title: 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).
abstract: OBJECTIVE
  To assess the effectiveness of a dietitian-based nutrition counseling and education program for patients with hyperlipidemia.
  
  
  METHODS
  A 4-session program implemented as a complement to a randomized physician-delivered intervention.
  
  
  METHODS
  From 12 practice sites of the Fallon Clinic, 1,162 subjects with hyperlipidemia were recruited, 645 of whom had data sufficient for our primary analyses.
  
  
  METHODS
  Two individual and 2 group sessions conducted over 6 weeks.
  
  
  METHODS
  Total and saturated fat levels; serum low-density lipoprotein cholesterol levels; and body weight, measured at baseline and after 1 year.
  
  
  METHODS
  Multiple linear regression was used to evaluate changes 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 fewer than 3 sessions or those never referred to a nutrition session. Reductions (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 reductions correspond to roughly a 22% relative change from baseline in those attending 3 or 4 sessions. Corollary reductions were observed for total fat (measured as percent of energy): 8.2 +/- 1.4%, 5.0 +/- 1.4%, and 0.7 +/- 0.4%; low-density 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-delivered intervention.
  
  
  CONCLUSIONS
  This investigation provides empirical data demonstrating the effectiveness of a dietitian-delivered intervention in the care of patients with hyperlipidemia.
authors.affiliation: Department of Medicine, University of Massachusetts Medical School, Worcester 01655, USA.
authors.forename: J R
authors.initials: JR
authors.lastname: Hebert
authors.forename: C B
authors.initials: CB
authors.lastname: Ebbeling
authors.forename: I S
authors.initials: IS
authors.lastname: Ockene
authors.forename: Y
authors.initials: Y
authors.lastname: Ma
authors.forename: L
authors.initials: L
authors.lastname: Rider
authors.forename: P A
authors.initials: PA
authors.lastname: Merriam
authors.forename: J K
authors.initials: JK
authors.lastname: Ockene
authors.forename: G M
authors.initials: GM
authors.lastname: Saperia
mesh_terms: D000328:Adult; D000368:Aged; D001835:Body Weight; D002784:Cholesterol / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood; D003376:Counseling; D018752:Diet, Fat-Restricted; D004046:Dietetics; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006949:Hyperlipidemias / Q000178:diet therapy*; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D009042:Motivation; D009747:Nutritional Physiological Phenomena; D010353:Patient Education as Topic; D018579:Patient Selection; D012944:Social Support; D015431:Weight Loss
chemical_list: D008078:Cholesterol, LDL; D002784:Cholesterol