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Effectiveness of dietetic consultation for lowering blood lipid levels in the management of cardiovascular disease risk: A systematic review and meta‐analysis of randomised controlled trials
Author(s) -
Ross Lynda J.,
Barnes Katelyn A.,
Ball Lauren E.,
Mitchell Lana J.,
Sladdin Ishtar,
Lee Patricia,
Williams Lauren T.
Publication year - 2019
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 - 10.1111/1747-0080.12509
Subject(s) - medicine , meta analysis , randomized controlled trial , psychological intervention , lipid profile , blood lipids , family medicine , physical therapy , cholesterol , nursing
Aim Evidence of the effectiveness of dietetic consultation for the management of cardiovascular disease (CVD) risk factors has not been previously synthesised. A systematic review and four meta‐analyses evaluated the effectiveness of dietetic consultation for lowering blood lipid levels in high‐risk individuals in primary health‐care settings. Methods Of the 4860 records identified, 10 eligible randomised controlled trials (RCTs, n = 1530) were evaluated for reporting blood lipid outcomes following dietetic consultation (DN)—defined as at least one exclusive individual face‐to‐face consultation with a dietitian and comparators (C)—defined as no nutrition intervention or usual or minimal care provided by physicians and/or nurses. Results DN groups were effective for lowering blood lipid levels across nine studies reporting total cholesterol (TC) and LDL; and across five of six studies reporting triglycerides (TG). Between‐group differences were not consistently assessed, with significance levels reported in four studies all in favour of DN, P < 0.05. Meta‐analyses for TC and LDL (seven studies) confirmed DN and C groups were equally effective, P > 0.05; and for TG (six studies) DN groups were significantly more effective than C groups, P < 0.05). Conclusions This review provides RCT evidence that dietetic counselling is effective for lowering TG levels and at least as effective as usual and minimal care for improving cholesterol levels in high‐risk individuals in primary health care. However, more adequate reporting of methods and greater consistency in timing interventions and data collection will enhance the quality of the evidence and increase confidence in the health benefits of dietetic counselling for the management of CVD risk.