A dietitian-delivered group nutrition program leads to reductions in dietary fat, serum cholesterol, and body weight: The Worcester Area Trial for Counseling in Hyperlipidemia (WATCH)

Objective To assess the effectiveness of a dietitian-based.., nutrition cou nseling and education program for patients with hyperlipidemia. Design A 4-session program implemented as a complement to a randomized phys ician-delivered intervention. Subjects/setting From 12 practice sites of the Fallon Clinic, 1,162 subject s with hyperlipidemia were recruited, 645 of whom had data sufficient for o ur primary analyses. Intervention Two individual and 2 group sessions conducted over 6 weeks. Main outcome measures Total and saturated fat levels; serum low-density lip oprotein cholesterol levels; and body weight, measured at baseline and afte r 1 year. Statistical analyses Multiple linear regression was used to evaluate change s in outcome measures. Results After 1 year, there were significant reductions in outcome measures for subjects attending 3 or 4 nutrition sessions vs subjects attending few er than 3 sessions or those never referred to a nutrition session. Reductio ns (mean+/- standard error) in saturated fat (measured as percent of energy ) were 2.7+/-0.5%, 2.1+/-0.5%, and 0.3+/-0.1%, respectively. These reductio ns correspond to roughly a 22% relative change from baseline in those atten ding 3 or 4 sessions. Corollary reductions were observed for total fat (mea sured as percent of energy):8.2+/-1.4%, 5.0+/-1.40% and 0.7+/-0.4%; low-den sity lipoprotein cholesterol: 0.48+/-0.11 mmol/L, 0.13+/-0.11 mmol/L, and 0 .02+/-0.03 mmol/L; and body weight: 4.5+/-0.9 kg, 2.1+/-0.8 kg, and 1.1+/-0 .2 kg. The specified changes were additive to. those of the-physician-deliv ered intervention. Applications/conclusions This investigation provides empirical data demonst rating the effectiveness of a dietitian-delivered intervention in the care of patients with hyperlipidemia.