAdults with plasma cholesterol levels of 5.5‐8.0 mmol/L attending two Sydney community health screening clinics were asked to participate: 179 agreed and 131 completed the study.InterventionsA pamphlet with brief advice; group dietary counselling; or individual counselling. Counselling included three sessions with a dietitian/nutritionist over six months.Main outcome measuresPlasma total cholesterol levels measured by Reflotron analyser; fasting serum lipid levels measured by standard laboratory methods; and calculated low‐density lipoprotein cholesterol levels.ResultsSignificantly lower plasma total cholesterol levels (Reflotron) were observed at two months and at six months with each of the three interventions. Additionally, both types of dietitian‐based counselling resulted in small but significant decreases in plasma low‐density lipoprotein cholesterol levels at six months in a subset of subjects.ConclusionAlthough there were no statistically significant differences in efficacy between the three types of intervention, dietitians have a role to play in setting up such counselling programs.