Effects of a simplified programme for dietary treatment of hyperlipdaemia in primary health care

Abstract

Objective -To evaluate a model for dietary treatment of hyperlipidaemia in primary health care.Design -The participating men received their initial dietary instructions from a dietitian, in a group, together with their wives. Thereafter the nurses used a checklist to evaluate dietary compliance throughout the year. The participants completed a simplified food frequency questionnaire six times during the study period.Results -Throughout the year the total body weight, body mass index (BMI), total cholesterol, LDL cholesterol and LDL/HDL cholesterol ratio decreased significantly. HDL cholesterol was significantly increased after one year.Setting -The Industrial Health Care Centre, Ovansiljans Foretagshalsovird AB in Mora, Sweden.Participants -35 men, aged 3 9 4 3 years (mean 51), with hyperlipidaernia, discovered at a health survey of persons attending an industrial health care centre. Hyperlipidaemia is one of the main risk factors for coronary heart disease (CHD). It is generally agreed that most patients with mild or moderate hyperlipoproteinaemia should be treated with non-pharmacological methods, but few controlled studies have been performed with the aim of evaluating the feasibility and efficacy of such treatment over an extended period. The Oslo study is one exception, in which excellent results were achieved with dietary treatment and advice to smokers to stop smoking (1). Changes in diet and exercise habits can often be sufficient to normalize or improve moderately elevated blood lipid levels (1-3). Today as many as one-fourth of all middle-aged men in Sweden may be considered to be hyperlipidaemic (4). Obviously it is not realistic to give everybody with mild hyperlipoproteinaemia individual lipid-lowering treatment. Conclusion 129in which the nurses would be responsible for the major part of the lipid-lowering treatment under the guidance of a dietitian.The aim of this study was to evaluate a practical method for dietary treatment of persons with hyperlipidaemia in primary health care, applying a simplified programme over a period of one year. Material and methodsThe study comprised 35 men, aged 39-63 years (mean 5 l), with hyperlipoproteinaemia (HLP) discovered at a health survey of persons attending an industrial health care centre. The inclusion criteria were HLP, defined as a serum triglyceride level of >2.0 mmol/l and/or a serum cholesterol level of >6.5 mmol/l when measured 4 weeks before the start of the intervention study. In a few of the men the lipid levels had become normalized, i.e. they were marginally below the cutoff points, on entry into the study, but these men were nevertheless included. The normalization was probably due to changes in the food intake during the interval. The initial value (time 0 weeks) was defined as the mean of the serum lipid concentrations at -4 and 0 weeks.All participants were in good health and used no drugs throughout the study period. None of the men had previously received individualized dietary advice from medical professionals or dietitians. They had not...

Effect of an empowerment‐based nutrition promotion program on food consumption and serum lipid levels in hyperlipidemic Thai elderly

“…The dietary strategy in this study gave results consistent with a simplified model (dietary instructions combined with dietary compliance) (Nydahl et al, 1994), intensive nutrition counseling (Rhodes et al, 1996;Hebert et al, 1999;Angkatavanich et al, 2001), nutrition education combined with dietary counseling (Timlin et al, 2002), dietary intervention (Lopes et al, 1999), effective strategies, and a health promotion program (Aree et al, 2003).…”