Effectiveness of Dietetic Consultations in Primary Health Care: A Systematic Review of Randomized Controlled Trials

Abstract

Dietetic consultations for adults in primary care settings appear to be effective for improvement in diet quality, diabetes outcomes (including blood glucose and glycated haemoglobin values), and weight loss outcomes (eg, changes in weight and waist circumference) and to limit gestational weight gain (Grade II: Fair evidence). Research evaluated in this review does not provide consistent support for the effectiveness of direct dietetic counseling alone in achieving outcomes relating to plasma lipid levels and blood pressure (Grade III: Limited evidence). Therefore, to more effectively control these cardiovascular disease risk factors, future research might explore novel nutrition counseling approaches as well as dietitians functioning as part of multidisciplinary teams.

Effectiveness of dietetic consultation for lowering blood lipid levels in the management of cardiovascular disease risk: A systematic review and meta‐analysis of randomised controlled trials

“…The results are comparable to those observed in pharmacotherapy studies conducted in high‐risk populations and provide evidence of the effectiveness of dietary therapies for reducing cardiometabolic risk factors. Dietary advice has previously been shown to be effective in the prevention of chronic disease, and dietetic consultation has been shown to elicit improvements in diet quality, weight loss and diabetes outcomes . However, this study is the first to synthesise the effectiveness of dietetic consultation for the management of CVD risk factors.…”

“…The current systematic review and meta‐analyses used the same search strategy previously reported for a broader systematic review conducted in 2016 and published in 2017 . RCTs only were included to obtain the highest level of evidence and the lowest likelihood of bias due to their study design and use of a control group.…”

“…Additional publications were identified through hand searches of the reference lists of included publications and from systematic reviews retrieved in the search. Further details of the search strategy have been published previously …”

“…Study eligibility for review was based on PICOS (Population, Intervention, Comparator, Outcome, Study design) criteria presented in Table . Full details of the study selection process have been published previously . In brief, an initial selection process identified articles for further consideration if the title or abstract contained at least one keyword from each of the search categories described.…”

“…A quality control training procedure was undertaken to ensure consistency of coding between reviewers. Agreement (97%) between reviewers was obtained for the coding of the first 250 abstracts . Where the coding differed, consensus was achieved through group discussion.…”