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Efficacy of a telephone‐based medical nutrition program on blood lipid and lipoprotein metabolism: Results of Our Healthy Heart
Author(s) -
Miller Kelsey E.,
Martz Daniel C.,
Stoner Cathey,
Jowers Audrey,
Taheri Megan L.,
Sarzynski Mark A.,
Davis Rachel A.H.,
Plaisance Eric P.
Publication year - 2018
Publication title -
nutrition and dietetics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.479
H-Index - 31
eISSN - 1747-0080
pISSN - 1446-6368
DOI - 10.1111/1747-0080.12366
Subject(s) - medicine , lipoprotein , body mass index , very low density lipoprotein , apolipoprotein b , lipid profile , blood lipids , anthropometry , high density lipoprotein , cholesterol , lipid metabolism , physiology , endocrinology , low density lipoprotein , physical therapy
Aim Derangements in blood lipid and lipoprotein metabolism are one of the leading causes of coronary heart disease ( CHD ). Therapeutic lifestyle changes such as diet and exercise are often prescribed to improve blood lipid and lipoprotein characteristics, but the efficacy of a telephone‐based health coaching program has not been thoroughly explored. Our purpose was to examine effects of the Our Healthy Heart ( OHH ) Program on blood lipid and lipoprotein characteristics of individuals with mixed dyslipidaemia. Methods Cholesterol content of serum very low‐density lipoprotein ( VLDL ), low‐density lipoprotein ( LDL ) and high‐density ( HDL ) subfractions and apolipoprotein concentrations were measured by vertical‐density ultracentrifugation (Vertical Auto Profile ( VAP )) from 1522 individuals with mixed dyslipidaemia (age 18–99 years, body mass index ( BMI ) 25–40, 62.7% female). Telephone‐based health coaching ( OHH , n = 722) or standard care (Control, n = 800) was provided for six months followed by VAP to evaluate changes in lipid and lipoprotein concentrations. Controls were obtained from individuals with similar blood lipid/lipoprotein characteristics who did not participate in the OHH Program. Coaches collected baseline self‐reported data on anthropometrics, food intake and exercise. Participants in the OHH group were then prescribed a hypocaloric 500 kcal/day caloric deficit with encouragement to participate in physical activity. A two‐way ANOVA was used to examine differences between groups over time, with results presented as means ± standard deviation. Results Health coaching significantly decreased serum concentrations of apoB100 (104.5 ± 25.8–94.3 ± 24.8 mg/ dL ), shifted LDL pattern size from B to A or A/B in over 60% of the OHH group and decreased cholesterol content of all VLDL subfractions ( P < 0.05) compared to the control. Conclusions Telephone‐based health coaching recommendations to reduce dietary energy intake and increase physical activity produced significant improvements in cholesterol content of atherogenic lipoproteins, which are known to increase CHD risk.