Dietetic Consultation Can Help Manage Cardiovascular Disease
- Post by: Dr Lauren Ball
- May 29, 2019
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Thanks to a recent study published in the April 2019 edition of Nutrition & Dietetics: Journal of the Dieticians Association of Australia, people suffering from or who exhibit risk factors for cardiovascular disease (CVD) can breathe easier. By using dietetic consultation in addition to their regular treatment regimen in their primary-care setting, high-risk CVD patients can lower their blood lipids and reduce the risk factors that often come with the disease.
Dietary behavior change is where it all starts
CVD has long thought to be a preventable and manageable condition, especially when dietary behaviour change is added to a patient’s regular treatment plan. The study includes evidence-based consultations with patients that consisted of face-to-face education designed specifically for the patient in question and counselling designed to help change their dietary behaviour. Using guidelines that were established before the start of the study, dieticians were able to measure clinical markers that showed how effective this type of intervention was in their patients.
Some of the changes to patient’s diets were aimed at improving the patient’s blood lipid profile. This included restricting the amount of energy taken in on a daily basis, increasing the fibre, fruit and vegetables in the diet, changing the type and amount of dietary fats the patient was eating, and introducing the intake of whole foods that are typically found in diet plans such as Dietary Approaches to Stop Hypertension (DASH) and the popular Mediterranean diets.
How the study was conducted
Prior to 2016, there had been no conclusive study on how dietetic consultation could help patients lower risk factors that led to CVD. Did one session work? Were multiple sessions between patient and dietician needed to see results? The study set out to help answer some of these questions. Healthcare professionals involved in the study conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) to determine just how effective face-to-face dietetic consultations are in helping patients reduce their blood lipid concentrations and how often these meetings needed to happen in order to see optimal results.
Built off a previous review on dietetic consultation that showed its effectiveness in other areas, such as weight-loss, this review only included RCTs with the highest amount of evidence and lowest bias due to the design of the study and the inclusion of a control group. It also only included previous studies that reported high-risk patient’s blood lipid outcomes. All study methods and reporting complied with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and were limited to include adults 18 years and over at high-risk of CVD who had at least one face-to-face consultation with a dietician in a primary health-care setting. Studies that included individuals treated in a setting that was not a primary healthcare setting or where the influence of the dietetic consultation could not be determined were excluded.
Dietetic consultation plays an important role in managing CVD
After reviewing and analysing the RCTs that met the criteria of the study it was found that dietetic consultation was effective in helping to reduce CVD risk factors in high-risk patients when used in conjunction with usual and minimal healthcare regimens. The RCTs showed patients had seen positive changes in their blood lipid concentrations. Patients who engage in dietetic consultation ranging from one visit to visits spanning the course of a year saw improvements in diet quality, weight loss, diabetes and now cardiovascular health.
While this news is positive for anyone at risk for CVD, more research needs to be conducted using methods to collect consistent, high quality, long-term data. By continuing to collect this information, healthcare professionals can build a body of evidence that will support future policy changes as well as aid in securing funding for dietetic counselling for the management of not just CVD but other chronic diseases in the primary health-care setting.
It is possible for a high-risk patient to lessen their risk factors by working with a dietician. If you have any questions or concerns about this study, or want to know more about dietetic consultation, please contact me. I am more than happy to speak with you and help you gain a better understanding of how you can help your patients reduce their CVD risk.