RANDOMIZED CLINICAL-TRIAL COMPARING THE EFFECTIVENESS OF 2 DIETARY INTERVENTIONS FOR PATIENTS WITH HYPERLIPIDEMIA

1. Intervention trials in free-living populations have shown relativel y small reductions in risk factors for cardiovascular disease, includi ng lipid levels, and have led some to question whether diet is an effe ctive treatment for hyperlipidaemia. However, behaviour change is a co mplex process and it is possible that standard intervention methods fa il to motivate people sufficiently to comply with dietary advice. 2. T his study applied motivational interviewing, a style of behaviour chan ge counselling, to dietary education for people with hyperlipidaemia. One-hundred and twenty-one patients with hyperlipidaemia who had been referred to a hospital dietetic department for dietary advice were ran domized to receive either standard or motivational dietary interventio ns for a period of 3 months. Outcomes assessed included dietary knowle dge, stage of change, dietary intakes, lipid levels and body mass indi ces. 3. From baseline, both methods of dietary intervention resulted i n self-reported changes in dietary habits and knowledge, statistically significant reductions in intake of total fat (from 32.8% to 28.4%), saturated fat (from 11.4% to 9.2%) and energy intakes [ -239 kcal (-99 9.98 kJ)/day], and in body mass indices (-0.45 kg/m(2)). Serum cholest erol did not change significantly in either intervention group. 4. Mot ivational and standard dietary interventions achieved statistically si gnificant changes in reported dietary knowledge and behaviour, and led to a reduction in body weight, but not serum cholesterol. Whether thi s lack of effect is real or due to subjects overestimating true dietar y change cannot be determined. Change in body weight was associated wi th a reported change in energy intake; this provides some support for there having been a real change in intake.