title: Long-term effects of nutritional group education for persons at high cardiovascular risk.
abstract: 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.
authors.affiliation: Department of General Practice, University of Groningen, The Netherlands. wanda.bemelmans@rivm.nl
authors.forename: Wanda J E
authors.initials: WJ
authors.lastname: Bemelmans
authors.forename: Jan
authors.initials: J
authors.lastname: Broer
authors.forename: Karin F A M
authors.initials: KF
authors.lastname: Hulshof
authors.forename: Frans W
authors.initials: FW
authors.lastname: Siero
authors.forename: Johan F
authors.initials: JF
authors.lastname: May
authors.forename: Betty
authors.initials: B
authors.lastname: Meyboom-de Jong
mesh_terms: 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
chemical_list: D004041:Dietary Fats; D004043:Dietary Fiber; D005227:Fatty Acids; D002784:Cholesterol