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Effectiveness of a dietary intervention strategy in general practice: effects on blood lipids, health and well-being

Published online by Cambridge University Press:  01 December 1998

UI Træden ,
L Holm ,
B Sandström ,
PK Andersen  and
M Jarden
UI Træden*
Affiliation:
Institute of Public Health, Department of Social Medicine and Psychosocial Health, University of Copenhagen, Denmark
L Holm
Affiliation:
Research Department of Human Nutrition, the Royal Veterinary and Agricultural University, Frederiksberg, Denmark
B Sandström
Affiliation:
Research Department of Human Nutrition, the Royal Veterinary and Agricultural University, Frederiksberg, Denmark
PK Andersen
Affiliation:
Institute of Public Health, Department of Biostatistics, University of Copenhagen, Denmark
M Jarden
Affiliation:
Institute of Public Health, Department of Biostatistics, University of Copenhagen, Denmark
*
*Corresponding author: Fax +45 31 35 11 81
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Abstract

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Objectives:

To evaluate the effect of a dietary treatment programme on blood cholesterol concentration in hypercholesterolaemic patients in general practice and to analyse subjectively experienced side-effects.

Design:

A 1-year parallel trial comparing a new treatment programme with conventional treatment.

Setting:

General practitioners in Roskilde county, Denmark.

Subjects:

355 men and women, aged 20–60 years, with a persistent blood cholesterol concentration above age- and gender-specific cut-off points (265 in an intervention group and 90 in a control group).

Intervention:

A treatment strategy based on collaboration between doctor and dietitian using individual dietary advice and feedback from measured biological parameters.

Main outcome measures:

Serum lipids, body weight, blood pressure, dietary behaviour, health parameters, quality of life parameters and acceptance by patients and general practitioners.

Results:

Total blood cholesterol concentration decreased by 14% (1.07 mmol l−1, P < 0.0001) in 159 patients in the intervention group, not having any lipid altering drug during treatment, in addition to 3% from screening to start of treatment. In 65 patients in the control group, without any lipid altering drug, the reduction of cholesterol concentration was 4% (0.27 mmol l−1, P < 0.01; intervention vs. control P < 0.001). In the intervention group overweight subjects (body mass index > 30) reduced body weight by 6% (P < 0.0001). Systolic blood pressure was reduced by 11% (P < 0.0001) and diastolic blood pressure by 10% (P < 0.0001) and 19% (P < 0.003) for intervals 90–110 mmHg and > 110 mmHg, respectively. Risk score decreased and self-assessed health, physical and psychological well-being improved.

Conclusions:

The treatment strategy tested proved to be efficient, without side-effects and well accepted by patients and general practitioners. The results strongly suggest that hypercholesterolaemia can efficiently be treated non-pharmacologically in general practice.

Keywords

Dietary interventionBlood cholesterolGeneral practicePublic healthWell-being
Type
Research Article
Information
Public Health Nutrition , Volume 1 , Issue 4 , December 1998 , pp. 273 - 281
Copyright
Copyright © The Nutrition Society 1998

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