A RANDOMIZED TRIAL COMPARING 2 DIFFERENT EDUCATIONAL INTERVENTIONS FOR TEACHING DIET IN 300 SUBJECTS HAVING A HIGH CARDIOVASCULAR RISK

Several non-pharmacological interventions such as weight reduction in obese subjects or diet alteration in subjects having hypercholesterole mia have been shown to be effective in therapeutic trials. Our aim was to test the value of two different ways of teaching patients about th eir diet. From March 1, 1993, to May 30, 1994, 300 consecutive patient s seen in a one-day care hospital were randomised into two groups. The 2 inclusion criteria were: 1) body mass index > 27 kg/m(2) in men and > to 25 kg/m(2) in women and/or 2) presence of a hypercholesterolemia defined by a total cholesterol > 6.5 mmol/l. Patients in the first gr oup (C) were educated in a 20 to 50 minutes consultation tailored to t heir needs. Patients in the second group (CC) were given in addition a one-hour course about diet. The goal of the diet was to loss at least 3 kg of body weight and/or to have a cholesterol value below 6.5 mmol /l without treatment. All Patients were followed-up by the same 3 diet ician nurses. An out-patient visit was planned at 3 months, and a reca ll letter was sent to the patients who missed their appointments. Amon g the 300 patients, 169 (55 %) were seen at the 3-month outpatient vis it. This proportion did not differ between the 2 groups. Knowledge on diet was assessed by the same 33-item self-administered questionnaire. At baseline scores were comparable between groups (16 vs 17). Scores improved more in the CC than in the C group both at the end of the tea ching question (27 vs 23 in the CC and C group respectively, p < 0.001 ), and at 3 months (25 vs 23 in the CC and C group respectively;p ( 0. 001). Total cholesterol decreased below 6.5 mmol/l in 28 % of the pati ents with dyslipidemia and a weight loss > 3 kg was observed in 32 % o f the obese subjects, but improvement did not differ between the 2 gro ups. We conclude that a specific one-hour course on diet is able to im prove knowledge of patients more than a consultation alone, but that b etter knowledge did not result in improved alteration of risk factors at 3 months.