Iris van Damme , Eva R. van Veldhuisen , Auke J.C.F. Verkaar , Remy H.H. Bemelmans , Marcel M.C. Hovens , Frank L.J. Visseren , Charlotte Koopal , Renate M. Winkels , Johanna M. Geleijnse
{"title":"6个月饮食咨询对心血管疾病患者饮食质量和心血管风险的影响：一项随机对照试验","authors":"Iris van Damme , Eva R. van Veldhuisen , Auke J.C.F. Verkaar , Remy H.H. Bemelmans , Marcel M.C. Hovens , Frank L.J. Visseren , Charlotte Koopal , Renate M. Winkels , Johanna M. Geleijnse","doi":"10.1016/j.clnu.2024.12.020","DOIUrl":null,"url":null,"abstract":"<div><h3>Background & aims</h3><div>A healthy diet improves cardiovascular disease (CVD) risk factors. However, dietary counseling is not yet widely implemented in health care for patients with CVD. We assessed how dietary counseling by a dietitian, focused on improving diet quality, influenced the cardiovascular risk profile of patients with CVD.</div></div><div><h3>Methods</h3><div>In this 6-month trial, 124 patients with CVD (68.1 ± 9.5 years, 72 % men) were randomly assigned to counseling by a dietitian (n = 63) or usual care (n = 61). Difference in cardiovascular risk profile between groups was assessed with a 10-year composite cardiovascular risk prediction score including changes in blood pressure and low-density lipoprotein cholesterol (LDL-C). Secondary outcomes included adherence to a healthy diet as assessed with the Dutch Healthy Eating Index-2015 (DHD15-index), individual risk factors (LDL-C, blood pressure, body weight, and high-sensitivity C-reactive protein [hs-CRP]) as well as depressive symptoms and optimism scores.</div></div><div><h3>Results</h3><div>DHD15-index at baseline was 103 ± 18 out of 160 and increased 5.7 points more in the dietary counseling group compared to the usual care group (95 % confidence interval (CI): 1.3; 10.1). Multivariate analysis revealed no statistically significant differences in changes over time in 10-year cardiovascular risk score (0.6 %, 95%CI: −4.1 %; 5.3 %), blood pressure (−2 mmHg, 95%CI: −7; 4), LDL-C (0.0 mmol/l, 95%CI: 0.2; 0.2), body weight (−0.7 kg, 95%CI: −2.9; 1.5), hs-CRP (0.71 mg/dl, 95%CI: −1.20; 2.62) or depressive symptoms and optimism scores between groups.</div></div><div><h3>Conclusions</h3><div>Dietary counseling for patients with CVD for 6 months only slightly improved adherence to a healthy diet in patients with established CVD and did not result in substantial improvement in cardiovascular risk profile or depressive symptoms and optimism scores.</div></div><div><h3>Clinical trial registration</h3><div>This trial was registered at <span><span>www.clinicaltrials.gov/study/NCT05071092</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"45 ","pages":"Pages 101-110"},"PeriodicalIF":6.6000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The effects of 6 months dietary counseling on diet quality and cardiovascular risk profile in patients with cardiovascular disease: A randomized controlled trial\",\"authors\":\"Iris van Damme , Eva R. van Veldhuisen , Auke J.C.F. Verkaar , Remy H.H. Bemelmans , Marcel M.C. Hovens , Frank L.J. Visseren , Charlotte Koopal , Renate M. Winkels , Johanna M. Geleijnse\",\"doi\":\"10.1016/j.clnu.2024.12.020\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background & aims</h3><div>A healthy diet improves cardiovascular disease (CVD) risk factors. However, dietary counseling is not yet widely implemented in health care for patients with CVD. We assessed how dietary counseling by a dietitian, focused on improving diet quality, influenced the cardiovascular risk profile of patients with CVD.</div></div><div><h3>Methods</h3><div>In this 6-month trial, 124 patients with CVD (68.1 ± 9.5 years, 72 % men) were randomly assigned to counseling by a dietitian (n = 63) or usual care (n = 61). Difference in cardiovascular risk profile between groups was assessed with a 10-year composite cardiovascular risk prediction score including changes in blood pressure and low-density lipoprotein cholesterol (LDL-C). Secondary outcomes included adherence to a healthy diet as assessed with the Dutch Healthy Eating Index-2015 (DHD15-index), individual risk factors (LDL-C, blood pressure, body weight, and high-sensitivity C-reactive protein [hs-CRP]) as well as depressive symptoms and optimism scores.