Long-term effects of nutritional group education for persons at high cardiovascular risk.
BACKGROUND
Treatment of persons at high risk for coronary heart disease (CHD) should include nutritional counselling, but little is known about the effects of different types of education.


METHODS
In a quasi-experimental study design the effects of a nutritional education programme (1st year: three group sessions by a dietitian; 2nd year: one group session; 3rd year: additional focus on saturated fat; reinforcement by written nutritional messages annually) (intervention group; n=103) are compared with the effects of a posted leaflet containing standard dietary guidelines (control group; n=163). Participants had hypercholesterolemia (6-8 mmol/l) and at least two other CHD risk factors.


RESULTS
After 3 years, no significant differences existed in established CHD risk factors between intervention and control groups (adjusted mean net differences: total cholesterol (0 mmol/l), diastolic blood pressure (-1.1 mm Hg; NS), and body weight (+0.3 kg, NS)). Regarding dietary intake, the intervention group had a lower intake of total (net difference -2.0% of energy, SEM 0.9) and saturated fat (-1.2% of energy, SEM 0.4) and a higher fish (+11 g/day, SEM 4) and vegetables consumption (+21 g/day, SEM 10) during the study period (p<0.05 for all).


CONCLUSIONS
A nutritional education programme with group sessions changed dietary intake more effectively than a posted leaflet, but no additional positive effects were observed on established CHD risk factors after three years of follow-up.
Bemelmans
Wanda J E
WJ
Department of General Practice, University of Groningen, The Netherlands. wanda.bemelmans@rivm.nl
Broer
Jan
J
Hulshof
Karin F A M
KF
Siero
Frans W
FW
May
Johan F
JF
Meyboom-de Jong
Betty
B
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001794:Blood Pressure; D015992:Body Mass Index; D001835:Body Weight; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D016009:Chi-Square Distribution; D002784:Cholesterol / Q000097:blood; D003327:Coronary Disease / Q000517:prevention & control; D003376:Counseling; D004032:Diet; D004041:Dietary Fats; D004043:Dietary Fiber; D002149:Energy Intake; D005227:Fatty Acids; D005260:Female; D005500:Follow-Up Studies; D005638:Fruit; D006266:Health Education / Q000379:methods; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications; D008297:Male; D008875:Middle Aged; D009747:Nutritional Physiological Phenomena; D012307:Risk Factors; D013997:Time Factors; D014675:Vegetables
D004041:Dietary Fats; D004043:Dietary Fiber; D005227:Fatty Acids; D002784:Cholesterol