Live well: a practical and effective low-intensity dietary counseling intervention for use in primary care patients with dyslipidemia--a randomized controlled pilot trial.
Live well: a practical and effective low-intensity dietary counseling intervention for use in primary care patients with dyslipidemia--a randomized controlled pilot trial.
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DOI：
10.1186/1471-2296-14-59
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发表时间：
2013-05-12
影响因子：
2.9
通讯作者：
Feller C
中科院分区：
文献类型：
--
作者：
Kulick D;Langer RD;Ashley JM;Gans KM;Schlauch K;Feller C
饮食是治疗胆固醇升高的第一线。高强度饮食咨询（与提供者接触≥360分钟/年）可改善血脂，但在当前的医疗环境中价格昂贵且不可持续。低强度咨询试验（≤ 30分钟/年）显示了适度的饮食变化，但血脂没有改善。这项试点研究评估了由初级保健医生（PCP）提供的低强度饮食咨询干预在心血管疾病风险患者中的可行性及其对血脂和饮食的影响。研究为期6个月，随机对照期为3个月（A组接受干预，B组作为对照），随后两组均接受3个月的干预。入组了61名年龄在21 - 75岁之间、LDL-胆固醇≥ 3.37 mmol/L、能够访问互联网和拥有活跃电子邮件帐户的成人。饮食评估使用Rate-Your-Plate问卷。PCP在日常办公室访问期间提供饮食咨询，间隔三个月，使用印刷的教育材料和最低限度的互动咨询网站。每周发送电子邮件，提醒参与者使用饮食咨询资源。结果是低密度脂蛋白胆固醇，其他脂质亚类和饮食质量的变化。在第3个月，A组（咨询从第1个月开始）的LDL-胆固醇降低了−0.23 mmol/L（−0.04至−0.42 mmol/L，P = 0.007），总胆固醇降低了−0.26 mmol/L（−0.05至−0.47 mmol/L，P = 0.001）。在第6个月，A组的总胆固醇和LDL-胆固醇仍然优于B组（咨询从第3个月开始）。A组的饮食评分在3个月时改善了50.3分（38.4至62.2，P < 0.001）;在6个月时进一步增加了11.8分（3.5至20.0，P = 0.007）。B组在6个月时饮食改善最大，为55分（40.0 - 70.1，P < 0.001），在3个月时改善较小但显著，为22.3分（12.9 - 31.7，P < 0.001）。两组HDL-胆固醇均无显著变化。PCP为心血管疾病风险患者提供的低强度饮食咨询在饮食和脂质方面产生了具有临床意义的改善，其幅度与高强度干预措施报告的变化相似。ClinicalTrials.gov：NCT01695837
Diet is the first line of treatment for elevated cholesterol. High-intensity dietary counseling (≥360 minutes/year of contact with providers) improves blood lipids, but is expensive and unsustainable in the current healthcare settings. Low-intensity counseling trials (≤ 30 minutes/year) have demonstrated modest diet changes, but no improvement in lipids. This pilot study evaluated the feasibility and the effects on lipids and diet of a low-intensity dietary counseling intervention provided by the primary care physician (PCP), in patients at risk for cardiovascular diseases. Six month study with a three month randomized-controlled phase (group A received the intervention, group B served as controls) followed by three months of intervention in both groups. Sixty-one adults age 21 to 75 years, with LDL-cholesterol ≥ 3.37 mmol/L, possessing Internet access and active email accounts were enrolled. Diet was evaluated using the Rate-Your-Plate questionnaire. Dietary counseling was provided by the PCP during routine office visits, three months apart, using printed educational materials and a minimally interactive counseling website. Weekly emails were sent reminding participants to use the dietary counseling resources. The outcomes were changes in LDL-cholesterol, other lipid subclasses, and diet quality. At month 3, group A (counseling started at month 1) decreased their LDL-cholesterol by −0.23 mmol/L, (−0.04 to −0.42 mmol/L, P = 0.007) and total cholesterol by −0.26 mmol/L, (−0.05 to −0.47 mmol/L, P = 0.001). At month 6, total and LDL-cholesterol in group A remained better than in group B (counseling started at month 3). Diet score in group A improved by 50.3 points (38.4 to 62.2, P < 0.001) at month 3; and increased further by 11.8 (3.5 to 20.0, P = 0.007) at month 6. Group B made the largest improvement in diet at month 6, 55 points (40.0 to 70.1, P < 0.001), after having a small but significant improvement at month 3, 22.3 points (12.9 to 31.7, P < 0.001). No significant changes occurred in HDL-cholesterol in either group. A low-intensity dietary counseling provided by the PCP in patients at risk for cardiovascular diseases produced clinically meaningful improvements in both diet and lipids of magnitude similar to changes reported with high intensity interventions. ClinicalTrials.gov: NCT01695837
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影响因子：
7.2
作者：
GORDON, DJ;HYDE, J;EKELUND, LG
通讯作者：
EKELUND, LG
影响因子：
37.8
作者：
Grundy, SM;Becker, D;Jehle, AJ
通讯作者：
Jehle, AJ
影响因子：
2
作者：
BROWNE, RH
通讯作者：
BROWNE, RH
影响因子：
5.1
作者：
AMMERMAN, AS;DEVELLIS, RF;SISCOVICK, DS
通讯作者：
SISCOVICK, DS
影响因子：
5.4
作者：
Flynn, Mary;Sciamanna, Christopher;Vigilante, Kevin
通讯作者：
Vigilante, Kevin