</div></div><div><h3>Results</h3><div>DHD15-index at baseline was 103 ± 18 out of 160 and increased 5.7 points more in the dietary counseling group compared to the usual care group (95 % confidence interval (CI): 1.3; 10.1). Multivariate analysis revealed no statistically significant differences in changes over time in 10-year cardiovascular risk score (0.6 %, 95%CI: −4.1 %; 5.3 %), blood pressure (−2 mmHg, 95%CI: −7; 4), LDL-C (0.0 mmol/l, 95%CI: 0.2; 0.2), body weight (−0.7 kg, 95%CI: −2.9; 1.5), hs-CRP (0.71 mg/dl, 95%CI: −1.20; 2.62) or depressive symptoms and optimism scores between groups.</div></div><div><h3>Conclusions</h3><div>Dietary counseling for patients with CVD for 6 months only slightly improved adherence to a healthy diet in patients with established CVD and did not result in substantial improvement in cardiovascular risk profile or depressive symptoms and optimism scores.</div></div><div><h3>Clinical trial registration</h3><div>This trial was registered at <span><span>www.clinicaltrials.gov/study/NCT05071092</span><svg><path></path></svg></span>.</div></div>\",\"PeriodicalId\":10517,\"journal\":{\"name\":\"Clinical nutrition\",\"volume\":\"45 \",\"pages\":\"Pages 101-110\"},\"PeriodicalIF\":6.6000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical nutrition\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0261561424004606\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical nutrition","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0261561424004606","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
The effects of 6 months dietary counseling on diet quality and cardiovascular risk profile in patients with cardiovascular disease: A randomized controlled trial
Background & aims
A healthy diet improves cardiovascular disease (CVD) risk factors. However, dietary counseling is not yet widely implemented in health care for patients with CVD. We assessed how dietary counseling by a dietitian, focused on improving diet quality, influenced the cardiovascular risk profile of patients with CVD.
Methods
In this 6-month trial, 124 patients with CVD (68.1 ± 9.5 years, 72 % men) were randomly assigned to counseling by a dietitian (n = 63) or usual care (n = 61). Difference in cardiovascular risk profile between groups was assessed with a 10-year composite cardiovascular risk prediction score including changes in blood pressure and low-density lipoprotein cholesterol (LDL-C). Secondary outcomes included adherence to a healthy diet as assessed with the Dutch Healthy Eating Index-2015 (DHD15-index), individual risk factors (LDL-C, blood pressure, body weight, and high-sensitivity C-reactive protein [hs-CRP]) as well as depressive symptoms and optimism scores.
Results
DHD15-index at baseline was 103 ± 18 out of 160 and increased 5.7 points more in the dietary counseling group compared to the usual care group (95 % confidence interval (CI): 1.3; 10.1). Multivariate analysis revealed no statistically significant differences in changes over time in 10-year cardiovascular risk score (0.6 %, 95%CI: −4.1 %; 5.3 %), blood pressure (−2 mmHg, 95%CI: −7; 4), LDL-C (0.0 mmol/l, 95%CI: 0.2; 0.2), body weight (−0.7 kg, 95%CI: −2.9; 1.5), hs-CRP (0.71 mg/dl, 95%CI: −1.20; 2.62) or depressive symptoms and optimism scores between groups.
Conclusions
Dietary counseling for patients with CVD for 6 months only slightly improved adherence to a healthy diet in patients with established CVD and did not result in substantial improvement in cardiovascular risk profile or depressive symptoms and optimism scores.
Clinical trial registration
This trial was registered at www.clinicaltrials.gov/study/NCT05071092.
期刊介绍：
Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.
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