1. Structured advice provided by a dietitian increases adherence of consumers to diet and lifestyle changes and lowers blood low-density lipoprotein (LDL)-cholesterol: the Increasing Adherence of Consumers to Diet & Lifestyle Changes to Lower (LDL) Cholesterol (ACT) randomised controlled trial.
- Author
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Sialvera TE, Papadopoulou A, Efstathiou SP, Trautwein EA, Ras RT, Kollia N, Farajian P, Goumas G, Dimakopoulos I, Papavasiliou K, Koutsouri A, and Zampelas A
- Subjects
- Adult, Consumer Behavior, Counseling, Diet Records, Feeding Behavior, Female, Health Behavior, Humans, Hypercholesterolemia blood, Life Style, Male, Nutritionists, Patient Education as Topic, Physicians, Phytosterols administration & dosage, Triglycerides blood, Behavior Therapy methods, Cholesterol, LDL blood, Diet, Dietetics methods, Exercise, Hypercholesterolemia therapy, Patient Compliance
- Abstract
Background: Evidence from healthcare professionals suggest that consumer compliance to healthy diet and lifestyle changes is often poor. The present study investigated the effect of advice provided by a physician or dietitian on consumer adherence to these measures combined with consuming foods with added plant sterols (PS) with the aim of lowering low-density lipoprotein cholesterol (LDL-C)., Methods: One hundred mildly-to-moderately hypercholesterolaemic individuals were enrolled into a parallel, randomised, placebo-controlled study. Dietitians (dietitian group; DG) advised 50 individuals in six weekly face-to-face behavioural therapy sessions, whereas the other 50 received standard advice from physicians (physician group, PG). Both groups consumed foods with added PS (three servings a day) for 6 weeks. Subsequently, all individuals were followed-up for another 6 weeks under real-life conditions. Blood lipids were measured at baseline and weeks 6 and 12 and 3-day diet diaries were taken at weeks 1, 6 and 12., Results: Individuals in the DG significantly improved their dietary habits, physical activity and increased PS intake compared to the PG. After 6 weeks, LDL-C decreased in both groups compared to baseline without any significant differences between groups. At week 12, LDL-C was further significantly improved only in the DG (P = 0.006) compared to week 6. Total cholesterol, LDL-C and triglycerides were significantly lower in the DG compared to the PG at week 12 after adjusting for levels at week 6 (P < 0.001, P < 0.001 and P = 0.009, respectively)., Conclusions: Although structured counselling by dietitians and common standard advice by physicians were equally effective with respect to improving blood cholesterol after 6 weeks, dietitians were more effective in the longer-term (i.e. 6 weeks after the end of the intervention period)., (© 2017 The British Dietetic Association Ltd.)
- Published
- 2018
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