MEDICAL NUTRITION THERAPY LOWERS SERUM-CHOLESTEROL AND SAVES MEDICATION COSTS IN MEN WITH HYPERCHOLESTEROLEMIA

This study was designed to evaluate whether medical nutrition therapy administered by registered dietitians could lead to a beneficial clini cal and cost outcome in men with hypercholesterolemia. Ninety-five sub jects participating in a cholesterol-lowering drug study took part in an 8-week nutrition intervention program before initiating treatment w ith a cholesterol-lowering medication. Patient records were reviewed v ia a retrospective chart review to determine plasma lipid levels at th e beginning and end of the program and the number and length of sessio ns with a dietitian. Complete information was available for 74 subject s aged 60.8+/-9.8 years (mean +/-SD). Medical nutrition therapy lowere d total serum cholesterol levels 13% (P<.0001), low-density lipoprotei n cholesterol (LDL-C) 15% (P<.0001), triglyceride 11% (P<.05), and hig h-density lipoprotein cholesterol (HDL-C) 4% (P<.05). Total dietitian intervention time was 144+/-21 minutes (range=120 to 180 minutes) in 2 .8+/-0.7 sessions (range-2, to 4) during 6.8+/-0.7 weeks of medical nu trition therapy (range=6 to 8 weeks). Analysis of covariance was condu cted to examine whether mean change in LDL-C differed by number of die titian visits. Results showed a marginal difference between the number of dietitian visits and change in LDL-C (f=2.6, P<.084). However, the magnitude of LDL-C reduction was significantly higher with 4 dietitia n visits (180 minutes) than with 2 visits (120 minutes) (21.9% vs 12.1 %; P=.027). Lipid drug eligibility was obviated in 34 of 67 (51%) subj ects per the National Cholesterol Treatment Program guidelines algorit hm. The estimated annualized cost savings from the avoidance of lipid medications was $60,561.68. Therefore, we conclude that 3 or 4 individ ualized dietitian visits of 50 minutes each over 7 weeks are associate d with a significant serum cholesterol reduction and a savings of heal th care dollars.